| 1. |
- Abeid, Muzdalifat, 1973-, et al.
(författare)
-
Community perceptions of rape and child sexual abuse : a qualitative study in rural Tanzania
- 2014
-
Ingår i: BMC International Health and Human Rights. - 1472-698X. ; 14, s. 23-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Rape of women and children is recognized as a health and human rights issue in Tanzania and internationally. Exploration of the prevailing perceptions in rural areas is needed in order to expand the understanding of sexual violence in the diversity of Tanzania's contexts. The aim of this study therefore was to explore and understand perceptions of rape of women and children at the community level in a rural district in Tanzania with the added objective of exploring those perceptions that may contribute to perpetuating and/or hindering the disclosure of rape incidences. Methods: A qualitative design was employed using focus group discussions with male and female community members including religious leaders, professionals, and other community members. The discussions centered on causes of rape, survivors of rape, help-seeking and reporting, and gathered suggestions on measures for improvement. Six focus group discussions (four of single gender and two of mixed gender) were conducted. The focus group discussions were recorded, transcribed verbatim, and analyzed using manifest qualitative content analysis. Results: The participants perceived rape of women and children to be a frequent and hidden phenomenon. A number of factors were singled out as contributing to rape, such as erosion of social norms, globalization, poverty, vulnerability of children, alcohol/drug abuse and poor parental care. Participants perceived the need for educating the community to raise their knowledge of sexual violence and its consequences, and their roles as preventive agents. Conclusions: In this rural context, social norms reinforce sexual violence against women and children, and hinder them from seeking help from support services. Addressing the identified challenges may promote help-seeking behavior and improve care of survivors of sexual violence, while changes in social and cultural norms are needed for the prevention of sexual violence.
|
|
| 2. |
- Abeid, Muzdalifat, et al.
(författare)
-
A community-based intervention for improving health-seeking behavior among sexual violence survivors: A controlled before and after design study in rural Tanzania
- 2015
-
Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 8
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Despite global recognition that sexual violence is a violation of human rights, evidence still shows it is a pervasive problem across all societies. Promising community intervention studies in the low- and middle-income countries are limited.Objective: This study assessed the impact of a community-based intervention, focusing on improving the community’s knowledge and reducing social acceptability of violence against women norms with the goal to prevent and respond to sexual violence.Design: The strategies used to create awareness included radio programs, information, education communication materials and advocacy meetings with local leaders. The intervention took place in Morogoro region in Tanzania. The evaluation used a quasi-experimental design including cross-sectional surveys at baseline (2012) and endline (2014) with men and women aged 18-49. Main outcome measures were number of reported rape cases at health facilities and the community’s knowledge and attitudes towards sexual violence.Results: The number of reported rape events increased by more than 50% at health facilities during the intervention. Knowledge on sexual violence increased significantly in both areas over the study period (from 57.3% to 80.6% in the intervention area and from 55.5% to 71.9% in the comparison area; p<.001), and the net effect of the intervention between the two areas was statistically significant (6.9, 95% CI 0.2–13.5, p= 0.03). There was significant improvement in most of attitude indicators in the intervention area, but not in the comparison area. However, the intervention had no significant effect in the overall scores of acceptance attitudes in the final assessment when comparing the two areas (-2.4, 95%CI: -8.4 – 3.6, p= 0.42).Conclusions: The intervention had an effect on some indicators on knowledge and attitudes towards sexual violence even after a short period of intervention. This finding informs the public health practitioners of the importance of combined strategies in achieving changes.
|
|
| 3. |
- Abeid, Muzdalifat, 1973-, et al.
(författare)
-
Evaluation of a training program for health care workers to improve the quality of care for rape survivors : a quasi-experimental design study in Morogoro, Tanzania
- 2016
-
Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 9
-
Forskningsöversikt (refereegranskat)abstract
- BACKGROUND:Sexual violence against women and children in Tanzania and globally is a human rights violation and a developmental challenge.OBJECTIVE:The aim of this study was to assess the impact of training health professionals on rape management. The specific objectives were to evaluate the changes of knowledge and attitudes toward sexual violence among a selected population of health professionals at primary health care level.DESIGN:A quasi-experimental design using cross-sectional surveys was conducted to evaluate health care workers' knowledge, attitude, and clinical practice toward sexual violence before and after the training program. The study involved the Kilombero (intervention) and Ulanga (comparison) districts in Morogoro region. A total of 151 health professionals at baseline (2012) and 169 in the final assessment (2014) participated in the survey. Data were collected using the same structured questionnaire. The amount of change in key indicators from baseline to final assessment in the two areas was compared using composite scores in the pre- and post-interventions, and the net intervention effect was calculated by the difference in difference method.RESULTS:Overall, there was improved knowledge in the intervention district from 55% at baseline to 86% and a decreased knowledge from 58.5 to 36.2% in the comparison area with a net effect of 53.7% and a p-value less than 0.0001. The proportion of participants who exhibited an accepting attitude toward violence declined from 15.3 to 11.2% in the intervention area but increased from 13.2 to 20.0% in the comparison area.CONCLUSIONS:Training on the management of sexual violence is feasible and the results indicate improvement in healthcare workers' knowledge and practice but not attitudes. Lessons learned from this study for successful replication of such an intervention in similar settings require commitment from those at strategic level within the health service to ensure that adequate resources are made available.
