Browsing by Author "Githaiga, Jennifer Nyawira"

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    Exploring the influence of romantic relationships on young adolescent men's sexual and reproductive health attitudes and practices
    (2024) Tolla, Tsidiso; Colvin, Christopher James; Githaiga, Jennifer Nyawira
    Romantic relationships serve as a training ground for the development and improvement of interpersonal negotiation and communication skills where adolescents may learn how to cater to their emotional and sexual needs and those of their partners. Sexual activity is common in adolescent romantic relationships, where adolescents may learn how to negotiate consent, communicate their sexual needs, and learn about their sexual preferences. While sex is not necessarily risky, it exposes adolescents to HIV, sexually transmitted infections (STIs), and pregnancy. In heterosexual romantic relationships, which are a focus of this study, gendered power dynamics become a crucial component with serious implications for sexual decision-making and sexual negotiation, including HIV and intimate partner violence (IPV). This qualitative study explored young adolescent men's experiences of heterosexual romantic relationships and how these shape their sexual and reproductive health (SRH), HIV, and IPV-related attitudes and practices. Specifically, the study explored (a) sexual negotiation and decision making (b) gendered power dynamics, and (c) young adolescent men's experiences and perceptions of IPV. Twenty-eight young adolescent men aged 14 to 19 years old from Gugulethu, Cape Town took part in individual interviews conducted telephonically and through WhatsApp. Thirteen young adolescent men participated in handwritten diary entries and a total of 8 in-person FGDs, with a minimum of four young adolescent men per group, were conducted. All data were transcribed, translated, and coded using NVivo software. Thematic and discourse analysis were used to analyse the data. Findings highlight that in heterosexual romantic relationships, young adolescent men oscillated between challenging and reinforcing gender norms, with mixed feelings of uncertainty, fear, and self-doubt. They also grappled with their desires for intimacy and emotional connection with their 2 partners, while negotiating their masculinities. The findings suggest that young adolescent men's sexual practices, their perceptions of risk to HIV, and STIs, and their attitudes towards IPV are located in and influenced by the romantic relationship context. As such, efforts towards improving the SRH of adolescents will require specific attention to romantic relationship dynamics.
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    Health system determinants of delivery and uptake of HPV vaccination services among involuntary migrant populations
    (2025) Githaiga, Jennifer Nyawira; Olivier, Jill; Amponsah-Dacosta, Edina
    Migrant populations are commonly under-immunised relative to general populations in host countries. Under-immunisation has been linked to upsurges of vaccine preventable diseases. The evidence base on routine vaccination among migrant children suggests higher priority is given to infants and younger children compared to adolescents. Though migrants are often classified as a homogenous group, different sub-populations of migrants exist, including voluntary migrants who choose to move versus involuntary migrants forcibly displaced by humanitarian crises. The human papillomavirus (HPV) vaccine, a relatively recent addition to global routine immunisation schedules for adolescents, serves as a useful proxy for understanding vaccine equity for this under-prioritised group. This qualitative systematic review explores health system determinants of delivery and uptake of HPV vaccination services among involuntary migrants. A literature search was conducted across ten electronic databases. An analytical framework tailored to the migrant context aided in capturing the complexity and magnitude of systemic factors that determine vaccine delivery and uptake among involuntary migrants. Of the 600 records retrieved, 25 studies were included in this review. Key determinants of vaccine delivery include adaptation of immunisation policies for migrant inclusiveness, implementation of migrant-targeted interventions, health provider recommendations, electronic health records and free vaccines. Uptake determinants include access dependent on legal status, awareness-related determinants akin to culturally appropriate health messaging, and acceptance-related determinants associated with sociocultural beliefs, misinformation and distrust. Prioritising vaccination programmes linked with non-outbreak-related childhood diseases is challenging in the disruptive context of humanitarian crises given fragile health systems, limited resources, loss of health infrastructure and deployment of health personnel to emergency care, all of which sideline preventative services like HPV vaccination programs. We strongly advocate for global actors at all health systems levels to actively restructure national HPV vaccination programs to enhance inclusivity of adolescent girls in crises settings or resettled in host countries.