Browsing by Author "Knight, Lucia"

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    A cross-cultural adaptation and validation of a scale to assess illness identity in adults living with a chronic illness in South Africa: a case of HIV
    (BioMed Central, 2022-08-21) Sematlane, Neo Phyllis; Knight, Lucia; Masquillier, Caroline; Wouters, Edwin
    Abstract The chronic illness trajectory and its outcomes are well explained by the concept of illness identity; the extent to which ill individuals have integrated their diagnosed chronic illness into their identity or sense of self. The capacity to measure illness identity in people living with HIV (PLHIV) is still relatively unexplored. However, this is potentially useful to help us understand how outcomes for PLHIV could be improved and sustained. This paper aims to explore the cross-cultural adaptation of a Belgian developed Illness Identity Questionnaire (IIQ) and validate the instrument using a sample of South African adults living with HIV. We followed a phased scale adaptation and validation process which included an investigation of conceptual, item, semantic and operational equivalence and also examined the psychometric properties of the IIQ. The concept of illness identity with its four factors; engulfment, rejection, acceptance and enrichment in PLHIV, was found to be relevant within this context. Five items from the original IIQ were excluded from the adapted IIQ due to either semantic insufficiency and/or inadequate measurement equivalence. The mode of administration of the IIQ was changed to accommodate current study participants. The original four factor 25-item model did not fit current data, however, a better contextualized, four-factor, 20-item model was identified and found valid in the current setting. The results showed adequate statistical fit; χ2/d.f. = 1.516, RMSEA = 0.076, SRMR = 0.0893, and CFI = 0.909. Convergent and discriminant validity were also tenable. The cross-cultural adaptation and validation of the IIQ was successful, resulting in the availability of an instrument capable of measuring illness identity in PLHIV in a high HIV prevalence and resource-constrained setting. This therefore addresses the paucity of information and expands on knowledge about illness identity.
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    A qualitative exploration of healthcare workers' perspectives on and experiences with colorectal cancer screening in the Western and Eastern Cape
    (2025) Payne, Alexandra; Knight, Lucia
    In South Africa (SA), colorectal cancer (CRC) incidence and mortality is growing at an alarming rate. CRC is often diagnosed at an advanced stage in SA with a noted increase in younger diagnoses and poor outcomes. However, CRC screening and specifically faecal immunochemical testing (FIT) is not currently offered in the public healthcare sector in SA. Before implementing any sort of screening test, it is important to address health system related factors that are specific to the South African context to better understand the potential feasibility and acceptability of a screening test. To establish a foundation for the potential implementation of a FIT screening program, this qualitative study aimed to explore primary and secondary healthcare workers' perceptions of CRC screening. Materials and Methods: The PRECEDE portion of the PRECEDE-PROCEED model, which identifies predisposing (intrapersonal), reinforcing (interpersonal) and enabling (structural) constructs within the context of health behaviours, served as the theoretical framework for this study. Eight healthcare providers (n=6 physicians and n=2 nurses) practicing in both the Western and Eastern Cape were purposively sampled to participate in semi-structured qualitative interviews. Interviews were analysed using thematic analysis guided by the model. Results: Perceived barriers to CRC screening were identified as socioeconomic status, work status and personal discomfort with tests (predisposing); geographical challenges and healthcare worker related factors (reinforcing); and pathology lab services, test costs, lack of proper ablutions, and lack of clinical continuity and communication (enabling). Perceived facilitators were identified as health education (predisposing); primary care physicians' training in CRC risk and testing location (reinforcing); and test affordability, communication across different health systems, and test availability at primary care level (enabling). Conclusion: This study identifies context specific perceived barriers and facilitators among primary and secondary healthcare workers to CRC screening in South Africa. If CRC FIT screening were to be implemented in SA, relevant policy makers and stakeholders would need to address these perceived barriers across multiple levels.
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    A qualitative exploration of high school dropout and retention among adolescent girls and young women (AGYW) in South Africa
    (2025) Kleinhans, Crystal; Knight, Lucia; Duby, Zoe
    In South Africa high school attrition and disengagement rates have been problematic for the past decade with adolescent girls and young women (AGYW) more likely to dropout of school than their male counterparts, especially those AGYW from socio-economically disadvantaged communities. Increased levels of education, a social determinant of health, strongly correlates with better health outcomes for youth. The disengagement and dropout of AGYW in high school is a public health concern. AGYW are at a greater risk of HIV infection and other sexually transmitted infection (STI) due to biological, cultural, religious, socio-economic and structural factors, and efforts to increase their retention and completion of high school, a protective factor, will increase the likelihood of better health outcomes in this population group. This study was a qualitative analysis of AGYW and stakeholders across five provinces from urban, semi-urban and rural districts. The transcripts were thematically analysed to explore the perceptions of and attitudes to high school completion and dropout and the factors which may contribute to either. Findings revealed that AGYW valued their high school education and associated it with future success and independence but several context specific factors on the individual, interpersonal and institutional levels influenced their retention and likelihood of dropping out of high school. An understanding of the multiple factors which influence high school dropout and retention, as indicated on the different levels of the socio-ecological model, may inform more target specific interventions to increase the retention and completion of high school of AGYW in South Africa.
