1,720,988 research outputs found
Exploration and description of barriers to male participation in antenatal and prevention of mother-to-child transmission of HIV (pmtct) services in Mumbwa district, in Zambia
Get PDFMagister Public Health - MPHThe reproductive health of women is hugely dependent on the involvement of their male partners. Men also serve as gatekeepers to women’s access to reproductive health services. Male involvement is an important recommendation for the Prevention of Mother-to-Child Transmission of HIV (PMTCT) program as their participation in antenatal care and HIV testing has been found to decrease infant HIV infection and increase HIV free survival. Male involvement is not just about promoting men to accompany their partners to antenatal clinic, but for men to provide supportive roles in their families, and also to bring men into HIV preventive
and care services. Male involvement in PMTCT is defined as the fathers’ active involvement in attending antenatal care services and HIV testing during the antenatal period as well as the couple’s acceptance of PMTCT if the mother is found to be HIV positive. Men are traditionally not directly involved in their partner’s health in many sub-Saharan countries, although they most often make decisions about use of services. They may provide financial support but attending health services with their partner is not seen as part of the male’s role. There are therefore huge challenges in efforts to get men involved in reproductive health services and there is a need to better understand how to promote male involvement in different settings. Male involvement in PMTCT was adopted by the Zambian Government in 1999 but not much is known on how best to initiate and develop male involvement in their partner’s health
Understanding attitudes and perceptions of nurses and medical doctors on providing intimate partner violence screening at Katutura Hospital, Namibia
Get PDFMagister Public Health - MPH (Public Health)This qualitative, explorative study aimed to explore the attitudes and perceptions of nurses and
medical doctors at frontline services units of the Katutura Intermediate Hospital in Windhoek,
Namibia, in providing intimate partner violence (IPV) screening during routine care. Frontline
services were selected because that is where most of the patients come into contact with nurses
and medical doctors for the first time, making this the first point of care contact at this referral
hospital. The researcher conducted in-depth interviews with purposively selected sample of 18
nurses and six medical doctors employed at frontline services units of the hospital.
All the respondents concurred that IPV was prevalent in Namibia, as evidenced by the daily
hospital records. Respondents admitted that the Casualty Section of the Katutura Hospital was the
busiest section at the hospital, and that incident and cases of IPV were recorded there every hour,
especially from Thursday through the weekend and on public holidays, as victims seek treatment
for their resultant injuries. Most of the respondents expressed concern about their inability to
screen for IPV during routine care due to a lack of time. Many respondents believed, however,
that screening for IPV was the responsibility of social workers and not necessarily that of nurses
and medical doctors. Others believed that a lack of skills among hospital staff to screen for IPV
as well as staff shortages and work overload were some of the factors preventing staff from
performing screening.
The study found that IPV cases were prevalent at the Katutura Intermediate Hospital, and that
there was ambivalence about IPV screening and reporting among the staff who participated in the
study. Some of the nurses and medical doctors who participated in the study saw IPV as a nonclinical
and social issue and believed that it was the responsibility of social workers, while others
felt that they might be able to do something about it but were hampered by factors such as staff
shortages, a lack of privacy and work overload. The researcher recommends further research on
the attitudes and perceptions of senior management and patients towards IPV screening
The dynamics of intimate partner violence during pregnancy and linkages with HIV infection and disclosure in Zimbabwe
No full textPhilosophiae Doctor - PhDThe study assessed the linkages between HIV infection and intimate partner violence (IPV) during pregnancy and after HIV status disclosure in a context where HIV testing has become almost mandatory through the provider-initiated counselling and testing approach and non-disclosure of HIV status to sexual partners has been criminalised in many countries including Zimbabwe. The study also explored women’s experiences of and health workers’ perceptions of IPV during pregnancy
The dynamics of intimate partner violence during pregnancy and linkages with HIV infection and disclosure in Zimbabwe
Get PDFIntroduction: The study assessed the linkages between HIV infection and intimate partner violence (IPV) during pregnancy and after HIV status disclosure in a context where HIV testing has become almost mandatory through the provider-initiated counselling and testing approach and non-disclosure of HIV status to sexual partners has been criminalised in many countries including Zimbabwe. The study also explored women’s experiences of and health workers’ perceptions of IPV during pregnancy.
