I am a Social and Behavioural researcher with over 20 years experience in the areas of: adolescents and young people’s Sexual and Reproductive Health behaviour
Parent-child communication about sexual and reproductive health in rural Tanzania: implications f... more Parent-child communication about sexual and reproductive health in rural Tanzania: implications for young people's sexual health interventions
BackgroundUse of family planning (FP) saves the lives of mothers and children, and contributes to... more BackgroundUse of family planning (FP) saves the lives of mothers and children, and contributes to better economic outcomes for households and empowerment for women. In Tanzania, the overall unmet need for FP is high. This study aimed: (1) to use focus group data to construct a theoretical framework to understand the multidimensional factors impacting the decision to use FP in rural Tanzania; (2) to design and pilot-test an educational seminar, informed by this framework, to promote uptake of FP; and (3) to assess acceptability and further refine the educational seminar based on focus group data collected 3 months after the education was provided.MethodsWe performed a thematic analysis of 10 focus group discussions about social and religious aspects of FP from predominantly Protestant church attenders prior to any intervention, and afterwards from six groups of church leaders who had attended the educational seminar.ResultsKey interpersonal influences included lack of support from hu...
Research in high income countries shows parent-child connectedness to be protective against undes... more Research in high income countries shows parent-child connectedness to be protective against undesirable sexual and reproductive health (SRH) outcomes among young people. Little has been done to understand the nature of parent-child connectedness, the structural factors that impact on connectedness and parents' understanding of how connectedness affects their children's sexual behaviour in sub-Saharan Africa and Tanzania in particular. Ethnographic research involved 30 days of observation in 10 households, 9 focus group discussions and 60 in-depth interviews. Thematic analysis was conducted using NVIVO qualitative data analysis software. The structural factors with greatest influence on connectedness were economic circumstances, gender, social status, state education, and globalisation. Economic circumstances impacted on parent-child connectedness through parents' ability to provide for their children's material needs, and the time their occupation allowed for them to...
Concurrent sexual partnerships (CSPs) have been speculated to drive the HIV pandemic in many sub-... more Concurrent sexual partnerships (CSPs) have been speculated to drive the HIV pandemic in many sub-Saharan African countries. We have limited understanding of how people think and talk about CSPs, how beliefs are transmitted across generations, and how this might affect the practice. This paper explores these issues to understand how CSPs are perpetuated and help identify opportunities for interventions to modify them. The study employed an ethnographic research design involving: participant observation in 10 households, 60 in-depth interviews (IDIs), and nine participatory focus group discussions (FGDs). Participants were young people aged 14-24 and parents/carers of young people within this age group. The 60 IDIs were conducted with: 17 fathers, 13 mothers, 13 young men and 17 young women (six of whom had had unplanned pregnancies and 11 had no children). The nine FGDs were conducted with groups of: fathers (2), mothers (2), young women (2), and young men (3). A discourse analysis w...
HIV/AIDS programmes and interventions are more likely to succeed if they engage with local people... more HIV/AIDS programmes and interventions are more likely to succeed if they engage with local people's beliefs about AIDS causation. This study examined beliefs about general illness, sexually‐transmitted infection (STI) and AIDS aetiology in rural Mwanza, Tanzania. From 1999–2002, participant observation was carried out in nine villages for a total of 158 person‐weeks. Beliefs about general illness causation included God's will, chance, natural/biological, ancestral spirits, and witchcraft. STIs were generally attributed to natural causes, but beliefs about AIDS causation were more complex. Few villagers had heard of HIV, but most had heard of AIDS and understood that AIDS could be contracted through sex. A small proportion of villagers knew that such an infected person might appear healthy, but they generally believed the asymptomatic period to last only a few months after exposure; if healthy beyond that, the person was not believed to have been infected. Many people in al...
Objectives We synthesise evidence on sexual harassment from studies in low-income and middle-inco... more Objectives We synthesise evidence on sexual harassment from studies in low-income and middle-income countries (LMICs) to estimate its prevalence and conduct a meta-analysis of the association between sexual harassment and depressive symptoms. Methods We searched eight databases. We included peer-reviewed studies published in English from 1990 until April 2020 if they measured sexual harassment prevalence in LMICs, included female or male participants aged 14 and over and conceptualised sexual harassment as an independent or dependant variable. We appraised the quality of evidence, used a narrative syntheses approach to synthesise data and conducted a random effects meta-analysis. Results From 49 included studies, 38 focused on workplaces and educational institutions and 11 on public places. Many studies used an unclear definition of sexual harassment and did not deploy a validated measurement tool. Studies either used a direct question or a series of behavioural questions to elicit ...
Background Primaquine is a gametocytocidal drug recommended by the World Health Organization (WHO... more Background Primaquine is a gametocytocidal drug recommended by the World Health Organization (WHO) in a single-low dose combined with artemisinin-based combination therapy (ACT) for the treatment and prevention of Plasmodium falciparum malaria transmission. Safety monitoring concerns and the lack of a universal validated and approved primaquine pharmacovigilance tool is a challenge for a national rollout in many countries. This study aimed to explore the acceptance, reliability and perceived effectiveness of the primaquine roll out monitoring pharmacovigilance tool (PROMPT). Methods This study was conducted in three dispensaries in the Coastal region of Eastern Tanzania. The study held six in-depth interviews with healthcare providers and six participatory focus group discussions with malaria patients (3) and parents/guardians of sick children (3). Participants were purposively sampled. Thematic analysis was conducted with the aid of NVivo qualitative analysis software. Results The ...
