Browsing by Author "Mohamed, Suraya"

Now showing 1 - 6 of 6
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    Adolescents’ utilization of reproductive health services in Kaduna, Nigeria: the role of stigma
    (Vulnerable Children and Youth Studies, 2020) Nmadua, Awawu Grace; Mohamed, Suraya
    The need to improve the sexual and reproductive health (SRH) and rights of adolescents is increasingly acknowledged. Unfortunately, many adolescents in Nigeria face significant barriers to accessing quality sexual and reproductive health services (SRHS), despite national policies promoting SRHS for adolescents. This paper explores the stigma influencing access to and utilization of SRHS among adolescents in Kaduna, Northwestern Nigeria. This qualitative study conducted semi-structured interviews with 14 adolescents and three nurses. Thematic analysis was employed for the study. The findings indicate that although the adolescents knew the importance of accessing SRHS, they were not inclined to utilize the services because of stigma.
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    Barriers to adolescents' access and utilisation of reproductive health services in a community in north-western nigeria: A qualitative exploratory study in primary care
    (OpenJournals Publishing AOSIS (Pty) Ltd, 2020) Mohamed, Suraya; Nmadu, Awawu Grace; Usman, Nafisat Ohunene
    There is a dearth of qualitative studies exploring in-depth barriers that adolescents face in accessing and utilising reproductive health services (RHS) in Nigerian primary healthcare centres. Aim: This study explored the barriers hindering adolescents' access to and utilisation of RHS in primary healthcare centres. Setting: This study was conducted in three primary healthcare centres in Kaduna North Local government area, Nigeria. Methods: This study used an exploratory descriptive qualitative design. Fourteen adolescents and three RHS providers were selected and interviewed. The data collection methods included individual in-depth interviews with adolescents and key informant interviews with service providers. Interviews were conducted between January 2017 and April 2017. Thematic content analysis was used to analyse the data. Results: This study identified three thematic barriers to adolescent's utilisation of RHS. These included individual, social and health system barriers. Individual factors included the following: inadequate knowledge about RHS and poor attitudes of adolescents towards RHS; social factors such as parental influence, community and religious norms, financial constraints and stigma; and health system factors such as poor attitudes of service providers and inconvenient health facility opening hours hindered adolescents from utilising RHS.
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    External stakeholders and health promoting schools: complexity and practice in South Africa
    (Emerald, 2014) Preiser, Rika; Struthers, Patricia; Mohamed, Suraya; Cameron, Neil; Lawrence, Estelle
    Purpose: This paper examines the role of two higher education institutions in the Western Cape, South Africa, and how their initiatives and collaboration brought about a particular Health Promoting Schools (HPS) program in a resource poor setting. The aim of this paper is to reflect on the importance of the role that external systemic actors and stakeholders can play in the process of designing and implementing HPS programs in resource poor settings. Design/methodology/approach: In this paper a complex systems approach is employed to describe two different participatory methods of engagement with HPS by higher education institutions. On the one hand, engagement took place in terms of a formal and funded project, directed at the organizational level of the school, with capacity building as its aim. On the other hand, engagement was initiated informally (as part of a service learning project) via collaboration with the formal project, directed at the individual level of learners in the school. Findings: In recognizing the complex nature of planning and implementing HPS programs, the paper demonstrates that HPS approaches could benefit from engaging with resources outside the ambit of institutional health and educational policies and structures. Originality/value: By acknowledging the systemic nature of implementing HPS strategies, novel collaborations emerge as a result. The paper highlights the important role that external stakeholders such as higher education institutions play in creating and sustaining tailor-made HPS programs for schools based in resource poor settings.