Methods: A mixed-methods study of IPV and HIV during pregnancy was conducted to determine the prevalence of and risk factors for IPV during pregnancy and after disclosing HIV status, to assess the relationship between HIV, pregnancy and IPV, to understand women’s perspectives of and midwives’ experiences of responding to IPV during pregnancy. A systematic review and meta-analysis of 19 African studies on IPV during pregnancy was first conducted to understand the rates of and risk factors for IPV including HIV and to assist in developing a study of IPV and HIV during pregnancy in Harare, Zimbabwe. This was followed by qualitative research comprising seven focus group discussions (FGDs) with 64 pregnant and post-natal women; and in-depth interviews with seven senior maternity health workers from the six clinics involved in the larger quantitative research, and analysed with thematic content analysis of transcripts. The qualitative phase of the study explored IPV and linkages with HIV and helped to plan and to interpret the quantitative findings.
The last phase of the study was a cross sectional survey of 2042 postnatal women about their IPV experiences and sexual risk practices using an adapted WHO questionnaire and the Sexual Risk Behaviour Questionnaire. Respondents’ antenatal HIV test results were collected from clinic records. The prevalence of IPV and that of HIV were calculated. A severe violence variable was constructed by calculating frequencies of IPV. Multiple logistic regression analysis was conducted to assess factors associated with experiencing IPV, severe IPV during pregnancy and severe IPV after disclosing HIV status.
Findings: The systematic review found a significant variation in the prevalence of IPV during pregnancy (2% to 57%), attributed both to measurement differences and to probable real variations across countries. After adjusting for confounders, IPV during pregnancy was significantly associated with HIV (OR1.48-3.10) and a history of violence (OR 2.43-274.34) in five out of eight studies while alcohol abuse by a partner was found to increase a woman’s chances of being abused during pregnancy (OR 2.89-11.60). The survey found one of the highest rates of IPV ever recorded, with 63.1% of respondents reporting at least one of physical, sexual and/or emotional violence during their most recent pregnancy. High levels of emotional (44%), sexual (38.9%), physical (15.9%) and combined physical and/or sexual (46.2%) IPV were reported and this was confirmed in qualitative research. At least 30.2% reported severe sexual violence (3+ episodes) while 10.1% reported severe (6+ episodes) physical and/or sexual IPV during pregnancy. 95.5% disclosed their HIV test results to their partners. Overall HIV prevalence was 15.3%, but the prevalence among women who did not disclose was more than double (35.2%) the rate among women who disclosed to their partners (14.3%). About 3.5% of women who tested negative did not disclose, but 10.7% of those testing positive did not disclose (p<0.0001). At least 40.5% of HIV positive women reported physical, sexual and/or emotional IPV after disclosure, compared to 31.5% of women disclosing HIV negative results (p=0.004). HIV status was not significantly associated with IPV or severe IPV during pregnancy but with sexual risk factors. Other risk factors for IPV, severe IPV and severe IPV after HIV disclosure, include high levels of gender inequality, past violence (during childhood and adulthood), heavy alcohol use, lack of social support and partner control of woman’s sexuality and reproductive health. Stronger associations were observed with severe IPV.
Institutionalised patriarchy, through the marriage institution, extended family, health system, and the church emerged as supporting and contributing to the abuse of women due to its promotion of gender inequality. Men reportedly refused to accept the physical, emotional, economic and sexual changes associated with pregnancy leading to abuse of women. Midwives were not knowledgeable, equipped or supported by the health system to recognise and address IPV and perceived IPV as a domestic problem and not part of their clinical work.
