The experiences of people living with HIV/AIDS in Gaborone, Botswana

ABSTRACT Study Aim and Objectives: The aim of the study was to explore what it means to have HIV/AIDS in Gaborone, Botswana. The study describes the demographic and socioeconomic circumstances of the participants. It also elicits and explores the experiences of people living with HIV/AIDS in Gaborone, Botswana. Methods Interviewees were purposely selected from a hospice, an NGO and a church that ministers to PLWHA. In depth interviews were conducted and recorded by audiotape. The interviews were conducted in Setswana and the interviewees responded to a statement, which essentially was, “Tell me about your life since you knew you had HIV/AIDS”. The audio recordings were transcribed into English. Care was taken to carry the Setswana way of speaking directly into English. A thematic analysis of the transcripts was made. A modified cut and paste method was used to gather the information into its various themes. Results There were 15 interviewees. Their average age was 35.3 years and on average, they had 1.6 children each. They were unemployed. The interviewees described a wide range of experiences, which were not necessarily experienced by all. Their narratives described the physical symptoms they suffered. They described stigma and discrimination that they went through. They gave accounts of psychological and emotional turmoil. Psychiatric problems were cited. They were very concerned that they could no longer support their children. They also worried about what would happen to their children when they died. As their disease progressed, they lost their jobs and were reduced to poverty. They could no longer support themselves and their dependents. They depended on relatives, friends, NGOs and government for relief. Relief from friends and relatives was often not available. They suffered hunger, as they could not satisfy their increased appetites after they started ARV drug therapy. Their relationships were disrupted when they got ill. Spouses and friends left and some relatives and friends stigmatised them. Interviewees were taken care of by relatives, friends, health professionals, NGOs, and social workers. In all these categories, there were good and bad care givers except the hospice and church, which were reported as good caregivers. Caregiver fatigue was described. Some interviewees found comfort in God. They believed that He knows what they are going through and will take care of them. The interviewees also found comfort and healing from the companionship of other PLWHA. The interviewees wanted to find jobs and work so that they could support themselves and their dependents. They wished government would train them and find them jobs. Conclusion The study confirmed the psycho-emotional problems and concern for children felt by PLWHA, that the literature revealed. It showed the physical problems they also suffer. The study revealed that interviewees lost jobs and became destitute. They could not satisfy their increased appetites after they started ARV drug therapy. Interviewees’ relationships were disrupted when they got ill. Spouses and friends left and some relatives did not treat them well. There were good and bad care givers in different categories. The African custom of botho/ubuntu seems to be succumbing to the onslaught of HIV/AIDS. The study showed that interviewees found comfort and support from family, friends, NGO’s and the church. They found God and other PLWHA especially valuable support systems. It was encouraging to notice that some interviewees felt that with time, stigmatisation of PLWHA is gradually subsiding

Reflections on Primary Health Care and Family Medicine in Botswana

No abstract available</p

Family medicine in Denmark: Are there lessons for Botswana and Africa?

Family medicine is a new specialty in Botswana and many African countries and its definitionand scope are still evolving. In this region, healthcare is constrained by resource limitation andinefficiencies in resource utilisation. Experiences in countries with good health indicators canhelp inform discussions on the future of family medicine in Africa. Observations made duringa visit to family physicians (FPs) in Denmark showed that the training of FPs, the practice offamily medicine and the role of support staff in a family practice were often different andsometimes unimaginable by African standards. Danish family practices were friendly andenmeshed in an egalitarian and efficient health system, which is supported by an effectiveinformation technology network. There was a lot of task shifting and nurses and clerical staffattended to simple or uncomplicated aspects of patient care whilst FPs attended to morecomplicated patient problems. Higher taxation and higher health expenditure seemed toundergird the effective health system. An egalitarian relationship amongst patients andhealthcare workers (HCW) may help improve patient care in Botswana. Task shifting shouldbe formalised, and all sectors of primary healthcare should have fast and effective informationtechnology systems. HCW training and roles should be revised. Higher health expenditure isnecessary to achieve good health indicators. Keywords: task shifting, Family Medicine, Family Physician, Denmark, health expenditure, egalitaria

Patient-centredness: meaning and propriety in the Botswana, African and non-Western contexts

No abstract availabl

The first National Family Medicine Conference in Botswana, May 2013

CITATION: Setlhare, V., Mash, B. & Tsima, B. 2014. The first National Family Medicine Conference in Botswana, May 2013. African Journal of Primary Health Care & Family Medicine, 6(1): 1-4, doi: 10.4102/phcfm.v6i1.595.The original publication is available at http://www.phcfm.orgIntroduction: The theme of the conference was ‘Family Medicine Training and Career Paths for Family Physicians in Botswana’. This topic was deemed to be appropriate as there is a need for countries to define the role of family physicians and the training requirements for family medicine (FM) in their own contexts.http://www.phcfm.org/index.php/phcfm/article/view/595Publisher's versio

Sub-national analysis and determinants of numbers of antenatal care contacts in Nigeria : assessing the compliance with the WHO recommended standard guidelines

Background: Nigeria has unimpressive maternal and child health indicators. Compliance with the WHO guidelines on the minimum number of antenatal care (ANC) contacts could improve these indicators. We assessed the compliance with WHO recommended standards on ANC contacts in Nigeria and identify the associated factors. Methods: Nationally representative cross-sectional data during pregnancy of 21,785 most recent births within five years preceding the 2018 Nigeria Demographic Health Survey was used. The number of ANC contacts was categorised into “None”, “1–3”, “4–7” and “8 or more” contacts based on subsequent WHO guidelines. Descriptive statistics, bivariable and multivariable multinomial logistic regression was used at p = 0.05. Results: About 25 % of the women had no ANC contact, 58 % had at least 4 contacts while only 20 % had 8 or more ANC contacts. The highest rate of 8 or more ANC contacts was in Osun (80.2 %), Lagos (76.8 %), and Imo (72.0 %) while the lowest rates were in Kebbi (0.2 %), Zamfara (1.1 %) and Yobe (1.3 %). Respondents with higher education were twelve times (adjusted relative risk (aRR): 12.46, 95 % CI: 7.33–21.2), having secondary education was thrice (aRR: 2.91, 95 % CI: 2.35–3.60), and having primary education was twice (aRR: 2.17, 95 % CI: 1.77–2.66) more likely to make at least 8 contacts than those with no education. Respondents from households in the richest and middle wealth categories were 129 and 67 % more likely to make 8 or more ANC contacts compared to those from households in the lowest wealth category respectively. The likelihood of making 8 ANC contacts was 89 and 47 % higher among respondents from communities in the least and middle disadvantaged groups, respectively,  compared to the most disadvantaged group. Other significant variables were spouse education, health care decision making, media access, ethnicity, religion, and other community factors. Conclusions: Compliance with WHO guidelines on the minimum number of ANC contacts in Nigeria is poor. Thus, Nigeria has a long walk to attaining sustainable development goal’s targets on child and maternal health. We recommend that the maternal and child health programmers should review existing policies and develop new policies to adopt, implement and tackle the challenges of adherence to the WHO recommended minimum of 8 ANC contacts. Women's education, socioeconomic status and adequate mobilization of families should be prioritized. There is a need for urgent intervention to narrow the identified inequalities and substantial disparities in the characteristics of pregnant women across the regions and statesPublisher PDFPeer reviewe