BackgroundGiven the well documented undesired impacts of HIV/AIDS globally, there is a need to create a statistical inventory of research output on HIV/AIDS. This need is particularly important for a country such as Lesotho, whose HIV/AIDS prevalence is one of the highest globally. Research on HIV/AIDS in sub-Saharan Africa continues to trail behind that of other regions, especially those of the developed countries. Lesotho, a sub-Saharan country, is a developing country with lower research output in this area when longitudinally compared to other countries. This study reviewed the volume and scope of the general research output on HIV/AIDS in Lesotho and assessed the coverage of the national research agenda on HIV/AIDS, making recourse to statistical principles.MethodsA bibliometric review of studies on HIV/AIDS retrieved from the SCOPUS and PubMed databases, published within the 30-year period between 1985 and 2016, was conducted. The focus of each of the studies was analysed and the studies were cross-matched with the national research agenda in accordance with bibliometric methodologies.ResultsIn total, 1280 studies comprising 1181 (92.3%) journal articles, 91 (7.1%) books and 8 (0.6%) conference proceedings were retrieved. By proportion, estimation of burden of infection (40.7%) had the highest research volume, while basic (5.5%) and preventive measures (24.4%) and national planning (29.4%) had the lowest. Out of the total studies retrieved, only 516 (40.3%) matched the national research agenda. Research on maternal and child health quality of care, viral load point-of-care devices, and infant point-of-care diagnosis had hardly any publications in the high priority research category of the agenda.ConclusionNotwithstanding a considerable research output on HIV/AIDS for Lesotho, there is insufficient coverage of the national research agenda in this research area. The major research gaps on general research output are in basic and preventive measures as well as national planning. There is also a need to increase targeted funding for HIV/AIDS research to appropriately address the most compelling gaps and national needs.
Swaziland is currently experiencing the worst impact of HIV and AIDS of any country in the world. In an effort to curb further spread of the virus, the country adopted mass male circumcision (MC) as recommended by the World Health Organization in 2007. Despite intense campaigns to promote the procedure over the past three years, the uptake of circumcision remains very low for reasons that are not very clear. The purpose of this study was to explore the reasons for the low uptake of MC in Swaziland despite the massive national MC campaigns. A qualitative research design was used, in which all men who were targeted by the mass MC campaign were eligible. Participants were identified as they came for sexual and reproductive health services at the Family Life Association of Swaziland (FLAS) Clinic, Mbabane. In-depth, individual face-to-face unstructured interviews were conducted to elicit the reasons why men were not going for circumcision. A total of 17 men were interviewed. Results showed that these reasons include fear of the procedure and the possible outcome, perception of no significant benefit of the procedure, impatience about waiting for the procedure or the healing process, religious/cultural beliefs, and worries about the fate of the foreskin. These reasons were attributed to misconceptions and lack of accurate and specific information about some aspects of the circumcision strategy of HIV preventions. Physiological changes and economic activities associated with adulthood were also found to be hindrances to MC uptake. The study recommended that a comprehensive description of the procedure and more precise facts and scientific bases of the MC strategy be incorporated and emphasised in the MC campaigns. Involvement of religious leaders will also facilitate clarification of religious or cultural misunderstandings or misconceptions. A focus on neonatal MC would also help.
Health systems worldwide are moving toward use of information technology to improve healthcare delivery. However, this requires basic computer skills. This study assessed the computer literacy of nurses in Lesotho using a cross-sectional quantitative approach. A structured questionnaire with 32 standardized computer skills was distributed to 290 randomly selected nurses in Maseru District. Univariate and multivariate logistic regression analyses in Stata 13 were performed to identify factors associated with having inadequate computer skills. Overall, 177 (61%) nurses scored below 16 of the 32 skills assessed. Finding hyperlinks on Web pages (63%), use of advanced search parameters (60.2%), and downloading new software (60.1%) proved to be challenging to the highest proportions of nurses. Age, sex, year of obtaining latest qualification, computer experience, and work experience were significantly (P < .05) associated with inadequate computer skills in univariate analysis. However, in multivariate analyses, sex (P = .001), year of obtaining latest qualification (P = .011), and computer experience (P < .001) emerged as significant factors. The majority of nurses in Lesotho have inadequate computer skills, and this is significantly associated with having many years since obtaining their latest qualification, being female, and lack of exposure to computers. These factors should be considered during planning of training curriculum for nurses in Lesotho.
