Browsing by Author "Nunu, W. N."

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    Developing Strategies for Integrating Indigenous Health and Modern Health Systems for Improved Adolescent Sexual Health Outcomes in Umguza and Mberengwa Districts in Zimbabwe
    (SAGE, 2021-07-07) Nunu, W. N.; Makhado, L.; Mabunda, J. T.; Lebese, R. L.
    Background: Strategies to improve sexual health outcomes have evolved over the years due to technology’s evolution to ensure that they are relevant. Challenges have been noticed in different systems that run parallel, particularly in Low-Income Countries where the majority utilise Indigenous Health Systems. Optimisation of resources and minimisation of conflicts could be realised through integrated health systems in the management of adolescents’ sexual health issues. This study sought to develop strategies to facilitate Indigenous Health System and Modern Health System integration to improve the management of Adolescent Sexual Health issues, leveraging results from 3 papers. Methods: A multi-stage approach was utilised, with Phase 1 focusing on a preliminary assessment through merging findings from the 4 papers. The Strengths, Weaknesses, Opportunities, and Threats analyses were then used, followed by the Basic Logic Model to identify critical aspects that needed to be considered in building the strategies. The second phase used the Build, Overcome, Eliminate and Minimise framework to build the strategies. Results: A total of 5 strategies were proposed to facilitate this integration, and these included revival of committees that were inclusive of all stakeholders; allocating Indigenous Health System space in clinics to work in; establishing adolescent-friendly clinics; intensifying information dissemination on sexual health-related issues, and developing clear Terms of Reference and procedures to govern this integration and ensure it is a success. Conclusions: Implementing these strategies could facilitate this integration and ensure that programs are planned and implemented in a complementary manner, thereby reducing conflicts between the 2 systems and ensuring collaborative efforts towards shared goals that would transform to better Sexual Health Outcomes for adolescents.
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    Effects of COVID-19 Among People With Disabilities in Plumtree, Zimbabwe: A Mixed-Method Survey
    (SAGE, 2024-07-24) Ndlovu, L.; Mudonhi, N.; Sibanda, N.; Nunu, W. N.; Manyeruke, N.
    Introduction: Persons with disabilities are the most affected by rising pandemics worldwide. COVID-19 has affected people with disabilities in many areas of their lives; however, its impact has been overlooked. This study aimed to assess the effects of COVID-19 on people with disabilities in Plumtree, Zimbabwe, to develop a disability-inclusive approach in response to COVID-19. Methods: A concurrent mixed-methods approach was used to collect qualitative and quantitative data from 7 key informants and ninety-two participants with disabilities, from January to May 2023. Quantitative data were analysed using STATA software version 12 and Microsoft Excel. Multiple Logistic Regression, Chi-square test, and paired-sample test were used to test for associations among COVID-19 cases, source of income, key challenges, and demographic characteristics. Qualitative data were analysed and presented in the form of themes. Results: We recruited more females (56.5%) than males with disabilities, and more than half were unemployed (56.5%). In contrast, only 3.3% of the respondents were formally employed. The results also indicated a significant relationship between age and COVID-19 positivity (P = .025). The results also indicated that efforts were being made by government and non- non-governmental departments to assist people with disabilities during the pandemic through finance, food, awareness campaigns, and social support. Conclusion: Restriction measures put in place disturbed the livelihood of people with disabilities in Plumtree. Therefore, entrepreneurship programmes targeting vulnerable groups, including people with disabilities, should be introduced to ensure that their sources of income are sustained despite emergencies or pandemics.
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    Effects of COVID-19 on malaria elimination initiatives in sub-Saharan Africa: a scoping review protocol
    (BJM Open, 2023-09-28) Nunu, W. N.; Ndirangu, J.; Tsoka-Gwegweni, J.