|
|
| 4. |
- Abeid, Muzdalifat, 1973-
(författare)
-
Improving Health-seeking Behavior and Care among Sexual Violence Survivors in Rural Tanzania
- 2015
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to assess the effects of providing community education and training to healthcare workers to improve community response, healthcare and support for rape survivors in the Kilombero district of Tanzania. The overall design of the project was to begin with an exploratory study (Paper I) to establish the community’s perceptions towards sexual violence and their perceived recommendations to address this issue. Using a structured questionnaire, the community’s knowledge and attitudes towards sexual violence were determined along with their associations with demographic factors (Paper II). Papers III and IV assessed the effect of healthcare workers’ training and a community information package, respectively, using a controlled quasi-experimental design. The findings highlighted the social norms and variety of barriers that impacted negatively on the survivors’ care-seeking from support services and health outcomes. Increasing age and higher education were associated with better knowledge and less accepting attitudes towards sexual violence. Training on the management of sexual violence was effective in improving healthcare workers’ knowledge and practice but not attitude. Knowledge on sexual violence among the communities in the intervention and comparison areas increased significantly over the study period; from 57.3% to 80.6% in the intervention area and from 55.5% to 71.9% in the comparison area. In the intervention area, women had significantly less knowledge than men at baseline (53% Vs 64%, p<.001).There was a reduction, though not significantly, in acceptance attitudes from 28.1% to 21.8% in favor of women. In conclusion, the current intervention provides evidence that healthcare workers’ training and community education is effective in improving knowledge but not attitudes towards sexual violence. The findings have potential implications for interventions aimed at preventing and responding to violence. The broader societal norms that hinder rape disclosure need to be re-addressed.
|
|
| 5. |
- Abeid, Muzdalifat, 1973-, et al.
(författare)
-
Knowledge and attitude towards rape and child sexual abuse - a community-based cross-sectional study in Rural Tanzania
- 2015
-
Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.METHODS: A cross-sectional study was undertaken between May and June 2012. The study was conducted in the Kilombero and Ulanga rural districts in the Morogoro Region of Tanzania. Men and women aged 18-49 years were eligible for the study. Through a three-stage cluster sampling strategy, a household survey was conducted using a structured questionnaire. The questionnaire included socio-demographic characteristics, attitudes about gender roles and violence, and knowledge on health consequences of rape. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 21. Main outcome measures were knowledge of and attitudes towards sexual violence. Multivariate analyses were used to assess associations between socio-demographic characteristics and knowledge of and attitudes towards sexual violence.RESULTS: A total of 1,568 participants were interviewed. The majority (58.4%) of participants were women. Most (58.3%) of the women respondents had poor knowledge on sexual violence and 63.8% had accepting attitudes towards sexual violence. Those who were married were significantly more likely to have good knowledge on sexual violence compared to the divorced/separated group (AOR = 1.6 (95% CI: 1.1-2.2)) but less likely to have non-accepting attitudes towards sexual violence compared to the single group (AOR = 1.8 (95%CI: 1.4-2.3)). Sex of respondents, age, marital status and level of education were associated with knowledge and attitudes towards sexual violence.CONCLUSIONS: Our study showed that these rural communities have poor knowledge on sexual violence and have accepting attitudes towards sexual violence. Increasing age and higher education were associated with better knowledge and less accepting attitudes towards sexual violence. The findings have potentially important implications for interventions aimed at preventing violence. The results highlight the challenges associated with changing attitudes towards sexual violence, particularly as the highest levels of support for such violence were found among women.
|
|
| 6. |
- Adolphson, Katja, et al.
(författare)
-
Midwives' experiences of working conditions, perceptions of professional role and attitudes towards mothers in Mozambique
- 2016
-
Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 40, s. 95-101
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: low- and middle-income countries still have a long way to go to reach the fifth Millennium Development Goal of reducing maternal mortality. Mozambique has accomplished a reduction of maternal mortality since the 1990s, but still has among the highest in the world. A key strategy in reducing maternal mortality is to invest in midwifery. AIM: the objective was to explore midwives' perspectives of their working conditions, their professional role, and perceptions of attitudes towards mothers in a low-resource setting. SETTING: midwives in urban, suburban, village and remote areas; working in central, general and rural hospitals as well as health centres and health posts were interviewed in Maputo City, Maputo Province and Gaza Province in Mozambique. METHOD: the study had a qualitative research design. Nine semi-structured interviews and one follow-up interview were conducted and analysed with qualitative content analysis. RESULTS: two main themes were found; commitment/devotion and lack of resources. All informants described empathic care-giving, with deep engagement with the mothers and highly valued working in teams. Lack of resources prevented the midwives from providing care and created frustration and feelings of insufficiency. CONCLUSIONS: the midwives perceptions were that they tried to provide empathic, responsive care on their own within a weak health system which created many difficulties. The great potential the midwives possess of providing quality care must be valued and nurtured for their competency to be used more effectively.
|
|
| 7. |
- August, Furaha, et al.
(författare)
-
Birth preparedness and complication readiness - a qualitative study among community members in rural Tanzania
- 2015
-
Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 8, s. 1-U12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Birth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR. Design: A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data. Results: The community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees. Conclusions: This study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via community health workers.
|
|
| 8. |
- August, Furaha, 1973-, et al.
(författare)
-
Community Health workers can improve male involvement in maternal health : Evidence from rural Tanzania
- 2016
-
Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Male involvement in maternal health is recommended as one of the interventions to improve maternal and newborn health. There have been challenges in realising this action, partly due to the position of men in society and partly due to health system challenges in accommodating men. The aim of this study was therefore to evaluate the effect of Home Based Life Saving Skills training by community health workers on improving male involvement in maternal health in terms of knowledge of danger signs, joint decision-making, birth preparedness, and escorting wives to antenatal and delivery care in a rural community in Tanzania.DESIGN:A community-based intervention consisting of educating the community in Home Based Life Saving Skills by community health workers was implemented using one district as the intervention district and another as comparison district. A pre-/post-intervention using quasi-experimental design was used to evaluate the effect of Home Based Life Saving Skills training on male involvement and place of delivery for their partners. The effect of the intervention was determined using difference in differences analysis between the intervention and comparison data at baseline and end line.RESULTS:The results show there was improvement in male involvement (39.2% vs. 80.9%) with a net intervention effect of 41.1% (confidence interval [CI]: 28.5-53.8; p <0.0001). There was improvement in the knowledge of danger signs during pregnancy, childbirth, and postpartum periods. The proportion of men accompanying their wives to antenatal and delivery also improved. Shared decision-making for place of delivery improved markedly (46.8% vs. 86.7%), showing a net effect of 38.5% (CI: 28.0-49.1; p <0.0001). Although facility delivery for spouses of the participants improved in the intervention district, this did not show statistical significance when compared to the comparison district with a net intervention effect of 12.2% (95% CI: -2.8-27.1: p=0.103).CONCLUSION:This community-based intervention employing community health workers to educate the community in the Home Based Life Saving Skills programme is both feasible and effective in improving male involvement in maternal healthcare.