Over the past decade, efforts have been made to promote the uptake of male circumcision (MC) in 14 selected high HIV epidemic countries, following reports that MC reduces the risk of female-to-male HIV transmission by about 60 per cent. Despite these efforts, the uptake of MC remains low, partly due to poor and/or subjective understanding of the concept “promote the uptake of MC” in the context of HIV prevention. This study aimed at clarifying the conceptual meaning of “promote the uptake of MC” for HIV prevention in high HIV and low MC prevalent settings. Walker and Avant’s eight-step method of concept analysis was used. An integrative review of literature was conducted. An open online search was conducted using Google and Google Scholar, targeting all relevant literature, grey and scientific. Specific databases were also explored, which included PubMed, Science Direct, SCORPUS, and CINAHL. Accessible relevant hard copy literature was also considered. Data were analysed qualitatively and thematically. Findings show that the concept “promote the uptake of MC” has connotations that extend to several contexts, which include culture and religion, biomedical sciences, education, construction, as well as health and medicine. Conceptually, in HIV prevention, it is a process that involves healthcare providers, uncircumcised men and their social environment. The integral components of the process are educative interactions, the provision of MC services and social support. It is recommended that healthcare providers carefully consider this conceptual understanding in their efforts to promote the uptake of MC for HIV prevention.
Circumcision has been practised for centuries among various groups of people world-wide, mainly for religious, traditional, hygienic or medical reasons. However, this practice was rare in Swaziland. Following recommendations by the World Health Organisation that circumcision should be added as an additional strategy for HIV prevention, the country embarked on mass male circumcision campaigns, aimed at scaling up the practice nationwide. Apparently the turnup for the procedure is below the set targets. Knowledge of factors that influence the uptake of circumcision is necessary in order to maximise the success of the strategy. This study aimed at assessing the influence of religion and/or culture on perception and hence uptake of circumcision in Swaziland. An explorative qualitative research design was used, in which in-depth face-toface interviews were conducted on seventeen participants individually. Results showed thatChristianity and African Traditional Religion are the dominant religions in Swaziland and each of them has both a negative and a positive influence on the perception of, and hence the decision to be, circumcised. This depended on the individuals’ interpretation and understanding of the doctrine of their religion or denomination. It was recommended that the identified positive influences be capitalised on to promote circumcision.
Background and objectives Infection prevention and control is a set of practices, protocols, and procedures that are put in place to prevent infections that are associated with health care service provision settings. It is an element of quality of care and safety in health care service delivery; health worker occupational health and safety practices; medical waste management; and is also concerned with clinical and public health surveillance and action. Healthcare facilities are ideal settings for the transmission of infections to patients (who are more susceptible), healthcare workers, their families and communities. Healthcare associated infections lead to prolonged hospital stay, increased cost of care and death. Therefore, the objective of this study was to assess infection prevention and control practices in various types and levels of health facilities in Nyandarua County, Kenya. Methodology A cross-sectional descriptive study was conducted in 47 health facilities that were sampled from a total of 153, using cluster sampling technique. The facilities were drawn from public, private and faith based organizations distributed across 5 sub-counties of Nyandarua County, Kenya. Data collection method was purely quantitative using a structured questionnaire. Descriptive analysis was done using SPSS version 17. Results 42/47 of the facilities were observing safe injection practices. Only 8/ 26 of the public health facilities had all their workers immunized against hepatitis B despite procurement, supply and distribution of adequate vaccine doses for the entire health workforce. Poor medical waste management practices where 37/47, 15/47 and 28/47 were segregating waste, had colour coded bins and had functional incinerators respectively. Only 28/47of the sampled facilities were decontaminating patient reusable equipment/instruments appropriately. Electricity, gas, charcoal and firewood were fuels used for autoclaving. About 33/47 and 30/47 of the sampled facilities had running water and soap/hand disinfectant respectively. Conclusions The findings revealed several gaps in the implementation of the national IPC policy especially in healthcare worker occupational health and safety, reprocessing of patient reusable equipment/instruments, medical waste management and hand hygiene practices. These findings will assist the department of health in designing interventions for strengthening and improving IPC practices, to mobilize and allocate resources for IPC activities, improve infrastructure and supplies
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