Browsing by Author "Lebese, R. T."

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    Exploring Adolescent Sexual Health Practices and Outcomes in Umguza and Mberengwa Districts in Zimbabwe
    (The Open Public Health Journal, 2022-07-20) Nunu, W. N.; Makhado, L.; Mabunda, J. T.; Lebese, R. T.
    Background: Worldwide, adolescents have had limited access to reproductive health services due to several factors. The nature of communities and their organisations play a significant role in shaping adolescent sexual behaviours and practices. This study sought to explore the extent of the influence of community environmental factors in moulding adolescent sexual behaviours in Mberengwa and Umguza districts. Methods: A quantitative cross-sectional survey was conducted on 370 and 360 systematically selected adolescents in Mberengwa and Umguza districts, respectively, using a pre-tested researcher-administered questionnaire. The collected data was captured in Excel and imported to STATA Version 13 Standard Edition for analysis. Different statistical methods (both descriptive and inferential) were utilised to interrogate collected data and inferences made. Results: Most respondents were female and were between 13-17 years. Most of the respondents were literate. Umguza district had a significantly higherprevalence of pregnancies, Sexually Transmitted Infections, and a higher number of adolescents engaging in sexual activities. Predictors of Sexually Transmitted Infections and pregnancies were the sex of the respondent, tribe, sexual encounters, age, and religion. Conclusion: Adolescents are at risk of contracting Sexually Transmitted Infections and impregnation as they engage in risky sexual behaviours, as evidenced by the findings. The two districts have a significantly higher prevalence of having sex than the national average
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    Health service providers’ perspectives on the infuence of modern health systems on adolescents’ sexual health practices in Umguza and Mberengwa districts of Zimbabwe
    (BMC, 2022) Nunu, W. J.; Makhado, L.; Mabunda, J. T.; Lebese, R. T.
    Background: Health service providers play a significant role in crafting and implementing health policies and programs that manage adolescent sexual health-related issues at different health system levels. These influence adolescent sexual behaviours and practices. Aim: This study explored the roles of health service providers in managing adolescent sexual issues and how this impacts their sexual behaviours and practices. The study further probed the health service providers on how the indigenous health system could be integrated into the modern health system for effective management of adolescent sexual health related issues. Methods: A qualitative cross-sectional survey was conducted on purposively selected health service providers in health facilities in Mberengwa and Umguza districts. Data was collected using unstructured interviews that were recorded, transcribed verbatim, and thematically analysed. Findings were presented as clearly defined as superordinate and subordinate themes. Results: A total of five superordinate themes and 19 subordinate themes emerged from the interrogated data. The superordinate themes were: overview of adolescent sexual health issues, role of modern health system in adolescent sexual health issues, challenges encountered, indigenous health system factors that could be factored into modern health systems, and strategies to foster the integration of indigenous health system and modern health system. The subordinate themes explored in-depth the findings of the key stakeholders under the five superordinate themes. Conclusions: From the findings, it can be concluded that health service providers play an essential role in shaping and providing adolescent sexual health services that adolescents utilise despite challenges that have reduced demand for these services. Therefore, there is a need to point out that there is a window of opportunity to foster collaborations between the indigenous health system and the modern health system as they strive to serve the adolescents to the best of their ability though in different contextual settings.
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    Indigenous Health Systems and Adolescent Sexual Health in Umguza and Mberengwa Districts of Zimbabwe: Community Key Stakeholders’ Perspectives
    (SAGE, 2021-04-06) Nunu, W. N.; Makhado, L.; Mabunda, J. T.; Lebese, R. T.
    Different stakeholders play varying roles in shaping up adolescent sexual behaviours that, in turn, influence their sexual experiences. In Zimbabwe, it has been reported that adolescents from cultural districts exhibit poor sexual health outcomes as compared to other districts. Therefore, this study sought to explore the role of different key community stakeholders in the indigenous health system and how it impacts on adolescent sexual health issues. The study further explored how the indigenous health system could be integrated into the modern health system. A qualitative cross-sectional survey was conducted on purposively and snowballed respondents in Umguza and Mberengwa districts. Interviews and focus group discussions were used to gather and record data from participants. The recorded data were transcribed verbatim, translated to English, coded and thematically analysed on MAXQDA Analytics Pro 2020. Four superordinate and 12 subordinate themes emerged from the data during analysis. Stakeholders play varied roles in adolescents’ upbringing and support though there are contradicting teachings from the indigenous health system and modern health system. It is possible to integrate these two systems though there were foreseen logistical challenges and clashes in the values and belief systems. Participants made suggestions on how these challenges could be overcome. There is a window of opportunity to pursue the suggested ways of integrating indigenous health systems and modern health systems for improved adolescent sexual health outcomes.
