scholarly journals Social and cultural factors perpetuating early marriage in rural Gambia: an exploratory mixed methods study

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1949
Author(s):  
Mat Lowe ◽  
Mamsamba Joof ◽  
Bomar Mendez Rojas
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Rural Areas ◽  
The Gambia ◽  
Early Marriage ◽  
Rural Settlements ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Key Informant

Background: Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%), however this rate is still high. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. Very few studies have been conducted to find out what and how local factors influence decisions about early marriage in the Gambia. More information is therefore needed on underlying reasons for the persistence of early marriage in the Gambia so that program managers can use this information to design strategies to decrease early marriages. Methods: The study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents, focus group discussions with 16 male and female parents, and eight key informant interviews with community-based decision makers. Focus group discussions and key informant interviews were transcribed verbatim and analyzed using thematic content analysis, while survey data were analyzed using Stata. Results: The study finds that ethnicity and the fear that girls may engage in premarital sex are two important factors associated with early marriage in rural Gambia. In addition, lack of meaningful alternatives to marriage including work opportunities in rural areas may also limit the options and resources available to girls, resulting in early wedlock. Conclusions: These findings suggest that in order to decrease early marriages in rural Gambia, future efforts should focus on understanding and addressing the role of ethnicity in determining marriage patterns and allaying the fear around premarital sex.The findings also suggest a need to provide girls with employment-oriented education including vocational skills which may result into more empowerment and a delay in marriage.

scholarly journals Social and cultural factors perpetuating early marriage in rural Gambia: an exploratory mixed methods study

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1949
Author(s):  
Mat Lowe ◽  
Mamsamba Joof ◽  
Bomar Mendez Rojas
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Rural Areas ◽  
The Gambia ◽  
Early Marriage ◽  
Rural Settlements ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Key Informant

Background: Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%), however this rate is still high. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. Very few studies have been conducted to find out what and how local factors influence decisions about early marriage in the Gambia. More information is therefore needed on underlying reasons for the persistence of early marriage in the Gambia so that program managers can use this information to design strategies to decrease early marriages. Methods: The study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents, focus group discussions with 16 male and female parents, and eight key informant interviews with community-based decision makers. Focus group discussions and key informant interviews were transcribed verbatim and analyzed using thematic content analysis, while survey data were analyzed using Stata. Results: The study finds that ethnicity and the fear that girls may engage in premarital sex are two important factors associated with early marriage in rural Gambia. In addition, lack of meaningful alternatives to marriage including work opportunities in rural areas may also limit the options and resources available to girls, resulting in early wedlock. Conclusions: These findings suggest that in order to decrease early marriages in rural Gambia, future efforts should focus on understanding and addressing the role of ethnicity in determining marriage patterns and allaying the fear around premarital sex.The findings also suggest a need to provide girls with employment-oriented education including vocational skills which may result into more empowerment and a delay in marriage.

scholarly journals Social and cultural factors perpetuating early marriage in rural Gambia: an exploratory mixed methods study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1949
Author(s):  
Mat Lowe ◽  
Mamsamba Joof ◽  
Bomar Mendez Rojas
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
The Gambia ◽  
Early Marriage ◽  
Premarital Sex ◽  
Independent Effect ◽  
Rural Settlements ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional

Background: Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%). Yet evidence indicates that nearly 8.6% of marriages in the Gambia involved girls younger than 15, and 46.5% of marriages are with girls aged 18 or below. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. Very few studies have been conducted to find out what and how local factors influence decisions about early marriage in the Gambia. More information is therefore needed on underlying reasons for the persistence of early marriage in the Gambia so that program managers can use this information to design strategies towards accelerating the decline of early marriages.  Methods: The study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents and focus group discussions with 16 male and female parents. Focus group discussions were digitally-recorded, transcribed verbatim and analyzed using thematic content analysis, while survey data were analyzed using Stata. Results: Using multiple regression analysis, this study found that ethnicity more than other factors, exerts an independent effect on early marriage. Themes identified during focus group discussions also revealed that fear of premarital sex and loss of virginity outside marriage were major reasons for the perpetuation of early marriage. Conclusions: These findings suggest that the practice of early marriage in rural Gambia is associated with ethnicity and practices related to social and cultural norms. The findings also suggest that in order to decrease early marriages, future efforts should focus on allaying the fears around premarital sex and loss of virginity related to delay in marriage.

