Environmental Science and Health

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Micro-spatial distribution of malaria cases and control strategies at ward level in Gwanda district, Matabeleland South, Zimbabwe
(BioMed Central, 2017) Manyangadze, T.; Chimbari, M.J.; Macherera, M.; Mukaratirwa, S.
Background Although there has been a decline in the number of malaria cases in Zimbabwe since 2010, the disease remains the biggest public health threat in the country. Gwanda district, located in Matabeleland South Province of Zimbabwe has progressed to the malaria pre-elimination phase. The aim of this study was to determine the spatial distribution of malaria incidence at ward level for improving the planning and implementation of malaria elimination in the district. Methods The Poisson purely spatial model was used to detect malaria clusters and their properties, including relative risk and significance levels at ward level. The geographically weighted Poisson regression (GWPR) model was used to explore the potential role and significance of environmental variables [rainfall, minimum and maximum temperature, altitude, Enhanced Vegetation Index (EVI), Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI), rural/urban] and malaria control strategies [indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs)] on the spatial patterns of malaria incidence at ward level. Results Two significant clusters (p < 0.05) of malaria cases were identified: (1) ward 24 south of Gwanda district and (2) ward 9 in the urban municipality, with relative risks of 5.583 and 4.316, respectively. The semiparametric-GWPR model with both local and global variables had higher performance based on AICc (70.882) compared to global regression (74.390) and GWPR which assumed that all variables varied locally (73.364). The semiparametric-GWPR captured the spatially non-stationary relationship between malaria cases and minimum temperature, NDVI, NDWI, and altitude at the ward level. The influence of LLINs, IRS and rural or urban did not vary and remained in the model as global terms. NDWI (positive coefficients) and NDVI (range from negative to positive coefficients) showed significant association with malaria cases in some of the wards. The IRS had a protection effect on malaria incidence as expected. Conclusions Malaria incidence is heterogeneous even in low-transmission zones including those in pre-elimination phase. The relationship between malaria cases and NDWI, NDVI, altitude, and minimum temperature may vary at local level. The results of this study can be used in planning and implementation of malaria control strategies at district and ward levels.
Patient satisfaction with nurse-delivery primary health care services in Free State and Gauteng provinces, South Africa: A comparative study. African Journal of Primary Health Care and Family Medicine, 9(1), pp.1-8.
(AOSIS, 2017) Munyewende, P.O.; Nunu, W.N.
The majority of health care users in South Africa utilise primary health care (PHC) services where these services are free at the point of entry. There is a dearth of knowledge on the factors influencing patient satisfaction with PHC clinic services. This study compared patient satisfaction with PHC services in the Free State (FS) and Gauteng (GP) provinces. Secondary data analysis was conducted on a cross-sectional survey obtained from the Research on the State of Nursing Project run by the Centre for Health Policy in 2012. A pre-tested satisfaction survey questionnaire with questions on facility evaluation, experience with providers and receipt of medication was administered to 1110 systematically randomly sampled adult patients attending antiretroviral, hypertension, diabetes and tuberculosis services. Of 1110 respondents, 1096 responded to the patient satisfaction survey signifying 98.8% response rate. Over 60% of respondents were women in both provinces. Over 90% of patients were satisfied with PHC services in both provinces. Factors associated with satisfaction in GP and FS were time spent waiting for consultation, nurses listened, being given information on condition and being treated politely. Having privacy respected came out as a significant factor in FS. High levels of satisfaction with PHC services were experienced by study participants in both provinces. Satisfied patients adhere to treatment plans and have better health-seeking behaviour, which translates to improved clinical outcomes. Therefore, nurses should continue listening, respecting and treating their patients with politeness, and also implement efficient work schedules to reduce patient waiting times.
Woody Species Diversity and Surface Soil Nutrients in an Opuntia Fulgida Engelm Invaded Semi-Arid Savannah Rangeland of South-West Zimbabwe
(2018) Francis, B.; Pepler, D.; Ndagurwa, H.G.T.
