12 results on '"Zulu, Joseph Mumba"'
Search Results
2. HIV, syphilis and sexual-risk behaviours’ prevalence among in-and out-of-school adolescent girls and young women in Zambia: A cross-sectional survey study
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Musonda, Patrick, primary, Halwiindi, Hikabasa, additional, Kaonga, Patrick, additional, Ngoma-Hazemba, Alice, additional, Simpungwe, Matildah, additional, Mweemba, Mable, additional, Tembo, Chowa, additional, Zyambo, Cosmas, additional, Chisoso, John, additional, Munakampe, Margaret, additional, Choonga, Powell, additional, Ngalamika, Owen, additional, Musukuma, Mwiche, additional, Chavula, Malizgani P., additional, Sichula, Noah, additional, Mweemba, Oliver, additional, Zulu, Joseph Mumba, additional, and Phiri, Henry, additional
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- 2024
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3. Exploring community health systems interventions that strength implementation of maternal and child health services: The case of community health assistants in Zambia
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Akinola, Olatubosun, primary, Banda, Nelia, additional, Silumbwe, Adam, additional, Mulubwa, Chama, additional, Chavula, Malizgani Paul, additional, Shakwelele, Hilda, additional, Chila, Sylvia, additional, and Zulu, Joseph Mumba, additional
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- 2024
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4. "The ones at the bottom of the food chain": structural drivers of unintended pregnancy and unsafe abortion amongst adolescent girls in Zambia.
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Zulu, Joseph Mumba, Crankshaw, Tamaryn L., Ouedraogo, Ramatou, Juma, Kenneth, and Aantjes, Carolien J.
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UNPLANNED pregnancy ,TEENAGE mothers ,TEENAGE girls ,TEENAGE pregnancy ,ABORTION ,ABORTION statistics - Abstract
Background: Access to safe abortion care is highly unequal and fundamentally rooted in socioeconomic inequalities which are amplified by restrictive social norms and legal systems. We analyse these inequalities along the reproductive health continuum amongst adolescent girls in Zambia. Methodology: This paper draws from 20 focus group discussions conducted in 2021 with community members (young/adult) in five urban, peri urban, and rural sites in Zambia. Data was analysed using thematic analysis. Results: Adolescent pregnancy in the community was reported to be very common across the communities with girls from poorer families being disproportionately affected. Parents were reported to be complicit in facilitating their daughter's sexual-economic exchanges which emerged as a key driver of pregnancies. Young age and unmarried status meant adolescent girls could face triple stigma: stigma around accessing contraception to prevent a pregnancy, stigma in experiencing an unintended pregnancy and stigma around terminating an unintended pregnancy. There were clear socioeconomic differences in adolescent girl's exposure to community and health provider censure and/or acceptance of their pregnancy, and in their ability to conceal an abortion. Having the means to pay for health care allows some adolescents to seek terminations earlier and to access private health facilities while poorer adolescent girls face greater exposure to community censure through their embeddedness within the community. Abortions in this group attracts greater visibility through complications arising from their constrained choice for safe abortion methods. Stigmatising attitudes of community members also undermined adolescents' reproductive agency and mental health. For adolescents who choose to keep an unintended pregnancy, reintegration into school was highly challenging despite a national policy in place, with marriage being viewed as the only future option for poorer teenage mothers. Conclusion: The embeddedness of adolescent pregnancies within community structures of economic insecurity and gendered and age-related power relations highlight the importance of introducing community level approaches to tackle unintended pregnancies and unsafe abortion. Understanding teenage pregnancy as a community issue creates opportunities for community level support to young girls especially when they return to school. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Halting and re-issuing of the Zambia community health strategy (2017–2021): a retrospective analysis of the policy process and implications for community health systems.
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Chavula, Malizgani Paul, Silumbwe, Adam, Munakampe, Margarate Nzala, Zulu, Joseph Mumba, Zulu, Wanga, Michelo, Charles, and Mulubwa, Chama
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MIDDLE-income countries ,PUBLIC health ,POWER (Social sciences) ,COMMUNITY coordination ,THEMATIC analysis - Abstract
Background: Over the years, low-and middle-income countries have adopted several policy initiatives to strengthen community health systems as means to attain Universal Health Coverage (UHC). In this regard, Zambia passed a Community Health Strategy in 2017 that was later halted in 2019. This paper explores the processes that led to the halting and re-issuing of this strategy with the view of drawing lessons to inform the development of such strategies in Zambia and other similar settings. Methods: We employed a qualitative case study comprising 20 semi-structured interviews with key stakeholders who had participated in either the development, halting, or re-issuing of the two strategies, respectively. These stakeholders represented the Ministry of Health, cooperating partners and other non-government organizations. Inductive thematic analysis approach was used for analysis. Results: The major reasons for halting and re-issuing the community health strategy included the need to realign it with the national development framework such as the 7th National Development Plan, lack of policy ownership, political influence, and the need to streamline the coordination of community health interventions. The policy process inadequately addressed the key tenets of community health systems such as complexity, adaptation, resilience and engagement of community actors resulting in shortcomings in the policy content. Furthermore, the short implementation period, lack of dedicated staff, and inadequate engagement of stakeholders from other sectors threatened the sustainability of the re-issued strategy. Conclusion: This study underscores the complexity of community health systems and highlights the challenges these complexities pose to health policymaking efforts. Countries that embark on health policymaking for community health systems must reflect on issues such as persistent fragmentation, which threaten the policy development process. It is crucial to ensure that these complexities are considered within similar policy engagement processes. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Collaboration for implementation of decentralisation policy of multi drug-resistant tuberculosis services in Zambia.