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    Strategies to facilitate safe sexual practices in adolescents through integrated health systems in selected districts of Zimbabwe: a mixed method study protocol
    (BMS, 2020) Nunu, W. J.; Makhado, L.; Mabunda, J. T.; Lebese, R. T.
    Background: Zimbabwe has the highest teenage pregnancy rate in Sub Saharan Africa. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence in adolescents that are from tribes that perform cultural initiations and subscribe to certain norms are higher than the national prevalence which is estimated at 12% (18 and 13.6% respectively) in Zimbabwe. Indigenous Health Systems (IHSs) and Modern Health Systems (MHSs) in Zimbabwe run parallel thereby introducing challenges in the management of adolescent sexual health due to conflicts. This study seeks to develop strategies that will facilitate the integration of IHSs and MHS in Mberengwa and Umguza districts. Methods: This research will be conducted in two phases. The first phase would utilise a concurrent triangulation mixed methods design with both qualitative and quantitative approaches. The findings from the qualitative and quantitative approaches would be merged through a comparison of findings side by side. The second phase would focus on the development and validation of strategies that would facilitate the integration of IHSs and MHSs. The Strength, Weakness, Opportunity and Threat (SWOT) analysis would be applied on interfaced findings from phase one. The Basic Logic and the Build, Overcome, Explore and Minimise (BOEM) models would then be used to develop strategies based on the SWOT findings. The developed strategies would be validated through the application of Delphi technique and administration of checklist to selected key stakeholders through organised workshops. Discussion: There have been no known studies found in the literature that explores the possibility and developed strategies of integrating IHSs and MHSs so as to promote safe sexual practices in adolescents. Most programs on sexual health have ignored the role of IHSs and MHSs in influencing safe sexual practices leading to them failing to attain desired goals. A lot of emphases has been targeted at minimising the spread of Sexually Transmitted Infections (STIs) through advocating for utilisation MHSs rather than focussing on an integrating systems that are meant to manage Adolescent Sexual Health (ASH) related issues. The study protocol was approved by the University of Venda Ethics Committee Registration (SHS/19/PH/17/2608) on the 26th of August 2019.
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    Validating Developed Strategies for Integrating Indigenous Health and Modern Health Systems for Improved Adolescent Sexual Health outcomes in Umguza and Mberengwa Districts in Zimbabwe
    (CrossMark, 2021-12-08) Nunu, W. N.; Makhado, L.; Mabunda, J. T.; Lebese, R. T.
    Background: Adolescent Sexual Health strategies developed and implemented in different country settings need to be contextualised through validation to align with the populace's needs. This study sought to validate developed strategies meant to facilitate the integration of Indigenous Health System and Modern Health System for improved Adolescent Sexual Health outcomes. Methods: The Delphi Technique was used to validate the strategies by recruiting fifteen experts in Indigenous Health systems, Health Systems and Policies, Adolescent Sexual Health and Program, Guideline, and Strategy Development to evaluate the developed strategies and assess their feasibility. Furthermore, 100 key stakeholders in Umguza and Mberengwa responded to a semi-structured checklist to express their opinions on the developed strategies and their feedback used to refine the strategies. Results: Experts suggested minor changes to one strategy and agreed with the other four strategies. Most key stakeholders (97%) endorsed the proposed strategies. The strategies were, therefore, refined and presented as per the suggestions of these consulted actors. Conclusion: Therefore, it is imperative that these strategies be piloted and implemented in the two districts and the progress monitored and evaluated. Suppose they are yielding positive results in as far as Adolescent Sexual health-related issues are concerned. In that case, an implementation must be expanded and rolled out in other districts that have a similar setup.