Place of Delivery Associated With Postnatal Care Utilization Among Childbearing Women in Zambia

ObjectivePostnatal care (PNC) utilization is critical to the prevention of maternal morbidity and mortality. Despite its importance, the proportion of women utilizing this service is still low in Zambia. We investigated if place of delivery was associated with PNC utilization in the first 48 h among childbearing women in Zambia.MethodsData from the 2013/14 Zambia Demographic and Health Survey for women, aged 15–49 years, who reported giving birth in the 2 years preceding the survey was used. The data comprised of sociodemographic and other obstetric data, which were cleaned, recoded, and analyzed using STATA version 13 (Stata Corporation, College Station, TX, USA). Multivariate logistic regression was used to examine the association of place of delivery and other background variables.ResultsWomen who delivered in a health facility were more likely to utilize PNC in the first 48 h compared to those who did not deliver in a health facility: government hospital (AOR 7.24, 95% CI 4.92–11.84), government health center/clinic (AOR 7.15 95% CI 4.79–10.66), other public sector (AOR 23.2 95% CI 3.69–145.91), private hospital/clinic (AOR 10.08 95% CI 3.35–30.35), and Mission hospital/clinic (AOR 8.56 95% CI 4.71–15.53). Additionally, women who were attended to by a skilled personnel during delivery of the baby were more likely to utilize PNC (AOR 2.30, 95% CI 1.57–3.37). Women from rural areas were less likely to utilize PNC in the first 48 h (AOR 0.70, 95% CI 0.53–0.90).ConclusionPlace of delivery was found to be linked with PNC utilization in this population although access to health care is still driven by inequity-related dynamics and imbalances. Given that inequity stresses are heaviest in the rural and poor groups, interventions should aim to reach this group.SignificanceThe study results will help program managers to increase access to health facility delivery and direct interventional efforts toward the affected subpopulations, such as the young and rural women. Furthermore, results will help promote maternal health education on importance of health facility delivery and advise policy makers and program implementers

“They say that I have lost my integrity by breaking my virginity”: experiences of teen school going mothers in two schools in Lusaka Zambia

Abstract Background Adolescent school-going mothers return to school in the rekindled hope of obtaining an education. However, their re-introduction into the school environment requires adequate support from teachers, fellow pupils, and the community. The purpose of this study was to explore the experiences of school-going mothers in Lusaka to understand their coping mechanism in the process of re-integration. Method This is a qualitative case study. We conducted in-depth interviews with 24 school going mothers between the ages of 16–19, purposively selected from 2 schools in Lusaka district. Audio-recorded interviews were transcribed, coded using Nvivo 10 software and analysed using thematic analysis. Results The girls reported experiencing stigmatization, discrimination, mockery and abuse from their teachers. Some community members labelled, humiliated, gossiped about and isolated the girls from their friends and classmates because of fear of ‘contamination’. Families forced some girls into early marriages making them feel rejected. These experiences resulted in low self-esteem, inferiority complex, poor performance in their academic work and identity crises in the young mothers. Therefore, because of the experiences the girls faced, they developed certain behaviours such as beer drinking, truancy and running away from home. They found it difficult to adjust to motherhood while doing their schoolwork. Conclusion There is a need for the teachers to undergo training on how to handle young mothers and have a flexible time-table to accommodate adolescent school going mothers when they miss lessons to attend to their babies. Non-parenting school girls should be counseled so that they do not stigmatize adolescent mothers. Parents need to be educated on how to deal with adolescent mothers in the community. The guidance office should have a qualified psychosocial counselor to help create a conducive learning environment for adolescent mothers, by helping them with missed lessons and seeing to it that they are not stigmatized

Uptake of HIV testing and its associated factors among long-distance truck drivers in Zambia, 2015

Introduction: Globally, long distance truckers have been reported to have an important role in the spread of sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV). Evidence on the uptake of HIV testing among this key population is not well established. We analysed the 2015 Behavioral Surveillance Survey (BSS) data to determine the uptake of HIV testing and assess factors associated with HIV testing among Long Distance Truck Drivers (LDTDs) in Zambia. Methods: We analysed secondary data from the 2015 BSS. The BSS was carried out in five of the 10 Corridors of Hope (COH) III project sites (Kazungula, Solwezi, KapiriMposhi, Chipata and Chirundu) among male LDTDs. The Zambian Corridors of Hope HIV and AIDS Prevention Initiative project was formed to address rising rates of HIV and other sexually transmitted infections. The BSS study included LDTDs from truck depots, border sites, Zambia Revenue Authority offices and those parked along the road side. Association between independent variables and history of HIV testing was determined by bivariate logistic analysis. Multivariable logistic regression was done to control for confounders. Results: Overall, 1,386 male LDTDs were included in the study, with mean age of 38 years. Over 75% reported being currently married and living with a spouse while 82% reported having only one wife. Uptake for ever having tested for HIV among LDTDs was 83%. Having a relative or friend who was infected or who had succumbed to HIV/AIDS (adjusted OR: 0.61, 95%CI: 0.40 – 0.92) and having two or more wives (adjusted OR: 0.4, 95%CI: 0.2 – 0.6) were independent inhibitory factors for uptake of HIV testing. Conclusion: Knowledge of someone infected or died of HIV and having at least two wives were drivers for HIV testing. These findings suggest the need to implement focused Behavioral Change interventions and messages to increase uptake of HIV testing among LDTDs