 |
The
University Of Zambia |
 |
|
University of Zambia Medical Library Socio-Behavioural Aspects: Behavioural Intervention Research
|
| Sex of Respondents | 10-15 | 16-20 | 21-25 | 26-30 | NA | Total No |
|---|---|---|---|---|---|---|
| Female | 22 (22.0%) | 115 (50.7%) | 56 (62.2%) | 4 (44.4%) | 15 (65.2%) | 212 (47.2%) |
| Male | 78 (78.0%) | 112 (49.3%) | 34 (31.8%) | 5 (55.6%) | 8 (34.8%) | 237 (52.8%) |
| Totals by Age | 100 (22.3%) | 227 (50.6%) | 90 (20.0%) | 9 (2.0%) | 23 (5.1%) | 449 (100%) |
The table shows that 78 of the male participants had first sexual intercourse between 15-20 years as compared to 22 female participants. Some implications from these results are:
| Name of AIDS in Local Language | Frequency | Percentage |
|---|---|---|
| Kalionde onde | 90 | 21.23 |
| Kuyondoloka | 39 | 9.2 |
| AIDS | 31 | 7.3 |
| Intandabwanga | 13 | 3.07 |
| Denkete | 3 | 0.71 |
| Mbande | 2 | 0.47 |
| Kasowe | 1 | 0.24 |
| Don't Know | 164 | 38.68 |
| Others | 81 | 19.10 |
Conclusion:
The findings of this study revealed that IEC (Information, Education and
Communication) methods used in the prevention of HIV/AIDS have had some impact
on the study group in terms of increase in knowledge and awareness about HIV/AIDS.
However, despite being aware and having knowledge about HIV/AIDS and its mode
of transmission in Zambia, the public still continue to have multiple sex partners and
practice traditional ritual cleansing by intercourse.
Objectives:
- To strengthen diagnosis and management capabilities at 30 STD/AIDS clinics.
- To update knowledge and skills of STD control officers and their support staff.
- To improve partner notification, counselling and condom promotion at 30 STD/AIDS clinics.
- To improve STD reporting and surveillance.
- To enhance the public's knowledge on the association between conventional STD and HIV-1. Methods: This review of the project's activities was carried out in June 1992. The procedures included visits to 17 STD clinics in 3 provinces, interviews with STD officers, hospital administrators and patients with STDs and AIDS. Comparisons between project STD/AIDS clinics and non-project STD/AIDS clinics were also made. Thus, 9 of 30 project clinics and 8 of 24 non-project clinics were visited. Evaluation of staff, facilities, supplies and functions were done.
Results/Findings:
- The national STD control programme (NSTDCP) has trained a cadre of clinical officers at UTH through a specialised training course in STD/AIDS. The clinical officers are well trained in diagnosis and management of STD/AIDS, partner notification, counselling and reporting. This appears to have had a significant impact on control of STDs. Nurses have also been trained in the assessment of HIV patients, in pre-test and post-test counselling, in contact tracing and in making home and community visits.
- Operational capabilities of STD/AIDS clinics were assessed based on the patient compliance, referral system, community participation, and health education and counselling services. Progress was seen in all these areas. All STD/AIDS clinics follow WHO recommended procedures of pre- and post-test counselling for HIV testing and deal ethically with patients. Crisis and preventive counselling is done regularly. Partner notification is done utilising passive methods in most instances. Condom promotion has been very effective at all STD/AIDS clinics. A decline in STD rates has been noted at 13 surveillance sites since 1988. It is not possible, however, to determine whether a single factor is responsible for the declining trend. Certainly, adequate management of STDs and health education efforts have had an impact. The practice of polygamy in Zambia and a reluctance to regularly use condoms are a big hurdle in attaining the desired goals. The best intervention available is probably the prompt diagnosis and effective treatment of STDs in symptomatic persons and their sexual partners through STD/AIDS clinics.
- Comparison of project clinics and non-project clinics reveals several shortcomings in the latter. These include a lack of defined goals, lack of administrative support, poor patient compliance with treatment and sexual behaviour change, absence of laboratory support, inadequate patient referral system, lack of counselling component, and lack of community participation.
Conclusions:
- The NSTDCP is well conceived.
- The staff are well motivated.
- Patient compliance at USAID project clinics is excellent.
- STD laboratories need to be further strengthened.
- Drug supply needs to be improved.
- More staff training and refresher courses are desired.
- Additional health education materials need to be prepared.
- Useful operational research should be made a component of each clinic site.
- Surveillance and reporting systems are good.
- This is a replicable model for other countries in Africa and Asia.
