24 research outputs found
Communication for porverty alleviation : The case study of Plan, An international Humanitarian, Child focused Development Organisation working in Zambia
No full textPoverty affects nations in many different ways. Many people in Zambia especially in rural areas live in poverty. Plan an international humanitarian, child-focused development organisation without religious or political affiliation is among many non-governmental organisations that are
lighting against poverty. The author was attached to Plan in Zambia from March to May 2004. The attachment provided the author with a rare opportunity to work for an international organisation. Plan has undertaken a number of programmes to improve the food security of its target
beneficiaries. Plan has spent a lot of resources on capacity building so that the communities can sustain the programmes after completion of its programmes. The groundnuts seed multiplication project in Chadiza and the livestock restocking project in Mazabuka have assisted a lot of people to improve their food security. Communication is vital in the successful implementation of any project. The researcher recommends that Plan in Zambia should publicise its activities so that people can know about its programmes. Communication strategies should put emphasis on dissemination of information about its programmes and how to sustain these programmes
From paternalism to partnership : the sensitive handover
No full textThis article forms part of the research in progress as part of the degree PhD (Missions) at the University of Pretoria.This article seeks to address the handover process of missions work from pioneer missionaries to indigenous leaders. It posits that this can only be done in a biblical way if paternalism yields to partnership. The article justifies paternalism in the commencement of missions work, but argues that there is a point beyond which paternalism becomes unjustifiable and crippling to the work of God's kingdom. Instead of simply condemning the crippling paternalism, the author goes on to point to the way in which true partnership can be birthed. It is through mutual respect and admiration between the missionaries and the indigenous leaders. The author uses the Bible to show that church planting missions work should go through at least three phases of development. He then ends his article by showing how mutual respect and admiration between missionaries and indigenous leaders enhances the handover process. In the light of the difficulties experienced at this juncture of missions work, and in view of the shift of the future of missions from the Western world to the Majority World, this article addresses a very pertinent subject.am2013mn201
A History of the care of orphans in pre-colonial and colonial Zambia, 1880-1964
No full textThe main purpose of the study was to present the care of orphans in pre-colonial and colonial Zambia as one of the most important welfare services besides education and health which have been the main focus in the historiography of welfare services in Zambia. The study also examined the causes and impacts of orphanhood. In addition, the roles of different institutions in the care of orphans were identifies such as the extended family system, missionary societies and the Colonial Government especially after 1948. Lastly, the study examined the impact of the institutionalization of orphans in orphanages.Research data for the study was obtained from the University of Zambia Library, the National archives of Zambia, the Ministry of Community Development’s Documentation Department, The Faith Encounter and Spiritual Centre of Zambia, Kasisi Orphanage (Children’s Home) and the Catholic Secretariat’s Social Welfare Department. In addition oral interviews were conducted to establish the possible impacts of the institutionalization of orphans in orphanages.The study has established the presences of orphans in pre-colonial and colonial Zambia and their plight contrary to many casual observers views’ that there were no orphans during the period under study. The study has presented evidence of the presence of oral traditions in form of folklore on the existence of orphans in African societies. During the colonial period and as a result of the socio-economic policies of the colonial government, there was a notable increase in the number of orphans in both the rural and urban centres according to Social Services Reports and Legislative Council debates. The stakeholders in the care of orphans were the extended family system, the missionaries who established orphanages such as Kasisi, Kalene Hills and Kabompo Orphanages and the government.Despite many concerns the colonial period raised over the possible negative impacts of institutionalization of orphans in orphanages, many orphans who were brought up in orphanages and left the orphanages when they became adults benefitted through academic and professional training. Hence they were better equipped and were easily integrated in the new society after independence. The author hopes the study will contribute to the historiography of social welfare in Zambia
Agricultural Solid Waste as Source of Supplementary Cementitious Materials in Developing Countries