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Chavula, Malizgani Paul, Matenga, Tulani Francis L., Maritim, Patricia, Munakampe, Margarate N., Habib, Batuli, Liusha, Namakando, Banda, Jeremiah, Sinyangwe, Ntazana N., Halwiindi, Hikabasa, Mweemba, Chris, Mubanga, Angel, Kaonga, Patrick, Chewe, Mwimba, Phiri, Henry, and Zulu, Joseph Mumba
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MULTIDRUG-resistant tuberculosis ,MEDICAL personnel ,COMMUNITY health workers ,HEALTH facilities ,PUBLIC health - Abstract
Background: Multi-drug-resistant tuberculosis (MDR-TB) infections are a public health concern. Since 2017, the Ministry of Health (MoH) in Zambia, in collaboration with its partners, has been implementing decentralised MDR-TB services to address the limited community access to treatment. This study sought to explore the role of collaboration in the implementation of decentralised multi drug-resistant tuberculosis services in Zambia. Methods: A qualitative case study design was conducted in selected provinces in Zambia using in-depth and key informant interviews as data collection methods. We conducted a total of 112 interviews involving 18 healthcare workers, 17 community health workers, 32 patients and 21 caregivers in healthcare facilities located in 10 selected districts. Additionally, 24 key informant interviews were conducted with healthcare workers managers at facility, district, provincial, and national-levels. Thematic analysis was employed guided by the Integrative Framework for Collaborative Governance. Findings: The principled engagement was shaped by the global health agenda/summit meeting influence on the decentralisation of TB, engagement of stakeholders to initiate decentralisation, a supportive policy environment for the decentralisation process and guidelines and quarterly clinical expert committee meetings. The factors that influenced the shared motivation for the introduction of MDR-TB decentralisation included actors having a common understanding, limited access to health facilities and emergency transport services, a shared understanding of challenges in providing optimal patient monitoring and review and their appreciation of the value of evidence-based decision-making in the implementation of MDR- TB decentralisation. The capacity for joint action strategies included MoH initiating strategic partnerships in enhancing MDR-TB decentralisation, the role of leadership in organising training of healthcare workers and of multidisciplinary teams, inadequate coordination, supervision and monitoring of laboratory services and joint action in health infrastructural rehabilitation. Conclusions: Principled engagement facilitated the involvement of various stakeholders, the dissemination of relevant policies and guidelines and regular quarterly meetings of clinical expert committees to ensure ongoing support and guidance. A shared motivation among actors was underpinned by a common understanding of the barriers faced while implementing decentralisation efforts. The capacity for joint action was demonstrated through several key strategies, however, challenges such as inadequate coordination, supervision and monitoring of laboratory services, as well as the need for collaborative efforts in health infrastructural rehabilitation were observed. Overall, collaboration has facilitated the creation of a more responsive and comprehensive TB care system, addressing the critical needs of patients and improving health outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Living a private lie: intersectional stigma, depression and suicidal thoughts for selected young key populations living with HIV in Zambia.
