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Chikava T, Eghtessadi R, Chingombe I, Murewanhema G, Cheza A, Dzinamarira T, Herrera H, Musuka GN. Zimbabwean law and its impact on HIV programmes for key populations. Front Public Health 2023; 11:1272775. [PMID: 37920588 PMCID: PMC10619717 DOI: 10.3389/fpubh.2023.1272775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Affiliation(s)
- Tendai Chikava
- Independent Consultant, Independent Legal Consultancy Services, Harare, Zimbabwe
| | | | - Innocent Chingombe
- Independent Consultant, Independent Public Health Consultancy, Harare, Zimbabwe
| | - Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Alexander Cheza
- Discipline of Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Godfrey N. Musuka
- Public Health Consultants, International Initiative for Impact Evaluation, Harare, Zimbabwe
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Mapingure M, Dzinamarira T, Mukandavire Z, Chingombe I, Cuadros DF, Eghtessadi R, Mutenherwa F, Herrera H, Madziva R, Mukwenha S, Murewanhema G, Musuka G. Understanding the role of intimate partner violence on HIV transmission in Zimbabwe: Secondary data analysis of data from the Zimbabwe demographic survey 2015-2016. Health Promot Perspect 2023; 13:113-119. [PMID: 37600546 PMCID: PMC10439455 DOI: 10.34172/hpp.2023.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/18/2023] [Indexed: 08/22/2023] Open
Abstract
Background Gender-based violence (GBV) has been shown to have significant and long-lasting impacts on women's physical and mental health. It is, therefore, important to study its occurrence in a population and its intersect with infectious diseases such as HIV to inform the wider health promotion agenda. This study aimed to determine the association between GBV and HIV status in women and adolescent girls in Zimbabwe. Methods A secondary data analysis of data from a cross-sectional Zimbabwe Demographic and Health Survey (ZDHS) was conducted. Statistical analysis was employed to establish the association between GBV and HIV status. Geospatial mapping was conducted using a kernel smoothing method was employed to generate a continuous kernel density surface to illustrate the local spatial variations of female HIV and GBV prevalence. Results Women and adolescent girls suffering emotional GBV, such as those subjected to humiliation by their husbands or partners, were 1.45 (1.14-1.84) [OR (95% CIs)] times more likely to be HIV positive than those who were never humiliated. The same was true for women and adolescent girls whose husbands or partners threatened to harm them or someone they love, 1.33 (1.04-1.68). There is a relationship between women's HIV status and intimate partner aggression, such as when their partners pushed, shook, or threw something at them or physically abused them. This was also the case for those who reported that partners kicked, dragged, or beat them, tried to choke or burn them on purpose, or threatened or attacked them with a knife, gun, or other weapons. Women who experienced forced sexual violence with threats were more likely 1.61 (1.08-2.41), to be HIV positive than those women who did not experience the same. Conclusion GBV is widely spread in Zimbabwe. There is a need for the government to implement creative strategies to reach out to survivors, especially those that are forced to have unprotected sex and are at increased risk of HIV acquisition. This manuscript raises issues that can be addressed by robust health promotion strategies to reduce the impact of the syndemic of GBV and HIV acquisition in Zimbabwe.
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Affiliation(s)
| | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare, Zimbabwe
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Zindoga Mukandavire
- Emirates Aviation University, Centre for Data Science and Artificial Intelligence, Dubai, UAE
| | | | - Diego F. Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, USA
| | | | | | | | - Roda Madziva
- School of Sociology and Social Policy, University of Nottingham, Nottingham, United Kingdom
| | | | - Grant Murewanhema
- Unit of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Musuka G, Mukandavire Z, Murewanhema G, Cuadros D, Mutenherwa F, Chingombe I, Eghtessadi R, Herrera H, Dzinamarira T, Mapingure MP. HIV status, knowledge and prevention of cervical cancer amongst adolescent girls and women: a secondary data analysis. Pan Afr Med J 2022; 41:262. [PMID: 35734312 PMCID: PMC9187985 DOI: 10.11604/pamj.2022.41.262.32615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/19/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction the objective of this manuscript was to describe the knowledge profiles and determinants of cervical cancer screening among HIV positive and negative adolescent girls and women in Zimbabwe. Methods we conducted secondary statistical data analysis to explore the determinants of cervical cancer screening among HIV positive and negative adolescent girls and women using Zimbabwe Demographic Health survey for 2015-16. Results a total of 9054 adolescent girls aged 15-19, and women aged 20-49 were included in the analysis and the majority (63%) of them resided in rural areas. More than two-thirds (65.9%) had attained secondary level of education. The majority (41.3%) of the adolescent girls and women belonged to the Apostolic sect. A number of key determinants have been identified for being ever screened for cervical cancer. The odds of being ever being screened increased by age, OR(CI) 4.38 (3.22-5.94), p<0.001 for women who are 40 years and older when compared to adolescent and young woman who are between 15-24 years. Conclusion our study reports significant programmatic gaps in the provision of cervical cancer screening and treatment services in the country. The nascent Zimbabwe cervical cancer screening and treatment progamme will benefit from expansion of the number of facilities offering the services and the provision of more efficient health education to adolescent women and girls.
