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Background: This article addresses the intersectional challenges faced by Queer people living with disabilities (QPwD). Objectives: The article aims to highlight the nature and extent of their struggles while proposing inclusive policies for societal integration and equality. Amid global efforts to promote Queer rights, discrimination and violence persist, particularly affecting those with disabilities. Method: Drawing upon a comprehensive review of literature and empirical research, this study investigated the experiences of QPwD, identifying key challenges such as limited access to inclusive services, heightened vulnerability to abuse and systemic unemployment. The methodological approach used in this study involves synthesising existing scholarship and empirical evidence to inform the proposed inclusive policies. Results: The findings reveal pervasive barriers encountered by QPwD, including societal stigma, attitudinal biases and physical obstacles. Discrimination in employment, education and healthcare further exacerbates their marginalisation, necessitating proactive measures to address systemic inequalities and promote social inclusion. Conclusion: In conclusion, this article underscores the urgent need for policy reforms and societal interventions to uphold the rights and dignity of QPwD. By advocating for Queer-inclusive workplace policies, enhancing accessibility in public infrastructure and fostering governmental support for equality initiatives, this study contributes to advancing social justice and inclusivity. Contribution: The article calls for concerted efforts to create a more equitable and inclusive society where all individuals, regardless of their sexual orientation or disability status, can thrive and fulfil their potential.

Background: Transgender women bear a huge burden of human immunodeficiency virus (HIV) in South Africa. However, they are not fully engaged in healthcare across the HIV continuum of care. In addition, transgender women face multiple facets of stigma and discrimination as well as socio-economic inequalities, which all have a negative impact on antiretroviral therapy (ART) adherence. Objective: The study aimed at exploring and describing the experiences of ART adherence of transgender women living with HIV in the Buffalo City Metro Municipality. Methods: The study employed an interpretative phenomenological analysis (IPA) design. Twelve participants were enrolled using a snowballing sampling technique. Data were collected using semi-structured interviews and analysed using an IPA framework. Results: While exploring determinants to ART adherence among transgender women living with HIV in Buffalo City Metro, two superordinate themes emerged: enablers to ART adherence and psychosocial factors promoting adherence. The study found that factors such as differentiated ART service delivery, ARV medicines-related factors, motivators for taking treatment and support systems facilitated ART adherence. Conclusion: Emerging from this study is the need to scale up differentiated, person-centred ART service deliveries that will enhance access and adherence to treatment for transgender women. Contribution: This study provides unique insights on factors enhancing ART adherence among transgender women. There is a paucity of literature on access to HIV care services for key and vulnerable populations, and these findings will be shared in the country and in the region.

Same-sex practices are commonly medicalised in various global spaces. Some societies view same-sex practices as some form of disease that needs to be cured. In Africa, the influence of Christianity has prompted many communities to conclude that there are spiritual forces behind same-sex orientations and practices. Therefore, same-sex practices are demonised, and those identifying with these sexualities and gender identities are viewed as sick, or as having some form of mental illness. As a fast-growing and influential movement in South Africa, Christianity plays a critical role in this narrative. Against this backdrop, this article examined how some Pentecostal pastors in South Africa use God-talk to propel the narrative that medicalises same-sex practices and how these pastors claim to have miraculous powers to heal these practices. Consequently, the gender and sexuality commonly accepted within African religiosity and spirituality are pushed to the peripheries. Therefore, it is argued in this article that the colonial-missionary discourses regarding African sexualities and genders are at play within the religious medicalisation of same-sex narratives. Thus, there is a need to problematise and transform this narrative. This act can contribute to delinking African genders and sexualities from Western repressions and subjugation agendas. The discussion moved from the premise of decoloniality while adopting a multidisciplinary approach that incorporated theology, gender and sexuality studies, psychology, health, and socio-political sciences. Again, the article used secondary literature analysis to examine this phenomenon and to gain a thorough understanding of how African Pentecostalism continues to use God-talk to medicalise same-sex practices in contemporary South Africa and the repercussions thereof. Contribution: The study contributed to the existing knowledge that addresses religious challenges faced by people identifying with non-normative sexualities and genders in Africa. This can contribute to the transformation of religious medicalisation of same-sex practices in South Africa, and elsewhere.