No full textConcrete production utilizes cement as its major ingredient. Cement production is an important consumer of natural resources and energy. Furthermore, the cement industry is a significant CO2 producer. To reduce the environmental impact of concrete production, supplementary cementitious materials such as fly ash, blast furnace slag, and silica fume are commonly used as (partial) cement replacement materials. However, these materials are industrial by-products and their availability is expected to decrease in the future due to, e.g., closing of coal power plants. In addition, these materials are not available everywhere, for example, in developing countries. In these countries, industrial and agricultural wastes with pozzolanic behavior offer opportunities for use in concrete production. This paper summarizes the engineering properties of concrete produced using widespread agricultural wastes such as palm oil fuel ash, rice husk ash, sugarcane bagasse ash, and bamboo leaf ash. Research on cement replacement containing agricultural wastes has shown that there is great potential for their utilization as partial replacement for cement and aggregates in concrete production. When properly designed, concretes containing these wastes have similar or slightly better mechanical and durability properties compared to ordinary Portland cement (OPC) concrete. Thus, successful use of these wastes in concrete offers novel sustainable materials and contributes to greener construction as it reduces the amount of waste, while also minimizing the use of virgin raw materials for cement production. This paper will help the concrete industry choose relevant waste products and their optimum content for concrete production. Furthermore, this study identifies research gaps which may help researchers in further studying concrete based on agricultural waste materials.Part of Special Issue "Sustainability in Construction and Building Materials"Materials and Environmen
Exploring International Educators\u27 Learning About Local and Global Social Justice in a Virtual Community of Practice
No full textIn this chapter, the authors report themes that emerged when a cross-cultural team of researchers involved in a virtual international community of practice (Global Social Justice in Education-GSJE) investigated reflections on activities focused on social justice in local and global contexts. The findings suggested that the activities elicited GSJE community members\u27 understandings of the complexities of social justice associated with naming practices, privilege, and the arts within their own and across contexts. The authors discuss implications of the activities to advance diverse educators\u27 understanding of social justice in global and local contexts. They also unpack the opportunities and challenges that resulted from the collaborative research process and the writing of this chapter completed by the international author team comprised of 11 education scholars from seven countries
Effectiveness of 4% chlorhexidine umbilical cord care on neonatal mortality in Southern Province, Zambia (ZamCAT): a cluster-randomised controlled trial
No full textSummaryBackgroundChlorhexidine umbilical cord washes reduce neonatal mortality in south Asian populations with high neonatal mortality rates and predominantly home-based deliveries. No data exist for sub-Saharan African populations with lower neonatal mortality rates or mostly facility-based deliveries. We compared the effect of chlorhexidine with dry cord care on neonatal mortality rates in Zambia.MethodsWe undertook a cluster-randomised controlled trial in Southern Province, Zambia, with 90 health facility-based clusters. We enrolled women who were in their second or third trimester of pregnancy, aged at least 15 years, and who would remain in the catchment area for follow-up of 28 days post-partum. Newborn babies received clean dry cord care (control) or topical application of 10 mL of a 4% chlorhexidine solution once per day until 3 days after cord drop (intervention), according to cluster assignment. We used stratified, restricted randomisation to divide clusters into urban or two rural groups (located <40 km or ≥40 km to referral facility), and randomly assigned clusters (1:1) to use intervention (n=45) or control treatment (n=45). Sites, participants, and field monitors were aware of their study assignment. The primary outcomes were all-cause neonatal mortality within 28 days post-partum and all-cause neonatal mortality within 28 days post-partum among babies who survived the first 24 h of life. Analysis was by intention to treat. Neonatal mortality rate was compared with generalised estimating equations. This study is registered at ClinicalTrials.gov (NCT01241318).FindingsFrom Feb 15, 2011, to Jan 30, 2013, we screened 42 356 pregnant women and enrolled 39 679 women (mean 436·2 per cluster [SD 65·3]), who had 37 856 livebirths and 723 stillbirths; 63·8% of deliveries were facility-based. Of livebirths, 18 450 (99·7%) newborn babies in the chlorhexidine group and 19 308 (99·8%) newborn babies in the dry cord care group were followed up to day 28 or death. 16 660 (90·0%) infants in the chlorhexidine group had chlorhexidine applied within 24 h of birth. We found no significant difference in neonatal mortality rate between the chlorhexidine group (15·2 deaths per 1000 livebirths) and the dry cord care group (13·6 deaths per 1000 livebirths; risk ratio [RR] 1·12, 95% CI 0·88–1·44). Eliminating day 0 deaths yielded similar findings (RR 1·12, 95% CI 0·86–1·47).InterpretationDespite substantial reductions previously reported in south Asia, chlorhexidine cord applications did not significantly reduce neonatal mortality rates in Zambia. Chlorhexidine cord applications do not seem to provide clear benefits for newborn babies in settings with predominantly facility-based deliveries and lower (<30 deaths per 1000 livebirths) neonatal mortality rates.FundingBill & Melinda Gates Foundation
Understanding the barriers to and opportunities for improving access to safe, legal abortion services in Ghana: a policy analysis
No full textUnsafe abortion continues to be a major public health problem in Ghana. It accounts
for 22-30% of the maternal mortality in the country. Although Ghana is one of the
countries in sub-Saharan Africa with a liberal abortion law, access to safe, legal
abortion in public health facilities is limited. Women with unwanted pregnancies
resort to unsafe abortion with the resultant heavy toll on their health and lives.
This study set out to understand the barriers to and opportunities for improving
access to safe, legal abortion services in Ghana. The study employed in-depth
interviews with key stakeholders and analysis of relevant documents with a view to
unravelling different dimensions of the problem for a deeper understanding of the
situation.
