scholarly journals Uganda’s response to sexual harassment in the public health sector: from “Dying Silently” to gender-transformational HRH policy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Constance Newman ◽  
Alice Nayebare ◽  
Stella Neema ◽  
Allan Agaba ◽  
Lilian Perry Akello

Abstract Introduction Sexual harassment is a ubiquitous problem that prevents women’s integration and retention in the workforce. Its prevalence had been documented in previous health sector studies in Uganda, indicating that it affected staffing shortages and absenteeism but was largely unreported. To respond, the Ministry of Health needed in-depth information on its employees’ experiences of sexual harassment and non-reporting. Methods Original descriptive research was conducted in 2017 to identify the nature, contributors, dynamics and consequences of sexual harassment in public health sector workplaces and assess these in relation to available theories. Multiple qualitative techniques were employed to describe experiences of workplace sexual harassment in health employees’ own voices. Initial data collection involved document reviews to understand the policy environment, same-sex focus group discussions, key informant interviews and baseline documentation. A second phase included mixed-sex focus group discussions, in-depth interviews and follow up key informant interviews to deepen and confirm understandings. Results A pattern emerged of men in higher-status positions abusing power to coerce sex from female employees throughout the employment cycle. Rewards and sanctions were levied through informal management/ supervision practices requiring compliance with sexual demands or work-related reprisals for refusal. Abuse of organizational power reinforced vertical segregation, impeded women’s productive work and abridged their professional opportunities. Unwanted sexual attention including non-consensual touching, bullying and objectification added to distress. Gender harassment which included verbal abuse, insults and intimidation, with real or threatened retaliation, victim-blaming and gaslighting in the absence of organizational regulatory mechanisms all suppressed reporting. Sexual harassment and abuse of patients by employees emerged inadvertently. Discussion/conclusions Sex-based harassment was pervasive in Ugandan public health workplaces, corrupted management practices, silenced reporting and undermined the achievement of human resources goals, possibilities overlooked in technical discussions of support supervision and performance management. Harassment of both health system patients and employees appeared normative and similar to “sextortion.” The mutually reinforcing intersections of sex-based harassment and vertical occupational segregation are related obstacles experienced by women seeking leadership positions. Health systems leaders should seek organizational and sectoral solutions to end sex-based harassment and make gender equality a human resource for health policy priority.

2020 ◽  
Vol 11 (3) ◽  
pp. 10-20
Author(s):  
Hien Do ◽  
Hien T Ho ◽  
Phu D Tran ◽  
Dang B Nguyen ◽  
Satoko Otsu ◽  
...  

Introduction: Hospitals are a key source of information for the early identification of emerging disease outbreaks and acute public health events for risk assessment, decision-making and public health response. The objective of this study was to identify potential facilitators and barriers for event reporting from the curative sector to the preventive medicine sector in Viet Nam. Methods: In 2016, we conducted 18 semi-structured, in-depth interviews, as well as nine focus group discussions, with representatives from the curative and preventive medicine sectors in four provinces. We transcribed the interviews and focus group discussions and used thematic analysis to identify the factors that appeared to affect public health event reporting. Results: We identified five major themes. First, the lack of a legal framework to guide reporting meant hospital staff relied on internal procedures that varied from hospital to hospital, which sometimes delayed reporting. Second, participants stated the importance of an enabling environment, such as leadership support and having focal points for reporting, to facilitate reporting. Third, participants described the potential benefits of reporting, such as support provided during outbreaks and information received about local outbreaks. Fourth, some challenges prohibited timely reporting such as not perceiving reporting to be the task of the curative sector and hesitancy to report without laboratory confirmation. Finally, limited resources and specialist capacities in remote areas hindered timely detection and reporting of unusual events. Discussion: This study identified potential opportunities to promote the detection and reporting of unusual events from health-care workers to the public health sector, and thus to improve the overall health security system in Viet Nam.