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    A qualitative exploration of the perceived factors that influence alcohol consumption among South African girls and young women (AFYW) and the relationship with sexual risk behaviour
    (2023) Grant, Jamie; Knight, Lucia
    South Africa (SA) has one of the highest rates of problematic alcohol consumption, with rates particularly concerning among young people. SA adolescent girls and young women (AGYW), from low-resourced settings, exhibit increasingly problematic alcohol consumption behaviours. As alcohol is a key determinant of sexual risk behaviours, it increases AGYW's already disproportionate burden of potentially negative sexual and reproductive health outcomes. This paper reports on analysis of qualitative data from interviews with AGYW and stakeholders, conducted in six SA provinces. Data were thematically analysed to explore respondent's perceptions of factors influencing AGYW's alcohol consumption and experiences of alcohol-induced sexual risk behaviour. Reasons for alcohol consumption included AGYW's desires for pleasure and enhanced sociability, but also to suppress negative emotions. Access to alcohol and social modelling were also perceived as influential factors. Alcohol consumption increased sexual risk through condomless sex and risk of sexual and physical violence against AGYW. Findings indicate that AGYW face negative social reactions to their consumption habits because they contradict social norms of youth and femininity. An understanding of motivations for alcohol use among AGYW, and the influence of the social environments, are useful for formulating alcohol risk-reduction strategies for AGYW and the communities in which they live.
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    An exploration of the determinants of sexual risk behaviour among adolescent girls and young women aged 15-24 years in South Africa: a sub-study of the 2019-2022 HERStory2 study
    (2024) Chamuka, Paidashe; Knight, Lucia; Duby, Zoe
    Objective: The study aims to understand why South African adolescent girls and young women (AGYW) engage in sexual risk behaviours, such as unsafe sex and transactional and inter-generational sexual relationships. These behaviours lead to adverse sexual and reproductive health (SRH) outcomes, including HIV, STIs, unplanned pregnancies, and forced sex. By exploring the perspectives of AGYW and community stakeholders, the study seeks to enhance future interventions aimed at reducing the risk of STIs, including HIV, and unintended pregnancies among AGYW. Methods The study is based on the qualitative component of the HERStory2 study, a mixed-methods evaluation of an SRH intervention for AGYW in six South African districts. Data from in-depth interviews with twenty-seven participants were thematically analysed using the social-ecological model as a theoretical framework. Results The findings showed that the reasons for AGYW's engagement in sexual risk behaviour are nested within individual, interpersonal, community, and structural levels. At the individual level, participants reported that AGYW may engage in sexual risk behaviours due to their age, low perception of risk, problematic alcohol consumption, and the need for high grades at school. At the interpersonal level, social media-induced peer pressure was cited as a reason for AGYW's engagement in sexual risk behaviours. Community-level factors included lack of safety and economic activities such as mining. At the structural level, poverty, negative attitudes from public healthcare providers at clinics, and social and gender norms were perceived to influence AGYW's sexual risk behavior. Conclusion The results suggest that AGYW's sexual risk behaviour is influenced by many complex factors beyond the individual. The results call for targeted holistic interventions to reduce sexual risk behaviour and improve the SRH outcomes for AGYW in this high HIV burden context.
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    An exploratory qualitative study of menstrual hygiene management among adult women of reproductive ages from an under-resourced community in Cape Town, South Africa
    (2023) Ncube, Semkelisiwe; Knight, Lucia
    Background: Poor menstrual hygiene management can result in health concerns for women, particularly in low-and-middle-income countries. The evidence for the lived menstruation experiences of adult women of reproductive ages is limited. This study sought to understand the menstrual hygiene management experiences of adult women from an under-resourced community in Cape Town in South Africa. Methods: In this exploratory qualitative research design, qualitative in-depth interviews were conducted using a semi-structured interview guide with 10 women aged 25 and 49 and three key informants namely a maternal health nurse and two community health care workers. The study occurred over a period of three months and all participants were purposively selected using a homogenous sampling strategy and key informants were purposively sampled using an intensive sampling strategy. Data was manually analysed using Braune & Clarke (2016) thematic data analysis and coding was done deductively and inductively to look for emergent codes. Findings were organized around a conceptual framework developed to map the distal and proximal factors affecting girls and women menstrual hygiene management in LMICs. Results: Women menstrual experiences were shaped by their socio-cultural context and resource limitations. The main findings include psychological impacts of poor menstrual hygiene management namely shame, discomfort, culminating in feelings of powerlessness, loss of confidence, increased anxiety, and negative perceptions of menstruation. Physical health challenges related to compromised menstrual hygiene including skin irritation and rashes, increased risk of reproductive tract infections. Financial challenges culminating in poor access to and use of pain relief medication and use of substandard sanitary materials. Poor menstrual hygiene management also led to environmental pollution caused by disposal of sanitary materials and in day-to-day activities, poor menstrual hygiene led to avoidance of sexual activities and public places, reduced performance, and participation at work. Conclusion: Adult women from an under-resourced community in Cape Town experience poor menstrual hygiene management affecting their physical and psychological health. Recommendations: There is need for health education about menstruation, improved access to resources and health services required for proper MHM and further research and programming among adult populations.
