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.
The lived experiences of men who have sex with men when accessing HIV care services in Zimbabwe
(AOSIS, 2020-10-26) Moyo, I.; Macherera, M.; Mavhandu-Mudzusi, A.H
BACKGROUND: Key populations such as men who have sex with men are disproportionately affected by human immunodeficiency virus (HIV), yet they are underserved. This vulnerable group also faces stigma and discrimination when utilising the healthcare services. However, to achieve the HIV epidemic control, it is important for them to have access to HIV care services. AIM: The aim of this study was to explore and describe the experiences of men who have sex with men (MSM) as they accessed HIV care services in healthcare settings in Bulawayo, Zimbabwe. SETTING: The study setting was healthcare facilities (state and private owned) in Bulawayo, Zimbabwe, that offer HIV care services. METHODS: The study used a descriptive phenomenological design targeting self-identified MSM living with HIV. Data were gathered by using in-depth individual interviews that were audio recorded. Data saturation determined sample size. Data were transcribed verbatim and later analysed thematically. RESULTS: The study revealed that counselling given to MSM was generalised and not individualised. Some clients faced stigma and discrimination after disclosure. Peer and family support were important in the journey to access HIV care services CONCLUSION: An enabling environment was not provided for MSM clients to access HIV care services in the majority of health facilities. This calls for sensitisation and competency clinical training of service providers so that the diverse needs of MSM are met. Peer and family support for MSM needs to be strengthened.
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.
Multisector Collaborative Groundwater-Surface Water Modelling Approach to Improve Resilience to Hydrological Extremes in the Limpopo River Basin
(Springer, 2021) Mustafa, S.M.T.; Van Loon, A.; Artur, L.; Bharucha, Z.; Chinyama, A.; Chirindja, F.; Day, R.; Franchi, F.; Geris, J.; Hussey, S.; Nesamvuni, E.
It is necessary to combine the understanding of physical environmental drivers with social, economic, cultural and political perspectives and information to build resilience to future flood and drought hazards. We present a flexible collaborative modelling approach to improve resilience to hydrological extremes in large basins with application to the Limpopo River Basin (LRB). It uses an iterative, knowledge co-production process to strengthen crucial bridges between scientists and water management stakeholders on the appropriate scale(s). In the proposed collaborative modelling approach, the integrated hydro (geo)logical model is combined with regional to transboundary people’s knowledges and policies. We analyse the effect and importance of stakeholders’ feedback on the numerical model prediction. The proposed methodology is applied in the Limpopo River Basin (LRB) where floods and droughts are recurrent events. Through this iterative multisector collaborative modelling approach, we aim to develop a reliable and feasible management instrument to help reduce the impact of alternating droughts and floods and increase the resilience to hydrological extremes.
Effectiveness of peer to peer strategy in reducing accidents and injuries at a selected platinum mine in Zimbabwe
(Elsevier, 2021-02-15) Nunu, W.N.; Ndlovu, B.; 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.
A feasibility study to assess Imbrasia belina (mopane worm) sensitisation and related respiratory health outcomes in a rural community in Gwanda district, Zimbabwe
(Springer Nature, 2021-02-22) Ndlovu, V.; Chimbari, M.; Sibanda, E.; Ndarukwa, P.
Background Allergic diseases are considered to be some of the fastest growing chronic conditions in Africa. Of concern is the paucity of knowledge about the local environment and its role in allergic disease development. In response to this, we explored whether Imbrasia belina, a popular indigenous edible insect commonly known as mopane worm, is a potential allergen of clinical and public health significance in Zimbabwe. This study was intended to assess the plausibility and feasibility of this hypothesis with a view to evaluate the insect’s health impact in a larger study. Methods The study participants included male and female villagers aged 10 years and above in Gwanda district, Zimbabwe. Eligible participants who completed the household questionnaire were referred to the local clinic for skin prick tests and to measure lung function and allergic airway inflammation. Allergen sensitisation patterns were evaluated using 10 different inhalant allergen extracts including an in-house preparation of mopane worm. Lung function was measured with a Koko Legend spirometer, and fractional exhaled nitric oxide levels (FeNO) (NIOX VERO) were measured in participants with at least one abnormal spirometric parameter. Data was analysed using Stata version 13 software. Results Of the 46 eligible participants that completed the household questionnaire, 17 went to the clinic giving a response rate of 37%. The majority who completed the questionnaire were adults (91%) and the children (9%) were all female. The prevalence of sensitisation to Imbrasia belina was 50%, and the prevalence ranged from 22 to 72% for the other allergens including cockroach, mosquito and house dust mites. The data collection tools were safe and well tolerated by participants with no adverse events reported. Self-reported respiratory symptoms, abnormal lung function and elevated FeNO were recorded amongst participants sensitised to mopane worm. Conclusion Pre-defined feasibility criteria were met with the exception of a lower than expected response rate for clinic data collection in this pilot study. For the main study, modifying the sampling strategy and applying more consistent community engagement will improve the response rates.

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