"You cannot eat rights": a qualitative study of views by Zambian HIV-vulnerable women, youth and MSM on human rights as public health tools

Background Human rights approaches now dominate the HIV prevention landscape across sub-Saharan Africa, yet little is known about how they are viewed by the populations they are designed to serve. Health interventions are most effective when they resonate with the worldviews and interests of target groups. This study examined local Zambian understandings of human rights approaches to HIV-prevention among three highly HIV-vulnerable groups: women, youth, and men-who-have-sex-with-men (MSM). Methods Focus groups included 23 women, youth, and MSM who had participated in activities organized by local non-governmental organizations (NGOs) using rights-based approaches, and interviews included 10 Zambian employees of these NGOs. Topics included participants’ experiences and views of the utility of these activities. Thematic analysis mapped out diverse ways participants viewed the concept of human rights in relation to HIV-prevention. Results Whilst NGO workers noted the need for human rights programs to address the complex drivers of the HIV epidemic, they struggled to tailor them to the Zambian context due to donor stipulations. Women program beneficiaries noted that the concept of human rights helped challenge harmful sexual practices and domestic abuse, and youth described rights-based approaches as more participatory than previous HIV-prevention efforts. However, they criticized the approach for conflicting with traditional values such as respect for elders and ‘harmonious’ marital relationships. They also critiqued it for threatening the social structures and relationships that they relied on for material survival, and for failing to address issues like poverty and unemployment. In contrast, MSM embraced the rights approach, despite being critical of its overly confrontational implementation. Conclusions A rights-based approach seeks to tackle the symbolic drivers of HIV—its undeniable roots in cultural and religious systems of discrimination. Yet, it fails to resonate with youth and women’s own understandings of their needs and priorities due to its neglect of material drivers of HIV such as poverty and unemployment. MSM, who suffer extreme stigma and discrimination, have less to lose and much to gain from an approach that challenges inequitable social systems. Developing effective HIV-prevention strategies requires careful dialogue with vulnerable groups and greater flexibility for context-specific implementation rather than a one-size-fits-all conceptualization of human rights

Community Mobilization as a tool against sexual and gender-based violence in SADC region

SADC has continued to register high rates of Sexual and Gender-based Violence. This violence is usually in the form of physical aggression, psychological abuse, social exclusion, sexual coercion, rape, economic and legal violence. Evidence shows that women, adolescent girls, persons with disabilities, and the LGBTQIA2S+ (Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, Asexual and Two-Spirit) community are particularly at risk. The mainstream mitigation strategies have traditionally focused on interventions that are necessary but not sufficient in addressing the unique conditions that perpetuate violence in the region. Community Mobilization has been suggested as useful response to this scourge. There is however lack of well documented evidence on the relevance of Community Mobilization as a tool against SGBV in SADC. This manuscript aims to fill these gaps by interrogating and documenting the relevance of Community Mobilization as a tool against SGBV in SADC. By doing so, it will also be providing grounds for creating better responses to this scourge. Through a process of systematic literature review, our findings demonstrate that Community Mobilization contributed to creating a protective and transformative social environment to fight SGBV. The three elements of Community Mobilization provided the lens through which this transformation could be realistically imagined. More specifically, Community Mobilization created possibilities of combating SGBV through the following ways: a) by building collective agency, b) by utilizing locally available resources, c) by combating inequities, and d) by creating local ownershi

Covid19 Response in Low-Income Country: The Case of a Lockdown in Zambia

Abstract Background The onset of the covid19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in low income countries like Zambia. Thus with the help of the SRT, we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia.MethodsA qualitative study in the form of interviews was conducted in Lusaka, Zambia involving a sample of 68 participants. Due to the lockdown measures that were in place during the study, the interviews were conducted via phone calls and the data collected were later analyzed by use of thematic analysis technique. ResultsThe lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and for protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to covid19 in Zambia. This observation demonstrates the folly of viewing, applying and characterizing the covid19 lockdown as a ‘one-size-fits-all’ approach in Zambia.ConclusionThus rather than definitely establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Zambians. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.</jats:p

COVID19 Response in low-income country: The case of a Lockdown in Zambia

Abstract Background The onset of the covid19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in low income countries like Zambia. Thus with the help of the SRT, we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia. Methods A qualitative study in the form of interviews was conducted in Lusaka, Zambia involving a sample of 68 participants. Due to the lockdown measures that were in place during the study, the interviews were conducted via phone calls and the data collected were later analyzed by use of thematic analysis technique. Results The lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and for protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to covid19 in Zambia. This observation demonstrates the folly of viewing, applying and characterizing the covid19 lockdown as a ‘one-size-fits-all’ approach in Zambia. Conclusion Thus rather than definitely establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Zambians. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.</jats:p

Community Mobilization as a tool against sexual and gender-based violence in SADC region

SADC has continued to register high rates of Sexual and Gender-based Violence. This violence is usually in the form of physical aggression, psychological abuse, social exclusion, sexual coercion, rape, economic and legal violence. Evidence shows that women, adolescent girls, persons with disabilities, and the LGBTQIA2S+ (Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, Asexual and Two-Spirit) community are particularly at risk. The mainstream mitigation strategies have traditionally focused on interventions that are necessary but not sufficient in addressing the unique conditions that perpetuate violence in the region. Community Mobilization has been suggested as useful response to this scourge. There is however lack of well documented evidence on the relevance of Community Mobilization as a tool against SGBV in SADC. This manuscript aims to fill these gaps by interrogating and documenting the relevance of Community Mobilization as a tool against SGBV in SADC. By doing so, it will also be providing grounds for creating better responses to this scourge. Through a process of systematic literature review, our findings demonstrate that Community Mobilization contributed to creating a protective and transformative social environment to fight SGBV. The three elements of Community Mobilization provided the lens through which this transformation could be realistically imagined. More specifically, Community Mobilization created possibilities of combating SGBV through the following ways: a) by building collective agency, b) by utilizing locally available resources, c) by combating inequities, and d) by creating local ownershi

Local characterization of the Covid19 Response in low-income country: The case of a Lockdown in Zambia

Abstract Background The onset of the covid19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in low income countries like Zambia. Thus with the help of the SRT, we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia.Methods A qualitative study in the form of interviews was conducted in Lusaka, Zambia involving a sample of 68 participants. Due to the lockdown measures that were in place during the study, the interviews were conducted via phone calls and the data collected were later analyzed by use of thematic analysis technique.Results The lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and for protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to covid19 in Zambia. This observation demonstrates the folly of viewing, applying and characterizing the covid19 lockdown as a ‘one-size-fits-all’ approach in Zambia.Conclusion Thus rather than definitely establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Zambians. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.</jats:p