Parent-child communication about sexual and reproductive health in rural Tanzania: implications f... more Parent-child communication about sexual and reproductive health in rural Tanzania: implications for young people's sexual health interventions
BackgroundUse of family planning (FP) saves the lives of mothers and children, and contributes to... more BackgroundUse of family planning (FP) saves the lives of mothers and children, and contributes to better economic outcomes for households and empowerment for women. In Tanzania, the overall unmet need for FP is high. This study aimed: (1) to use focus group data to construct a theoretical framework to understand the multidimensional factors impacting the decision to use FP in rural Tanzania; (2) to design and pilot-test an educational seminar, informed by this framework, to promote uptake of FP; and (3) to assess acceptability and further refine the educational seminar based on focus group data collected 3 months after the education was provided.MethodsWe performed a thematic analysis of 10 focus group discussions about social and religious aspects of FP from predominantly Protestant church attenders prior to any intervention, and afterwards from six groups of church leaders who had attended the educational seminar.ResultsKey interpersonal influences included lack of support from hu...
Research in high income countries shows parent-child connectedness to be protective against undes... more Research in high income countries shows parent-child connectedness to be protective against undesirable sexual and reproductive health (SRH) outcomes among young people. Little has been done to understand the nature of parent-child connectedness, the structural factors that impact on connectedness and parents' understanding of how connectedness affects their children's sexual behaviour in sub-Saharan Africa and Tanzania in particular. Ethnographic research involved 30 days of observation in 10 households, 9 focus group discussions and 60 in-depth interviews. Thematic analysis was conducted using NVIVO qualitative data analysis software. The structural factors with greatest influence on connectedness were economic circumstances, gender, social status, state education, and globalisation. Economic circumstances impacted on parent-child connectedness through parents' ability to provide for their children's material needs, and the time their occupation allowed for them to...
Concurrent sexual partnerships (CSPs) have been speculated to drive the HIV pandemic in many sub-... more Concurrent sexual partnerships (CSPs) have been speculated to drive the HIV pandemic in many sub-Saharan African countries. We have limited understanding of how people think and talk about CSPs, how beliefs are transmitted across generations, and how this might affect the practice. This paper explores these issues to understand how CSPs are perpetuated and help identify opportunities for interventions to modify them. The study employed an ethnographic research design involving: participant observation in 10 households, 60 in-depth interviews (IDIs), and nine participatory focus group discussions (FGDs). Participants were young people aged 14-24 and parents/carers of young people within this age group. The 60 IDIs were conducted with: 17 fathers, 13 mothers, 13 young men and 17 young women (six of whom had had unplanned pregnancies and 11 had no children). The nine FGDs were conducted with groups of: fathers (2), mothers (2), young women (2), and young men (3). A discourse analysis w...
HIV/AIDS programmes and interventions are more likely to succeed if they engage with local people... more HIV/AIDS programmes and interventions are more likely to succeed if they engage with local people's beliefs about AIDS causation. This study examined beliefs about general illness, sexually‐transmitted infection (STI) and AIDS aetiology in rural Mwanza, Tanzania. From 1999–2002, participant observation was carried out in nine villages for a total of 158 person‐weeks. Beliefs about general illness causation included God's will, chance, natural/biological, ancestral spirits, and witchcraft. STIs were generally attributed to natural causes, but beliefs about AIDS causation were more complex. Few villagers had heard of HIV, but most had heard of AIDS and understood that AIDS could be contracted through sex. A small proportion of villagers knew that such an infected person might appear healthy, but they generally believed the asymptomatic period to last only a few months after exposure; if healthy beyond that, the person was not believed to have been infected. Many people in al...
Objectives We synthesise evidence on sexual harassment from studies in low-income and middle-inco... more Objectives We synthesise evidence on sexual harassment from studies in low-income and middle-income countries (LMICs) to estimate its prevalence and conduct a meta-analysis of the association between sexual harassment and depressive symptoms. Methods We searched eight databases. We included peer-reviewed studies published in English from 1990 until April 2020 if they measured sexual harassment prevalence in LMICs, included female or male participants aged 14 and over and conceptualised sexual harassment as an independent or dependant variable. We appraised the quality of evidence, used a narrative syntheses approach to synthesise data and conducted a random effects meta-analysis. Results From 49 included studies, 38 focused on workplaces and educational institutions and 11 on public places. Many studies used an unclear definition of sexual harassment and did not deploy a validated measurement tool. Studies either used a direct question or a series of behavioural questions to elicit ...
Background Primaquine is a gametocytocidal drug recommended by the World Health Organization (WHO... more Background Primaquine is a gametocytocidal drug recommended by the World Health Organization (WHO) in a single-low dose combined with artemisinin-based combination therapy (ACT) for the treatment and prevention of Plasmodium falciparum malaria transmission. Safety monitoring concerns and the lack of a universal validated and approved primaquine pharmacovigilance tool is a challenge for a national rollout in many countries. This study aimed to explore the acceptance, reliability and perceived effectiveness of the primaquine roll out monitoring pharmacovigilance tool (PROMPT). Methods This study was conducted in three dispensaries in the Coastal region of Eastern Tanzania. The study held six in-depth interviews with healthcare providers and six participatory focus group discussions with malaria patients (3) and parents/guardians of sick children (3). Participants were purposively sampled. Thematic analysis was conducted with the aid of NVivo qualitative analysis software. Results The ...
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