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Zulu, Joseph Mumba, Budhwani, Henna, Wang, Bo, Menon, Anitha, Kim, Deogwoon, Zulu, Mirriam, Nyamaruze, Patrick, Govender, Kaymarlin, and Armstrong, Russell
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SUICIDAL ideation , *MEN who have sex with men , *YOUNG adults , *HIV-positive men , *INTERSECTIONALITY , *LIE detectors & detection - Abstract
Background: Limited research has been conducted on the forms, manifestations and effects of intersectional stigma among young HIV-positive men who have sex with men (MSM) and transgender women (TGW) in Zambia. In this study, we aimed to address this gap by elucidating the experiences of these in a small group of young, HIV + MSM and TGW in Zambia. Methods: We applied a mixed-methods design. Data were collected from January 2022 to May 2022. Qualitative data were collected using in-depth interviews while quantitative data were collected using a questionnaire. Qualitative transcripts were coded using thematic analysis while paper-based questionnaire data were entered into Kobo Connect. Descriptive statistics, using chi-squared tests were calculated using Excel. In this paper, we provide a descriptive profile of the sample and then focus on the qualitative findings on intersectional stigma, depression, and contemplation of suicide. Results: We recruited 56 participants from three sites: Lusaka, Chipata, and Solwezi districts. Participants' mean age was 23 years. The study found that 36% of all participants had moderate to significant symptoms of depression, 7% had major depression, 30% had moderate signs of anxiety, 11% had high signs of anxiety, 4% had very high signs of anxiety and 36% had contemplated suicide at least once. A greater proportion of TGW had moderate to significant symptoms of depression (40%) or major depression (10%) compared to MSM, at 33% and 6%, respectively (X2 = 0.65; p = 0.42). Similarly, more TGW (55%) had contemplated suicide than MSM peers (36%, X2=1.87; p = 0.17). In the qualitative data, four emergent themes about the forms, manifestations, and effects of intersectional stigma were (1) HIV, sexual orientation, and gender identity disclosure; (2) Dual identity; (3) Challenges of finding and maintaining sexual partners; (4) Coping and resilience. Overall, having to hide both one's sexuality and HIV status had a compounding effect and was described as living "a private lie." Conclusion: Effectively addressing stigmas and poor mental health outcomes among young HIV-positive MSM and TGW will require adopting a socio-ecological approach that focuses on structural interventions, more trauma-informed and identity-supportive care for young people with HIV, as well as strengthening of authentic community-informed public health efforts. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Drivers of child marriage in Eastern and Western Provinces in Zambia and effective preventive interventions: Findings from a rapid document review and three stakeholder meetings
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Kabelka, Hannah, primary, Zulu, Joseph Mumba, additional, Baatsen, Pam, additional, and Kok, Maryse, additional
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- 2024
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9. Community and health systems factors contributing to delayed tuberculosis detection in an urban setting: situating software and hardware bottlenecks in local health systems
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Chillala, Sandra Beauty, primary, Silumbwe, Adam, additional, Zulu, Joseph Mumba, additional, Tetui, Moses, additional, Bulawayo, Maio, additional, Chewe, Mwimba, additional, and Hangoma, Peter, additional
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- 2024
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10. A scoping review of the roles, challenges, and strategies for enhancing the performance of community health workers in the response against COVID-19 in low- and middle-income countries
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Zulu, Joseph Mumba, primary, Silumbwe, Adam, additional, Munakampe, Margarate, additional, Chavula, Malizgani Paul, additional, Mulubwa, Chama, additional, Sirili, Nathanael, additional, Zulu, Wanga, additional, Michelo, Charles, additional, and Tetui, Moses, additional
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- 2024
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11. Being both a grandmother and a health worker: experiences of community-based health workers in addressing adolescents' sexual and reproductive health needs in rural Zambia.
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Mulubwa, Chama, Zulu, Joseph Mumba, Hurtig, Anna-Karin, and Goicolea, Isabel
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REPRODUCTIVE health services , *YOUNG adults , *REPRODUCTIVE health , *RURAL health , *TEENAGERS , *RIGHT to health - Abstract
Introduction: Community-based health workers (CBHWs) possess great potential to be the missing link between the community and the formal health system for improving adolescents' access to sexual and reproductive health and rights (SRHR) information and services. Yet, their role in addressing adolescents' SRHR within the context of the community-based health system has received very little attention. This paper analyses how CBHWs experience and perceive their role in addressing adolescents' SRHR needs in rural Zambia, including the possible barriers, dilemmas, and opportunities that emerge as CBHWs work with adolescents. Methods: Between July and September 2019, we conducted 14 in-depth interviews with 14 community-based health workers recruited across 14 different communities in the central province of Zambia. The interviews were focused on eliciting their experiences and perceptions of providing sexual and reproductive health services to adolescents. Charmaz's grounded theory approach was used for the analysis. Results: We present the core category "being both a grandmother and a CBHW", which builds upon four categories: being educators about sexual and reproductive health; being service providers and a link to SRHR services; being advocates for adolescents' SRHR; and reporting sexual violence. These categories show that CBHWs adopt a dual role of being part of the community (as a grandmother) and part of the health system (as a professional CBHW), in order to create/maximise opportunities and navigate challenges. Conclusion: Community-based health workers could be key actors providing context-specific comprehensive SRHR information and services that could span all the boundaries in the community-based health system. When addressing adolescents SRHR, playing dual roles of being both a grandmother and a professional CBHW were sometimes complimentary and at other times conflicting. Additional research is required to understand how to improve the role of CBHWs in addressing adolescents and young people's sexual and reproductive health. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Exploring the barriers, facilitators, and opportunities to enhance uptake of sexual and reproductive health, HIV and GBV services among adolescent girls and young women in Zambia: a qualitative study.
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Ngoma-Hazemba A, Chavula MP, Sichula N, Silumbwe A, Mweemba O, Mweemba M, Simpungwe MK, Phiri H, Kasengele CT, Halwiindi H, Munakampe MN, and Zulu JM
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- Humans, Zambia, Adolescent, Female, Young Adult, Patient Acceptance of Health Care statistics & numerical data, Patient Acceptance of Health Care psychology, Sexual Health, Interviews as Topic, Qualitative Research, HIV Infections, Reproductive Health Services statistics & numerical data, Health Services Accessibility, Gender-Based Violence statistics & numerical data, Gender-Based Violence psychology
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Introduction: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia., Methods: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis., Results: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services., Conclusion: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population., (© 2024. The Author(s).)
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- 2024
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