|
|
| 9. |
- August, Furaha, 1973-
(författare)
-
Effect of Home Based Life Saving Skills education on knowledge of obstetric danger signs, birth preparedness, utilization of skilled care and male involvement : A Community-based intervention study in rural Tanzania
- 2016
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Use of skilled care during antenatal visits and delivery is recommended to address the burden of maternal mortality. However there are few facility deliveries and insufficient knowledge of danger signs, especially in rural Tanzania. The aim of this thesis was to explore the perceptions and challenges that the community faces while preparing for childbirth and to evaluate an intervention of the Home Based Life Saving Skills education programme on knowledge of danger signs, facility delivery and male involvement when delivered by rural community health workers in Tanzania.In Paper I, Focus Group Discussions explored the perceptions and challenges that the community encounters while preparing for childbirth. Structured questionnaires assessed men’s knowledge of danger signs and birth preparedness and complication readiness in Paper II. The effect of the Home Based Life Saving Skills education programme in the community was assessed with a before-and-after evaluation in two districts; one intervention and one comparison. Paper III assessed the effect of the programme on knowledge of danger signs and birth preparedness and facility delivery among women, while Paper IV evaluated its effect on male involvement.The community perceived that all births must be prepared for and that obstetric complication demands hospital care; hence skilled care was favoured. Men’s knowledge of danger signs was limited; only 12% were prepared for childbirth and complications. Preparedness was associated with knowledge of obstetric complications (AOR=1.4 95% CI 1.8 – 2.6). The intervention showed women utilizing antenatal care (four visits) significantly more (43.4 vs 67.8%) with a net effect of 25.3% (95% CI: 16.9 – 33.2; p < .0001). The use of facility delivery improved in the intervention area (75.6 vs 90.2%; p = 0.0002), but with no significant net effect 11.5% (95% CI: -5.1 – 39.6; p = 0.123) when comparing the two districts. Male involvement improved (39.2% vs 80.9%) with a net intervention effect of 41.1% (CI: 28.5 – 53.8; p < .0001). Improvements were demonstrated in men’s knowledge level, in escorting partners for antenatal care and delivery, making birth preparations, and shared decision-making.The intervention, in educating this rural community, is effective in improving knowledge, birth preparedness, male involvement and use of skilled care.
|
|
| 10. |
|
|
| 11. |
- August, Furaha, 1973-, et al.
(författare)
-
Men's Knowledge of Obstetric Danger Signs, Birth Preparedness and Complication Readiness in Rural Tanzania
- 2015
-
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:5, s. e0125978-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Men's involvement in reproductive health is recommended. Their involvement in antenatal care service is identified as important in maternal health. Awareness of obstetric danger signs facilitates men in making a joint decision with their partners regarding accessing antenatal and delivery care. This study aims to assess the level of knowledge of obstetric complications among men in a rural community in Tanzania, and to determine their involvement in birth preparedness and complication readiness.METHODS: A cross-sectional survey was conducted where 756 recent fathers were invited through a two-stage cluster sampling procedure. A structured questionnaire was used to collect socio-demographic characteristics, knowledge of danger signs and steps taken on birth preparedness and complication readiness. Data were analyzed using bivariate and multivariable logistic regression to determine factors associated with being prepared, with statistically significant level at p<0.05.RESULTS: Among the invited men, 95.9% agreed to participate in the community survey. Fifty-three percent could mention at least one danger sign during pregnancy, 43.9% during delivery and 34.6% during the postpartum period. Regarding birth preparedness and complication readiness, 54.3% had bought birth kit, 47.2% saved money, 10.2% identified transport, 0.8% identified skilled attendant. In general, only 12% of men were prepared. Birth preparedness was associated with knowledge of danger signs during pregnancy (AOR = 1.4, 95% CI: 1.8-2.6). It was less likely for men living in the rural area to be prepared (AOR=0.6, 95% CI; 0.5-0.8).CONCLUSION: There was a low level of knowledge of obstetric danger signs among men in a rural district in Tanzania. A very small proportion of men had prepared for childbirth and complication readiness. There was no effect of knowledge of danger signs during childbirth and postpartum period on being prepared. Innovative strategies that increase awareness of danger signs as well as birth preparedness and complication readiness among men are required. Strengthening counseling during antenatal care services that involve men together with partners is recommended.
|
|
| 12. |
|
|
| 13. |
- Axemo, Pia, et al.
(författare)
-
Training university teachers and students in Sri Lanka on Gender Based Violence: testing of a participatory training program
- 2018
-
Ingår i: MedEdPublisher. - : F1000 Research Ltd. - 2312-7996.