    Introduction: The occurrence of the COVID-19 pandemic significantly impacted health systems, resulting in varied outcomes of different variables in terms of health. Due to the nature of the causative organism that is spread mainly in the air, the disease rapidly spread to numerous countries, leading to a series of mitigation measures being proposed and implemented, including but not limited to travel restrictions, decongesting and in some instances closure of workplaces and schools and banning of social gatherings. This could have negatively impacted implementing strategies meant to ensure the effective management of malaria, hoping to eliminate it in different countries in sub-Saharan Africa (SSA). This review seeks to explore the effect of the COVID-19 pandemic on malaria elimination initiatives in SSA. Methods and analysis: An exploratory scoping review will be conducted on literature (searched using keywords and a search strategy) sources published in English on Web of Science, Cochrane Library, PUBMED, Dimensions, ProQuest, Scopus and African Journals Online. These would then be imported to Rayyan Software for screening for possible inclusion. The JBI Guidelines on Reviews, Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist would guide the data collection, extraction and analysis from the accessed literature. Furthermore, charting, trends and developing themes would ensure the findings are presented comprehensively and yet understandable. The data collection and analysis process leading to the final submission of a review paper to a journal will be conducted from September 2023 to February 2024. Ethics and dissemination: An application for ethical approval was lodged with the Health Sciences Research. Ethics Committee at the University of the Free State in Bloemfontein, South Africa. This ethics committee granted ethics clearance (ethics number: UFS-HSD2022/1754). Results will be communicated through peer-reviewed publications, presentations, conferences, workshops and other means and forums to reach the critical stakeholders.
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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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    Exploring Barriers and Facilitators That Influence Uptake of Oral Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in Bulawayo, Zimbabwe: Key Stakeholder’s Perspectives
    (SAGE, 2023-12-08) Moyo, P. L.; Nunu, W. N.
    The world has been on the path to ending HIV and AIDS as a global threat by 2030; despite these efforts, the rate of new HIV infections among men who have sex with men remains very high. This study sought to explore the perceptions of key stakeholders on the potential barriers and facilitators of pre-exposure prophylaxis use among this key population. An exploratory, descriptive (through interviews) qualitative study was conducted on 10 key informants who were purposively selected and snowballed based on their knowledge and experience toward pre-exposure prophylaxis programming among men who have sex with men. The interviews were recorded, transcribed verbatim, coded, and thematically analyzed on MAXQDA. Stated barriers were stigma, lack of information, wrong messaging around pre-exposure prophylaxis, hearing negative things about the pills, the burden of taking pills daily, negative attitudes from health care providers, non-friendly health care facilities, pre-exposure prophylaxis not being affordable, and lack of flexibility and privacy from public hospitals. Identified facilitators were correct messaging on pre-exposure prophylaxis, long-lasting injectable pre-exposure prophylaxis, improved packaging, de-stigmatization, more friendly facilities, differentiated service approach, community groups, engagement, and partnership. To address these barriers and leverage the facilitators, it is imperative to have accessible, affordable services, non-judgmental health care providers, and peer support networks to empower men who have sex with men to make informed decisions regarding their sexual and reproductive health. Continued efforts to remove barriers and promote facilitators are crucial for maximizing the potential of pre-exposure prophylaxis as an effective HIV prevention tool among this population.
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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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    Factors Influencing Patient Satisfaction with Healthcare Services Offered in Selected Public Hospitals in Bulawayo, Zimbabwe
    (The Open Publuc Halth Journal, 2021-03) Nyakutombwa, C.; Nunu, W. N.; Mudonhi, N.; Sibanda, N.
    Introduction: Patient satisfaction with health care services is vital in establishing gaps to be improved, notably in public health facilities utilised by the majority in Low and Middle-Income Countries. This study assessed factors that influenced patient satisfaction with United Bulawayo Hospitals and Mpilo Hospital services in Bulawayo in Zimbabwe. Methods: A cross-sectional survey was conducted on 99 randomly selected respondents in two tertiary hospitals in Bulawayo. Chi-squared tests were employed to determine associations between different demographic characteristics and patient satisfaction with various services they received. Multiple Stepwise Linear regression was conducted to assess the strength of the association between different variables. Results: Most of the participants who took part in the study were males in both selected hospitals. It was generally observed that patients were satisfied with these facilities' services, symbolised by over 50% satisfaction. However, patients at Mpilo were overall more satisfied than those at United Bulawayo Hospitals. Variables “received speciality services,” “average waiting times,” and “drugs being issued on time” were significant contributors to different levels of satisfaction observed between Mpilo and United Bulawayo Hospitals. Conclusion: Generally, patients are satisfied with the services and interactions with the health service providers at United Bulawayo Hospitals and Mpilo Hospitals. However, patients at Mpilo were more satisfied than those at United Bulawayo Hospitals. There is generally a need to improve pharmaceutical services, outpatient services, and interaction with health service provider services to attain the highest levels of patient satisfaction.
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    Health effects associated with proximity to waste collection points in Beitbridge Municipality, Zimbabwe
    (ELSEVIER, 2020-02-26) Nunu, W. N.; Munyai, O.
