Training in malaria microscopy and South Sudan’s first malaria slide bank

No Abstract

The benefits of participatory methodologies to develop effective community dialogue in the context of a microbicide trial feasibility study in Mwanza, Tanzania

BACKGROUND: As part of a microbicide trial feasibility study among women at high-risk of HIV and sexually transmitted infections in Mwanza City, northern Tanzania we used participatory research tools to facilitate open dialogue and partnership between researchers and study participants. METHODS: A mobile community-based sexual & reproductive health service was established in ten city wards. Wards were divided into seventy-eight geographical clusters and representatives at cluster and ward level elected in a process facilitated by the projects Community Liaison Officer. A city-level Community Advisory Committee (CAC) with representatives from each ward was established. Workshops and community meetings at ward and city-level were conducted to explore project-related concerns using tools adapted from participatory learning and action techniques such as listing, scoring, ranking, chapatti diagrams and pair-wise matrices. RESULTS: Key issues identified included beliefs that blood specimens were being sold for witchcraft purposes; worries about specula not being clean; inadequacy of transport allowances; and delays in reporting laboratory test results to participants. To date, the project has responded by inviting members of the CAC to visit the laboratory to observe how blood and genital specimens are prepared; demonstrated the use of the autoclave to community representatives; raised reimbursement levels; introduced HIV rapid testing in the clinic; and streamlined laboratory reporting procedures. CONCLUSIONS: Participatory techniques were instrumental in promoting meaningful dialogue between the research team, study participants and community representatives in Mwanza, allowing researchers and community representatives to gain a shared understanding of project-related priority areas for intervention

Influence of conspiracy theories and distrust of community health volunteers on adherence to COVID-19 guidelines and vaccine uptake in Kenya

This cross-sectional study collected data between 25 May –27 June 2021 n=447. It involved all registered community health volunteers (CHVs) who had participated in the COVID-19 vaccine hesitancy study. This data was collected as part of an Epidemic Ethics/WHO initiative that FCDO/Wellcome Grant 214711/Z/18/Z has supported. WHO’s specific grant number was 2020/1077878-0). The funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation. No authors received a salary from the funders.Marion W Mutugi, Edward Mugambi Ireri, James Mwirigi Mwitari, Jean-Benoit Falisse, & Lydia Kemunto Atambo. (2022). Influence of conspiracy theories and distrust of community health volunteers on adherence to COVID-19 guidelines and vaccine uptake in Kenya [Data set]. Zenodo. https://doi.org/10.5281/zenodo.655464

Improving Healthcare at the Intersection of Gender and Protracted Displacement amongst Somali and Congolese Refugees and Internally Displaced People, 2020-2024

The study aimed to acquire the following aims: 1) To support the right to healthcare and Universal Health Coverage (UHC) in contexts of protracted displacement and vulnerability (SDG3). 2) To improve gender equality in the context of gendered access to healthcare services (SDG5). The main objectives were: 1) To identify and analyse current policy processes that respond to the health needs of forcibly displaced people and thereby identify existing models for integrating those populations into health systems that could be made applicable to our various protracted displacement contexts. 2) To identify key neglected chronic mental health conditions (and comorbid chronic physical health conditions) associated with protracted displacement, conflict, and gendered violence. 3) To map the types and locations of healthcare providers that displaced people turn to for treatment for chronic mental health conditions (and comorbid physical health conditions). 4) To document how gender and other factors influence health seeking by displaced people for physical and mental health conditions associated with displacement, conflict and violence. The research questions were: 1) What existing models for integrating displaced people into national healthcare systems could be applied in our protracted displacement contexts? 2) What mental health chronic conditions (and comorbid physical conditions) associated with displacement, violence, and gendered conflict are currently neglected in our field sites? 3) What types of healthcare providers do displaced people turn to for treatment for mental (and physical) ill-health conditions associated with displacement, conflict and violence? 4) How do gender and other factors influence whether and when displaced people seek treatment for mental and physical health conditions associated with conflict and violence?This project aimed to help displaced people to access appropriate healthcare for long-term physical and mental health conditions associated with protracted displacement, conflict, and gendered violence. The category of Sexual and Gender-Based Violence (SGBV) receives a great deal of attention. However, there is limited research on how gendered violence, including violence relating to sexuality, is experienced in displacement contexts. There is also limited understanding of how gender, sexuality, and related violence affect access to healthcare, and how that can result in neglected chronic health conditions, particularly mental ill-health. Similarly, much attention is devoted to immediate healthcare needs following SGBV, but longer-term physical and mental health conditions are not adequately addressed. Displaced people face multiple barriers when seeking healthcare in protracted displacement settings, with the result that long-term health conditions are often misdiagnosed and mistreated or undiagnosed and untreated. This project examined access to care and the responsiveness of healthcare providers for displaced Congolese and Somalis in Eastern Democratic Republic of Congo (DRC), Somali, Kenya, and South Africa. Eastern DRC and Somalia have both experienced long-term conflict and displacement since the early 1990s, leading to large populations of Internally Displaced People (IDPs) within these countries and large refugee populations across the region. Conflict and displacement in Eastern DRC and Somalia are characterised by high rates of sexual and gender-based violence, and victims are stigmatised through prevailing gender and sexual norms. Existing health research tends to focus on the immediate aftermath of violence rather than on long-term mental and physical health conditions. The project had eight field sites in four countries. The four IDP field sites were one formal camp and one informal settlement each in Eastern DRC and Somalia, both of which have weak health systems. The four refugee field sites were Congolese and Somali settlements in Kenya and South Africa, which have different health systems and different refugee laws and policies. The project brought together researchers and practitioners from international development, migration studies, gender studies, medical anthropology, public health and health policy, and medical sciences to undertake interdisciplinary empirical research in these protracted displacement contexts. Panzi Foundation (DRC) and ARQ International (Netherlands) guided teams of researchers based at the University of Edinburgh (UK), the University of Kinshasa (DRC), the Somali Institute for Development and Research (Somalia), Amref International University (Kenya), and the University of Witwatersrand (South Africa). Project activities were designed to: 1) enhance the capacity of partner organisations; 2) support the inclusion of displaced people in healthcare systems; 3) foster international networks.</p