Conclusion: A high prevalence of IPV was reported during pregnancy and after disclosing HIV status with more HIV positive women experiencing abuse than HIV negative women after disclosure. IPV is closely related to gender inequities between partners. The relationship between HIV and IPV is complex and prevention interventions of IPV and HIV must consider levelling gender inequalities. Targeting children and adolescents is critical in primary prevention while the pregnancy context offers an opportunity for secondary prevention in antenatal care. Disclosure of HIV should be conducted without further making women vulnerable to abuse
Delayed disclosure of sexual violence incidents among victims in Newcastle, Kwazulu-Natal
Get PDFMagister Public Health - MPHThe aim of this study was to identify factors associated with reporting incidents of sexual violence after seventy-two hours at the sexual assault service centre in Newcastle, KwaZulu-Natal. This descriptive study was based on retrospective analysis of 534 medical records of victims of sexual violence at the Newcastle hospital between 2005 and 2009. A data collection sheet was designed to extract information from three sources namely: the victims' hospital files, J88 forms and specific hospital forms that were completed for sexual assault victims. The collected data were entered into and processed for analysis using EPI INFO statistical package. Frequencies, means and standard deviations were calculated for the data set. Test of significance was also done using the Chi-square test and presented using odds ratios with 95% CI and p-value of <0.05. The victims' age range was 2-81years (mean= 18.84, σ=13.25). Approximately 87% were female and 59.4% of the victims were aged 0-17 years. One in five victims (19.7%) was HIV positive, and most (74.4%) reported rape with vaginal penetration. Fifty-nine percent reported within 72 hours of being assaulted. The most common reason for delayed reporting (21.5%) was fear of the perpetrator. Most of the sexual assaults were committed by male (96%) and single perpetrator (90%). Nearly a third (32.4%) of the sexual violence occurred within intimate relationships and more than two-thirds (68%) knew the perpetrators. In all, 35% sustained injuries during the assault and a third (34.5%) reported the use of weapons during the assault. Nearly half of the victims (48.7%) were referred to hospital by their relatives who also accompanied them to the facility (42.1%). Of the 198 victims that were offered post-exposure prophylaxis (PEP), 87% collected the full 28-day course.South Afric
Refusal of male partner responsibility and pregnancy support: prevalence, associated factors and health outcomes in a cross sectional study in Harare, Zimbabwe
No full textBackground The phenomenon of fathers refusing responsibility during pregnancy has not received adequate
attention in African studies. This paper assesses associated factors and pregnancy-related outcomes when fathers
refuse to support partners’ pregnancies and undertake parental responsibilities.
Methods A cross-sectional survey of 15–49-year-old postnatal (1–6 weeks) women was conducted at six urban
health facilities in Harare. Participants were interviewed about their male partners’ refusal to support their pregnancies
and parenting, bride price payments (indicating marriage commitment), partner violence and control, alcohol abuse
and family planning decision-making. Pregnancy health outcome data including antenatal care attendance, low
birth weight (LBW)(<2500 g) and postnatal depression were collected through interviews and clinic records. Multiple
regression models were built to assess gender-related factors and health outcomes associated with male partners’
refusal of parenting responsibilities.
Results Of the 2042 women interviewed, 6.4% reported partner refusal to support the pregnancy or parenting.
Higher odds of partner refusal of fathering responsibility were associated with partners not paying bride price (aOR
9.31; 95% CI 1.16–74.59), violence perpetration during pregnancy (aOR 2.84; 1.28–6.23), highly controlling behaviours
(aOR 4.96; 2.83–8.69), alcohol abuse (aOR 1.78; 1.05–3.02), unintended pregnancy (aOR 3.72; 1.84–7.53) and partner
refusal to use contraceptives (aOR 3.64; 1.86–7.14). Women who used contraceptives (aOR 0.40; 0.23–0.71), made joint
(aOR 0.30; 0.14–0.67) or individual (aOR 0.25; 0.07–0.94) pregnancy decisions were protected from partner refusal of
parenting responsibility. Women’s depressive symptomatology (aOR2.64; 1.52–4.59), LBW (aOR5.30; 1.18–23.74) and
partner discouragement of antenatal care attendance (aOR 3.86; 1.13–13.17) were pregnancy outcomes associated
with partner refusal of parenting responsibility.
Conclusions Male partners’ refusal to acknowledge parenting responsibility was associated with men’s abusiveness,
absence of commitment to long-term relationship/marriage, gender unequal practices and negative maternal and child health outcomes. Parenting programmes must be instituted and prioritise transforming traditional gender
norms to improve fathering responsibilities.Flemish interuniversity cooperation (VLIR-UOS).PM202
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Expectations and experiences of Hiv vaccine trial participants at the Mbeya Medical Research Programme in Mbeya, Tanzania 2006-2007
Get PDFMagister Public Health - MPHA qualitative descriptive study approach was used to gather the required information. The sample for this study was drawn from an existing group of volunteers who participated in the vaccine trial at Mbeya Medical Research Centre in 2006-2007. A purposive sampling method was used to select respondents because they had had experience of being participants in a HIV vaccine trial. Twenty audio recorded in-depth interviews were conducted. The interviews were conducted at the clinic during their routine follow up visits. An open ended interview guideline was used to guide the discussion to elicit the required information from the respondents. The data was transcribed, translated and then analyzed by both content and thematic approach. Ethical procedures were observed, including getting permission from the local ethical committee in Mbeya region and participants were given an informed consent form to read and sign before starting the interview.South Afric
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
- …
