1358 research outputs found
Sort by
Main report on the costing of the Zimbabwe National Health Strategy 2016-2020
No full textUNICEF, CHAI and WH
Renal dysfunction in HIV positive patients on highly active antiretroviral therapy (HAART)
No full textBACKGROUND: The use of HAART has turned HIV/AIDS into a chronic disease and people live longer. They now present with complications related to the treatment, ageing process and the virus itself. Renal dysfunction is a recognized complication in HIV infected patients on HAART and can present as acute kidney injury or chronic kidney disease.
METHODS: A cross sectional study was conducted at Parirenyatwa Hospital on patients receiving HAART. Inclusion criteria were age ≥ 18 years and provision of an informed consent. Clinical data was recorded. Body mass index, CD4 count, serum creatinine, urine for dipstick proteinuria and protein: creatinine ratio was collected. Creatinine was calculated using the Cockcroft-Gault formula. Renal dysfunction was defined as Creatinine clearance (CrCl)< 60mL/min.
RESULTS: A total of 122 patients with complete data were analysed. 69% were females. Mean age of patients was 37.7 ±11.3 years and Body mass index was26.0 ±5.2 kg/m². Renal dysfunction defined as CrCl< 60mL/min was found in 18.9 %,(n =23/122). Microalbuminuria was found to be a risk factor for renal dysfunction [OR 4.24 95% CI 1.00-17.04] p < 0.049.
CONCLUSION: Renal dysfunction is common among patients on HAART and micro albuminuria is a risk factor for developing renal dysfunction. For patients on HAART routine urine protein: creatinine ratio and calculation of creatinine clearance should be done at regular intervals to monitor if the patients are developing renal dysfunction
Outcomes of early post traumatic seizures in head injury patients at Parirenyatwa hospital
No full textPrimary Objective; To compare the outcome of Traumatic Brain Injury (TBI) patients who develop early post traumatic seizures with the outcome of patients with post traumatic seizures who do not develop early post traumatic seizures.
Secondary Objectives; To estimate the incidence and risk factors of early post traumatic seizures in traumatic brain injured patients at Parirenyatwa Hospital.
Study factors; Early post traumatic seizures were the main study factor. Other various clinical and radiological factors were also considered.
Study outcomes; The Glasgow outcome score was used to assess outcome. Patients with a GOS of 1,2 or 3 were considered to have a poor outcome whereas patients with GOS of 4 or 5 were considered to have a good outcome.
Subjects; 252 consecutive patients, regardless of age who were admitted at Parirenyatwa Hospital for traumatic brain injury from 01/10/2014 to 15/05/2015.
Methods; A prospective observational study. A data sheet was created which listed all study and outcome factors.
Statistics; Contingency tables and Chi-square statistics were used to compare the outcomes. Both univariate and multivariate analysis was carried out.
Results; 252 patients have been recruited so far. 200 were males and 63 females. 31 patients developed early post traumatic seizures during the course of the study, giving an incidence of 12.3%. 35 patients died giving a case fatality rate of 13.8%. 52 patients (20.6%) had poor outcome. Of the patients who fitted, 64.5% had bad outcome compared to 14.5% of those who did not fit. The association between fits and poor outcome was found to be statistically significant. The relative risk of poor outcome on univariate analysis in patients with early post traumatic seizures was 10.7 (CI 4.7-24.5) with a p-value of 0.000. Factors which were statistically significantly associated with poor outcome on univariate analysis were; fits, low Glasgow coma scale, age, male sex, anisocoria, alcohol ingestion, retained foreign body, acute epidural haematoma, intracerebral haematoma, multiple cerebral contusions and subarachnoid haematoma. Risk factors found to be associated with fits were; GCS, hemiparesis, retained foreign body, intracerebral haemorraghe, multiple contusions and subarachnoid haemorrhage.
Conclusion; The study demonstrated that early post traumatic seizures are strongly associated with poor outcome. It also showed that several risk factors may be associated with the development of seizures. Reducing the incidence of early post traumatic seizures should reduce the number of TBI patients with poor outcome. This can be done by giving seizure prophylaxis to TBI patients with risk factors for early post traumatic seizures on admission.
