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Adolescent pregnancies are high risk obstetric occurrences. Antenatal care (ANC) provides opportunities to recognise and treat obstetric complications, enhancing the pregnancy outcomes for mothers and babies. The purpose of the study was to identify factors influencing adolescents' non-utilisation of ANC services in Bulawayo. The Health Belief Model (HBM) was used to contextualise the study. A quantitative, non-experimental, descriptive research design was adopted, using structured interviews to collect data. Purposive, non-probability sampling was used to conduct structured interviews with 80 adolescent mothers from the postnatal wards who had delivered their babies without attending ANC. Factors influencing these adolescent mothers’ non-utilisation of ANC services included socio-economic issues, individuals' perceptions about ANC, limited knowledge about ANC, policies and structural barriers. However, these adolescents knew that delivering their babies with skilled attendance could enhance the outcomes for the mothers and babies, would help secure documents to facilitate the acquisition of their children's birth certificates, and that obstetric complications required the services of skilled midwives/doctors. Policy-related issues, such as requiring national identity cards from pregnant adolescents (or from their spouses) prohibited some of them from utilising ANC services. There is a need to improve adolescents’ reproductive health outreach (including ANC) programmes and to offer free ANC services in Zimbabwe. Restrictive policies, such as the required identity cards of the pregnant adolescents (or their husbands), impacted negatively on the accessibility of ANC services and should be addressed as a matter of urgency in Bulawayo.

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Record-breaking summer heat events are increasing in frequency in Zimbabwe and 2016 was a particularly hot year with the country experiencing its worst heat wave event in decades. Currently, Zimbabwe has no coordinated public health response to deal with heat wave events and no specific data on heat-related morbidity and mortality. The country has no legislation for protecting workers against environmental heat exposure, particularly those most vulnerable who are employed in the informal sector. These workers are also at risk due to their outdoor work environments. The article outlines the state of climate and heat stresses in Zimbabwe, as benchmarked against other African countries and France. It further summarizes outdoor workers' susceptibility to heat exposure and the need for the Zimbabwean Government to develop policies to ensure the health and safety of an increasing population of outdoor workers in Zimbabwe.

infection at baseline. Efficacy data were synthesised using a DerSimonian and Laird weighted random-effect model. The mean odds ratio (OR) and 95% confidence interval (CI) for the association between Cervarix™, Gardasil ® and HPV-16 monovalent vaccine and HPV-associated cervical intraepithelial neoplasia grade 3 or worse (CIN3+) was 0·90 (CI: 0·56, 1·44) and for the association between Gardasil ® and HPV-associated vulval/vaginal intraepithelial neoplasia grades 2-3 (VIN2-3/VaIN2-3) OR 1·20 (CI: 0·07, 20·40). Conclusion There was no evidence that the HPV vaccines are effective in preventing vaccine-type HPV-associated pre-cancer in women with evidence of prior HPV exposure in this analysis. However, these studies were not designed to investigate the efficacy in this group, so statistical power (sample size, follow-up period and event rate) was insufficient to detect a small effect size. Longer follow-up is also needed to detect possible prevention of re-infection. Background Zimbabwe has a target to reach 80% voluntary medical male circumcision (VMMC) coverage among HIV-negative 15-29 year-old men by 2015. This is a central strategy in the nation's HIV response. Despite considerable recent investment, uptake has been slower than hoped. A cluster-randomised trial began in 2012 to assess the effectiveness of a sport-based VMMC demand-creation intervention. Methods At baseline, 663 men aged 18-45 years (median age 24 years) on 47 local soccer teams (both social and professional) in Bulawayo completed a self-administered questionnaire on VMMCrelated knowledge, perceptions and intent using touchscreen mobile phones. Linear and logistic regressions were used to assess differences by age, educational attainment, and study group, adjusting for team-level clustering. Results 141 men (21.0%) reported being circumcised, the majority (80.6%) at a hospital or clinic and 24 (17.0%) within the last three months. Among the uncircumcised men, the majority (90.8%) knew that VMMC reduces HIV risk and thought that getting circumcised was a good idea (89.3%). About half (54.2%) correctly identified at least one local clinic providing VMMC services and 62.6% reported that they were planning to get circumcised. Among uncircumcised men, those with A-level/higher education had better VMMC knowledge (AOR = 3.15, 95% CI = 1.52-6.53), but were less likely to intend to become circumcised (AOR = 0.57, 95% CI = 0.37-0.89). Being circumcised was weakly associated with having A-Level/higher education (AOR = 1.52, 95% CI = 0.95-2.43). No differences were observed between study groups in reported circumcision status, age, education, VMMC knowledge, or VMMC intention. Conclusion This study provides evidence that VMMC-related knowledge and intentions are high amongst uncircumcised, soccerplaying men in Bulawayo, though VMMC coverage remains far below 80%. Effective demand creation interventions are needed and should ensure uncircumcised men are aware of local sites offering VMMC services. Further research should investigate barriers to VMMC uptake ...