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Affiliation(s)
| | - Zindoga Mukandavire
- Emirates Aviation University, Centre for Data Science and Artificial Intelligence, Dubai, UAE
| | - Grant Murewanhema
- Unit of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Diego Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, USA
| | | | | | | | | | - Tafadzwa Dzinamarira
- Columbia University, Harare, Zimbabwe
- School of Health Systems and Public Health, University of Pretoria, Pretoria, 0002, South Africa
- Corresponding author: Tafadzwa Dzinamarira, School of Health Systems and Public Health, University of Pretoria, Pretoria, 0002, South Africa.
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Mutenherwa F, Eghtessadi R, Dzinamarira T, Musuka G. COVID-19 and its intersect with ethics and human rights in Sub-Saharan Africa. J Infect Dev Ctries 2021; 15:910-12. [PMID: 34343114 DOI: 10.3855/jidc.14795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/24/2021] [Indexed: 10/31/2022] Open
Abstract
Confirmed new cases of Coronavirus disease 2019 (COVID-19) have accelerated in Sub-Saharan Africa against a backdrop of fragile health systems, a high burden of comorbidities and socioeconomic instability. The context makes the region particularly vulnerable to the virus and its impact. As cases escalate, the need to tailor-make COVID-19-related response strategies to the African context is imperative. This paper aims to discuss key considerations on the public health response to the pandemic and its intersection with ethics and human rights. With this perspective, we bring attention to the conflict between healthcare workers' obligations and patient rights under the unclear policy and regulatory frameworks and the application of restrictive measures in the context of poverty. The indirect effects of the pandemic on already existing health problems are also highlighted. We appeal to the African States to establish appropriate systems which integrate human rights-based approaches to COVID-19 response. These systems should be ethically sound systems and ensure no-one is left behind in terms of testing, access to therapeutics and vaccination, and social protection; based on lessons learned over the past 12 months of the pandemic's presence in SSA, and patterns emerging across the globe.
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Dzinamarira T, Mukwenha S, Eghtessadi R, Cuadros DF, Mhlanga G, Musuka G. Coronavirus Disease 2019 (COVID-19) Response in Zimbabwe: A Call for Urgent Scale-up of Testing to meet National Capacity. Clin Infect Dis 2021; 72:e667-e674. [PMID: 32865204 PMCID: PMC7499560 DOI: 10.1093/cid/ciaa1301] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 08/27/2020] [Indexed: 11/13/2022] Open
Abstract
Control of the coronavirus disease 2019 (COVID-19) heavily relies on universal access to testing to identify who is infected; tracking them to make sure they do not spread the disease further; and tracing those with whom they have been in contact. The recent surge in COVID-19 cases in Zimbabwe is an urgent national public health concern and requires coordinated efforts to scale up testing using capacity already in existence in country. There is need for substantial decentralization of testing, investment in better working conditions for frontline health workers and implementation of measures to curb corruption within government structures
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Affiliation(s)
- Tafadzwa Dzinamarira
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Solomon Mukwenha
- Center for International Programs (ICAP) at Columbia University, Harare, Zimbabwe
| | - Rouzeh Eghtessadi
- Southern Africa HIV & AIDS Information Dissemination Service (SAfAIDS) Regional Office, Harare, Zimbabwe
| | - Diego F Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, Ohio, USA.,Health Geography and Disease Modeling Laboratory, University of Cincinnati, Cincinnati, Ohio, USA
| | - Gibson Mhlanga
- Office of the Secretary of Health and Child Care, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Godfrey Musuka
- Center for International Programs (ICAP) at Columbia University, Harare, Zimbabwe
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Eghtessadi R, Mukandavire Z, Mutenherwa F, Cuadros D, Musuka G. Safeguarding gains in the sexual and reproductive health and AIDS response amidst COVID-19: The role of African civil society. Int J Infect Dis 2020; 100:286-291. [PMID: 32920231 PMCID: PMC7484728 DOI: 10.1016/j.ijid.2020.08.086] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 11/19/2022] Open
Abstract
This article outlines the role of African civil society in safeguarding gains registered to date in sexual and reproductive health and the response to HIV. The case is made for why civil society organizations (CSOs) must be engaged vigilantly in the COVID-19 response in Africa. Lockdown disruptions and the rerouting of health funds to the pandemic have impeded access to essential sexual and reproductive health (SRH) and social protection services. Compounded by pre-existing inequalities faced by vulnerable populations, the poor SRH outcomes amid COVID-19 call for CSOs to intensify demand for the accountability of governments. CSOs should also continue to persevere in their aim to rapidly close community-health facility gaps and provide safety nets to mitigate the gendered impact of COVID-19.
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Affiliation(s)
| | - Zindoga Mukandavire
- Centre for Data Science, Coventry University, Coventry, UK; School of Computing, Electronics and Mathematics, Coventry University, Coventry, UK
| | | | - Diego Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, OH 45220, USA; Health Geography and Disease Modelling Laboratory, University of Cincinnati, Cincinnati, OH 45220, USA
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