2020 ◽  
Author(s):  
Mulugeta Dile Worke ◽  
Zewdie Birhanu Koricha ◽  
Gurmesa Tura Debelew

Abstract Background: Workplace sexual harassment is a public health problem that depends on gender, context, and perceivers ideology. Though studies documented the prevalence and consequences worldwide, the perception, experience, risk, and effects on victims are still at an earlier stage and not well understood in low and middle-income countries, particularly Ethiopia. The issue is worsened among women employees in the hospitality workplace that comprises hotels, bars, restaurants, fast-food establishments, and cafeterias. Hence, this study aimed to explore workplace sexual harassment perception and experience among women in these workplaces.Methods: An exploratory qualitative study was conducted from January 1 to August 30, 2019. Data were collected from women employees, managers, cashiers, and customers from several hospitality workplaces in the Bahir Dar City. The data were collected through focus group discussions, in-depth interviews, and key-informant interviews. Women who experienced sexual harassment were selected using the snowball method, and the key informants were recruited purposefully until the data theoretically saturated. Key informants who were supposed to give adequate information to study objectives were selected. The selection process was based on their responsibility concerning women working in hospitality workplaces. Data were analyzed via the thematic analysis approach using the ATLAS ti version 8.4.24 software package. Results: In this study, six focus group discussions, ten in-depth interviews, and thirteen key informant interviews were conducted. The majority of the participants perceived that sexual harassment is pressuring, threatening, touching, abducting for sexual advances; and experienced verbal, physical, and non-verbal forms. Similarly, the perceived risk factors were organization related, customer-related, victim-related; and the consequences were work-related, health-related, finance-related, and family undermining.Conclusions: Workplace sexual harassment in hospitality workplaces was poorly understood but widely experienced by women. It was also caused by multiple factors and affected both organizational and individual-level factors. Awareness creation campaigns, pre-service education, and in-service training, prevention, and rehabilitation are needed. Likewise, organizational policies and strategies should have to be developed and implemented.


2021 ◽  
Author(s):  
Gbadebo Collins Adeyanju ◽  
Cornelia Betsch ◽  
Abdu A. Adamu ◽  
Khadijah Sanusi Gumbi ◽  
Michael G Head ◽  
...  

Abstract Background: Vaccine hesitancy is the delay or refusal of vaccines despite the availability of vaccination services. Although it is considered an important global health threat, it has only rarely been systematically studied within the African context. In this study, we explored the factors that influence vaccine hesitancy among caregivers of children and adolescent girls that are eligible for routine childhood immunisation and the human papillomavirus (HPV) vaccine in Malawi. Methods: The study employed a qualitative exploratory research design. In-depth information was obtained from caregivers of children and adolescent girls eligible for routine immunisation (RI) and the HPV vaccine, respectively, as well as national and district-level representatives of the expanded program on immunisation (EPI) and community stakeholders through key informant interviews and focus-group discussions. These participants were purposively selected using predefined criteria A total of 25 key informant interviews and two focus-group discussions with 13 participants were conducted. Data collection took place between April 20 and May 24, 2020. The interviews were audio-recorded, transcribed verbatim, and then analysed using a thematic content analysis approach. Results: The study shows that most of the vaccine-hesitancy drivers for RI also influenced the newly introduced HPV vaccine. Such drivers were inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, inability to translate knowledge and attitudes into actual vaccination behaviour, low literacy levels of caregivers, complacency occasioned by the stress of distance and transportation logistics, and disconnection between the community healthcare system and community leaders, among others. Conclusion: This study provides deeper insights into the determinants of vaccine hesitancy within the Malawian context. The findings can inform the design of context-specific interventions by decision-makers. While the study provided behavioural insights regarding vaccination behaviour in Malawi, there is need for further quantitative studies that can assess the prevalence of the determinants as well as their causal relationships to vaccine uptake.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mulugeta Dile Worke ◽  
Zewdie Birhanu Koricha ◽  
Gurmesa Tura Debelew

Abstract Background Workplace sexual harassment is a public health problem that depends on gender, context, and perceived ideology. Although studies have documented the prevalence and consequences of workplace sexual harassment worldwide, victims’ perceptions and experiences are still poorly understood in low and middle-income countries, particularly Ethiopia. Female workers in the hospitality industry, including hotels, bars, restaurants, fast-food restaurants, and cafeterias, are particularly affected. Hence, this study aimed to explore sexual harassment perceptions and experiences among women working in these workplaces. Methods An exploratory qualitative study was conducted from 1 January to 30 August 2019. Data were collected from female employees and key informants from several hospitality workplaces in Bahir Dar City. Data were collected through focus group discussions, in-depth interviews, and key-informant interviews. Women who experienced sexual harassment were selected using the snowball method, and key informants were recruited purposefully. Six focus group discussions, ten in-depth interviews, and thirteen key informant interviews were conducted. Data were analysed using the ATLAS ti version 8.4.24. Results In this study, most participants perceived that sexual harassment is pressuring, threatening, touching, abducting sexual advances, and experiencing verbal, physical, and non-verbal types. Similarly, the perceived risk factors were related to the organisations, the customers, and the victims, with the consequences being work-related, health-related, financial-related, and family-related. Conclusions Workplace sexual harassment in hospitality workplaces is poorly understood, but many women experience it. A variety of factors also caused it, and it influenced both organisations and people. Public awareness programs, pre-service preparation, in-service training, prevention, and psychosocial support are needed. Similarly, policies and strategies for the organisations should be developed and implemented.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Rayan Korri ◽  
Sabine Hess ◽  
Guenter Froeschl ◽  
Olena Ivanova

