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Poor reproductive health among youth and adolescents threatens their future health and economic wellbeing in Zimbabwe amidst a high HIV/AIDS prevalence. This study evaluates the impact of a multi-pronged adolescent sexual and reproductive health (ASRH) strategy implemented by government of Zimbabwe between 2010 and 2015 to improve ASRH in terms of...
Contexts in source publication
Context 1
... 4 and 5 present the effects of higher program intensity on ASRH outcomes. In Table 4, results of Manicaland province are compared to Mashonaland Central while in Table 5 they are compared to results of Mashonaland East. ...Similar publications
Background
Well-designed retrospective studies (RSs) and small-sample prospective studies (PSs) evaluating the efficacy of interventions have received much attention. This study was designed to evaluate the differences between well-designed RSs and small-sample randomized controlled trials based on the efficacy of laparoscopic distal gastrectomy (L...
The literature on socio-economic variations in the association between retirement timing and health is inconclusive and largely limited to the moderating role of occupation. By selecting the sample case of Mexico where a sizeable number of older adults have no or very little formal education, this study allows the moderating role of education to be...
Objectives
A pay-for-performance (P4P) programme is a management strategy that encourages healthcare providers to deliver high quality of care. In Taiwan, the P4P programme has been implemented for diabetes, and certified diabetes physicians voluntarily enrol patients with diabetes into the P4P programme. The objectives of this study were to compar...
IFIs provide funding for SMEs, but what impact does this actually have on these firms? This working paper assesses the impact of funding by the EIB on the performance of more than 5,000 SMEs in eight countries in Central and Eastern Europe during 2008-2014. Using propensity score matching and difference-in-difference estimation exercises, it indica...
Citations
... Oral PrEP is a safe and effective prevention of HIV and should be scaled up among the sexually active youth and adolescents from key populations 3 . Moreover, innovative approaches to create demand for PrEP use and prevention of other STIs should be developed 13,14,15,16 . Thus, this study aimed to analyze the specificities and challenges of demand creation for the recruitment and participation of adolescent MSM and TGW (AMSM and ATGW, respectively) aged 15 to 19 years in a PrEP demonstration project in Brazil. ...
... The gap in scientific knowledge on the potential and complicating factors in PrEP and demand creation among young people must be bridged 10,13,14 . This problem is worsened when such factors intertwine with social markers of difference, intersectionality, and social and health vulnerabilities, as in the LGBTQIA+ population 28,29 . ...
This study aimed to analyze the challenges in demand creation for participation in an HIV pre-exposure prophylaxis (PrEP) project in two Brazilian capitals. This qualitative study was conducted with men who have sex with men and transgender women aged 15 to 19 years who lived in two Brazilian state capitals. For this analysis, 27 semi-structured interviews carried out from 2019 to 2020 were evaluated by reflexive thematic content analysis. For participants, PrEP demand creation was essential for their interaction, mediation, bonding, and attachment and proved effective for PrEP acceptability and adherence. Adolescents’ narratives showed that the strategies promoted HIV combination prevention, opened up opportunities for recruitment meetings, helped to negotiate with and convince individuals to use PrEP, strengthened peer education, and evoked a feeling of “being with” and “walking together” despite the challenges. Face-to-face or online interactions using social technologies played a crucial role in recruiting adolescents for the project, expanding knowledge on PrEP and other combination prevention strategies and access to health services and self-care.
... These services are important to youth and adolescents, and they help to promote access to SRHR 13,14 . However, such services appear ineffective because some adolescents lack relevant information about sexuality, which makes them fall prey to misinformation and myths shared by peers and other unreliable sources 15,7 . ...
... The collaboration with traditional leadership in this study was not only a way of seeking entry into the community but also to invite their contribution as stewards of the several initiation schools in the community. Among the native African groups, initiation or rite of passage rituals are organized on the authority and powers of traditional Chiefs 15,31,23,26 . Additionally, collaboration with the traditional leadership is to create a platform to enhance the openness in speaking about SRHR with youth in the community. ...