Objectives:
To identify and assess behaviour change indicators in 28 communities where community counselling services/activities are taking place and trained community counsellors exist to promote sustainable behaviour change. To assess community capacity in the prevention of HIV/AIDS. Methods:
The Chikankata AIDS Care and Prevention department started in March 1987. Community counselling is undertaken by this department. Other programmes include: home based care for HIV infected persons and AIDS health education/promotion. Activities of concept transfer are shared in the monthly AIDS management training seminars.Results:
- Community counselling: This is a concept originally framed by the Chikankata AIDS team. It is defined as an activity focussing on groups and communities which promote responsibility transfer for behaviour change from others, including health care professionals, to the community. Through this process communities are supported to act assertively and confidentially (in their interest); in this case to reduce the spread of HIV through methods such as ritual cleansing by sexual means. The desire to act on this change of behaviour comes about by the facilitated community counselling process which agrees with the counselling process on a one-on-one basis.
- Community counselling process: This process includes the following facets: community selection, relationship building, problem identification and exploration, decision-making, implementation, and evaluation. This process has been enhanced by the presence, within the communities, of leadership and decision-making structures and working through them to community members, and with them to bring about the desired change. Implementation must be evaluated with the set goals. Evaluation is a team effort, both with the community, community counsellor and the hospital community team. The team looked at the extent to which the agreed change goals were addressed. Solutions to obstacles are sought for and utilised to bring about the desired change in behaviour.
- The law to abolish ritual cleansing by sexual intercourse has been enacted in all the three chiefs in Chikankata Hospital catchment area. Ritual cleansing is either done using means other than sexual or protected/safer sex using condoms.
- Communities have been able to identify risk behaviours, come up with preventive strategy and indicators of behaviour change, i.e. an attempt to measure behaviour change.
- Communities have been able to identify achievable and non- achievable goals to implement.
- Of the 43 trained community counsellors, 85 per cent are actively involved in AIDS education in their respective communities, only 15 per cent have dropped out.
- Normalisation of HIV/AIDS in the communities is evident; the home based care (HBC) has been easier, community counsellors are supported in their work and consulted on HIV/AIDS-related issues, patient acceptance level has increased; only about 5 per cent of HBC patients complain of an abnormal home environment as a result of their presence.
Conclusion:
The communities have a greater role to play in the prevention of HIV/AIDS. Just as individuals need counselling to deal with or think through the implications of HIV/AIDS for their lives, communities too have a similar need. This is a long term task-oriented problem-solving process calling for consistency and commitment for those that are empowering communities including health professionals. Community based counsellors do not only speed up the process of care and prevention but are also essential in monitoring and sustaining behaviour change. It is possible to measure behaviour change using quantifiable change indicators.
This study was designed to compare two HIV-related risk reduction approaches targeting in-school adolescents in Zambia. In the initial stage of the project, preliminary questionnaires and ethnographic interviews were conducted to determine which beliefs, values, and behaviours are important to target in effectively structuring HIV-related risk reduction campaigns among adolescents. Data on HIV/AIDS knowledge, attitudes and behaviours are being collected at the schools by individual interviews and group questionnaires. When female adolescents in the group classroom setting responded to questions regarding their sexual behaviours preliminary information was gathered. Pilot data show that results are different than when asked about their behaviour in-depth individual interview. In a group setting, 35 per cent think that almost all or most of their classmates are having sexual intercourse. However, in the individual interview, 72 per cent report having had no intercourse and 15 per cent report having had intercourse in the past year. This paper will present comparisons of the results obtained from a sample of 100 female in-school adolescents. The implications of this study for designing school based prevention programmes in Zambia are discussed.
Available data show that STDs and their consequences are a major health problem in Zambia. This study focuses on factors which could have implications for partner notification as a tool for prevention. Fifty women and fifty men with STD were interviewed at two out-patient clinics in Lusaka, where partner notification is not functioning optimally. A majority of the sexual partners during the last three months were known by the patients who also stated a willingness to bring more partners than they were asked to do. Women had symptoms for a longer period than men before they came for treatment. They were less aware of symptoms connected with STD and a majority of them did not know that they were receiving treatment for STD. The communication between the health care provider and the patients about disease, treatment and partner notification needs to be improved especially for women.
[Table of Contents] [AIDS/Zambia Index] [Bibl. Contents] [Alphabetical Index] [Zamnet] [UNZA] [UNZA Library]
Last updated February 4, 1999
|
UNIVERSITY OF ZAMBIA Med Guide Index Zamnet UNIVERSITY OF ZAMBIA UNIVERSITY OF ZAMBIA Library CONTACTING SCHOOL OF MEDICINE OTHER INSTITUTIONS BACK TO SOM HOME PAGE DEPARTMENTS Central Board of Health Send comments and/or suggestions
to: Stan chewe |