    Population growth, urbanisation and economic development have led to the increasing generation of municipal solid waste while environmentally sustainable management remains a challenge the world over. This study sought to investigate health effects associated with proximity to waste collection points in Beitbridge Municipality, Zimbabwe. A cross-sectional study was undertaken to compare the occurrence of disease among the residents living within different distances from the waste collection points (50 m, 100 m, 150 m, 200 m, 250 m, 300 m and above 300 m). A handheld GPS device was used to collect coordinates of the location for the purposes of mapping. The Fishers Exact test and the Multiple Logistic Regression model conducted (on STATA V 13 SE) to determine the association between different variables and the occurrence of health effects. Questionnaires were administered to 700 stratified randomly selected respondents. Five refuse collection points and spatial distribution of health conditions were mapped at Dulibadzimu high-density suburb. The overall response rate was 98% and females constituted the majority of respondents (58%). Most of these respondents were aged between 26 and 35 years of age and were involved in informal trading (35%). Reported health conditions were diarrhoea, dyspnoea, dry cough, eye irritation and asthma. Distance, waste collection point, level of education, nature of occupation and sex were significant contributors to the prevalence of health effects associated with exposure to waste. Exposure to waste is a serious health concern in Beitbridge. Local authority is encouraged to abolish these waste collection points and invest more on conventional waste management systems in partnership with different stakeholders.
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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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    Knowledge of Students regarding HIV/AIDS at a Rural University in South Africa
    (The Open Aids Journal, 2021-07) Murwira, T. S.; Khoza, L. B.; Mabunda, J. T.; Maputle, T. S.; Mpeta, M.; Nunu, W. N.
    Introduction: Knowledge about HIV/AIDS is essential for facilitating safer sexual behaviour hence, it is important in controlling HIV. Therefore, in the absence of a cure for the pandemic, adequate knowledge about the virus remains the backbone of prevention efforts. Objective: To assess the knowledge regarding HIV/AIDS among undergraduate students at a rural university in Limpopo Province, South Africa. Methods: A cross-sectional descriptive quantitative survey-based study was conducted at a rural-based university in South Africa. Stratified random sampling was used to select 345 students. A self administered questionnaire composed of 26 questions was utilised to gather data and the data were analysed using SPSS version 26. Multiple logistic regression and chi-square tests [χ2] were employed to determine the association between HIV/AIDS knowledge and demographic variables. Results: The overall HIV/AIDS knowledge score of students shows that (74)21% had a poor level of knowledge, (126)37% had average knowledge, and (145)42% had adequate knowledge. There was no significant difference between male and female students regarding their knowledge about HIV/AIDS. Factors, such as age, level of study, the field of study, and religion, were not significantly associated with HIV/AIDS knowledge. However, the race was significantly associated with knowledge with coloureds and mixed races, almost six times less knowledgeable than blacks. Conclusion: In conclusion, students had inadequate knowledge about HIV/AIDS. Misconceptions about HIV/AIDS facts, transmission routes, and prevention aspects were also prevalent among students. The present study accentuates the need for providing students with more HIV/AIDS education to fill HIV knowledge gaps and misconceptions.
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    Maternal Complications Among Women with Disabilities in Bulawayo, Zimbabwe
    (Bentham Open, 2024) Mpofu, L.; Mudonhi, N.; Mpofu, M. W.; Sibanda, N.; Nunu, W. N.; Ndlovu, V.; Manyeruke, N.
    Background: Maternal complications are the third most common cause of maternal mortality, contributing to a significant percentage of all maternal deaths, with the largest burden estimated in developing countries, especially in Africa. Many studies have been conducted in relation to maternal complications experienced by women in different parts of the world; little attention has been given to women with disabilities in relation to their pregnancy outcomes or complications. This study sought to explore maternal complications among women with different types of disabilities in the City of Bulawayo, Zimbabwe. Methodology: A quantitative cross-sectional survey (using a semi-structured questionnaire) was conducted on 71 women living with disabilities accessed through the register kept at the National Council for Disabled Persons of Zimbabwe. The collected data were cleaned, coded, and analyzed using STATA version 15. Logistic regression analysis was used to determine the factors contributing to maternal complications. Descriptive analyses were conducted to explore participants’ sociodemographic and disability profiles and cross-tabulation of different types of disability and maternal complications experienced. Statistical significance was set at P < 0.05. Regression analysis was performed to ascertain the relationship between disability and maternal complications. Results: The findings showed that the most dominant age was the 26-35 age group (40.07%), while the types of disabilities that were most noted were wheelchair-bound (25%), deaf (26.4%), and speech impairment (26.4%). An association was established between level of education (p = 0.000), employment status (p = 0.0033), and different types of disability. Gravida (p-value 0.04), number of live births (p-value 0.022), deformed limbs (p-value 0.014), and age group were established to be significant in terms of contributing to maternal complications. There was no statistical evidence for an association between disability and maternal complications. Conclusion: Overall, women with disabilities experience maternal complications similar to those of other women. However, some contributing factors may aggravate the occurrence of maternal complications in women with disabilities. Provision of adequate resources and improvement of infrastructure in health facilities to cater to women with disabilities.