Abstract Background The war in Syria caused the forced displacement of millions of Syrians to neighboring countries. Lebanon is the host country with the largest overall number of Syrian refugees per capita. Adolescent refugee girls experience a unique level of vulnerability during human emergencies and are at increased risk of suffering from poor sexual and reproductive health (SRH) outcomes. We conducted an exploratory qualitative study to learn about the SRH perceptions and experiences of refugee adolescent girls living in Bourj Hammoud, an urban setting in Lebanon. Methods We employed a qualitative design with eight focus group discussions (FGDs) conducted with 40 Syrian Arab and Syrian Kurdish adolescent girls between January and March 2020. Every FGD consisted of five participants aged 13 to 17 years. A semi-structured guide was used covering multiple themes: menstruation, puberty, SRH awareness, and sexual harassment. FGDs were transcribed and analyzed using thematic analysis. Findings The participants discussed adolescent girls’ health and named six elements of good health, such as healthy activities and self-protection. The majority of the FGD participants reported a lack of awareness about menstruation when they experienced it for the first time and the social stigma associated with menstruation. When defining puberty, they indicated its social link to a girl’s readiness for marriage and her need to become cautious about sexual harassment. Most FGD participants had very poor knowledge of the female reproductive system. Mothers were the most approached persons to receive information on SRH issues; however, the girls indicated a wish to receive advice from specialists in a comfortable and private atmosphere. All the girls reported that either they themselves, or an acquaintance, had experienced some type of sexual harassment. The girls rarely reported those incidents due to fear of being blamed or subjected to mobility restrictions, or forced to drop out of school. Conclusions The findings show the refugee girls need for satisfactory knowledge on SRH issues and interventions to prevent sexual and gender-based violence that take into consideration the complexity of urban settings.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  

Abstract Background Men in Sub-Saharan Africa are less engaged than women in accessing HIV testing and treatment and, consequently, experience higher HIV-related mortality. Reaching men with HIV testing services is challenging, thus, increasing the need for innovative ways to engage men with low access and those at higher risk. In this study, we explore men’s perceptions of drivers and barriers of workplace-based HIV self-testing in Uganda. Methods An exploratory study involving men working in private security companies employing more than 50 men in two districts, in central and western Uganda. Focus group discussions and key informant interviews were conducted. Data were analyzed using inductive content analysis. Results Forty-eight (48) men from eight private security companies participated in 5 focus group discussions and 17 key informant interviews. Of the 48 men, 14(29.2%) were ages 26–35 years. The majority 31(64.6%) were security guards. The drivers reported for workplace-based HIV self-testing included convenience, autonomy, positive influence from work colleagues, the need for alternative access for HIV testing services, incentives, and involvement of employers. The barriers reported were the prohibitive cost of HIV tests, stigma, lack of testing support, the fear of discrimination and isolation, and concerns around decreased work productivity in the event of a reactive self-test. Conclusions We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace.


2015 ◽  
Vol 15 (2) ◽  
pp. 51-56
Author(s):  
Dinesh Ghimire ◽  
Jagannath Shrestha ◽  
Anup K.C

This study presents the potentiality of biogas plants and their role for the conservation of environment. It is basedon primary data collected from 84 household surveys, 6 key informant interviews and two focus group discussions. It was observed that more than 95% of the people residing in the VDCs were using firewood as a main source ofenergy. The total amount of firewood consumed was 510.570 ton/year which emits 775.052tCO2e/year. Due to the presence of agriculture based livestock holding population, there is a great potential of biogas technology. Thestudy showed that biogas technology could saved 34.40% of firewood which conserves 5.415 ha of forests area. There is a potentiality of 58 biogas plants of size 6 cu.m which will reduce 440.800 tCO2e/year.DOI: http://dx.doi.org/njst.v15i2.12114Nepal Journal of Science and Technology Vol. 15, No.2 (2014) 51-56


2019 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Muslimah Muslimah ◽  
Dian Ayubi

