Environmental Science and Health Publications

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Environmental Science and Health Publications

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Browsing Environmental Science and Health Publications by Author "Khozah, M. Y."

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    Exploring challenges to the uptake of sexual and reproductive health services among lesbian and bisexual women in Bulawayo, Zimbabwe: a qualitative enquiry
    (SAGE, 2024-09-19) Khozah, M. Y.; Nunu, W. N.
    Background: Reproductive healthcare is essential for all people, including lesbian and bisexual women. However, lesbians and bisexual women are among society’s most marginalised and excluded members. Objective: This study aimed to explore the challenges faced by lesbian and bisexual women in accessing Sexual and Reproductive Health (SRH) Services in Bulawayo, Zimbabwe. Design: An exploratory, descriptive qualitative study was conducted on two populations that included eight participants identified through the Voice of the Voiceless organisation in Bulawayo and 10 key informants and probed the challenges faced by lesbians and bisexual women when accessing SRH services. Methods: Data were gathered through 10 key informant interviews and 1 focus group discussion (FGD; with 8 participants). The interviews and FGDs were recorded, transcribed verbatim, coded and thematically analysed. Results: The themes that emerged included the uptake of SRH services among lesbians and bisexual women, the challenges faced by lesbians and bisexual women when accessing SRH services, and strategies to aid the uptake of SRH services by lesbians and bisexual women. The findings showed that the uptake of SRH services was generally low and was influenced by factors such as clinical settings. The challenges mentioned included stigma and the unavailability of specific lesbian and bisexual women’s services. By contrast, the most frequent strategies included affirmative training for healthcare providers and improved clinical settings to become friendly and inclusive. Conclusion: There is an imperative for targeted SRH services that address the distinct needs of lesbians and bisexual women, in line with the 95-95-95 strategy and Sustainable Development Goals target 3.7. The observed low uptake of these services can be attributed to several systemic barriers, including inadequate training of health providers, negative attitudes and lack of inclusive policies. Enhancing the sensitivity of health facilities, strengthening links to sexual health education and implementing supportive legal frameworks are essential steps to improve SRH outcomes in this population. These findings elucidate critical gaps within the current healthcare system and present significant opportunities for policymakers to formulate evidence-based strategies to ensure equitable access to SRH services, thereby advancing public health objectives.
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    Exploring the uptake of sexual and reproductive health services for lesbians and bisexual women in Bulawayo, Zimbabwe. A quantitative enquiry
    (SAGE, 2024-05-27) Khozah, M. Y.; Nunu, W. N.
    Background: Sexual and reproductive healthcare is essential for all individuals, including LGBTQ+ individuals. However, lesbians and bisexual women often lack tailored services, leading to underutilization. This study aimed to assess the availability and uptake of sexual and reproductive health services for lesbian and bisexual Bulawayo women. Methods: A cross-sectional study surveyed 67 lesbian and bisexual women recruited through the Voice of the Voiceless Organization. The participants completed a structured questionnaire on available services, factors influencing their uptake, and access challenges. Cross-tabulation was used to examine the associations between variables. Data were analyzed using Microsoft Excel and STATA Version 15 S.E. Results: Most respondents were bisexual women aged 35years. Cross-tabulations revealed significant associations between delayed or avoided services and the absence of specific services for lesbians and bisexual women as well as the presence of gender identity nondiscrimination policies. Conclusion: Sexual and reproductive health programs play a vital role in meeting lesbian and bisexual women’s needs. Improving service uptake requires strengthening the linkages between clinics and sexual health education programs, providing lesbian and bisexual women-friendly clinical services, and ensuring access to comprehensive information.
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    Policies and their Impact on Sexual and Reproductive Health Services Accessible by Lesbians and Bisexual Women in Zimbabwe
    (Bentham Open, 2024) Khozah, M. Y.; Nunu, W.N.
    Aims: Sexual and gender minority groups, such as lesbians, gays, bisexuals, and transgender people (LGBT), are often unjustly excluded from accessing Sexual and Reproductive Health services (SRH) in many countries. In Zimbabwe, most SRH policies are not sensitive to the needs of Gender and Sexual Minorities (GSMs), including lesbians and bisexual women. This study sought to review policies available in Zimbabwe and explore their influence on access to SRH services by lesbians and bisexual women. Methods: Relevant pieces of legislation that directly or indirectly influence issues regarding SRH service access and lesbians and bisexual women, were identified and analysed using a policy analysis triangle to provide contextual basis for the study. Findings from the policy review were presented in a table detailing the outcome of each policy under four critical pillars, i.e., Policy Content, Context, Actors, and Strategies. Results: Twelve policies were reviewed, including the Constitution of Zimbabwe and the Zimbabwe National HIV and AIDS Strategic Plan (ZNASP), to mention a few. The policy analysis revealed that the national constitution and other policies were not synchronised with Sexual and Reproductive Health and Rights policies and that the criminalisation of same-sex sexual practices in Zimbabwe is a fertile ground for all the other challenges faced by lesbians and bisexual women. Conclusion: The SRH program is crucial in fulfilling the immediate and future SRH requirements. Based on the findings, most current policies are silent on the SRH needs of lesbians and bisexual women. These policies are misaligned with the national constitution, hindering them from accessing SRH services.
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    Sexual and Gender Minorities Inclusion and Uptake of Sexual and Reproductive Health Services: A Scoping Review of Literature
    (SAGE, 2023-06-07) Khozah, M. Y.; Njabulo Nunu, W. N.
    Despite the efforts to ensure that sexual and reproductive health services are integrated into global, regional, and national initiatives, a significant number of countries are overwhelmed by frames of exclusion and violations of fundamental human rights, particularly for sexual and gender minority groups such as lesbians, gays, bisexuals, and transgender people. This study sought to review the literature on access and barriers faced by sexual and gender minorities. A scoping literature review was conducted on literature that focused on sexual and gender minorities and sexual and reproductive health services and published in the English language. Studies were independently screened and coded, categorizing themes such as policies, uptake of services, barriers to sexual and reproductive health access, and strategies to aid the uptake of services. The search yielded 1,148 literature sources, of which 39 met the inclusion criteria and were reviewed. The average sexual and reproductive health service uptake was generally low overall and was influenced by factors such as clinical settings, punitive laws, and availability of services specific to sexual and gender minorities. Noted strategies to aid sexual and reproductive health uptake include education, friendly health care facilities, availability of specific services, and legislative reform. The sexual and reproductive health program is an important component of short-term and long-term sexual and reproductive health needs. Health intervention initiatives targeted at improving or increasing sexual and reproductive health uptake must be supported by suitable legal and regulatory framework contexts and based on context-specific evidence.