Assessing determinants of programmatic performance of community management of malaria, pneumonia, and diarrhea in children in Africa: Protocol and data collection for a mixed-methods evaluation of iCCM (Preprint)

2021 ◽  
Author(s):  
Aliya Karim ◽  
Don de Savigny ◽  
Serge Ngaima ◽  
Daniel Mäusezahl ◽  
Daniel Cobos Muñoz ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Child Health ◽  
Data Collection ◽  
Intervention Effectiveness ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Middle Income ◽  
Key Informant ◽  
Low And Middle Income

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.

scholarly journals Feeding practices and risk factors for chronic infant undernutrition among refugees and migrants along the Thailand-Myanmar border: a mixed-methods study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
A. H. Hashmi ◽  
P. B. Nyein ◽  
K. Pilaseng ◽  
M. K. Paw ◽  
M. C. Darakamon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mixed Methods ◽  
Focus Group ◽  
Infant Feeding ◽  
Maternal Nutrition ◽  
Feeding Practices ◽  
Infant Feeding Practices ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional

Abstract Background This study aims to provide a comprehensive understanding of maternal risk factors, infant risk factors and maternal infant feeding practices among refugees and migrants along the Thailand-Myanmar border. Methods This study employed a mixed-methods approach with two components: (1) cross-sectional survey (n = 390) and (2) focus group discussions (n = 63). Participants were chosen from one of three clinics providing antenatal and delivery services for Karen and Burman refugees and migrants along the border. Participants were pregnant women and mother-infant dyads. Results Refugee and migrant mothers demonstrated high rates of suboptimal breastfeeding and low rates of minimum dietary diversity and acceptable diet. Multivariable regression models showed infant stunting (AOR: 2.08, 95% CI: 1.12, 3.84, p = 0.020) and underweight (AOR: 2.26, 95% CI: 1.17, 4.36, p = 0.015) to have increased odds among migrants, while each 5 cm increase in maternal height had decreased odds of stunting (AOR: 0.50, 95% CI: 0.38, 0.66, p < 0.001) and underweight (AOR: 0.64, 95% CI: 0.48, 0.85, p = 0.002). In addition, small-for-gestational-age adjusted for length of gestation, infant age and gender increased odds of infant’s stunting (AOR: 3.42, 95% CI: 1.88, 6.22, p < 0.001) and underweight (AOR: 4.44, 95% CI: 2.36, 8.34, p < 0.001). Using the Integrated Behavioural Model, focus group discussions explained the cross-sectional findings in characterising attitudes, perceived norms, and personal agency as they relate to maternal nutrition, infant malnutrition, and infant feeding practices. Conclusions Inadequate infant feeding practices are widespread in refugee and migrant communities along the Thailand-Myanmar border. Risk factors particular to maternal nutrition and infant birth should be considered for future programming to reduce the burden of chronic malnutrition in infants.

scholarly journals Opportunities for improving patient experiences among medical travellers from Canada’s far north: a mixed-methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030885 ◽  
Author(s):  
Kate Kerber ◽  
Fariba Kolahdooz ◽  
Meeka Otway ◽  
Melinda Laboucan ◽  
Se Lim Jang ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Cultural Awareness ◽  
Health Workers ◽  
Patient Experiences ◽  
Access To Healthcare ◽  
Community Advisory Board ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Key Informant

ObjectivesThis paper explores patient experiences and identifies barriers and opportunities for improving access to healthcare for patients from the Canadian north who travel to receive medical care in a Southern province.DesignA mixed-methods, cross-sectional study involved one-on-one interviews, focus group discussions and key informant interviews.Participants52 one-on-one interviews with Northwest Territories (NWT) patients and patient escorts and two focus group discussions (n=10). Fourteen key informant interviews were conducted with health workers, programme managers and staff of community organisations providing services for out-of-province patients. A Community Advisory Board guided the development of the questionnaires and interpretation of results.ResultsRespondents were satisfied with the care received overall, but described unnecessary burdens and bureaucratic challenges throughout the travel process. Themes relating to access to healthcare included: plans and logistics for travel; level of communication between services; clarity around jurisdiction and responsibility for care; indirect costs of travel and direct costs of uninsured services; and having a patient escort or advocate available to assist with appointments and navigate the system. Three themes related to healthcare experiences included: cultural awareness, respect and caring, and medical translation. Respondents provided suggestions to improve access to care.ConclusionsPatients from NWT need more information and support before and during travel. Ensuring that medical travellers and escorts are prepared before departing, that healthcare providers engage in culturally appropriate communication and connecting travellers to support services on arrival have the potential to improve medical travel experiences.

scholarly journals Perspectives of future pharmacists on the potential for development and implementation of pharmacist prescribing in Qatar

2020 ◽  
Vol 42 (1) ◽  
pp. 110-123
Author(s):  
Mohammad Issam Diab ◽  
Angham Ibrahim ◽  
Oraib Abdallah ◽  
Alla El-Awaisi ◽  
Monica Zolezzi ◽  
...  
Keyword(s):  
Focus Group ◽  
Treatment Options ◽  
Developed Countries ◽  
Focus Group Discussions ◽  
Cross Sectional Survey ◽  
Group Discussions ◽  
Cross Sectional ◽  
Pharmacist Prescribing ◽  
Barriers To Implementation ◽  
Special Training Program