Background: The coronavirus disease 2019 (COVID-19) pandemic has further placed additional stress on the already fragile and overstretched healthcare system in Zimbabwe. Most healthcare institutions reported staff shortages, inability to cope with the extra workload, burnout and the resultant psychological implications. Objectives: This study aimed to develop a psychosocial support model that sustains a support structure that will contribute to an enabling work environment promoting efficiency and effectiveness in response to public health emergencies. Method: Empirical findings from interpretive phenomenological analysis studies on healthcare workers’ experiences during the COVID-19 in Zimbabwe formed the basis for model development. The model development in this study was informed by the work of Donabedian, Dickoff, James and Wiedenbach, Walker and Avant, Chinn, Kramer and Wilkes. Results: The developed model is described using the elements of Donabedian’s framework (structure, process and outcome) and of Dickoff, James and Wiedenbach’s (1968) practice theory elements (agents, recipients, context, process, dynamics and outcome) and within the national and international context of the COVID-19 pandemic. Conclusion: The fragile and under-resourced healthcare system has psychosocial implications to the well-being of healthcare workers. The utilisation of this model is critical and facilitates the provision of an enabling and supportive environment that facilitates efficiency in response activities during pandemics. Contribution: This study provides a reference guide in the provision of psychosocial support for healthcare workers particularly during public health emergencies. There is paucity of evidence focusing on the well-being of healthcare workers during a crisis, hence the significance of this study.

Background: Despite government initiatives to ensure the delivery of safe and high-quality care in health establishments, most health establishments in the City of Tshwane Metropolitan Municipality, South Africa were non-compliant with the National Core Standards. This study explored the experiences of quality assurance managers regarding quality standards implementation in these establishments. Objectives: This study aimed to explore and describe factors affecting the implementation of quality standards at public health facilities based on quality assurance managers’ lived experiences in the research setting. Method: This qualitative study used phenomenological design by conducting individual in-depth interviews with nine purposively selected quality assurance managers in 2021. The collected data were analysed using Colaizzi’s phenomenological analysis framework. Results: The study’s findings revealed that the legislative framework and the policy environment were motivators for quality standard compliance among the participants. Furthermore, human resources, materials-related issues and poor infrastructure were found to be barriers to the implementation of quality standards in health facilities. Conclusion: The explored and described barriers must be addressed to improve compliance with the National Core Standards at public health facilities in the City of Tshwane Metropolitan Municipality. In addition, capacity-building for quality assurance managers should be ongoing to ensure the highest quality implementation standards and to strengthen the enforcement of quality standard regulations. Contribution: The study’s findings explored and described the factors that influence the implementation of quality standards. Addressing these factors could improve the quality of healthcare delivery in the research setting’s health facilities.

BackgroundThere is presently dearth of evidence in Ethiopia on patients' perception on quality of care given for multi-drug resistant tuberculosis (MDR-TB) and their satisfaction with the care and services they receive for the disease. Moreover, there is no evidence on the experiences and practices of caregivers for MDR-TB regarding the functionality of the programmatic management of MDR-TB at referral hospitals in Ethiopia. Thus, this study was conducted to address these gaps. Evidence in these areas would help to institute interventions that could enhance patient satisfaction and their adherence to the treatment given for MDR-TB.Design and methodsThis study employed an inductive phenomenological approach to investigate patients' perception of the quality of care given for MDR-TB, level of their satisfaction with the care they received for MDR-TB and the experiences and practices of caregivers for MDR-TB on the functionality of the programmatic management of MDR-TB at referral hospitals in Ethiopia. The data were analysed manually, and that helped to get more control over the data.ResultsThe majority of the patients were satisfied with the compassionate communication and clinical care they received at hospitals. However, as no doctor was dedicated exclusively for the MDR-TB centre of the hospitals, patients could not get timely medical attention during emergent medical conditions. Patients were dissatisfied with the poor communication and uncaring practice of caregivers found at treatment follow-up centres (TFCs). Patients perceived that socio-economic difficulties are both the cause of MDR-TB and it has also challenged their ability to cope-up with the disease and its treatment. Patients were dissatisfied with the poor quality and inadequate quantity of the socio-economic support they got from the programme. Despite the high MDR-TB and HIV/AIDS co-infection, services for both diseases were not available under one roof.ConclusionsSocio-economic challenges, inadequate socio-economic support, absence of integrated care for MDR-TB and HIV/AIDS, and the uncaring practice of caregivers at treatment follow-up centres are found to negatively affect patients' perceived quality of care and their satisfaction with the care given for MDR-TB. Addressing these challenges is recommended to assist patients' coping ability with MDR-TB and its treatment.