... In spite of these beliefs regarding SRHR, most participants in this study demonstrated low levels of knowledge on sexual reproductive health and services, a phenomenom which negatively impacts participants' utilizataion of SHR services. This is consistent with other studies where they reported that increase in SRH knowledge and increased self-efficacy among adolescents is associated with intentions to reduce sexual risk behaviours as well as increase intention to and use of SRH services [18][19][20]. Another author identified that the availability of SRH corners for adolescents leads to increased knowledge and use of SRH services among adolescents. ...
Background
Evidence globally indicates that female adolescents face numerous sexual and reproductive health (SRH) risks. Utilization of sexual reproductive health services among adolescents is of global health importance and plays a crucial role in adolescent sexual reproductive health outcomes and their quality of life.
Aim
The current study explored sexual reproductive health service utilization concerns among female adolescents in the Tema Metropolis in Southern Ghana using the Anderson and Newman Behavioural model of Health Service Utilization as a guiding framework.
Methods
The study utilized a qualitative exploratory descriptive design. Purposive sampling was used to recruit female adolescents. In-depth face-to-face interviews were conducted using a semi-structured interview guide. In all, 12 interviews were conducted. Each interview lasted between 45 and 60 minutes. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Thematic analysis was guided by the constructs of the Anderson and Newman Behavioural model of health service utilization.
Results
Utilization of sexual reproductive health services among female adolescents is low in the Tema metropolis. Factors such as unprotected non-consensual sexual activity or an unwanted pregnancy sometimes triggered the use of these services. Barriers to utilization identified include lack of awareness on sexual reproductive health services, unreliable sources of SRH information, underestimation of the severity of sexual reproductive health problems faced, unmet expectations and poor experiences with service providers.
Conclusion
The current study identified poor utilization of sexual reproductive health services among female adolescents within the Tema metropolis of Ghana. There is the need to increase the number of adolescent health corners, increase awareness about SRH services among adolescents, improve parent-child SRH communication and provide adequate training for healthcare providers to improve provider attitude towards adolescent SRH service delivery in order to increase utilization of sexual reproductive health services among female adolescents in the Metropolis.
... Although many empirical studies on ASRH have been conducted in Kenya [20,21,22,23,24,25] among others, it has been noted that there are contextual, methodology, and conceptual gaps since none of all prior studies conducted have addressed the effect of adolescents and sexual reproductive health policy on girl child retention in public secondary schools in Butula sub-county. This proposed research intends to fill these gaps by specifically investigating the effect of ASRH information, ASRH services, educational opportunity, and community involvement on girl child retention in public secondary schools in Butula sub-county, Kenya. ...
The challenge of girls' retention in educational institutions has been identified as a significant obstacle. The inability to maintain the enrollment of female students in secondary schools can be regarded as a squandering of valuable human capital and financial investments made in their primary education, as well as a loss of time invested in their initial enrollment. These young females have the potential to develop into a demographic of women lacking in literacy skills, resulting in diminished economic, social, and political contributions. Among the critical contemporary social issues affecting many countries is teenage pregnancies. The matter of ASRH is a global issue affecting both developed and underdeveloped countries. The problem has drawn attention of governments from both developed and underdeveloped nations. Researchers have also given it consideration and studied it to some extent in their efforts to solve the recurring puzzle of solving the sex related matters that affect adolescents. This research was guided by a general objective, the effect of adolescents and sexual reproductive health policy on girl child retention in public secondary schools in Butula sub-county, Kenya. The study also adopted specific objective as; i)To assess the effect of educational opportunities on girl child retention in public secondary schools in Butula Sub-county Kenya.The study was guided by Human Capital theory of adolescence. Research adopted the descriptive survey design. The study also targeted a sample size of 488 respondents, out of the targeted population of 1335 respondents. The criteria for selecting sample size using convenient and purposive sampling techniques was fixed upon Mugenda and Mugenda (2004) formula. Also, the data from both primary and secondary sources was utilized in the study. The instruments for gathering the data comprised questionnaires, interviews, and records from the schools. Before utilizing the instruments in this research, they were tested using test-retest methods to ascertain validity and reliability. To establish links between variables, the study used correlational analysis. Precisely, a SPSS version 25 was used when seeking to establish any link between the Adolescent Sexual Reproductive Health Policy and girl child retention in public secondary schools Butula Sub-County, Busia County. There is an expectation that this study increased towards knowledge or understanding of the effect of teenage pregnancy on class attendance in public secondary schools in Butula Sub-county. Due to the sensitivity of the research all information that was obtained it was regarded as confidential and the participants including the schools kept it anonymous. Also, no one was coerced to become part of the sample space, but consent was the criteria upon selection of respondents in the study. Therefore, this study involved the highest level of confidentiality, acknowledgment and consent when dealing with respondents and sources of data. The finding of the study was that ASRH services were significant to girl retention in schools. Moreover, it was found that information on ASRH on girls’ retention was from media and school. This study recommends that school administrators assume the role of fostering a collaborative relationship between schools and the community. This partnership would facilitate the identification of opportunities for teachers, parents, and community members to collaborate in order to enhance the educational outcomes of students.