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    Factors influencing the implementation of health promoting schools : a multiple case study of three secondary schools in a resource limited community in Cape Town
    (University of the Western Cape, 2016) Mohamed, Suraya; Stern, Ruth; Struthers, Patricia
    Introduction: This study was conducted because of a gap in information on the factors influencing the health promoting schools (HPS) implementation process in South Africa (SA) specifically and in secondary schools globally. The aim of this context- sensitive, practice-based study was to explore and understand the complexity of the factors that influenced the implementation process of HPS in three secondary schools in a resource-limited setting in Cape Town, SA. This research drew on a five year project that initiated the implementation of HPS in these schools. Methodology: An exploratory qualitative study was used, adopting a multiple case study design. The sample included two principals, ten teachers and 30 students involved in HPS implementation at their schools, and the three school facilitators, who served as mentors to the schools. The data collection methods included: individual interviews, focus group discussions, documentary review, secondary data and observations. A conceptual framework was developed drawing on the settings approach and various implementation frameworks and was used to analyse the findings. Thematic analysis was employed and the data for each case were analysed separately first before undertaking cross case analysis. Findings: A combination of several internal and external factors influenced the ability of the schools to implement and integrate HPS as a whole school approach. A key factor was the degree of understanding of the HPS concept by all key actors and where there was lucid understanding, there was better integration. Significant school factors included the schools’ readiness for change; a culture of collaboration and cooperation; existing school structures, practices and workload; the leadership style and management role of the principals; the role and influence of HPS champion teachers; and the role that students played. The major external factors included the role of the education district; the role of project team as external catalysts for change; and the community context. The main achievements in all schools were discrete activities, including co-curricular activities rather than changes to routine school functions. This highlighted the difficulty in implementing HPS as a whole school approach, a challenge typical of all health promoting settings. Conclusion: The findings illustrate the challenge of achieving full integration of HPS, although the influencing factors, and hence level of integration varied mainly according to context. This highlights the complexity of the different factors and their impact. The study demonstrates the paradox of HPS implementation. In that, despite the recognition of the value of HPS, the challenges to address the complexity of factors that would have brought about change through a whole school approach were too great. It was too difficult to change the status quo from what was routinely done to a more radical way of working due to the conservatism of traditional ways of working and extent of adjustment that it would have resulted. It was therefore only possible to put simple, discrete, strategies in place and that was not too resource intensive. The study concluded that this does not imply that HPS should not be attempted, particularly where there are adverse conditions that would benefit from HPS. Starting with marginal changes, it can be effective in increasing the schools’ readiness for change, building on the achievements both in activities and structures, and the resultant commitment by those involved. Once they experience these changes it will more likely enable schools to incrementally attempt more complex changes. The key recommendations for within the school include: building the understanding and capacity of relevant actors to actively support the implementation of HPS; building the capacity of the principal to create an environment which is conducive to change; and providing support for the HPS champions and students. Recommendations for those external to the school include: support from external catalysts who can provide expertise and mentorship; support from the education district, especially in terms of policies on integration, resources, and raising the profile of HPS; and better collaboration between the education and health sectors. Although most of the literature on HPS implementation identifies similar issues to those found in this study, the complexity has not, to date, been sufficiently described. The contribution of this study, therefore, is to take the debate on the complexity of the factors influencing HPS implementation forward.
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    “The pen is a powerful weapon; it can make you change”: The value of using reflective writing with adolescents
    (Occupational Therapy Association of South Africa, 2017) Wegner, Lisa; Struthers, Patricia; Mohamed, Suraya
    INTRODUCTION: Adolescent programmes have been criticised for implementing activities but not allowing opportunities for reflection. One way that reflection can be facilitated is through writing. This paper describes the use of reflective writing with adolescents as part of a health promoting schools project in Cape Town, South Africa. METHOD: The project included an annual leadership camp for adolescent learners. A descriptive, qualitative study was conducted to describe how the learners responded to writing as a means to express their feelings about, and experiences of, the camp. Thirty learners participated in two writing sessions resulting in 53 written reflections that were analysed thematically. FINDINGS: Three themes emerged: (1) Reflections on self; (2) Reflections on self in relation to others; and (3) Reflections on writing. Participants reflected on connecting with complex, positive and negative feelings, and felt that reflective writing had enabled them to express themselves with courage and honesty, connect with themselves, identify weaknesses and let go of negative emotions and feelings. Furthermore, writing was perceived as being non-judgmental, providing a sense of relief and release, and evoking emotions. CONCLUSION: Reflective writing enabled the participants to acknowledge personal changes and development, and provided insight into their feelings and experiences. This study shows the value of reflective writing for use by health professionals such as occupational therapists, as a tool for empowerment in the pursuit of health and wellbeing.
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    “We can’t handle things we don’t know about”: perceived neurorehabilitation challenges for Malawian paediatric cerebral malaria survivors
    (Springer Nature, 2020) Mboma, Sebastian M.; Boubour, Alexandra; Mohamed, Suraya
    Background: We sought to identify perceptions of neurorehabilitation challenges for paediatric cerebral malaria (CM) survivors post-hospital discharge at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. Methods: An exploratory approach was used to qualitatively investigate the perceived neurorehabilitation challenges for paediatric CM survivors. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs). Eighteen data-gathering sessions were conducted with 38 total participants, including 3 FGDs with 23 primary caregivers, 11 IDIs with healthcare workers at QECH, and 4 IDIs with community-based rehabilitation workers (CRWs). Results: FGDs revealed that caregivers lack important knowledge about CM and fear recurrence of CM in their children. Post-CM children and families experience substantial stigma and sociocultural barriers to integrating into their community and accessing neurorehabilitative care.