Background: Interventions aimed at improving accessing of health care services, including HIV testing, remain a priority in global HIV eradication efforts. Grassroot Soccer Zimbabwe (GRSZ) is an adolescent health organisation that uses the popularity of soccer to promote healthy behaviours. We assessed HIV knowledge levels, risky behaviours and attitudes in school going adolescents and young adults who attended GRSZ programmes and determined if HIV knowledge levels were associated with increased levels of accessing of health care services by youths. Methods: This was a cross-sectional study carried out on 450 participants aged 13-30 years who attended at least one of the three programmes offered by GRSZ. Self-administered and self-reporting questionnaires were used to collect information on participants' demographics, knowledge on HIV and reproductive health, sources of information, access to HIV and reproductive health services and attitudes and risky behaviours. Results: A total of 392 (87.1%) responses were received. High HIV and reproductive health knowledge levels were recorded (77.7%) on our scale with females recording higher levels (81.1%) than males (71.1%). The majority of participants (72%) indicated willingness to abstain from risky behaviours such as use of drugs and attending youth sex parties. However about 33.3% of the participants who had sexual intercourse reported having condomless sex. There was marginal association between high HIV and reproductive health knowledge levels and accessing health care services in the past 24 months (p = 0.045). Conclusions: HIV and reproductive health knowledge levels were relatively high among adolescents and were associated with accessing health care services in the past 24 months. There however are some gaps associated with engaging in risky sexual behaviours such as condomless sex which could be addressed by using these findings to assist organizations working with adolescents, educators and policy makers in developing programmes that address adolescent sexual behaviours.

This study aimed to determine knowledge, attitudes and practices related to a HIV prevention of parent-to-child transmission (PPTCT) programme among pregnant women who book for antenatal care. The intention was to develop new strategies toward improving the acceptance rate of the programme, which had a low uptake despite its availability, accessibility and affordability. A descriptive survey was used and 33 randomly selected pregnant mothers participated in a structured interview. Data are presented in tables and accompanied by a research-article and analysis of the participants’ answers. The study revealed that pregnant women are exposed to information on PPTCT. Negative attitudes of the community, spouses/partners and some pregnant women toward the programme contribute to practices of risky behaviour. Interventions to improve acceptance of the PPTCT programme should target the pregnant mothers, their partners and the community at large during the design, implementation and evaluation stages.

Record-breaking summer heat events are increasing in frequency in Zimbabwe and 2016 was a particularly hot year with the country experiencing its worst heat wave event in decades. Currently, Zimbabwe has no coordinated public health response to deal with heat wave events and no specific data on heat-related morbidity and mortality. The country has no legislation for protecting workers against environmental heat exposure, particularly those most vulnerable who are employed in the informal sector. These workers are also at risk due to their outdoor work environments. The article outlines the state of climate and heat stresses in Zimbabwe, as benchmarked against other African countries and France. It further summarizes outdoor workers' susceptibility to heat exposure and the need for the Zimbabwean Government to develop policies to ensure the health and safety of an increasing population of outdoor workers in Zimbabwe.