Environmental Science and Health Publications

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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.
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.
An assessment of risk factors for contracting rabies among dog bite cases recorded in Ward 30, Murewa district, Zimbabwe
(PLoS neglected tropical diseases, 2021-03-31) Chikanya, E.; Macherera, M.; Maviza, A.
Background Zoonoses are a major threat to human health. Worldwide, rabies is responsible for approximately 59 000 deaths annually. In Zimbabwe, rabies is one of the top 5 priority diseases and it is notifiable. It is estimated that rabies causes 410 human deaths per year in the country. Murewa district recorded 938 dog bite cases and 4 suspected rabies deaths between January 2017 and July 2018, overshooting the threshold of zero rabies cases. Of the 938dog bite cases reported in the district, 263 were reported in Ward 30 and these included all the 4suspected rabies deaths reported in the district. This necessitated a study to assess risk factors for contracting rabies in Ward 30, Murewa. Methodology/ Principal findings A descriptive cross sectional survey was used for a retrospective analysis of a group of dog bite cases reported at Murewa Hospital, in Ward 30. Purposive sampling was used to select dog bite cases and snowball sampling was used to locate unvaccinated dogs and areas with jackal presence. The dog bite cases and relatives of rabies cases were interviewed using a piloted interviewer-administered questionnaire. Geographical Positioning System (GPS) coordinates of dog bite cases, vaccinated and unvaccinated dogs and jackal presence were collected using handheld GPS device. QGIS software was used to spatially analyse and map them. Dog owners were 10 times more likely to contract rabies compared to non-dog owners (RR = 10, 95% CI 1.06–93.7). Owners of unvaccinated dogs were 5 times more likely to contract rabies compared to owners of vaccinated dogs (RR = 5.01, 95% CI 0.53–47.31). Residents of the high density cluster (area with low cost houses and stand size of 300 square meters and below) were 64 times more likely to contract rabies compared to non-high density cluster residents (RR = 64.87, 95% CI 3.6039–1167.82). Participants who were not knowledgeable were 0.07 times more likely to contract rabies, compared to those who had knowledge about rabies. (RR = 0.07, 95% CI 0.004–1.25). Our study shows that the risk factors for contacting rabies included; low knowledge levels regarding rabies, dog ownership residing in the high density cluster, owning unvaccinated dogs and spatial overlap of jackal presence with unvaccinated dogs.
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.
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.
Climate change/variability and hydrological modelling studies in Zimbabwe: a review of progress and knowledge gaps
(Springer Nature, 2021-04-12) Maviza, A.; Ahmed, F.
This paper reviews developments in climate science and hydrological modelling studies in Zimbabwe over the past 29 years in an effort to expose knowledge gaps within this research domain. We initially give a global and regional overview and then follow a systematic thematic approach in reviewing specifically online published, peer-reviewed journal articles on climate change/variability and hydrological modelling in Zimbabwe. The state and progress towards advanced integrated climate and hydrological modelling research are assessed, tracking benchmarks in the research methodologies (tools and techniques) used therein including geographic information systems and remote sensing. We present descriptive summaries of key findings, highlighting the main study themes (categories) and general conclusions arising from these studies while examining their implications for future climate and hydrological modelling research in Zimbabwe. Challenges associated with climate and hydrological modelling research in Zimbabwe are also briefly discussed and the main knowledge gaps in terms of research scope and methodologies employed in the reviewed studies also exposed. We conclude by presenting plausible potential areas of focus in updating and advancing scientific knowledge to better understand the climate-land use-hydrology nexus in Zimbabwe. While this paper is primarily relevant for researchers, the general findings are also important for policy-makers since it exposes potential areas for policy intervention or agenda setting in as far as climate and hydrology science research is concerned so as to effectively address pertinent questions in this domain in Zimbabwe.