-
Tidskriftsartikel (refereegranskat)abstract
- In all societies, violence is a social problem and violation of human rights. Changing attitudes and behaviors, which accept violence atindividual and societal levels are key components in prevention strategies.The aim of this study was to produce educational material on Gender Based Violence (GBV). A participatory study design including educators and university students was used to create four teaching modules. The teaching was evaluated by descriptive surveys before andafter the training and focus group discussions followed the training session. The questionnaire covered attitudes to gender, violence and laws. One hundred eleven teachers and 25 students representing different faculties and universities participated in separate workshops in three Sri Lankan universities. The students lacked knowledge of the meaning of GBV, consequences and existing laws. Women held more gender-equitable attitudes. Both women and men favoured equal participation of work and decision in the households. Male undergraduates showed less accepting attitudes toward rape or blaming women for rape Three categories emerged after the FGDs; Maketraining module compulsory and teacher led; Mind your own business; What can be done.The newly prepared and context specific material was well-received by educators and students and they provided valuable inputs, which improved the educational modules.
|
|
| 14. |
- Darj, Elisabeth, 1953-, et al.
(författare)
-
'Even though a man takes the major role, he has no right to abuse' : future male leaders' views on gender-based violence in Sri Lanka
- 2017
-
Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Distinct gender roles influence gender inequality and build the foundation for gender-based violence. Violence against women is a major public health problem in all societies, and a violation of human rights. Prevalence surveys on gender-based violence have been published from Sri Lanka, but qualitative studies on men's perceptions are lacking. Objectives: The aim of this study was to explore young educated Sri Lankan men's perceptions of violence against women. Methods: Seven focus-group discussions were held. Men at the end of their university studies were purposefully selected. A topic guide was used, covering various scenarios of violence against women. Qualitative content analysis was carried out. Results: Four categories were developed through the analytic process: fixed gender roles patriarchal values are accepted in society, female mobility control, and slowly changing attitudes; violence not accepted but still exists - sexual harassment exists everywhere, different laws for different people, female tolerance of violence, and men's right to punish; multiple factors cause violence - alcohol, violent behavior is inherited, violence culturally accepted, low education, and lack of communication; and prevention of violence against women - both parents must engage and socialize girls and boys equally, life skills education, premarital counselling, working places value clarification, and more women in politics and boards are suggested. Conclusions: Medical and management students, possible future male leaders of the country, have suggestions of prevention strategies in life skills to reduce gender-based violence and to increase knowledge of health consequences with the aim of changing attitudes.
|
|
| 15. |
- Eriksson, Elisabet, et al.
(författare)
-
Ambivalence, silence and gender differences in church leaders' HIV-prevention messages to young people in KwaZulu-Natal, South Africa
- 2010
-
Ingår i: Culture, Health and Sexuality. - : Informa UK Limited. - 1369-1058 .- 1464-5351. ; 12:1, s. 103-114
-
Tidskriftsartikel (refereegranskat)abstract
- A series of semi-structured interviews on HIV prevention were conducted with South African clergy with pastoral and liturgical responsibilities from the Roman Catholic Church, the Lutheran Church and the Assemblies of God. The interviews were tape-recorded, transcribed verbatim and analysed by interpretive descriptive analysis. Three themes indicative of church leaders' approach to HIV prevention among youth emerged: dilemmas in breaking the silence on HIV and AIDS; ambivalent HIV-prevention messages from church leaders to young people; and gender differences in HIV-prevention messages. While church leaders had taken steps to overcome the stigma, the dilemmas of balancing theological understanding with resistance from their congregations presented a complex scenario. Ambivalence to HIV prevention concerned whose responsibility it was to educate young people about HIV; talking about sexuality in public; pre-marital abstinence and condom use; and resistance from congregation members towards HIV prevention. Finally, findings indicated a discrepancy between church leaders' belief in gender equality and the HIV-prevention messages they verbalised, which appears to burden girls.
|
|
| 16. |
- Eriksson, Elisabet
(författare)
-
Christian Communities and Prevention of HIV among Youth in KwaZulu-Natal, South Africa
- 2011
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Young people in South Africa, particularly females, are at great risk of acquiring HIV, and heterosexual sex is the predominant mode of HIV transmission. In order to curb the epidemic the Department of Health encourages all sectors in the society, including religious institutions, to respond effectively. The present thesis seeks to increase the understanding of the role of Christian communities in prevention of HIV for young people. Three denominations in KwaZulu-Natal were selected to reflect the diversity of Christian churches in South Africa: the Roman Catholic Church, the Evangelical Lutheran Church in Southern Africa, and the Assemblies of God. Using qualitative interviews the first paper explores how religious leaders (n=16) deal with the conflict between the values of the church and young people’s sexuality. Study II reports on attitudes to HIV prevention for young people among religious leaders (n=215) using questionnaire survey data. Study III investigates how young people (n=62) reflect on messages received from their churches regarding premarital sex by analysing nine focus group discussions. In the fourth paper, based on questionnaire survey data, we report on young people’s (n=811) experiences of relationships with the opposite sex and their perceived risk of HIV infection. The view that young people in churches are sexually active before marriage was common among religious leadership. The majority of religious leaders also reported that they are responsible for educating young people about HIV prevention. Religious leaders who had received training on HIV were more likely to run a life skills programme for young people, however they were ambivalent about prevention messages. Young people reported premarital sexual abstinence as the main HIV prevention message from their churches. The majority responded that they had received information about HIV in church. To be in a relationship was common, more so for males for whom multiple relationships also were viewed more acceptable. To perceive themselves at risk of HIV infection was common. Further training for religious leaders is needed to enable them to manage the conflict between the doctrine of the church and their willingness to assist young people in the transition into adulthood.
|
|
| 17. |
- Eriksson, Elisabet, et al.