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    Modelling an Optimal Climate-Driven Malaria Transmission Control Strategy to Optimise the Management of Malaria in Mberengwa District, Zimbabwe: A Multi-Method Study Protocol
    (MDPI, 2025-03-29) Dhlamini, M.; Chivasa, T.; Maviza, A.; Nunu, W. N.; Tsoka-Gwegweni, J.
    Malaria is a persistent public health problem, particularly in sub-Saharan Africa where its transmission is intricately linked to climatic factors. Climate change threatens malaria elimination efforts in limited resource settings, such as in the Mberengwa district. However, the role of climate change in malaria transmission and management has not been adequately quantified to inform interventions. This protocol employs a multi-method quantitative study design in four steps, starting with a scoping review of the literature, followed by a multi-method quantitative approach using geospatial analysis, a quantitative survey, and the development of a predictive Susceptible-Exposed-Infected-Recovered-Susceptible Geographic Information System model to explore the link between climate change and malaria transmission in the Mberengwa district. Geospatial overlay, Getis–Ord Gi* spatial autocorrelation, and spatial linear regression will be applied to climate (temperature, rainfall, and humidity), environmental (Land Use–Land Cover, elevations, proximity to waterbodies, and Normalised Difference Vegetation Index), and socio-economic (Poverty Levels and Population Density) data to provide a comprehensive understanding of the spatial distribution of malaria in Mberengwa District. The predictive model will utilise historical data from two decades (2003–2023) to simulate near- and mid-century malaria transmission patterns. The findings of this study will be used to inform policies and optimise the management of malaria in the context of climate change.
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    Molecular detection of Imbrasia belina proteins associated with allergic reactions on harvesters and consumers from selected districts in Matabeleland: a comparative study
    (Springer, 2023-07-13) Dlamini, W.; Nunu, W. N.; Ndlovu, V.; Nleya, N.; Mudonhi, N.; Sibula, M.
    Background: Harvesting and consuming insects (entomophagy), particularly Imbrasia belina is widespread in developing countries like Zimbabwe. Due to their extraordinary nutritional content, tastiness, ease of processing and storage, Imbrasia belina has become a delicacy, reachable nutritious complement, and money source for some people in Zimbabwean communities. However, some harvesters and consumers have become allergic to the Imbrasia belina, popularly known as Mopani worms. This has been attributed or associated with the changes in the genetic structure of Imbrasia belina. Therefore, this research sought to compare the presence of the genes associated with allergic reactions to mopane worms from Gwanda and Umguza districts in Zimbabwe. Methods: A lab-based observational study was conducted on collected Imbrasia belina samples from both districts. Fifteen samples of mopane worms were collected from each district, and DNA extraction was performed using DNeasy blood and tissue kit. The DNA extraction products were then amplified using a Polymerase chain reaction. The polymerase chain reaction products were run on agarose gel electrophoresis to determine the presence of the target genes. Results: Three of the five samples from Gwanda district were positive for the tropomyosin gene, whereas two samples from Umguza district were positive. All the samples from the two districts were negative for arginine kinase genes. Conclusion: The study results highlighted that allergic reactionsto Imbrasia belina reported in Gwanda district are associated with the presence of the tropomyosin gene, which has undergone polymorphism. Responsible authorities such as Gwanda local authority should develop bylaws that govern Imbrasia belina harvesting in the district.
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    Oral Pre-Exposure Prophylaxis Accessibility, Knowledge, Barriers, and Facilitators Among Men Who Have Sex With Men in Bulawayo, Zimbabwe
    (SAGE, 2023-09-27) Moyo, P. L.; Nunu, W. N.