This study assessed the impact of the Opuntia fulgida invasion on the native vegetation in the south·western partt of Zimbabwe. Random sampling was used with three categories which were based on the history of invasion, namely, not invaded (O. fulgida absent), recently invaded (invaded in the mid-1990s) and historically invaded (invaded over 50 years ago}. Woody species richness and diversity and soil nutrient concentrations were assessed in each category. Soil samples were collected from the surface (O to 1Ocm) to determine the levels of pH, nitrogen (N), phosphorus (P), potassium (K), calcium (Ca) and magnesium (Mg), and their significant differences were realised. Woody species diversity and the levels of N declined with the increase of density levels of O. fulgida, while Mg increased. Generally, pH was low in all the sites while levels of P, K and Ca were insignificant. The significant differences in soil and vegetation variables suggest that O. fuLgida is altering soil nutrient, native vegetation structure and composition. The management of O. fulgida is therefore recommended.
Hydrological modelling as a tool for interdisciplinary workshops on future drought
(2018) Rangecroft, S.; Birkinshaw, S.; Rohse, M.; Day, R.; McEwen, L.; Makaya, E.; Van Loon, AR.
Transformative interdisciplinary methods and tools are required to address crucial water-related challenges facing societies in the current era of the Anthropocene. In a community-based study in the Limpopo basin of South Africa, physical and social science methods were brought together to run interdisciplinary workshops aimed at enhancing preparedness for possible future drought. To generate storylines for the workshops, relevant scenarios were modelled using a catchment-scale hydrological model, SHETRAN. Set up using freely available data, local knowledge, and narrative-based group interviews on past experiences of drought, the model acted as a locally-relevant tool for prompting discussions about potential future drought impacts, responses and preparedness, and to stimulate the production of community future narratives. In this paper, we discuss the elements involved in the modelling process: the building of the model through an interdisciplinary approach; setting up the model with limited data; and the translation of the model results into storylines for the workshops. We found that by using this methodology scientific grounding was given to the workshop storylines, and that the local context of the model and the engaging approach of creating narratives encouraged participant involvement in discussions about the future. The method of generating these futurestories was an important process for the participants in developing their thinking about possible futures, preparedness and adaptation. In this paper we show how this alternative approach of using a hydrological model has benefits and we discuss the limitations and lessons of the approach for future interdisciplinary research.
An evaluation of the effectiveness of the Behaviour Based Safety Initiative card system at a cement manufacturing company in Zimbabw
(2018) Nunu, W.N.; Kativhu, T.; Moyo, P.
Background: A behavior-based safety initiative card-issuing system was introduced at a cement manufacturing company in Zimbabwe in 2008 to try and curb accident occurrence. The purpose of this study was to evaluate the effectiveness of the Behaviour Based Safety Initiative card system as a tool used for reducing accident frequencies. Methods: A mixed-method approach that involving administering piloted questionnaires to 40 out of 244 randomly selected employees, making observations, and reviewing secondary data were done to collect data from different sources in the organization in 2013. A paired t-test was conducted to test whether there was significant difference in accident occurrence before and after the implementation of the BBSI. Scatterplots were also used to establish the correlation between the issuance of cards and the accident and injury occurrence. Results: The findings suggest that the introduction of the card system brought a significant decrease in accident and injury occurrence. A negative correlation between card issuance and accident occurrence was observed, i.e., the greater the number of cards issued, the fewer the number of accidents. It was also noted that the card system positively influenced the mindset of workers towards safe work practices. Conclusion: The card system had an influence on the reduction of accidents and injuries. The organization should leverage on issuing more cards to further reduce the number of accidents and injuries to zero.
Land use− land cover changes and Mopani worm harvest in Mangwe District in Plumtree, Zimbabwe
(Springer, 2019) Ndlovu, I.; Nunu, W.N.; Mudonhi, N.; Dube, O.; Maviza, A.
Background: Mopani worms have been considered a critical food security resource as people living in Mopani woodlands depend on the worms both as a food source and as an income generating resource. These become a readily available substitute if agriculture fails and droughts loom. However the yields from these worms have been dwindling over the years and this has been associated with land use−land cover changes as the worms depend on vegetation. This research sought to investigate the relationship between land use−land cover changes and Mopani worm harvests in Mangwe District in Plumtree from the period 2007 to 2016 in Zimbabwe. Methods: Satellite imagery was collected using LandSat 5 and LandSat 8 satellite and then classified using the Semi Automatic Classification plugin in Quantum Geographic Information System to identify trees, dams, bare soil and settlements. Thematic maps were then produced and used to quantify extent of Land Use–Land Cover changes in the period from 2007 to 2016. Ground control data was collected using hand held Global Positioning System. Harvests trends (and reasons thereof) were estimated through usage of interviewer administered questionnaires on selected Mopani worm harvesters and harvest data kept by the community leaders. Results: Results showed that settlements and bare soil cover had greatly increased from 2007 to 2016. There was a significant decline on vegetation cover from 2007 to 2016. There was also decline in the Mopani worm harvest over the years. Reasons for reduction of harvest were cited as deforestation, drought, overharvesting, cooking with lids on and occurrence of veld fires. Conclusions: Findings of this study highlight that land use−land cover changes impacted negatively on Mopani worm harvests over the period 2007 to 2016. It is also of paramount importance to note that major reasons for this decline has been associated with Land Use changes that are associated with human activities. There is need for Natural Resource Conservation Agencies to embark on awareness campaigns to encourage reforestation and also control cutting down of Mopani woodlands. Research needs to be conducted to determine the association between cultural beliefs and Mopani worm conservation and utilisation.