(författare)
-
Faith, Premarital Sex and Relationships: Are Church Messages in Accordance with the Perceived Realities of the Youth? : A Qualitative Study in KwaZulu–Natal, South Africa
- 2013
-
Ingår i: Journal of religion and health. - : Springer Science and Business Media LLC. - 0022-4197 .- 1573-6571. ; 52:2, s. 454-466
-
Tidskriftsartikel (refereegranskat)abstract
- Since religious messages on life style have a strong impact in South Africa, it is important to assess how they relate to the situation for young people at risk of HIV infection. Nine focus group discussions were conducted with youth (n=62), aged 13–20 years, from the Roman Catholic Church, the Lutheran Church, and the Assemblies of God. Young people were ambivalent toward sexual contacts since these generally were expected to be part of a relationship even though the church condemns premarital sex. Girls perceived the moral norms to concern them more than the boys for whom sexual needs were more accepted. These moral barriers lead to lack of information about protection and may increase the risk of HIV. The realities young people facing should be a major concern for the faith communities.
|
|
| 18. |
- Eriksson, Elisabet, et al.
(författare)
-
Involvement of religious leaders in HIV prevention, South Africa
- 2011
-
Ingår i: Svensk Missionstidsskrift. - 0346-217X. ; 99:2, s. 119-135
-
Tidskriftsartikel (refereegranskat)abstract
- Religious leaders do not easily get involved in HIV prevention for young people since discussing sexuality publicly is taboo. A self-administrated questionnaire survey was conducted among local religious leaders (n=215) August-October 2008, when they convened at regional meetings in KwaZulu-Natal, South Africa. The questionnaire included socio-demographic data, previous HIV education and attitudes to HIV prevention for young people, policy issues, and questions on stigma. The participants (186 males, 29females) were affiliated to the Catholic Church (66), Lutheran church (82),and the Assemblies of God (67). Religious leaders regarded themselves as responsible for educating young people about HIV, and were interested in topics concerning young people’s sexuality. However, only 39% reported that their church had run a life-skill programme for youth in the last six months. The results indicated that religious leaders who had participated in HIV training were more likely to have arranged a life-skill programme for young people and also more likely to have taken an HIV test. Religious leaders were positive about further training on HIV- related issues, and if learning opportunities are offered to them, this might increase their involvement in HIV prevention among young people.
|
|
| 19. |
- Eriksson, Elisabet, et al.
(författare)
-
Sexuality and HIV prevention: concerns of young people within faith communities in KwaZulu–Natal, South Africa :
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This paper explores HIV prevention messages reported by young people, and their perceived risk of HIV infection in faith communities. A questionnaire survey was conducted, including young people (n=1102) affiliated to the Roman Catholic Church, the Lutheran Church and the Assemblies of God. The questionnaire included: sociodemographic characteristics, the teachings of the churches on sexuality and HIV prevention, experiences of relationships, and the perceived risk of HIV infection. Participants were also encouraged to write questions on sexuality and HIV/AIDS. Unmarried individuals aged 15-24 years (n=811) were included in the analysis. The majority (83%) participated in youth groups and considered themselves as religious (80%). Premarital sexual abstinence was the most frequent (88%) reported prevention message from the church, followed by: faithfulness (23%), HIV testing (18%), and condom use (17%). The majority (83%) had experience of a relationship and perceived themselves at risk of HIV infection (53%); 29% of the respondents had been tested. Using binary logistic regression analysis, we found that religious affiliation was associated with education on sexuality and HIV in youth groups, suggesting better information for members in the Lutheran and Catholic churches. Lutheran youth were more likely to be tested for HIV. The personal questions illustrated that young people in churches have serious questions about their sexuality, relationships, and HIV transmission. In conclusion, faith communities focus on abstinence messages, while the information on sexuality and relationships appear to be less frequent. Faith communities need to strengthen their capacity to educate young people about sexuality, relationships and HIV prevention.
|
|
| 20. |
- Eriksson, Elisabet, et al.
(författare)
-
Young people, sexuality, and HIV prevention within Christian faith communities in South Africa : a cross-sectional survey
- 2014
-
Ingår i: Journal of religion and health. - : Springer Science and Business Media LLC. - 0022-4197 .- 1573-6571. ; 53:6, s. 1662-1675
-
Tidskriftsartikel (refereegranskat)abstract
- Faith communities exert a powerful influence on the life of their members, and studies are needed about how they may be able to influence young people's attitudes regarding sexuality and HIV prevention. Data were collected through a self-administered questionnaire from young people (811), aged 15-24 years, affiliated to the Roman Catholic Church, the Lutheran Church and the Assemblies of God. The majority of participants perceived themselves at risk of HIV infection (53 %). Premarital sexual abstinence was the most frequently (88 %) reported prevention message, followed by faithfulness (23 %), HIV testing (18 %) and condom use (17 %). Furthermore, religious affiliation was associated with education on sexuality and HIV in youth groups, with better information given to members of the Lutheran and Catholic churches. Faith communities need to strengthen their capacity to educate young people in a more holistic way about sexuality and HIV prevention.
|
|
| 21. |
- Granlund, Margareta, et al.
(författare)
-
Antimicrobial resistance in colonizing group B Streptococci before the implementation of a Swedish intrapartum antibiotic prophylaxis program.