    Great strides have been made globally toward ending HIV and AIDS as a threat by 2030, although the rate of new HIV infections among men who have sex with men remains very high. Due to their risk of getting HIV and AIDS, utilization of pre-exposure prophylaxis (PrEP) can potentially reduce the risk of HIV transmission among this population. This study sought to analyze the accessibility, knowledge, and potential barriers and facilitators to assessing PrEP by men who have sex with men. The quantitative method was conducted on 65 men who have sex with men through questionnaires loaded on Kobo Collect. Chi-square test, odds ratios, and logistic regression were used to associate different demographic characteristics with knowledge and significance of barriers in PrEP access using STATA 15. A hotspot map of PrEP and locations was created using QGIS. About 84% of respondents accessed pills from friendly facilities. The remaining accessed them from public hospitals, namely Mpilo and United Bulawayo Hospitals. Over 90% of the respondents were found to be highly knowledgeable. Notably, barriers included lack of information, fear of side effects, pills not accessible, pill taste, odor and size, stigma, and lack of protection from other sexually transmitted infections. Facilitators were educated about PrEP, the existence of friendly health facilities, making pills available at all times, partner support, increased number of friendly health facilities and support groups. Maximizing the potential of PrEP as an efficient HIV-prevention intervention among this population requires ongoing efforts to remove barriers and promote facilitators.
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    Oral Pre-exposure Prophylaxis Uptake and Acceptability Among Men Who Have Sex With Men: A Scoping Review of the Literature
    (SAGE, 2023-08-31) Moyo, P. L.; Nunu, W. N.
    Despite the global effort to end the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) epidemic as a global threat by 2030, the rate of new HIV infections worldwide remains unacceptably high among men who have sex with men, hence the need to use pre-exposure prophylaxis (PrEP) to reduce the risk of HIV infection. This population has an increased risk of getting HIV; thus, it is imperative to assess the uptake and acceptability of PrEP. This study investigated the willingness, availability, accessibility, and knowledge and identified barriers and facilitators to using PrEP among this population. A scoping literature review search was conducted on research papers published in English and focused on men who have sex with men and their use of PrEP. These were independently screened and coded. Of about 1,202 literature sources, 55 were included in the study. Findings reported that the uptake and acceptability of PrEP were influenced by knowledge and perception of being high-risk. Generally, PrEP uptake and understanding were high in North America, Latin America, and Europe and low in Asia and Africa. Low uptake and acceptability have been largely attributed to fear of side effects, societal stigma, cost, and perception of not being at risk. Noted facilitators to PrEP use include education, availability of free pills, support groups, and friendly health care facilities. Health intervention programs to increase the use of PrEP must be backed by appropriate legal and regulatory frameworks.
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    Perceptions and Experiences of Males who have Sex with Men Regarding Sexual and Reproductive Health Services in Bulawayo, Zimbabwe
    (The Open Public Health Journal, 2022-06-30) Munyimani, T.; Nunu, W. N.
    Background: Sexual and Reproductive Health services are a cornerstone for each nation to achieve Sustainable Development Goal Number 3, which challenges nations to ensure healthy lives and promote the well-being of all ages, including access to SRH services. Generally, stigma and policies against men who have sex with men have heightened the risk of getting and spreading sexually transmitted diseases in this key population. This study, therefore, sought to explore men who have sex with men's perceptions and experiences of sexual and reproductive health services offered in Bulawayo in Zimbabwe. Methods: An exploratory, descriptive qualitative study was conducted on twenty-four (24) purposively selected men who had sex with men identified through Sexual Rights Centre in Bulawayo. The study participants responded to unstructured interview questions that probed on their lived experiences and perceptions of sexual and reproductive health services offered by health facilities in the city of Bulawayo. The interviews were recorded, transcribed verbatim, coded, and thematically analyzed on MAXQDA Version 20 Pro. Results: Findings suggested that men who had sex with men sought a wider range of sexual and reproductive health services that ranged from voluntary counseling and testing, treatment of sexually transmitted infections, and obtaining pre-exposure prophylaxis tablets, among other issues. However, men who had sex with men faced discrimination, stigma, and hostile treatment by some health service providers. This scenario, in some instances, is perceived to have fueled their vulnerability and led to internalized homophobia. Conclusion: In pursuit of Sustainable Development Goal Number 3, which challenges all nations to ensure healthy lives and promote well-being at all ages, men who have sex with men are not fully accorded their rights. Therefore, there is a need to reorient health services and align policies to ensure the inclusion of this key population in accessing and utilizing sexual and reproductive health services.