Integration of physicochemical assessment of water quality with remote sensing techniques for the Dikgathong Damin Botswana.
No full textWater quality has become a global concern due to ever increasing population and developmental activities that are polluting water resources. Botswana’s water resources are threatened by various pollution sources such as agricultural runoff, industrial and domestic effluents.This study was carried out to assess the water quality of Dikgathong Dam in Botswana using physicochemical analysis of water quality parameters and remote sensing techniques.The study first assessed landuse patternsbefore construction (2010) and after construction (2015) to establish dominant landuse inorder to select water quality parameters related to the principal landuse in the catchment. Images for 2010 and 2015 were acquired from Landsat and were classified using the supervised classification through the Maximum Likelihood algorithm. Results showed that forest and shrubs were the dominant landuse covering 73.7 % of the total area, followed by settlements (21.1 %) and agricultural fields (2.76 %).Chl_a, COD, EC, TP, TN, TSS, NO3 and NO2 were selected for testing and analysis based on their relationship with forest, settlements and agricultural fields.For assessment of water quality, ten points were sampled in the dam from 15th January to 07th April 2016. Temperature,pH, EC, COD, TDS, TSS, turbidity, chloride, nitrates, sodium, potassium, calcium, magnesium, sulphates, phosphates, total phosphorus, alkalinity, hardness and algae were tested and analysedaccording to standard methods. Only COD, turbidity and TSSexceededthe limits set by Environmental Protection Agency (EPA)surface water standards of 2001, making Dikgathong Dam slightly polluted.One way ANOVA showed significant variations (p<0.05) between water quality values in all sampling points only for NO3, SO4, pH, algae and Na. Five different groups of sites were identified from ten sites using cluster analysis.The principal component analysis identified ten parameters (COD, EC, turbidity, TSS, Ca, Mg, NO3, SO4, total hardness and alkalinity)based on similarities of water quality characteristics. The Water Utilities Corporation, which is responsible for the dam,can therefore monitor water quality at five points focusing mainly on ten parametersfound to be principal. This study also investigated the likelihood of integrating remote sensing and in-situ measurements to assess the water quality status of the dam. Quasi analytical algorithms andMODIS datawere used to quantify Chl_aand TSS concentrations in the dam. Values forChl_awerebetween 1.74and 24.4 mg/m3, whileTSS ranged from 2.34 mg/l to 59.2 mg/l. Based on chlorophyll concentrations thedam can be classified as both oligotrophic and mesotrophic as per the EPA 2001 standard.The QAA and MODIS can therefore be deployed as a mechanism for near real time monitoring of water quality in Botswana reservoirs.Spearman’s correlation was used to test whether satellite retrieved water quality parameters relate to in-situ measurements.Strong positive significant correlation was observed between chl_a and turbidity (r=0.794 and 0.830), TSS (r = 0.819 and 0.770), SO4 COD (r=0.781 and 0.769).), SO4 (r= 0.851 and 0.646) and alkalinity (r= 0.847). Moderate positive and non-significant relationship is observed for temp (r= 0.055), pH (r= 0.587), EC (r= 0.409), TDS (r=0.348), Na (r= 0.406) and Cl (r= 0.394).Strong positive and significant correlation was observed between remote sensing retrieved TSSand in-situ measured TSS (r= 0.733) andturbidity (r= 0.867).This study concludes that there is strong positive correlation between parameters retrieved through remote sensing and in-situ measurements and therefore can be used in monitoring and assessment of the water quality in the lake at any point in time.WaterNe
The association between knowledge levels regarding male circumcision and uptake of male circumcision among males aged 18 to 45 years at Nyanga District Hospital Manicaland province