Key findings included the observation that Ghana's abortion law is relatively liberal
but has gaps and inconsistencies making it liable for misinterpretation. There is need
to provide safe, legal services; evaluation of these services might help to improve the
law. Two main barriers confront provision of safe abortions: the service-related
barriers constitute legal and policy ambiguities and inconsistencies, provider
attitudes and lack of training. Important socio-cultural barriers were cultural values,
social norms, moral and religious objection which create dilemmas in professional
practice. Midwives were found to be conservative and reluctant to provide
comprehensive abortion care. Most respondents, including religious people, saw
`medical grounds' as legitimate for comprehensive abortion care. Medicalising
abortion may help lift it out of the moral/religious sphere in people's minds, and
therefore make it more acceptable.
In conclusione, fforts shouldb ea imeda t future law reformt o takec areo f its current
ambiguities that challenge application. In the short term, it would be better to
sensitizem edicalp ractitionersto the flexibility of the law. It is essentialf or the
GhanaH ealth Servicet o assisth ealthp rovidersa ndk ey stakeholdertso re-examine
their values and change their attitudes towards abortion care to ensure that legal
abortions are provided in public hospitals to help women in need of the services
Stunting and growth velocity of adolescents with perinatally acquired HIV: differential evolution for males and females. A multiregional analysis from the IeDEA global paediatric collaboration
No full textINTRODUCTION: Stunting is a key issue for adolescents with perinatally acquired HIV (APH) that needs to be better understood. As part of the IeDEA multiregional consortium, we described growth evolution during adolescence for APH on antiretroviral therapy (ART). METHODS: We included data from sub-Saharan Africa, the Asia-Pacific, and the Caribbean, Central and South America regions collected between 2003 and 2016. Adolescents on ART, reporting perinatally acquired infection or entering HIV care before 10 years of age, with at least one height measurement between 10 and 16 years of age, and followed in care until at least 14 years of age were included. Characteristics at ART initiation and at 10 years of age were compared by sex. Correlates of growth defined by height-for-age z-scores (HAZ) between ages 10 and 19 years were studied separately for males and females, using linear mixed models. RESULTS: Overall, 8737 APH were included, with 46% from Southern Africa. Median age at ART initiation was 8.1 years (interquartile range (IQR) 6.1 to 9.6), 50% were females, and 41% were stunted (HAZ<-2 SD) at ART initiation. Males and females did not differ by age and stunting at ART initiation, CD4 count over time or retention in care. At 10 years of age, 34% of males were stunted versus 39% of females (p < 0.001). Females had better subsequent growth, resulting in a higher prevalence of stunting for males compared to females by age 15 (48% vs. 25%) and 18 years (31% vs. 15%). In linear mixed models, older age at ART initiation and low CD4 count were associated with poor growth over time (p < 0.001). Those stunted at 10 years of age or at ART initiation had the greatest growth improvement during adolescence. CONCLUSIONS: Prevalence of stunting is high among APH worldwide. Substantial sex-based differences in growth evolution during adolescence were observed in this global cohort, which were not explained by differences in age of access to HIV care, degree of immunosuppression or region. Other factors influencing growth differences in APH, such as differences in pubertal development, should be better documented, to guide further research and inform interventions to optimize growth and health outcomes among APH
The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis
No full textBackgroundGlobally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in “real-life” settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia.Methods and findingsThrough the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5–5.2) years for the total cohort and 6.4 (3.6–8.0) years in Europe, 3.7 (2.0–5.4) years in North America, 2.5 (1.2–4.4) years in South and Southeast Asia, 5.0 (2.7–7.5) years in South America and the Caribbean, and 2.1 (0.9–3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3–2.1) years in North America to 7.1 (5.3–8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4–2.6) years in North America to 7.9 (6.0–9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%–2.8%), 15.6% (15.1%–16.0%), and 11.3% (10.9%–11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%–1.1%]) and highest in South America and the Caribbean (4.4% [3.1%–6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%–6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%–13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria.ConclusionTo our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses.</div
On the pathway to better birth outcomes? A systematic review of azithromycin and curable sexually transmitted infections.
No full textThe WHO recommends the administration of sulfadoxine-pyrimethamine (SP) to all pregnant women living in areas of moderate (stable) to high malaria transmission during scheduled antenatal visits, beginning in the second trimester and continuing to delivery. Malaria parasites have lost sensitivity to SP in many endemic areas, prompting the investigation of alternatives that include azithromycin-based combination (ABC) therapies. Use of ABC therapies may also confer protection against curable sexually transmitted infections and reproductive tract infections (STIs/RTIs). The magnitude of protection at the population level would depend on the efficacy of the azithromycin-based regimen used and the underlying prevalence of curable STIs/RTIs among pregnant women who receive preventive treatment. This systematic review summarizes the efficacy data of azithromycin against curable STIs/RTIs