Risk factors associated with high malaria incidence among communities in selected wards in Binga district, Zimbabwe: a case-control study
(2020) Maseko, A.; Nunu, W.N.
Background: : Malaria remains a global problem with 216 million cases reported in 2016 and 90% of these cases were recorded in African countries. In 2018 Binga district in Zimbabwe experienced epidemics which resulted in an increase in malaria incidence from 14/10 0 0 in 2015 to 34/10 0 0 in 2018. This occurrence reversed the progress of wards that were moving towards malaria elimination. This study, therefore, was conducted to invesitigate risk factors that were associated with high malaria incidence in selected wards in Binga District. Methods: : A case-control study was conducted on sixty-one systematically randomly selected malaria cases that were matched with one hundred and eighty-three controls to identify risk factors associated with malaria infection in selected wards. The sample size was determined using EPI INFO sample size calculator and matching is done using geographic location and sex of respondents. Information on previous exposure to a risk factor(s) was obtained through a researcher administered questionnaire. Multiple Logistic Regression was conducted to determine the relationship between risk factors and malariaincidence in cases and controls on STATA Version 12 SE. Results: : On comparison, cases were more likely to have been sleeping in poorly constructed shelters with one or more house openings [OR = 5.47; CI = 2.39-12.51], their household located near an active/potential mosquito breeding site or water body [OR = 5.86; CI = 2.61- 13.17] and did not own a treated bed net [OR = 9.14; CI = 4.08-20.45]. Early Treatment seeking behaviour had a significant protective effect [OR = 0.51; CI = 0.39-0.86] and delay to seek treatment was influenced by distance to a health facility [OR = 5.91; CI = 3.02-11.55] just to mention a fewConclusions: : Findings of this study highlight important risk factors that are influential in the transmission of malaria. There is a need for the district to invest in source reduction by use of larvicides and reduction of possible breeding sites so as to minimise breeding. There is need to also embark on awareness campaigns to educate the community members
Barriers related to the provision of cataract surgery and care in Limpopo province, South Africa: Professional ophthalmic service providers’ perspective
(2020) Khoza, L.B.; Nunu, W.N.; Ndou, N.D.; Makgopa, J.; Ramakuela, N.G.; Manganye, B.S.; Tshivhase, S.E.; Mambanga, P. a; Mutwira, T.S.
Background: Cataract has been reported to be the leading single cause of visual impairment and blindness. However, uptake of cataract services is very low in rural areas though these services are available for free. This study, therefore, sought to explore barriers related to the low uptake of these services through engaging health service providers. Methods: This study used a qualitative design to explore barriers related to the uptake of cataract surgery and care from professional nurses’ perspective in Vhembe District of Limpopo province, outh Africa. The target population comprised of 20 ophthalmic service providers. Of these 20 in Limpopo Province, 15 were general nurses involved in eye health service provision, 3 registered ophthalmic nurses and 2 registered eye specialists. Three Focus Group Discussions were held with 8, 6 and 6 participants respectively. Data was collected through the use of a digital tape recorder, transcribed and then thematically analyzed. Results: The majority of the respondents were aged between 56 and 60 years and females constituted 80% of the respondents. In terms of experience in working in the field of oph- thalmology, most of the respondents had between 1 and 10 years of experience. Reported barriers related to the provision of cataract services by patients were: Lack of provision of comprehensive awareness programs; Failure to tailor-make cataract programs that overcome cultural myths; Unavailability of cataract services at the grass-root level; Shortage of ophthalmologist and supportive ophthalmic health professionals; and inadequate cataract facilities and resources. Conclusion: There is a need for the development of comprehensive awareness campaigns and the integration of traditional health systems and the modern system to overcome myths associated with cataracts. There is a need for investment in the ophthalmic services and ensure that the service is decentralized to health facilities in the communities so as to increase coverage. More health service providers are to be trained to ensure that they are able to provide this service at the grass-root level. This would, in turn, reduce the waiting times and ensure efficient and effective ophthalmic services.