No full textThe purpose of the study was to determine the association between knowledge levels regarding male circumcision and male circumcision uptake among males aged 18 to 45 years at Nyanga District Hospital Manicaland Province. The research came as result of low uptake of male circumcision at a rate of 10 % since its inception in 2009 from a targeted background of 85 % of males to be circumcised by 2015(ZIMSTAT, 2013). A cross sectional analytic study design was utilised where knowledge levels and uptake were assessed simultaneously at a single point to establish association. Systematic interval sampling was used to select a sample size of 160 respondents. Data collection was done using a structured questionnaire comprising of demographic information in section A, uptake of male circumcision in in section B and knowledge levels regarding male circumcision in section C. Validity and reliability of the instrument was ensured by carrying out a pilot study at Mt Melleray Mission Hospital. The Statistical Package for Social Sciences (SPSS) was utilised in analysing data using descriptive and inferential statistics. The Pearson Coefficient was (r = 0.418 p = < 0.001) showing a significant positive linear correlation. Increased knowledge levels regarding male circumcision have a positive impact on the uptake of male circumcision. The regression analysis was 0.175 meaning that 17.5 % of male circumcision was due to high knowledge levels of male circumcision. However, there is need to explore other factors like culture, attitudes and behaviour. The low uptake of male circumcision is attributed to knowledge as well as other factors like fear of pain; fear of sexual impairment hence the need to assure clients of quality services that will not cause them harm. Embracing male circumcision will reduce HIV and AIDS disease burden by reducing new HIV infections, a scenario that will reduce parent to child transmission of HIV infection. Maternal HIV and AIDS related mortality deaths are averted thus MDG 4, 5 and 6 are addressed
A critical examination of sexuality education in Malawi: A case study of Blantyre district
No full textThe writer of this dissertation examines how sexual learning (sexuality learning acquired out-of-school, and without written formalities) both complements and contradicts sexuality education in realizing sexual and reproductive health (SRHR) rights in Malawi. Notwithstanding being a State party to various Human Rights Instruments, and having a number of national laws and policies supporting realization of SRHR, Malawi is in breach of the instruments, the laws and the policies and ignore reality that although children are not taught in sexuality education how to play sex, they still know it from sexual learning. The writer therefore carried out a comparative study between sexuality education and sexual learning for realizing SRHR using sexual learning as a benchmark.
The methodological framework was informed by exploring reality of learners’ sexuality lives to interrogate and investigate the law and policies. As a result, Women’s Law approach went together with: grounded approach, human rights approach, ‘charmed circle of sex approach’, open systems approach, and cultural relativism approach. A qualitative data collection method was embraced to aid in collection of non-numerical data. A total of 149 people were involved in the research i.e. 71 males and 78 females. The data collection methods included desk research and interviews of key informants, random individual interviews, in-depth interviews, and focus group discussion.
The findings of the comparative study show that sexuality education is wanting in conceptualization, and competences of teachers teaching sexuality. Further, unlike sexuality learning, there is extreme and unsustainable sexual control of adolescent sexuality in sexuality education. Sex/gender barriers are affecting sexuality education. The research also finds that learners especially girls do not have access to fertility control, let alone information on fertility control in schools and homes of learners. Finally, to avoid culture from blocking human rights, in developing sexuality education curriculum, Malawi did not use Relativist approach.