AbstractBackground Pharmacists in many developed countries have been granted prescribing authorities under what is known as “non-medical prescribing” or “pharmacist prescribing”. However, such prescribing privileges are not available in many developing countries. Objective The objective of this study was to determine the perspectives of future pharmacists (recent pharmacy graduates and pharmacy students) on pharmacist prescribing and its potential implementation in Qatar. Methods A convergent parallel mixed-methods design was used: (1) a cross-sectional survey using a pre-tested questionnaire and; (2) focus group discussions to allow for an in-depth understanding of the issue, with a focus on pharmacists prescribing competencies as well as barriers for its implementation. Main outcome measures Future pharmacists’ perspectives and attitudes towards pharmacist prescribing in Qatar. Results The majority of the respondents (94.4%) indicated awareness of the prescribing competency related to selecting treatment options. Furthermore, the majority (92.4%) believed that pharmacists should undergo prescribing training and accreditation before been legally allowed to prescribe, a point that was reiterated in the focus group discussions. Participants generally expressed support for collaborative and supplementary prescribing models when developing prescribing frameworks for Qatar. Four categories emerged under the theme barriers to implementation of pharmacist prescribing: lack of prescribing competency, pharmacist mindset, lack of accessibility to patient records and counseling rooms, and diversity of education and training background. Conclusion The majority of recent pharmacy graduates and students were in favor of pharmacist prescribing been implemented in Qatar. However, a special training program was deemed necessary to qualify pharmacists to prescribe safely and effectively.

scholarly journals Nairobi Early Childcare in Slums (NECS) Study Protocol: a mixed-methods exploration of paid early childcare in Mukuru slum, Nairobi

2020 ◽  
Vol 4 (1) ◽  
pp. e000822
Author(s):  
Robert C Hughes ◽  
Patricia Kitsao-Wekulo ◽  
Sunil Bhopal ◽  
Elizabeth W Kimani-Murage ◽  
Zelee Hill ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Early Years ◽  
Epidemiological Methods ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Early Childcare ◽  
Depth Interviews ◽  
Childcare Providers

IntroductionThe early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the ‘new normal’ for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.AimsTo build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.Methods and analysisMixed methods will be employed. Qualitative research (in-depth interviews and focus group discussions) with parents/carers will explore need for and decision-making about childcare. A household survey (of 480 households) will estimate the use of different childcare strategies by parents/carers and associated parent/carer characteristics. Subsequently, childcare providers will be mapped and surveyed to document and assess quality of current paid childcare. Semistructured observations will augment self-reported quality with observable characteristics/practices. Finally, in-depth interviews and focus group discussions with childcare providers will explore their behaviours and motivations. Qualitative data will be analysed through thematic analysis and triangulation across methods. Quantitative and spatial data will be analysed through epidemiological methods (random effects regression modelling and spatial statistics).Ethics and disseminationEthical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.

scholarly journals Drivers and barriers to workplace-based HIV self-testing among high-risk men in Uganda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Private Security ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Private Security Companies ◽  
Self Testing ◽  
Key Informant ◽  
Hiv Testing Services ◽  
Security Companies

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.

scholarly journals A mixed methods approach to determine the climate of interprofessional education among medical and health sciences students

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nabil Sulaiman ◽  
Youssef Rishmawy ◽  
Amal Hussein ◽  
Maha Saber-Ayad ◽  
Hamzah Alzubaidi ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Patient Care ◽  
Interprofessional Education ◽  
Health Sciences ◽  
Study Cohort ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Positive Attitudes ◽  
Health Sciences Students

Abstract Background High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students’ readiness and positive attitudes towards IPE have been reported from the Arabian context. Methods A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed. Results This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. Conclusion This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.

scholarly journals Women Who Study in Madrasah School Experienced Higher Number of Female Circumcision Compared to Western or English Schools

2016 ◽  
Vol 25 (1) ◽  
Author(s):  
Salmah Lao Manalocon- Basher
Keyword(s):  
Focus Group ◽  
Qualitative Methods ◽  
Rural Areas ◽  
Prevalence Rate ◽  
Female Circumcision ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Experiences Of Women ◽  
Quantitative And Qualitative Methods ◽  
External Genital Organs

Female circumcision refers to the procedures that intentionally alter or cause injury to the female external genital organs. The reasons for doing this vary but it is commonly observed in places where Muslims predominate. The study is intended to determine: 1) the rate of females who had undergone female circumcision in Madrasah School compared to those who went to English schools, 2) the prevalence rate of female circumcision among Meranaos, and 3) the practices and experiences of women who have undergone FC. The study utilized a combination of quantitative and qualitative methods using a designed questionnaire, interview and focus group discussions with the respondents. The results showed that more girls who were studying in Madrasah have undergone this practice compared to the number of girls who are in Western or English schools. It also showed that the prevalence rate of this practice is indeed high in the rural areas, which is 86%. The practice of FC is performed either during Fridays, Holidays or Mondays and Thursdays. Each mentioned day has meanings and there are certain procedures and instructions being followed in doing the practice. In conclusion, religious justification remains the strong reason why FC is still rampantly performed in the different rural areas of Lanao del Sur, Philippines.

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