Browsing by Author "Lembani, Martina"

Now showing 1 - 6 of 6
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    Access to HIV healthcare services by farm workers in sub-Saharan Africa (SSA): A systematic review protocol
    (BMJ Publishing Group, 2022) Mlangeni, Nosimilo; Adetokunboh, Olatunji; Lembani, Martina
    Sub-Saharan Africa (SSA) region harbours the highest burden of HIV infections in the world. Agricultural work has been reported as one of the occupations with a high prevalence of HIV. Farm workers generally have poor access to health services, which prevents them from receiving proper HIV prevention and care. Furthermore, poor policies and policy implementation, and lack of workplace programmes increases farm workers’ vulnerability to HIV infection. Thus, the aim of this study is to conduct a systematic review to assess HIV prevention and treatment services and national policies governing access to healthcare services by farm workers in SSA.
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    The effects of poor menstrual hygiene management on sexual and reproductive health and education outcomes among adolescent schoolgirls in rural Tanzania
    (University of the Western Cape, 2023) Ngilangwa, David Paul; Lembani, Martina
    Background: In Tanzania, 11 million children are enrolled in primary schools, half of them being girls. As the majority of girls start their menstruation while in primary school, their retention in schools is likely to be hampered by inadequate and poor menstruation hygiene management facilities. It is important to conduct research to understand the association between poor menstruation hygiene management and school absenteeism, psychological well-being, and reproductive tract infections to inform interventions and policies that may enhance the full realization of girls pursuing education successfully. Much research conducted previously has focused on the knowledge and practices of menstruation hygiene management among girls in secondary schools. There is limited evidence of the associations between menstrual hygiene management and particularly sexual and reproductive health and education outcomes, among adolescent schoolgirls in rural Tanzania
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    Non-booking for antenatal care and risks for vertical HIV transmission among women in Chitungwiza, Zimbabwe: a cross-sectional study
    (BMC Pregnancy and Childbirth, 2022) Schaay, Nikki; Lembani, Martina; Mandima, Patricia; Ngara, Bernard
    Background: The success of prevention of mother to child transmission of HIV (PMTCT) programs dependents on pregnant women accessing antenatal care (ANC) services. Failure to access ANC throughout the course of pregnancy presents a missed opportunity to fully utilize PMTCT services and a high risk for vertical HIV transmission. Whilst not booking for ANC was about 6% in Zimbabwe, according to the 2015 Zimbabwe Demographic and Health Survey, it is important to determine the local burden of pregnant women both un-booked for ANC and living with HIV. in Chitungwiza city, to inform local response. This study aimed at determining the proportion of women un-booked for antenatal care and among them, the proportion of women who were with HIV and to identify risk factors associated with not-booking for ANC in Chitungwiza city in Zimbabwe.
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    Post-doctoral research fellowship as a health policy and systems research capacity development intervention: a case of the CHESAI initiative
    (BioMed Central, 2016) Lembani, Martina; Teddy, Gina; Molosiwa, Dintle; Hwabamungu, Boroto
    BACKGROUND: Building capacity in health policy and systems research (HPSR), especially in low- and middle-income countries, remains a challenge. Various approaches have been suggested and implemented by scholars and institutions using various forms of capacity building to address challenges regarding HPSR development. The Collaboration for Health Systems Analysis and Innovation (CHESAI) – a collaborative effort between the Universities of Cape Town and the Western Cape Schools of Public Health – has employed a non-research based post-doctoral research fellowship (PDRF) as a way of building African capacity in the field of HPSR by recruiting four post-docs. In this paper, we (the four post-docs) explore whether a PDRF is a useful approach for capacity building for the field of HPSR using our CHESAI PDRF experiences. METHODS: We used personal reflections of our written narratives providing detailed information regarding our engagement with CHESAI. The narratives were based on a question guide around our experiences through various activities and their impacts on our professional development. The data analysis process was highly iterative in nature, involving repeated meetings among the four post-docs to reflect, discuss and create themes that evolved from the discussions. RESULTS: The CHESAI PDRF provided multiple spaces for our engagement and capacity development in the field of HPSR. These spaces provided us with a wide range of learning experiences, including teaching and research, policy networking, skills for academic writing, engaging practitioners, co-production and community dialogue. Our reflections suggest that institutions providing PDRF such as this are valuable if they provide environments endowed with adequate resources, good leadership and spaces for innovation. Further, the PDRFs need to be grounded in a community of HPSR practice, and provide opportunities for the post-docs to gain an in-depth understanding of the broader theoretical and methodological underpinnings of the field. CONCLUSION: The study concludes that PDRF is a useful approach to capacity building in HPSR, but it needs be embedded in a community of practice for fellows to benefit. More academic institutions in Africa need to adopt innovative and flexible support for emerging leaders, researchers and practitioners to strengthen our health systems
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    Systems dynamics analysis of health systems resilience: Case Studies from Cote d’Ivoire and Nigeria
    (University of the Western Cape, 2023) Lembani, Martina; Ager, Alastair; de Pinho, Helen
    Background: There is increasing interest in applying the concept of resilience to understand ways of promoting robust health service delivery in contexts of acute or chronic crisis. Identifying key sources of vulnerability and health systems structures and designs that promote resilient functioning can inform policy-making across a broad range of settings.
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    Understanding key drivers of performance in the provision of maternal health services in eastern cape, South Africa: a systems analysis using group model building
    (BMC, 2018) Lembani, Martina; de Pinho, Helen; Delobelle, Peter
    Background: The Eastern Cape Province reports among the poorest health service indicators in South Africa with some of its districts standing out as worst performing as regards maternal health indicators. To understand key drivers and outcomes of this underperformance and to explore whether a participatory analysis could deepen action-oriented understanding among stakeholders, a study was conducted in one of the chronically poorly performing districts. Methods: The study used a systems analysis approach to understand the drivers and outcomes affecting maternal health in the district in order to identify key leverage points for addressing the situation. The approach included semistructured interviews with a total of 24 individuals consisting health system managers at various levels, health facility staff and patients. This was followed by a participatory group model building exercise with 23 key stakeholders to analyze system factors and their interrelationships affecting maternal health in the district using rich pictures and interrelationship diagraphs (IRDs) and finally the development of causal loop diagrams (CLDs). Results: The stakeholders were able to unpack the complex ways in which factors were interrelated in contributing to poor maternal health performance and identified the feedback loops which resulted in the situation being intractable, suggesting strategies for sustainable improvement. Quality of leadership was shown to have a pervasive influence on overall system performance by linking to numerous factors and feedback loops, including staff motivation and capacity building. Staff motivation was linked to quality of care in turn influencing patient attendance and feeding back into staff motivation through its impact on workload. Without attention to workload, patient waiting times and satisfaction, the impact of improved leadership and staff support on staff competence and attitudes would be diminished. Conclusion: Understanding the complex interrelationships of factors in the health system is key to identifying workable solutions especially in the context of chronic health systems challenges. Systems modelling using group model building methods can be an efficient means of supporting stakeholders to recognize valuable resources within the context of a dysfunctional system to strengthen systems performance.