According to the findings, there is need for advocacy and public awareness campaigns to sexuality education. Ministry of Education and Malawi Human Rights Commission should take lead in managing the desired change in collaboration with Ministry of Health, Ministry responsible for Youth, and Ministry responsible for Gender and children.Norwegian Agency for the Development Co-operation (NORAD
Security sector reform: State security and human security relations in Zimbabwe - the case of Zimbabwe Defence Forces (ZDF) 1980-2008
No full textThis thesis examined the origins, concepts and practices of the security sector reform (SSR),
as the independent variable, using state security (SS) and human security (SS) as the
dependent variables for analysis. The Zimbabwe Defence Forces (ZDF) period 1980-2008
was the main focus of the case study. Findings of the study showed that the ZDF senior
officers perceive SSR differently from the external and internal Western drivers of the SSR,
who popularise it. In its current form SSR is an externally and internally driven prescriptive
exercise which differentiates civilians from the military. The ZDF senior officer’s perception
is that SSR is a process with its origins from the liberation struggle (historical) as an
indigenous and non-prescriptive process. In 1980 the Demobilisation, Disarmament and
Reintegration (DDR), the amalgamation of the Zimbabwe African National Liberation
Forces (ZANLA), Zimbabwe People’s Revolutionary Army (ZIPRA) and the Rhodesian
Security Forces (RSF) into a single force was one of a successful SSR process as the second
level of consciousness. Operation dissident flash in the 1980s, regional operations and peace
support operations in the 1990s, ‘Operation Murambatsvina or Restore Order’ of the 2000s
and the professionalization process of the ZDF thereafter, remains an SSR process which is
indigenous. The Ubuntu philosophy shapes the major theoretical conceptual framework of
this case study. This case study used quester-views, participant observation and focus group
discussions as major data collection instruments. The data was managed with the use of the
Computer Assisted Qualitative Data Analysis Software (CAQDAS) package, which is a
qualitative data-management and analysis tool. This thesis found that the way in which
security sector reform (SSR) was introduced to Zimbabwe betrays the motives of internal
and external Western drivers of the concept and its ideology as a donor-driven security
model. Findings showed that separating the ZDF from direct national, regional, international,
security and political involvement is seen as tantamount to militating against the ideas of the
liberation struggle. Effective functioning state structures are prerequisites and preconditions
for successful defence management system. These should be based on the essentials of
defence institution building process. As a result, the concept of the ‘apolitical’ soldier is a
euphemism for something else because the gun cannot be divorced from the cause for which
it stands. For that reason, the ZDF is part of the state security machinery and therefore is codependent
on the politics from which it derives its authority. On the contrary the current
character of SSR is such that it is based on Western formulae and hence has caused the
development of massive mutual mistrust and suspicion. And yet properly understood, SSR
was mooted during the liberation struggle in Zimbabwe as a concept and continues to be so
as a process uniting civilians and the military. Thus, SSR is not an issue because it is being
practised as a process in the ZDF. As a word SSR is new in its content, philosophy and
ideology but as a concept in the ZDF it is not new. The thesis showed that realism in some
cases is the means, as in the 1980s on national reconciliation, operation dissident Flash, the
Unity Agreement of 1987 and the Global Political Agreement of 15 September 2008, and
Ubuntu as the process and goal in SR, SS and HS relations in terms of uniting the population
as a family in SSR, SS and HS relations
Impacts of land use and land cover changes on the water quality of surface water bodies: Muzvezve Sub-Catchment, Zimbabwe.
No full textMany catchments in Southern Africa, including the Muzvezve Subcatchment in the central part of Zimbabwe have been negatively affected by the deterioration of water quality. This study aimed at assessing the impacts of land use and land cover changes on the water quality of Muzvezve River and Claw dam in Zimbabwe. Five sampling campaigns across the wet and dry seasons were conducted from Mid-December 2015 to end of February 2016 at six systematically selected sampling points. Eight physico-chemical parameters including turbidity, electrical conductivity (EC) Total Dissolved Solids (TDS), pH, Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), phosphorus and nitrogen, were analysed using Standard Methods. The biological parameters measured were faecal coliforms and total coliforms. Heavy metals analysed included; Copper, Zinc, Cadmium and Lead. The river water quality was compared to EMA ambient water quality guidelines. Land cover was characterized using the Normalized Difference Vegetation Index (NDVI) and was correlated with selected ground measured parameters of turbidity and TDS. A rapid water quality assessment for Claw Dam was done using remotely sensed and ground measured data. Analysis was conducted within a GIS environment and statistical software. Results showed that, for the measured parameters along the Muzvezve River, most were below the EMA standard guidelines, indicating that the river water quality is fairly good. The parameters which were below the threshold levels include EC, TDS, coliforms, BOD, COD, turbidity, phosphates and coliforms. However, based on WHO standards, the Muzvezve River water is not safe for drinking, without some form of appropriate effective treatment. Agriculture and settlement had no significant effect on water quality (p >0.05). Mining had significant effect (p< 0.05) as seen by high zinc and lead especially in the dry season. Results of the NDVI correlation with measured water quality parameters of turbidity and TDS showed that NDVI had a strong and significant positive relationship (p <0.05) with turbidity (r=0.998) and TDS (r ranging from 0.961 to 0.980) in the dry season. From these results, it was concluded that land cover could be used to predict turbidity during the dry season and TDS during the wet season. Turbidity showed positive correlation with the Blue, Red and NIR bands of Landsat 8 imagery. Results, however, showed that Secchi depth and Chlorophyll a correlations were weak. It was concluded that more work needs to be done on testing whether remotely sensed data can be used to estimate water quality in environments similar to the study area.WaterNe
An empirical investigation into the impact of public debt on economic growth: The case of Zimbabwe (1980-2014)
No full textZimbabwe’s public debt has been mounting yet the real growth rate has been on average
declining. Could this possibly mean that the escalating public debt is hampering the real growth
rate of Zimbabwe? This study investigates the impact of public debt on economic growth in
Zimbabwe for the period 1980-2014. The public debt stock is disaggregated into external debt
and domestic debt in order to determine the impact of each on economic growth independently.