... 54 An evaluation of the impact of the ASRH strategy on service utilisation and health outcomes in Zimbabwe found no impact on STI prevalence and condom use. 55 A community-randomised trial in Ghana on the effects of an ASRH intervention on use of services by young people showed improved adolescent usage of STI, antenatal and perinatal services, but had no significant effect on adolescent usage of HIV counselling and testing services. 56 A systematic review of interventions for preventing unintended pregnancies among adolescents concluded that programmes that included a combination of education and additional interventions promoting contraception use contributed to reducing unintended adolescent pregnancies. ...
Adolescent sexual and reproductive health (ASRH) services are key to improving the health of adolescents. This study aimed to establish the effectiveness of an intervention that combined activities in health facilities and communities in Kenya to increase utilisation of ASRH services. A quasi-experimental evaluation design was used to assess the effectiveness of the intervention. Using a stratified cluster sampling approach, two cross-sectional household surveys targeting girls aged 15–19 were conducted at baseline (September 2019) and endline (December 2020) in intervention and comparison. We combined the difference-in-difference approach to analyse the net change in outcomes between intervention and comparison arms of the study at baseline and endline and coarsened exact matching for variables that were significantly different to address the imbalance. There were a total of 1011 participants in the intervention arm and 880 in the comparison arm. Descriptive results showed a net increase of 12.7% in intervention sites in the knowledge of misconceptions about sex, pregnancy, and contraception, compared to 10.4% in the control site. In the multivariate regression analysis, two outcomes remained significant: decreases in adolescents’ discomfort when seeking ASRH services because of either fear of parents (aPR = 0.58, 95% CI = 0.42–0.79, P = 0.001) or a lack of support from their partner (aPR = 0.25, 95% CI = 0.08–0.82, P = 0.023). The intervention combining a facility and community approach was not effective in increasing the use of ASRH information and services. Possible reasons for this are explored.
... Despite substantial progress in HIV care and treatment in the country, continued work to reduce new infections is needed significantly. As of 2019, 90% of PLWH in Zimbabwe were aware of their status, 94% of those diagnosed were on HAART, and of those diagnosed and on treatment, 86% were virally suppressed [8]. Strategies for controlling the HIV epidemic developed by the World Health Organization (WHO) and the UNAIDS have almost been universally adopted by SSA countries. ...