Adolescents and parents’ perceptions of condom distribution in selected secondary schools in the high density suburbs of Bulawayo, Zimbabwe
(2020) Mudonhi, N.,; Nunu, W.N.; Ndlovu, B.; Khumalo, N.; Dube, O.
Condoms have been highlighted as one of the most effective strategies to prevent the spread of HIV and AIDS. This study assessed how adolescents and parents perceive the condom distribution programme in selected secondary schools in the high density suburbs of Bulawayo. A concurrent mixed method survey was conducted on three selected secondary schools. Three hundred adolescents and three hundred parents responded to a pre tested semi structured questionnaire. Likert scales were developed to assess knowledge and attitude levels. The χ2 test and multiple logistic regression were used to associate different demographic characteristics with attitudes and levels of knowledge regarding condom distribution at schools using STATA Version 13. Practices and beliefs were assessed using unstructured interviews on purposively selected adolescents and parents. Qualitative data collected was thematically analysed on MAXQDA. The response rate was 100% and 81% for adolescents and parents/guardians respectively. There were more females than males in both response groups. About 67% of adolescents and 60% of parents/guardians were knowledgeable about condom usage and its implications on prevention of spread of sexually transmitted infections and pregnancies. A large proportion of parents/adolescents (72%) had good attitudes towards condom distribution in schools compared to adolescents (27%). Age was strongly associated with knowledge in adolescents, with older adolescent 102 times more likely to be knowledgeable compared to younger adolescents. Religion was the strongest predictor of attitudes in parents/guardians with Catholic having an odds of 227. The concerned sexual health institutions should increase awareness among adolescents, targeting their attitudes towards condom distribution and usage. Targeting attitudes will hopefully foster safe sexual practices.
Survey on prevalence of cataract in selected communities in Limpopo Province of South Africa
(Elsevier, 2020) Nunu, W.N.,; Ndou, N.D.; Manyange, B.S.; Ramakuela, N.J.; Manganye, B.S.; Tshivhase, S.E.; Mambanga, P.; Murwira, T.S.
Background: Over three-quarters of all blindness worldwide are preventable and usually caused by cataract. However data on the prevalence and risk factors about cataract are not always available in South Africa. This study sought to determine prevalence and factors associated with cataracts in selected communities in Limpopo Province of South Africa. Methods: A population-based cross-sectional survey was conducted on respondents aged 18 years and above in selected villages of Vhembe District. Visual Acuity (VA) was evaluated at 6 m using Snellen’s E chart whilst eye examinations were conducted using torch light, 2.5 X magnifying lenses and an ophthalmoscope. Chi Squared tests ( χ2 ) and Multiple Logistic Regressions (MLRs) were conducted to determine associations of different variables using STATA V 13 SE. Results: About 387 out 467 targeted respondents participated in the study. Household heads were the majority of the respondents (246; 63.6%). Cataract prevalence amongst r5espondents was estimated at 44% of which 261 (67.4%) were females with 3.1% of the respondents having permanent blindness. Cataract knowledge still remains low as 228 (58.9%) and Age of respondent, gender specific, marital status, occupation, and primary care giver were significantly associated with prevalence of cataracts. Conclusions: There is an urgent need to improve eye care services so as to improve access to cataract surgery as soon as one is diagnosed. There is also need to conduct community awareness campaigns that are gender specific so as to improve community members’ knowledge on cataracts and ensure they develop proactive eye services seeking behavior. This would minimize chances of the community members suffering permanent blindness due to cataracts.
Strategies to facilitate safe sexual practices in adolescents through integrated health systems in selected districts of Zimbabwe: a mixed method study protocol. Reproductive health, 17, pp.1-16.
(BMC, 2020) Nunu, W.N.; 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.
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.
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.
Effectiveness of peer to peer strategy in reducing accidents and injuries at a selected platinum mine in Zimbabwe
(Springer, 2021) Ndlovu, B.; Nunu, W.N.; Mudonhi, N.; Moyo, N.; Murwira, T.S.