- 2010
-
Ingår i: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. - : Springer Science and Business Media LLC. - 1435-4373 .- 0934-9723. ; 29:10, s. 1195-201
-
Tidskriftsartikel (refereegranskat)abstract
- The prevalence of antibiotic resistance and their genetic determinants in colonizing group B streptococci (GBS) sampled in a Swedish nationwide survey was examined. In five GBS isolates (1.3%), kanamycin/amikacin resistance and the presence of the aphA-3 gene was identified. Three of these isolates carried the aad-6 gene and were streptomycin-resistant. Screening with kanamycin and streptomycin 1,000-μg disks enabled a rapid and easy detection of these isolates. In all, 312/396 (79%) GBS were tetracycline-resistant and 95% of the examined isolates harbored the tetM gene. Among the 22 (5.5%) GBS resistant to erythromycin and/or clindamycin, the ermB gene was detected in nine isolates (41%) and erm(A/TR) in ten isolates (45%). A high level of erythromycin and clindamycin resistance with minimum inhibitory concentrations (MICs) >256mg/L was found in four serotype V isolates that harbored ermB. The erythromycin/clindamycin resistance was distributed among all of the common serotypes Ia, Ib, II, III, IV, and V, but was not present in any of the 44 serotype III isolates associated to clonal complex 17. Screening for penicillin resistance with 1-μg oxacillin disks showed a homogenous population with a mean inhibition zone of 20mm. A change in the present oxacillin breakpoints for GBS is suggested.
|
|
| 22. |
- Håkansson, Stellan, et al.
(författare)
-
Group B streptococcal carriage in Sweden : a national study on risk factors for mother and infant colonisation
- 2008
-
Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - Stockholm : Wiley. - 0001-6349 .- 1600-0412. ; 87:1, s. 50-58
-
Tidskriftsartikel (refereegranskat)abstract
- Background. To study group B streptococcus (GBS) colonisation in parturients and infants in relation to obstetric outcome and to define serotypes and antibiotic resistance in GBS isolates acquired. Methods. A population-based, national cohort of parturients and their infants was investigated. During 1 calendar week in 2005 all women giving birth (n=1,754) were requested to participate in the study. Results. A total of 1,569 mother/infant pairs with obstetric and bacteriological data were obtained. Maternal carriage rate was 25.4% (95% confidence interval (CI): 23.3-27.6). In GBS-positive mothers with vaginal delivery and no intrapartum antibiotics, the infant colonisation rate was 68%. Some 30% of infants were colonised after acute caesarean section, and 0% were colonised after an elective procedure. Duration of transport of maternal recto/vaginal swabs of more than 1 day impeded culture sensitivity. Infant mMales were more frequently colonised than females (76.9 versus 59.8%, odds ratio (OR): 2.16; 95% CI: 1.27-3.70), as were infants born after rupture of membranes ≥24 h (p =0.039). Gestational age, birth weight and duration of labor did not significantly influence infant colonisation. Some 30% of parturients with at least one risk factor for neonatal disease received intrapartum antibiotics. The most common GBS serotypes were type III and V. Some 5% of the isolates were resistant to clindamycin and erythromycin, respectively. Conclusions. Maternal GBS prevalence and infant transfer rate were high in Sweden. Males were more frequently colonised than females. The sensitivity of maternal cultures decreased with the duration of sample transport. Clindamycin resistance was scarce. The use of intrapartum antibiotics was limited in parturients with obstetric risk factors for early onset group B streptococcal disease.
|
|
| 23. |
- Jayasuriya, Vathsala, et al.
(författare)
-
Intimate Partner Violence Against Women in the Capital Province of Sri Lanka : Prevalence, Risk Factors, and Help Seeking
- 2011
-
Ingår i: Violence against Women. - : SAGE Publications. - 1077-8012 .- 1552-8448. ; 17:8, s. 1086-1102
-
Tidskriftsartikel (refereegranskat)abstract
- This article presents findings from a cross-sectional community survey exploring intimate partner violence (IPV) against women in the Western province of Sri Lanka. Findings show that lifetime prevalence of physical violence (34%), controlling behavior (30%), and emotional abuse (19%) was high and the prevalence of sexual violence was low (5%). Young women and those with partners who abused alcohol/drugs and had extra-marital affairs are at increased risk of violence. Although living in a patriarchal society, low prevalence of child marriages and lack of dowry-related violence could be to Sri Lankan women's advantage relative to their Asian counterparts in preventing IPV.
|
|
| 24. |
- Muganyizi, c, 1961-
(författare)
-
Rape against Women in Tanzania : Studies of Social Reactions and Barriers to Disclosure
- 2010
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis assessed responses toward rape against women as experienced by the victims and victim supporters in the context of the interaction between victims, supporters, and formal agencies in Tanzania. The overall research design was based on triangulation with a combination of qualitative and quantitative methods. A semi-qualitative study, in which free listings and semi-structured questionnaires were used, explored social reactions from 44 community nurses and 50 rape victims (Paper I). A tool developed from this first study was utilized for collecting data on people’s attitudes and their behavior toward rape and rape victims from a representative community sample of 1505 men and women aged 18-65 years (Paper II). Both studies helped to access suitable rape victims and supporters who participated in the third study to share experiences on the process of rape disclosure to formal and informal social networks (Papers III and IV). The results highlighted the salient social reactions and how rape victims perceived the impact of these reactions. Half of the participants interpreted rape situations based on social relationships, circumstances, and social status of the woman, rather than the legal definition. Two-thirds of the adults explained they would express negative social reactions toward a victim in some rape scenarios, and this correlated with their attitudes towards rape and rape victims. A variety of barriers in the informal and formal networks with potentially negative impacts on rape reporting, service utilization and, health outcomes were identified. In conclusion, successful interventions aimed at improving people’s response to rape, rape disclosure and, health outcomes in Tanzania should assume a holistic approach to address the negative factors identified at the individual, family and, community levels without forgetting the normative context that appears to underlie most decisions and practice.
|
|
| 25. |
- Muganyizi, Projestine, 1961-, et al.
(författare)
-
Effect of Supporter Characteristics on Expression of Negative Social Reactions Toward Rape Survivors in Dar Es Salaam, Tanzania
- 2010
-
Ingår i: Health Care for Women International. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 31:8, s. 668-685
-
Tidskriftsartikel (refereegranskat)abstract
- Using a community representative sample of 1,505 adults we examined interpretations of rape situations in order to establish attitudes toward rape. We assessed their intentions to express negative social reactions (NSRs) toward rape survivors. We then determined effects of attitudinal and sociodemographic characteristics in logistic regression models assessing the odds of expressing NSRs. Being old, male, and Muslim, and failing to interpret the legal circumstances of rape increased their risks of expressing NSRs. The degree of interpretation of lack of consent as rape affected their intentions to express NSRs, but not how they responded to survivors of different social status.
|
|
| 26. |
- Muganyizi, Projestine, 1961-, et al.