HIV and AIDS continue to be a significant public health concern globally, with about 36 million people currently living with the epidemic. Several HIV interventions have been implemented to intensify virus transmission prevention, screening, and diagnosis in sub-Saharan African countries, including Zimbabwe. HIV prevalence is substantially high in Zimbabwe despite the significant progress made in the previous years. As the country moves closer to attaining the epidemic control status, there is a need for targeted HIV interventions focusing on HIV risk individuals. Most current HIV interventions are based on evidence about specific sub-population groups, undermining the diversity of individual risk levels within such groups. Therefore, this study applied random forest classifier, support vector machine, and logistic regression to predict HIV status outcomes using Zimbabwe Population-Based HIV Impact Assessment data to identify high-risk individuals and develop targeted interventions based on risk. This study shows that logistic regression outperformed the random forest classifier and support vector machine with the prediction accuracy of 85%, recall of 98%, and F1-score of 92%. However, the random forest classifier has the highest precision of 87% compared to the other models. The support vector machine outperformed the random forest classifier in recall and F1-score metrics, with a recall of 96% and F1-score of 91%. Machine learning models can help identify individuals at high risk of contracting HIV and assist policymakers in developing targeted HIV prevention and screening strategies informed with socio-demographic and risk behavioural data. However, this study only used socio-demographic and behavioural predictors to predict HIV status. There is a need to include other HIV clinical predictors to optimise HIV status prediction models better and further integrate them into real-world healthcare settings.
... It also reflects the ripple effect of the phenomenon as other partners risk being infected, making universities a possible breeding ground for STDs. Muchabaiwa and Mbonigaba (2019) in support of these findings reveals that youths in Zimbabwe generally exhibit poor decision-making abilities in relation to sexual and reproductive health rights and that this exposes them to unintended pregnancies, HIV/ AIDS infections, unsafe abortions, and other risky behaviors. Gore et al. (2011) further established that there was low uptake of HIV testing among the youth, many of which are in universities, indicating that this was a cause of concern. ...
While it remains uncontested that women and girls continue to face various kinds of sexual harassment at home, at work places and within societies, concerns over a trending phenomenon known as “thigh-for-marks” within university institutions have attracted close scrutiny from various interested stakeholders. This has prompted an exploration of the phenomenon in order to ascertain its implications on the educational as well as sexual and reproductive health rights of learners. Through qualitative lenses, the study found out that this form of sexual harassment is associated with intense psycho-emotional trauma, compromised educational output, loss of social capital and increased susceptibility to HIV/AIDS. Anchored on developmental social work principles, the paper advocates for robust sexual harassment policies within universities as well as clear reporting systems in order to safeguard the sexual and educational rights of students from outright infringement. The paper further argues for the adoption of a school social work model within institutions of higher learning in order to strengthen psycho-social support services in universities.
... Universally, bold commitments have been made by governments to uphold and safeguard Sexual Reproductive Health Rights (SRHR) of women and young girls (UNFPA, 2017;Singh et al., 2018). Currently, the fight to preserve SRHR for women and young girls is recognised through Sustainable Development Goal SDG 3, which aims to provide universal access to sexual and reproductive health services to all (Muchabaiwa and Mbonigaba, 2019). Over the years such international agendas have created a foundation on which countries continuously enact laws and policies that better protect vulnerable groups in the society and fight reproductive oppression (Hanskinsky, 2014). ...
... Comparable to most developing countries, Zimbabwe is not immune to the numerous SRH challenges that are experienced by women and adolescent girls (GoZ, 2016). About 40% of the young girls in Zimbabwe have sex before the age 18 and as a result the country experiences very high levels of teenage pregnancies and child marriages (Muchabaiwa and Mbonigaba, 2019). Statistics by the Ministry of Health and Child Care indicate that 24% of maternal deaths in the country occur among young women (10-24 years), who are part of the 30% total of the Zimbabwean population (GoZ, 2016). ...
... Although deaths attributed to HIV and AIDS have been decreasing in Zimbabwe over the last decade, due in part to increasing availability of antiretroviral treatment, and a significant number of new HIV infections are occurring in those aged 15-19 years (Rink and Won-Grunwald 2017). This increase in HIV infections among young adults is largely a result of the socio-economic issues prevalent in the country that include high risk sexual behaviours (multiple concurrent sex partners, inconsistent and incorrect condom use), high unemployment levels and drug use (Muchabaiwa and Mbonigaba, 2019). In a report by the Guttmacher Institute, Ahmed (2014) noted that the lack of empowerment among Zimbabwean women further increases their vulnerability to HIV and other sexually transmitted diseases as they are less able to refuse sex or insist on protected sexual activity. ...