The selected mining company implemented the "Peer to Peer" strategy in 2008 to fast track achievement of zero tolerance to injuries and fatalities incidents at its workplace. Our study, therefore, sought to assess the effectiveness of this strategy in reducing accidents and injuries at this selected platinum mine in Zimbabwe. A mixed-method cross-sectional survey was conducted on 32-day shift employees using a semi-structured questionnaire with closed and open-ended questions. Furthermore, incident trend analysis was done on data obtained from the records from 2004 to 2017. Covert observations were then employed to triangulate findings from data collected using the questionnaire on practices. The tests Hotelling, Chi-square, time series plots, and Multiple Logistic Regressions were employed to compare the variables of interest before and after implementing the peer to peer strategy. There was a significant drop in the number of incidents after implementing the peer to peer strategy. There was no association between tested demographic characteristics and the level of employees’ knowledge of the strategy. Employees were afraid to implement the strategy to their superiors fully. Findings pointed out that this strategy was effective despite being part of a cocktail of strategies. There was a vast decrease in the rate of occurrence of incidents after the implementation of this strategy. However, there is a need for engagement to address the subordinate management dynamics that was observed to be a threat in the comprehensive implementation of this strategy.
Exploring traditional medicine utilisation during antenatal care among women in Bulilima District of Plumtree in Zimbabwe
(Springer, 2021) Mudonhi, N.; Nunu, W.N.; Sibanda, N.; Khumalo, N.
Traditional medicine utilisation during antenatal care has been on the increase in several countries. Therefore, addressing and reinforcing the Sustainable Development Goal of maternal mortality reduction, there is a need to take traditional medicine utilisation during pregnancy into consideration. This paper explores traditional medicine utilisation during antenatal care among women in Bulilima District of Plumtree in Zimbabwe. A cross-sectional survey was conducted on 177 randomly selected women using a semi-structured questionnaire. Fisher’s Exact Test, Odds Ratios, and Multiple Logistic Regression were utilised to determine any associations between diferent demographic characteristics and traditional medicine utilisation patterns using STATA SE Version 13. The prevalence of Traditional Medicine utilisation among pregnant women was estimated to be 28%. Most traditional remedies were used in the third trimester to quicken delivery. The majority of women used holy water and unknown Traditional Medicine during pregnancy. There was a strong association between age and Traditional Medicine utilisation as older women are 13 times more likely to use Traditional Medicine than younger ones. Women use traditional medicine for diferent purposes during pregnancy, and older women’s likelihood to use Traditional Medicine is higher than their counterparts. The traditional system plays an essential role in antenatal care; therefore, there is a need to conduct further studies on the efficacy and safety of utilising Traditional Medicines.
Traditional medicine utilisation and maternal complications during antenatal care among women in Bulilima, Plumtree, Zimbabwe
(BMC, 2021) Mudonhi, N.; Nunu, W.N.
Background: As part of the expectation enshrined in the Sustainable Development Goals, countries are expected to ensure maternal health outcomes are improved. It follows that under ideal circumstances, pregnant women should deliver safely without complications, neonatal, and maternal mortality. This paper analyses the relationship between traditional medicine utilisation and maternal complications during antenatal care among women in Bulilima, Plumtree, Zimbabwe. Methods: A quantitative cross-sectional survey was conducted on 185 randomly selected women who responded to a pre-tested semi-structured questionnaire. The Fisher’s Exact Test and the Test of Proportions were used to probe the relationship between traditional medicine utilisation and the prevalence of maternal complications using STATA SE Version 13. Results: Complications were reported by (51) 29% of the women who were under study. The proportion of women who developed complications was higher in those that did not use traditional medicine as compared to those that used traditional medicine (30 and 26% respectively). In a generalised assessment, women who did not use traditional medicine contributed a significantly higher proportion of complications as compared to those that utilised traditional medicine. Conclusion: This study found a significant relationship between the utilisation of traditional medicines and lesser chances of experiencing maternal complications. Significantly higher prevalence of maternal complications was observed in women who did not use traditional medicine compared to those that did. There is, therefore, a need to investigate further the constituents or active ingredients in this traditional medicine. This study provides a window of opportunity for fully recognising and integrating traditional medicine into Modern Health Systems. It can be argued that traditional medicine utilisation could be a viable alternative to modern medicine, particularly in resource-poor settings where access to modern medicine is seriously constrained.
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.
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.
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.
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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