Measles and Rubella (MR) is a disease that is highly contagious and usually occurs in children aged 9 months until the age of 15 years. One effort that can be done to reduce the incidence of the disease is through health promotion about the importance of immunization. Purpose the promotion was packaged in the form of advertisements on electronic media with the aim of building perceptions that the importance of immunization for public health. Methods this research was a qualitative study with a method of collecting in-depth interviews and focus group discussions. The number of informants in this study was 19 mothers who had children aged 0.9 to 15 years in one of the Puskesmas work areas in Merangin District, Jambi Province. Before the data collection process, all informants were asked to see two MR immunization advertisements. Results that immunization advertisements are interesting and contain humor. Meanwhile, informants who did not give MR immunization to their children tended to be negative towards MR immunization advertisements and tended to ignore the effects that arose if they did not give immunizations to their children. The recommendation that MR immunization advertisements should avoid using the fear arousal method and use the pay off idea method in those ads


2021 ◽  
Author(s):  
Aliya Karim ◽  
Don de Savigny ◽  
Serge Ngaima ◽  
Daniel Mäusezahl ◽  
Daniel Cobos Muñoz ◽  
...  

BACKGROUND Integrated community case management (iCCM) is a child health program designed to provide integrated, community-based care for pneumonia, malaria and diarrhea for children in hard-to-reach areas of low- and middle-income countries (LMICs). The foundation of the intervention is service-delivery by community health workers (CHWs) who depend on reliable provision of drugs and supplies, consistent supervision, comprehensive training, and community acceptance and participation to perform optimally. The effectiveness of the program may also depend on a number of other elements, including an enabling policy environment, financing mechanisms from the national to the local level, data transmission systems, and appropriate monitoring and evaluation. The extent to which these factors act upon each other to influence the effectiveness and viability of iCCM is both variable and challenging to assess, especially across different implementation contexts. OBJECTIVE In this paper, we describe a mixed-methods systems-based study protocol to assess the programmatic components of iCCM which are associated with intervention effectiveness, and report preliminary results of data collection. METHODS This protocol employs a mixed qualitative and quantitative study design based on a Systems Thinking approach within four iCCM programs in Malawi, Democratic Republic of the Congo, Niger State, and Abia State, Nigeria. Routine monitoring data is collected to determine intervention effectiveness, namely testing, treatment and referral outcomes. Surveys with CHWs, supervisors, and caregivers are performed to collect quantitative data on their demographics, activities, and experiences within the program, and how these relate to the areas of intervention effectiveness. Focus group discussions are conducted with these stakeholders as well as local traditional leaders to contextualize this data. Key informant interviews are undertaken with national and district-level program stakeholders and officers knowledgeable in critical program processes. RESULTS We performed 3,836 surveys and 45 focus group discussions with CHWs, supervisors, and caregivers, and traditional leaders; 120 key informant interviews with district and national-level program managers, health officers, and ministry officials. Policy and program documents were additionally collected for review. CONCLUSIONS Evidence from this study will inform child health programs and practice in low- and middle-income settings, and future policy development within the iCCM intervention.


2018 ◽  
Vol 10 (3) ◽  
pp. 261-273
Author(s):  
M. I. Khan ◽  
M. M. Islam ◽  
G. K. Kundu ◽  
M. S. Akter

The Padma is the second longest and one of the trans-boundary rivers of Bangladesh that significantly contributes to fisheries production and supports the fishers’ livelihoods. This study assesses the livelihood characteristics of the Padma river-dependent migratory and non-migratory fishers, employing household interviews, focus group discussions (FGDs), and key informant interviews from July to October, 2015. All migratory fishers were full-time fishers, whereas, non-migratory fishers included full time (88.89%), part-time and occasional fishers (11.11%). Maximum fishers were belonging to the age group of 31 to 50 years of which 94.74% were migratory and 57.4% were non-migratory fishers. Half of the migratory and non-migratory fishers were illiterate. 89.47% migratory fishers used river water for drinking and other purposes, whereas, 94.44% non-migratory fishers used tube-well water. Average annual incomes of both migratory (58%) and non-migratory (65%) fishers ranged from Tk. 30,000 to 60,000, whereas 26% migratory and 5% non-migratory fishers had average annual incomes above Tk. 60,000. The overall livelihood status of the migratory and non-migratory fishers was not satisfactory as they have faced problems like conflicts with elite groups for resources, lack of fish preservation facilities. Effective initiatives and their proper implementations are very crucial to develop the Padma river fisher’s livelihood conditions.


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