The data was subjected to diagnostic tests before estimation. A long-run relationship was
established amongst the variables real economic growth, domestic debt, external debt, budget
deficit, external debt service and investment. Thus, a short-run Error Correction Model (ECM)
had to be used to capture the dynamics in short-run disequilibrium towards the long-run
equilibrium. The empirical results showed that external debt negatively affects the real growth
rate of Zimbabwe, both in the short and long-run. This confirms the existence of ‘debt
overhang’ in Zimbabwe. In the long-run, domestic debt positively affects economic growth.
However, in the short-run, the effect is negative but insignificant. Several policy implications
emerged from the empirical results. Zimbabwe should strengthen its debt management in order
to keep the public debt within sustainable thresholds. Furthermore, the country can make use
of debt to equity swaps by privatising underperforming parastatals. This would make them
competitive and efficient. This move could attract more foreign direct investment inflows and
create more employment thus lead to an increase in real growth rate of Zimbabwe
Participation of persons with disabilities in the formulation of economic empowerment policies in Zimbabwe: The case of Harare.
No full textThis thesis examines the extent to which persons with disabilities participate in the formulation of economic empowerment policies in Zimbabwe. To this effect, two disability categories have been chosen namely visual impairment and albinism. These disability types have been chosen largely because voices from literature coupled with anecdotal evidence show that besides impairments, they are not subject to any chronic physiological or mental challenges likely to militate against the performance of life tasks considered normal in any civilized society. Using a qualitative methodology, the study was largely informed by a combination of in-depth interviews from twenty participants, two focus group discussions each with persons with visual impairments and albinism respectively, ethnographic information collected at workshops, seminars and symposia on disability as well as a detailed literature search of theses, dissertations, papers, reports and books on participation, disability, empowerment and policy formulation. Research findings revealed that persons with disabilities were not effectively represented in the national political and administrative structures of government. It was however acknowledged that in spite of their limited number, parliamentarians representing persons with disabilities were trying their level best to push forward the disability agenda. Research findings further showed that in societies where the political and economic participation of persons with disabilities is promoted such as the case of South Africa, the lives of persons with disabilities have tended to improve. The study further revealed that civil society organisations tended to exclude persons with disabilities both within their administrative and programmatic structures simply on account of negative social attitudes including perceived incapacity. As a result, persons with disabilities played a peripheral role in civil society organisations’ programme activities. there was a tendency for civil society organisations to leave disability matters to Disabled Persons Organisations (DPOs). The study also revealed that disabled persons organizations experienced administrative, financial and technical challenges. The need to mainstream disability within mainstream organisations as is the case with gender was therefore emphasized. Similarly, the study unearthed numerous endogenous and exogenous barriers militating against the quest of persons with disabilities to participate in the political and economic life of the country. These include poor education, myths and misconceptions surrounding disability, political violence, low self-esteem and confidence as well as lack of unity and technical expertise within the disability movement. The study however revealed that persons with disabilities had the zeal and sense of agency to improve their situation. In view of these findings, recommendations were passed