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    Risk factors associated with a high incidence of sexually transmitted infections in Beitbridge, Zimbabwe
    (AOSIS, 2022) Siziba, A.; Nunu, W. N.; Mudonhi, N.; Ndlovu, V.; Munyai, O.; Ndlovu, B.; Sanganyado, E.
    Sexually transmitted infections (STIs) are a major public health challenge, particularly in developing countries where the health infrastructure is often poor. Despite having a number of interventions in Beitbridge (such as the 24-h wellness centre), Zimbabwe, the incidence and prevalence of STIs is increasing. This study, therefore, aims to assess the risk factors associated with the high incidence of STIs in urban Beitbridge. A case-control study was conducted on 30 respondents who had suffered from STIs (selected from the registers at Beitbridge hospital and followed up) and 90 respondents who had not suffered from STIs (from the community) who resided in Beitbridge for at least 6 months and this excluded all those who were in transit. The factors contributing to the high incidence of STIs were identified using a pretested interviewer-administered semi-structured questionnaire in conjunction with a Likert scale to establish the attitudes and risk behaviours of the respondents on STIs. A significant association was observed between high STI incidences and the nature of occupation (odds ration [OR]: 3.8), area of residence (OR: 2.78), number of sexual partners (OR: 7.56), payment demanded for sex (OR 22), condom use (OR: 3.7), alcohol use (OR: 2.86),and suspicion that partners had other sexual companions (OR: 15.5). Furthermore, a larger proportion of controls were knowledgeable on STIs as compared to the cases who participated in the study. There is a need to develop awareness strategies that foster safe sexual practices, particularly among populations who do not choose abstinence or a single sexual partner lifestyle.
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    Sustainability of water facilities under community based management in Zimbabwe
    (Iwa Publishing, 2022) Kativhua, T.; Nunu, W. N.; Madzivanyika, T. T.; Macherera, M.; Chinyama, A
    Community Based Management (CBM) has been envisaged as a panacea to sustainability challenges faced in the Water Sanitation and Hygiene (WASH) sector globally. In spite of this approach having success stories, studies have shown that failures are also being recorded. This study investigated the sustainability of rural water supply facilities under the CBM approach in Chipinge District of Zimbabwe. The specific objectives were to assess the technical, financial and institutional factors influencing sustainability. A cross sectional study design was used. Data was collected using Focus Group Discussions, Key Informant Interviews, household questionnaires and an observation checklist. Quantitative data was analysed using SPSS and Microsoft Excel while qualitative data was analysed using the thematic approach. Results showed that the technical factors which are influencing sustainability are age of the water facility, frequency of carrying out preventive maintenance and existence of external support. Regression analysis showed a positive linear correlation between age and breakdown frequency (R2 ¼ 0.46) and the odds of obtaining a breakdown decreased as the frequency of preventive maintenance increased. User communities were contributing inadequate O&M funds resulting in long downtimes. Non-functionality of WPCs negatively influenced sustainability. The study recommends training of user communities on CBM and technical skills.
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    Traditional Medicine Utilisation Among Pregnant Women in Sub-saharan African Countries: A Systematic Review of Literature
    (SAGE, 2021-11-18) Mudonhi, N.; Nunu, W. N.
    Traditional medicine has the potential to boost the health and economies of many SSA countries, especially if regulatory mechanisms are deployed to govern their protection and utilisation. There is lack of knowledge regarding traditional medicines and their impact on pregnancy. This paper reviews the literature on traditional medicine utilisation among pregnant women in Sub-Saharan African countries. The paper, determined the proportion of pregnant women utilising traditional medicines in Sub-Saharan Africa, identified the different types of traditional medicine used during antenatal care and reasons for Use in Sub-Saharan Africa and also identified challenges that are faced by women who use traditional medicine in antenatal care. A systematic exploratory review was conducted guided by the PRISMA framework. The databases that were searched included Google Scholar, PubMed, Cochrane, HINARI and the World Health Organization. Forty-one literature sources were eligible and included in the review process. Reported traditional medicine utilisation ranged between 12 and 93% among pregnant women in Sub-Saharan Africa. Different types of traditional medicines have been utilised in Sub-Saharan Africa for different purposes. Safety and poor management of usage were reported to be some of the challenges associated with traditional medicine. There is a need to determine chemical components and mode of action of these herbs as some could be beneficial, whilst others harmful, leading to severe pregnancy complications.