(författare)
-
Managing in the Contemporary World : Rape Victims’ and Supporters’ Experiences of Barriers Within the Police and the Healthcare System in Tanzania
- 2011
-
Ingår i: Journal of Interpersonal Violence. - Newbury Park, Calif. : SAGE Publications. - 0886-2605 .- 1552-6518. ; 26:16, s. 3187-3209
-
Tidskriftsartikel (refereegranskat)abstract
- Grounded theory guided the analysis of 30 in-depth interviews with raped women and community members who had supported raped women in their contact with the police and health care services in Tanzania. The aim of this study was to understand and conceptualize the experiences of the informants by creating a theoretical model focusing on barriers, strategies, and responses during the help seeking process. The results illustrate a process of managing in the contemporary world characterized as walking a path of anger and humiliation. The barriers are illustrated by painful experiences of realizing it's all about money, meeting unprofessionalism and irresponsibility, subjected to unreliable services, and by being caught in a messed-up system. Negotiating truths and knowing what to do capture the informants' coping strategies. The study indicates an urgent need for improvement in the formal procedures of handling rape cases, improved collaboration between the police and the health care system, as well as specific training for professionals to improve their communication and caring skills.
|
|
| 27. |
- Muganyizi, Projestine, 1961-, et al.
(författare)
-
Reporting Rape : Experiences of Rape Victims and Supporters of Barriers Created in the Informal Networks in Dar es Salaam
- 2011
-
Ingår i: Violence against Women. - 1077-8012 .- 1552-8448.
-
Tidskriftsartikel (refereegranskat)abstract
- To understand the barriers rape victims and their supporters face from their informal networks while disclosing rape events in Tanzania, 30 in-depth interviews with victims and supporters were conducted. We found, that decisions to disclose rape events were influenced at the individual, family, and community levels. The overall theme, ‘normative justification of rape’ indicated wider societal beliefs and attitudes through all levels. The categories ‘internalizing shame and fearing the consequences’, ‘defending family integrity’, ‘reconciling role of the elders’, and ‘marginalizing victims and supporters’ captured the impact the identified normative justification of rape had on specific levels. The possible consequences and implications for interventions are discussed.
|
|
| 28. |
- Muganyizi, Projestine S, et al.
(författare)
-
Social reactions to rape : experiences and perceptions of women rape survivors and their potential support providers in Dar es Salaam, Tanzania
- 2009
-
Ingår i: Violence and Victims. - : Springer Publishing Company. - 0886-6708 .- 1945-7073. ; 24:5, s. 607-26
-
Tidskriftsartikel (refereegranskat)abstract
- Social reactions to rape are socioculturally determined and have a strong influence on the coping and recovery of the survivor. The existing knowledge on social reactions emanates from Western countries with limited research attention on non-Western populations, particularly sub-Saharan Africa. We aimed to establish the types and perceptions of social reactions that are expressed to rape survivors and people's intentions to express them to survivors of varied social backgrounds in Tanzania. Using triangulation of research methods, experiences of social reactions among rape survivors (n = 50) and nurses (n = 44) from a community in Tanzania were explored, and the intentions to express typical social reactions to rape survivors of different social backgrounds were established from a representative community sample (n = 1,505). Twelve typical social reactions were identified with the positive reactions more commonly mentioned than the negative reactions. Nondisclosure of rape events and distracting the survivor from the event were perceived as both positive and negative. A commercial sex worker was most vulnerable to negative reactions. The cultural influences of social reactions and implications for practical applicability of the results are discussed.
|
|
| 29. |
- Wickramasinghe, Ayanthi, et al.
(författare)
-
‘I don’t know how we can stop ragging’ : a qualitative study on the perceptions of staff and work-affiliated individuals at a Sri Lankan university, on the phenomena of ragging
- 2023
-
Ingår i: Contemporary South Asia. - : Routledge. - 0958-4935 .- 1469-364X.
-
Tidskriftsartikel (refereegranskat)abstract
- Ragging in Sri Lanka is a longstanding initiation ritual, similar to hazing and bullying. The severe harassment of new students by seniors has led to adverse consequences including depression, university dropouts and suicide. Although, a significant problem, research on ragging is scarce. This research aimed to explore how staff and work-affiliated individuals at Jaffna University resonate around the phenomenon of ragging. Seven focus group discussions and eleven semi-structured interviews were conducted. Foucauldian Discourse Analysis and Bandura’s Moral Disengagement theory were used to interpret the data. Three main discourses reflected the context: ragging as normal and necessary, insecurity and fear of reprisal, and voices of resistance. Participants often felt unsupported and therefore adapted their moral compasses to survive in this insecure environment. These findings demonstrate a fragmented approach to ragging that not only diminished any efforts towards elimination but affected how staff were forced to adjust their behavior to work in this environment. To address ragging, there is a need to adhere to a consistent strategy focusing on increasing awareness and supporting staff by holding accountable those at all levels of the administrative hierarchy in promoting a safe working environment for all.
|
|
| 30. |
- Wickramasinghe, Ayanthi, et al.