... Universally, bold commitments have been made by governments to uphold and safeguard Sexual Reproductive Health Rights (SRHR) of women and young girls (UNFPA, 2017;Singh et al., 2018). Currently, the fight to preserve SRHR for women and young girls is recognised through Sustainable Development Goal SDG 3, which aims to provide universal access to sexual and reproductive health services to all (Muchabaiwa and Mbonigaba, 2019). Over the years such international agendas have created a foundation on which countries continuously enact laws and policies that better protect vulnerable groups in the society and fight reproductive oppression (Hanskinsky, 2014). ...
... Comparable to most developing countries, Zimbabwe is not immune to the numerous SRH challenges that are experienced by women and adolescent girls (GoZ, 2016). About 40% of the young girls in Zimbabwe have sex before the age 18 and as a result the country experiences very high levels of teenage pregnancies and child marriages (Muchabaiwa and Mbonigaba, 2019). Statistics by the Ministry of Health and Child Care indicate that 24% of maternal deaths in the country occur among young women (10-24 years), who are part of the 30% total of the Zimbabwean population (GoZ, 2016). ...
... Although deaths attributed to HIV and AIDS have been decreasing in Zimbabwe over the last decade, due in part to increasing availability of antiretroviral treatment, and a significant number of new HIV infections are occurring in those aged 15-19 years (Rink and Won-Grunwald 2017). This increase in HIV infections among young adults is largely a result of the socio-economic issues prevalent in the country that include high risk sexual behaviours (multiple concurrent sex partners, inconsistent and incorrect condom use), high unemployment levels and drug use (Muchabaiwa and Mbonigaba, 2019). In a report by the Guttmacher Institute, Ahmed (2014) noted that the lack of empowerment among Zimbabwean women further increases their vulnerability to HIV and other sexually transmitted diseases as they are less able to refuse sex or insist on protected sexual activity. ...
... Zimbabwe has adopted multi-pronged approaches to implement the 1994 International Conference on Population and Development (ICPD) action plan of improving adolescent sexual reproductive health (ASRH) outcomes. Policy and programmatic interventions are enunciated in a number of strategic documents, such as the National Reproductive Health Policy, Zimbabwe National HIV and AIDS Strategic Plan (ZNASP3) (Ministry of Health and Childcare (MoHCC) and National AIDS Council (NAC), 2017), National Health Strategy and the Educational Policy (Muchabaiwa and Mbonigaba, 2019). Although Zimbabwe has one of the highest rates of contraceptive use (68% among sexually active, unmarried women age 15-49) in Southern Africa (ZIMSTAT, 2016), there are still barriers that have limited access to dual protection among sexually active adolescents contributing to poor health outcomes. ...
... There is often conflict in trying to program and meet the needs of adolescents due to socio-cultural and legal expectations surrounding the sexuality of adolescents. For example, Muchabaiwa and Mbonigaba (2019) note that in their study, there was lack of impact on condom utilisation, which could be attributed to legal barriers in the distribution of condoms and contraceptives to school-going youth in Zimbabwe, which works against promoting safe sex. Additionally, the Zimbabwean laws require parental consent for anyone below the age of 18 to access services and information on contraception and STI prevention (Center for Reproductive Law and Policy (CRLP) and and the Child and Law Foundation (CLF), 2002). ...
Drawing on interviews and focus group discussions with 26 participants aged between 10 and 17, the paper describes sexual reproductive health problems, health-seeking behaviour, access to and utilisation of sexual reproductive health services among children living on the street in Harare. An intersectionality approach showed how participants’ social location, age and gender created vulnerabilities leading to STIs, maternal complications and sexual violence among others. Additionally, these factors contributed to challenges in accessing sexual reproductive health services among children living on the street. Thus there is need for tailor-made interventions to influence better health outcomes among children living on the street.
