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

Vallely, Andrew; Shagi, Charles; Kasindi, Stella; Desmond, Nicola; Lees, Shelley; Chiduo, B.; Hayes, Richard; Allen, Catherine; Ross, David A.

doi:10.1186/1471-2458-7-133

Cited by 52 publications

(67 citation statements)

References 32 publications

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“…Engagement in community collaborations and community participation in the design and implementation of health programs allows for increased ownership as well as avenues to address emerging concerns or questions. Community participation should be an evolving process, whose tensions and contradictions are created and resolved through stages of demands and accommodations [41,42,85,86]. …”

Section: Discussionmentioning

confidence: 99%

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

et al. 2013

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BackgroundThe success of health programs is influenced not only by their acceptability but also their ability to meet and respond to community expectations of service delivery. The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended medical male circumcision (MC) as an essential component of comprehensive HIV prevention programs in high burden settings. This study investigated community-level perceptions of MC for HIV prevention in Papua New Guinea (PNG), a setting where diverse traditional and contemporary forms of penile foreskin cutting practices have been described.MethodsA multi-method qualitative study was undertaken in four provinces in two stages from 2009 to 2011. A total of 82 in-depth interviews, and 45 focus group discussions were completed during Stage 1. Stage 2 incorporated eight participatory workshops that were an integral part of the research dissemination process to communities. The workshops also provided opportunity to review key themes and consolidate earlier findings as part of the research process. Qualitative data analysis used a grounded theory approach and was facilitated using qualitative data management software.ResultsA number of diverse considerations for the delivery of MC for HIV prevention in PNG were described, with conflicting views both between and within communities. Key issues included: location of the service, service provider, age eligibility, type of cut, community awareness and potential shame amongst youth. Key to developing appropriate health service delivery models was an appreciation of the differences in expectations and traditions of unique cultural groups in PNG. Establishing strong community coalitions, raising awareness and building trust were seen as integral to success.ConclusionsDifficulties exist in the implementation of new programs in a pluralistic society such as PNG, particularly if tensions arise between biomedical knowledge and medico-legal requirements, compared to existing socio-cultural interests. Community participatory approaches offer important opportunities to explore and design culturally safe, specific and accessible programs.

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Section: Discussionmentioning

confidence: 99%

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

et al. 2013

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“…A purposeful, deductive approach was used in this research, where the information gathered was used to draw specific conclusions regarding the tasks for which interventions should be developed, and the interventions that should be selected for further research. Similar approaches have been successfully used in other women's health and development projects in Africa [20,21]. The PI worked with the local project team and the focus group facilitator to interpret the focus group data both during and immediately after the discussions.…”

Section: Discussionmentioning

confidence: 99%

Participatory approach to identify interventions to improve the health, safety, and work productivity of smallholder women vegetable farmers in the Gambia

Vanderwal¹,

Rautiainen²,

Kuye³

et al. 2011

International Journal of Occupational Medicine and Environmental Health

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Objective: This paper describes the qualitative, community-based participatory approach used to identify culturally-acceptable and sustainable interventions to improve the occupational health, safety, and productivity of smallholder women vegetable farmers in The Gambia (West Africa). Materials and Methods: This approach was used to conduct: 1) analysis of the tasks and methods traditionally used in vegetable production, and 2) selection of interventions. Results: The most arduous garden tasks that were amenable to interventions were identified, and the interventions were selected through a participatory process for further evaluation. Conclusions: Factors contributing to the successful implementation of the participatory approach used in this study included the following: 1) ensuring that cultural norms were respected and observed; 2) working closely with the existing garden leadership structure; and 3) research team members working with the subjects for an extended period of time to gain first-hand understanding of the selected tasks and to build credibility with the subjects.

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“…In Indonesia, Tanah Papua Province is experiencing a generalized HIV epidemic that has many parallels with the epidemic in neighbouring PNG. HIV prevalence among men and women aged 15–49 years in Tanah Papua was recently estimated at 2.4%, the highest in Indonesia and approximately 15 times the national average [61]. Among ethnic Papuans, HIV prevalence was almost twice that of other residents (2.8%, 1.5% respectively).…”

Section: Introductionmentioning

confidence: 99%

Intravaginal practices and microbicide acceptability in Papua New Guinea: implications for HIV prevention in a moderate-prevalence setting

et al. 2012

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BackgroundThe acceptability of female-controlled biomedical prevention technologies has not been established in Papua New Guinea, the only country in the Pacific region experiencing a generalised, moderate-prevalence HIV epidemic. Socio-cultural factors likely to impact on future product uptake and effectiveness, such as women’s ability to negotiate safer sexual choices, and intravaginal hygiene and menstrual practices (IVP), remain unclear in this setting.MethodsA mixed-method qualitative study was conducted among women and men attending a sexual health clinic in Port Moresby. During in-depth interviews, participants used copies of a hand-drawn template to indicate how they wash/clean the vulva and/or vagina. Interviewers pre-filled commercially available vaginal applicators with 2-3mL KY Jelly® to create a surrogate vaginal microbicide product, which was demonstrated to study participants.ResultsA total of 28 IDIs were conducted (women=16; men=12). A diverse range of IVP were reported. The majority of women described washing the vulva only with soap and water as part of their daily routine; in preparation for sex; and following sexual intercourse. Several women described cleaning inside the vagina using fingers and soap at these same times. Others reported cleaning inside the vagina using a hose connected to a tap; using vaginal inserts, such as crushed garlic; customary menstrual ‘steaming’ practices; and the use of material fragments, cloth and newspaper to absorb menstrual blood. Unprotected sex during menstruation was common. The majority of both women and men said that they would use a vaginal microbicide gel for HIV/STI protection, should a safe and effective product become available. Microbicide use was considered most appropriate in ‘high-risk’ situations, such as sex with non-regular, transactional or commercial partners. Most women felt confident that they would be able to negotiate vaginal microbicide use with male sexual partners but if necessary would be prepared to use product covertly.ConclusionsNotional acceptability of a vaginal microbicide gel for HIV/STI prevention was high among both women and men. IVP were diverse in nature, socio-cultural dimensions and motivators. These factors are likely to impact on the future acceptability and uptake of vaginal microbicides and other biomedical HIV prevention technologies in this setting.

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

Abstract: Background: During a microbicide trial feasibility study among women at high-risk of HIV and sexually transmitted infections in Mwanza, northern Tanzania we used participatory research tools to facilitate open dialogue and partnership between researchers and study participants.

Cited by 52 publications

References 32 publications

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

Participatory approach to identify interventions to improve the health, safety, and work productivity of smallholder women vegetable farmers in the Gambia

Intravaginal practices and microbicide acceptability in Papua New Guinea: implications for HIV prevention in a moderate-prevalence setting

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