Background: Several human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) prevention strategies have been implemented to counteract the impact of the disease, including the use of condoms, social marketing, testing, voluntary counselling and education programmes. One of the platforms which has not been fully explored is that of traditional initiation schools. Objectives: This study aimed to explore and discuss Vhavenda traditional initiation schools, which can be used as panacea for HIV and AIDS management in the Vhembe district of South Africa. Method: This ethnographic study was conducted in the Vhembe district of South Africa, among nine purposively sampled key informants drawn from a cohort of Vhavenda traditional healers and leaders. Data were collected using semistructured face-to-face interviews and analysed using ethnographic content analysis. Results: The results indicate that Vhavenda traditional initiation schools positively affect the management of HIV and AIDS. Initiation schools are centres for cultural education and the formation of a cultural identity. During the initiation process, initiates are taught social norms, customs and values which will serve them well in adulthood. They are also taught matters of sexuality, courtship, marriage and respect for others. Conclusion: The positive attributes of Vhavenda initiation schools should be accommodated and implemented in curricula from the primary school level up to the tertiary level to reduce and curb the spread of HIV infection. Contribution: Improved expertise at the initiation schools will aid the Department of Health and Education and Training to develop and implement suitable cultural contextualised HIV and AIDS prevention strategies.

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a far-reaching, negative impact on healthcare systems worldwide. Healthcare workers play a critical role in the country’s healthcare delivery system, as they facilitate a continuum of care and containment of diseases such as the COVID-19 pandemic. Objectives: The aim of this study was to explore and describe the experiences of healthcare workers who provided care to COVID-19 patients at a central hospital in Zimbabwe. Method: The researchers used an interpretative phenomenological analysis design. In-depth interviews were conducted virtually with 10 frontline healthcare workers working at a COVID-19 centre in Zimbabwe. Data collection was guided by an interview guide. All audio-recorded interview data were transcribed verbatim into written text. Data analysis was conducted using an interpretative phenomenological analysis framework. An expert in qualitative research acted as an independent co-coder and conducted the open coding of each transcript. Results: Findings reveal inadequate preparation and training of healthcare providers before the commencement of duty, resources-related challenges and a lack of support as significant experiences of healthcare providers. Moreover, healthcare providers have been subjected to stigma and discrimination attached to COVID-19, resulting in psychological effects on frontline healthcare providers. Conclusion: The COVID-19 pandemic brings unique and challenging experiences for frontline healthcare workers, resulting in a physically and emotionally drained workforce. This study calls for comprehensive support in the form of counselling, reasonable work schedules, training and adequate provision of personal protective equipment.

Background: The focus of this study was on women living with HIV in rural Zimbabwe, who face many challenges, both in the family and community. Patriarchy compounds these problems as these women navigate access to health and other services. Objectives: The study sought to explore ubuntuism and the sociocultural factors that facilitate or constrain women living with HIV from accessing community services and resources. Method: An interpretive phenomenological analysis research design was utilised for the study. Purposive and quota sampling were applied to recruit 40 participants from six villages. Data were collected using in-depth interviews and focus group discussions that were audio recorded and transcribed. The data were analysed using the interpretive phenomenological analysis framework. Results: The study found that women living with HIV face stigma and discrimination in the form of social exclusion and reduced access to community-based health activities and empowerment opportunities. These challenges were compounded by the negative impact of patriarchy that gives rise to land, resettlement and acculturation challenges. Conclusion: Ubuntu is a reflection of mutual dependence and can be used to promote more compassionate relationships with those who are HIV positive in the community. Contribution: The study provides unique insights into the challenges experienced by women living with HIV and how ubuntu could mitigate those challenges so that it adds to the humanistic philosophies in interpersonal relationships.

Background: Healthcare workers play a critical role in the delivery of healthcare services. Because of the high risk of exposure to healthcare workers, the emergence of coronavirus disease 2019 (COVID-19) has had a significant impact as they struggled to contain the pandemic. The purpose of this study was to explore and describe the challenges they faced after contracting COVID-19. Methods: An interpretative phenomenological analysis (IPA) design was employed to gain insight into the lived experiences of healthcare workers who contracted COVID-19 in the course of their duties. This study involved participants who were healthcare workers based at a central hospital in Bulawayo, Zimbabwe. Data were collected through in-depth interviews that were audio recorded. A sample size of ten was reached based on data saturation. Results: The study showed that healthcare workers lacked psychosocial support, experienced economic challenges as they incurred diagnostic and treatment costs. The study also found that the healthcare workers experienced stigma and discrimination both at work and in the community. Findings also indicate that healthcare workers did not receive institutional support. The study demonstrated lack of preparedness at the institution evidenced by inadequate testing for COVID-19 and shortage of personal protective equipment. Conclusion: This study’s findings will be critical for health authorities, programmers and policymakers to facilitate planning and preparedness for pandemics. The researchers recommend setting up a differentiated service delivery support system for healthcare workers to cater for their mental health and well-being and that of their families.