Environmental Science and Health

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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 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.
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.
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.
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.
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.
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.
Health service providers’ perspectives on the influence of modern health systems on adolescents’ sexual health practices in Umguza and Mberengwa districts of Zimbabwe
(2022) Nunu, W.N.; Makhado, L.; Mabunda, T.; Lebese, R.T.
Background: Health service providers play a significant role in crafting and implementing health policies and programs that manage adolescent sexual health-related issues at different health system levels. These influence adolescent sexual behaviours and practices Aim: This study explored the roles of health service providers in managing adolescent sexual issues and how this impacts their sexual behaviours and practices. The study further probed the health service providers on how the indigenous health system could be integrated into the modern health system for effective management of adolescent sexual health related issues. Methods: A qualitative cross-sectional survey was conducted on purposively selected health service providers in health facilities in Mberengwa and Umguza districts. Data was collected using unstructured interviews that were recorded, transcribed verbatim, and thematically analysed. Findings were presented as clearly defined as superordinate and subordinate themes. Results: A total of five superordinate themes and 19 subordinate themes emerged from the interrogated data. The superordinate themes were: overview of adolescent sexual health issues, role of modern health system in adolescent sexual health issues, challenges encountered, indigenous health system factors that could be factored into modern health systems, and strategies to foster the integration of indigenous health system and modern health system. The subordinate themes explored in-depth the findings of the key stakeholders under the five superordinate themes. Conclusions: From the findings, it can be concluded that health service providers play an essential role in shaping and providing adolescent sexual health services that adolescents utilise despite challenges that have reduced demand for these services. Therefore, there is a need to point out that there is a window of opportunity to foster collaborations between the indigenous health system and the modern health system as they strive to serve the adolescents to the best of their ability though in different contextual settings.
Health service providers’ perspectives on the infuence of modern health systems on adolescents’ sexual health practices in Umguza and Mberengwa districts of Zimbabwe
(BMC, 2022) Nunu, W. J.; Makhado, L.; Mabunda, J. T.; Lebese, R. T.
Background: Health service providers play a significant role in crafting and implementing health policies and programs that manage adolescent sexual health-related issues at different health system levels. These influence adolescent sexual behaviours and practices. Aim: This study explored the roles of health service providers in managing adolescent sexual issues and how this impacts their sexual behaviours and practices. The study further probed the health service providers on how the indigenous health system could be integrated into the modern health system for effective management of adolescent sexual health related issues. Methods: A qualitative cross-sectional survey was conducted on purposively selected health service providers in health facilities in Mberengwa and Umguza districts. Data was collected using unstructured interviews that were recorded, transcribed verbatim, and thematically analysed. Findings were presented as clearly defined as superordinate and subordinate themes. Results: A total of five superordinate themes and 19 subordinate themes emerged from the interrogated data. The superordinate themes were: overview of adolescent sexual health issues, role of modern health system in adolescent sexual health issues, challenges encountered, indigenous health system factors that could be factored into modern health systems, and strategies to foster the integration of indigenous health system and modern health system. The subordinate themes explored in-depth the findings of the key stakeholders under the five superordinate themes. Conclusions: From the findings, it can be concluded that health service providers play an essential role in shaping and providing adolescent sexual health services that adolescents utilise despite challenges that have reduced demand for these services. Therefore, there is a need to point out that there is a window of opportunity to foster collaborations between the indigenous health system and the modern health system as they strive to serve the adolescents to the best of their ability though in different contextual settings.
Health System Strategies and Adolescent Sexual Health: A Systematic Review of the Literature using Rodgers Concept Analysis Framework
(The Open Public Health Journal, 2021-10) Nunu, W.J.; L. ,Mabunda; Lebese, R.T.
Background: Health Systems Strategies play a key role in determining Adolescent Sexual Health outcomes. This study aims to review the literature on the relationship between Health Systems Strategies and Adolescent Sexual Health issues guided by Rodger's evolutionary concept analysis framework. The study further develops a Conceptual Framework that would guide a study that seeks to “Develop strategies to facilitate safe sexual practices in adolescents through Integrated Health Systems in selected Districts in Zimbabwe.” Methods: Adolescents, Health Systems, Sexual Health, and Strategies were used to search for published literature (in English) on Google Scholar, PUBMED, EBSCO, Cochran Library, and Science Direct. A total of 142 Articles and 11 reports were obtained, and the content was screened for relevance. This led to 42 articles and 03 reports being found suitable and relevant, and thus, the content was reviewed. Thematic analysis was done to identify attributes, antecedents, and consequences of Health Systems Strategies on Adolescent Sexual Health. These findings were then used to inform the development of the Conceptual Framework. Results: Key attributes, antecedents and consequences of Health System Strategies on Adolescent Sexual Health were identified. Strategies to Improve Adolescent Sexual Health outcomes were also identified. Conclusions: Different contextual factors influence policy changes and the consequences are mixed, with both positive and negative outcomes.
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.

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