Determinants of health and health needs assessment of artisanal and small-scale gold miners in Kadoma, Zimbabwe: A mixed method approach
(Elsevier, 2021-03-22) Becker, J.; Furu, P.; Singo, J.; Shoko, D.; Elbel, J.; Bose-O’Reilly, S.; Steckling-Muschack, N.
Background The role of artisanal and small-scale gold mining (ASGM) as a source of income is rapidly gaining importance in the economically difficult times in Zimbabwe. Small-scale miners are now responsible for over 50% of the Zimbabwean gold production. However, the sector is still characterised by high labour-intensity, low productivity and capital, limited mechanisation and outdated technologies. Since increasing efforts in recent years to improve miners’ health while reducing the exposure to mercury have not been effective, a more sustainable approach is needed to identify interventions targeting the health of artisanal and small-scale miners and the mining communities. Objective The main objective of this study was the accurate and extensive empirical identification of the determinants of health in ASGM and of the miners’ health needs. In tandem with these needs, topics which generate more effective, sustainable, and feasible future health interventions targeting occupational health should be identified. Methods Based on the identification of determinants of health, a health needs assessment (HNA) was used to conduct miners’ needs by applying a mixed methods approach and triangulation. This included qualitative and quantitative interviews with individuals, group interviews, focus group discussions, observations and informal conversations. Results There were 85 structured and 84 semi-structured interviews, a focus group discussion, and observations conducted. Six main themes were identified around which miners’ health needs can be aggregated as follows: living conditions, nutrition and hygiene; safe work environment and mining processes; financial support; health care services; formalisation and education. Discussion The following aspects were considered most important for sustainable interventions: possible health impacts, feasibility, value for miners and their willingness to adapt. Accordingly, interventions aiming at increasing education, knowledge and awareness of miners were identified as most promising in improving occupational health.
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.
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.
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.
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.
Effects of COVID-19 Among People With Disabilities in Plumtree, Zimbabwe: A Mixed-Method Survey
(2024) Ndlovu, L.; Mudonhi, N.; Nunu, W.N.; Sibanda, N.; Manyeruke, N.
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-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.
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.
Effects of COVID-19 on malaria elimination initiatives in sub-Saharan Africa: a scoping review protocol
(BMJ, 2023) 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 reviewwill 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. Results will be communicated through peer-reviewed publications, presentations, conferences, workshops and other means and forums to reach the critical stakeholders.
Evaluation of the Skill of Monthly Precipitation Forecasts from Global Prediction Systems over the Greater Horn of Africa
(Weather and Forecasting, 2021-04-27) Endris, H.S.; Hirons, L.; Segele, Z.T.; Gudoshava, M.; Woolnough, S.; Artan, G.A.
The skill of precipitation forecasts from global prediction systems has a strong regional and seasonal dependence. Quantifying the skill of models for different regions and time scales is important, not only to improve forecast skill, but to enhance the effective uptake of forecast information. The Subseasonal to Seasonal Prediction project (S2S) database contains near-real-time forecasts and reforecasts from 11 operational centers and provides a great opportunity to evaluate and compare the skill of operational S2S systems. This study evaluates the skill of these state-of-the-art global prediction systems in predicting monthly precipitation over the Greater Horn of Africa. This comprehensive evaluation was performed using deterministic and probabilistic forecast verification metrics. Results from the analysis showed that the prediction skill varies with months and region. Generally, the models show high prediction skill during the start of the rainfall season in March and lower prediction skill during the peak of the rainfall in April. ECCC, ECMWF, KMA, NCEP, and UKMO show better prediction skill over the region for most of the months compared with the rest of the models. Conversely, BoM, CMA, HMCR, and ISAC show poor prediction skill over the region. Overall, the ECMWF model performs best over the region among the 11 models analyzed. Importantly, this study serves as a baseline skill assessment with the findings helping to inform how a subset of models could be selected to construct an objectively consolidated multimodel ensemble of S2S forecast products for the Greater Horn of Africa region, as recommended by the World Meteorological Organization.
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
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.
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.
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.
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.

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