(författare)
-
Prevalence of depression among students at a Sri Lankan University : A study using the Patient Health Questionnaire-9 (PHQ-9) during the COVID-19 pandemic
- 2023
-
Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe prevalence of mental health disorders is known to be high among university students globally. Currently there are only a few studies on depression among university students in Sri Lanka. The aim of this study was to screen for the prevalence of Major Depressive Disorder (MDD) and other forms of depression, and to evaluate the factors associated with MDD.MethodsA cross sectional survey using the Patient Health Questionnaire (PHQ-9) was conducted among 637, second-year students from the faculties of Management Studies & Commerce, Science and Medicine at the University of Jaffna, during the Coronavirus (COVID-19) pandemic. Bivariate associations were assessed using chi-squared tests. Logistic regression was used to evaluate factors associated with any type of ragging.ResultsMDD was considered to have been experienced by 31% of the students. From all three faculties, 70% of the students claimed to have experienced some form of depression ranging from mild to severe. The factor associated with MDD was the students’ ethnicity.ConclusionDue to the high MDD risk among university students, it is imperative to develop psychosocial interventions to ensure early detection of mental health disorders and provide adequate support to safeguard this vulnerable population.
|
|
| 31. |
- Wickramasinghe, Ayanthi, et al.
(författare)
-
Ragging, a Form of University Violence in Sri Lanka-Prevalence, Self-Perceived Health Consequences, Help-Seeking Behavior and Associated Factors
- 2022
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:14
-
Tidskriftsartikel (refereegranskat)abstract
- Ragging is an initiation ritual practiced in Sri Lankan universities for generations, although research is scarce. This practice has several adverse consequences such as physical, psychological, and behavioral effects and increased university dropouts. The aim of this study was to investigate the prevalence of different types of ragging: emotional/verbal, physical and sexual ragging, self-perceived health consequences, help-seeking behavior, and factors associated with the experience of ragging. A cross-sectional study was conducted among 623, second- and third-year students from the medical, and technology faculties in Jaffna University. Bivariate associations were assessed using chi-squared tests. Logistic regression was used to evaluate factors associated with any type of ragging. Ragging was experienced by 59% of the students, emotional/verbal ragging being the most common. A total of 54% of students suffered one or more health consequences and mainly sought help from friends and family, with few seeking formal help. Factors associated with any type of ragging were faculty and year of study. This study emphasizes the urgent need to address this public health problem. It is important that there are adequate student support services, planning and implementation of effective interventions, as well as ensuring that existing policies are strengthened, to reduce or eliminate ragging in Sri Lanka.
|
|
| 32. |
- Wickramasinghe, Ayanthi, et al.
(författare)
-
Ragging as an expression of power in a deeply divided society : a qualitative study on students perceptions on the phenomenon of ragging at a Sri Lankan university
- 2022
-
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:7
-
Tidskriftsartikel (refereegranskat)abstract
- Initiation rituals such as hazing, bullying, and ragging, as it is referred to in Sri Lanka, is a global phenomenon and has become a serious public health problem. Students are bullied and harassed by senior students causing them to suffer severe adverse consequences including depression, increased university dropouts and suicide. Although this has led to a significant burden on the country, research on ragging is scarce. The aim of this study was to explore the perceptions of students concerning the phenomenon of ragging and to understand how ragging affects student life and culture at the University of Jaffna, Sri Lanka. This paper is based on 17 focus group discussions with male and female students of Sinhalese, Tamil, and Muslim ethnicity. Thematic analysis was employed to navigate through the theoretical lenses of structural violence, intersectionality, and social dominance. The findings revealed how students perceived ragging differently; as an expression of power to initiate order and as a way to express dissatisfaction towards social inequalities occurring within the larger society or to facilitate bonds between university students. Students trivialized violence related to ragging and accepted it as a part of the university subculture despite being aware of the dire consequences. There was a described cyclical nature to ragging whereby victims become perpetrators. The student’s perspective appeared to be a missed opportunity in finding feasible solutions to a societal problem that must take all parties involved, into consideration.
|
|
| 33. |
- Wickramasinghe, Ayanthi
(författare)
-
The Phenomenon of Ragging : Violence among University students in Sri Lanka
- 2022
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Ragging is an initiation ritual carried out in Sri Lankan universities, where new students are harassed by senior students. This practice has severe adverse consequences including depression, increased university dropouts and suicide. Although this is a significant public health problem and a burden on the country, research on ragging is scarce.This thesis aimed to investigate and gain a deeper understanding of the phenomenon of ragging, through the various perspectives of students and individuals attached to the University of Jaffna, Sri Lanka. The prevalence of Major depressive disorder (MDD) among the students was also examined. Paper I, a cross-sectional survey, demonstrated that 59% of the students from the faculties of Medicine and Technology experienced ragging. Health consequences were experienced by 54% and help was mainly sought from friends and family. The student’s faculty and year of study was associated with ragging.In Paper II, 17 focus group discussions (FGD) were conducted with students representing all faculties. Thematic analysis was employed to navigate through the theoretical lenses of structural violence, intersectionality, and social dominance. Findings revealed students used ragging as an expression of power to initiate order and express dissatisfaction towards social inequalities. Students trivialized violence despite being aware of the dire consequences.In Paper III, 11 semi-structured interviews and seven FDGs were conducted with staff and work-affiliated individuals at the university. Foucauldian Discourse Analysis and Bandura’s Moral Disengagement theory were utilized to interpret the findings. The main discourses were; Ragging as normal and necessary, Insecurity and fear of reprisal, and Voices of resistance. Participants felt unsupported and in order to survive in this insecure environment, they adapted their moral judgments.In Paper IV, Patient Health Questionnaires (PHQ-9) were used to screen for MDD among students (n=637), from Faculties of Management, Science and Medicine. MDD was experienced by 31% of students. Among all the student participants, 70% had experienced some form of depression ranging from mild to severe. MDD was associated with the student’s ethnicity.Interventions targeting both individual and multisectoral levels are needed in order to curb ragging, and create a safe and nurturing environment for all.
|
|