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    ART adherence trajectories and correlates of treatment outcomes among adolescents in the Eastern Cape Province of South Africa
    (2025) Zhou, Siyanai; Knight, Lucia; Toska, Elona
    Background: Sustained adherence to antiretroviral treatment (ART) is essential for viral suppression among adolescents living with HIV. In turn, suppressed viral load reduces the risk of onward transmission, HIV-related morbidity, and mortality, optimising overall health and well-being. Yet, adherence to ART among adolescents living with HIV (ALHIV) remains suboptimal compared to children and adults. Adherence measurement varies widely with no gold standard, and composite assessments such as longitudinal self-reported adherence have not been thoroughly evaluated among ALHIV in low-resource settings. In sub-Saharan Africa, evidence on longitudinal sustained ART adherence and its impacts on subsequent HIV treatment outcomes for ALHIV remains scarce. Prior studies on ART adherence—largely cross-sectional—have relied on traditional aggregate methods, dichotomising adolescents as adherent versus non-adherent which is insufficient to capture variations in adherence over time. Longitudinal ART adherence trajectories may aid the assessment of sustained long-term adherence and its impact on HIV treatment outcomes among ALHIV. To address these gaps, this PhD examined the validity of longitudinal self-reported measures of ART adherence among ALHIV in South Africa. It used group-based trajectory models (GBTMs) to identify ART adherence trajectories and examined their association with HIV treatment outcomes—viral suppression and mortality. It further explored factors contributing to distinct adherence trajectories, and the impact of psychosocial and structural provisions on long-term HIV treatment outcomes among ALHIV in South Africa. Methods: This PhD is an analysis of a three-wave longitudinal cohort study of 1046 ALHIV and 473 HIV-negative peers aged 10-19 years at baseline, in the Eastern Cape province of South Africa. From 2014 to 2018, participants completed questionnaires that included their socio-demographic information and self-reported adherence at all three visits. All participants and their caregivers gave informed consent to participate. In parallel, routine viral load data were extracted from physical and electronic patient files in health facilities, and the National Health Laboratory Services (NHLS) of South Africa (2014-2019). Viral load laboratory test results for 75.2% of the participants were obtained. Mortality was ascertained through community tracing and reporting from 2016 to 2022. All analyses in this thesis used the longitudinal cohort data to address the specific objectives. Statistical analyses included mixed effects logistic regression, group-based trajectory modelling, and path analysis. Findings: The first analysis (Chapter 4) explored the validity of five longitudinal self-reported adherence measures to screen for non-adherence and identify ALHIV with elevated viral load (>1000 copies/mL). Self-report measures included any missed dose in the past 3-days, past-week, past-month, days missed in the past-month, and any past-year missed clinic appointment and were all significantly associated with elevated viral load. The individual sensitivity of each measure varied from 79.5% to 91.6%, and positive predictive values were above 75%. Using the five self-reported adherence measures and group-based trajectory modelling, four adolescent adherence trajectories were identified (Chapter 5), namely ‘consistent (49.8%), ‘low start and increasing' (20.8%); ‘gradually decreasing' (23.5%), and ‘low and decreasing (5.9%) adherence. Compared to the consistent adherence trajectory, membership in each of the three inconsistent adherence trajectories was significantly associated with lower adjusted odds of durable viral suppression—having suppressed viral load (<1000 copies/ml) at two or more consecutive study waves. Complementary mortality analysis (Chapter 6) showed that all-cause mortality rates differ across the four adherence trajectories, and sustained adherence to ART was associated with lower rates of mortality among ALHIV. The analysis found that ALHIV experience higher all-cause mortality than their HIV-negative peers, despite ART rollout in South Africa. Guided by the socio-ecological model (Chapter 7), pathways linking barriers contributing to the distinct longitudinal adherence trajectories were established using path analysis. Experiencing mental health symptoms, medication side effects, internalised HIV stigma, food insecurity, longer clinic travel time (>1 hour), and witnessing domestic violence or conflict were associated with inconsistent adherence trajectories relative to the ‘consistent adherence' trajectory. More importantly, the pathways linking co-occurring barriers, and mental health symptoms to longitudinal adherence were unique for each trajectory or ALHIV sub-group. The final analysis (Chapter 8) revealed that access to government-provided social protection and family psychosocial support was associated with greater improvements in long-term ART adherence and viral load outcomes. Conclusions: This PhD documents multiple ART adherence trajectories, low rates of viral suppression, and high all-cause mortality among ALHIV in South Africa. Self-reported adherence shows promise for low-cost and relatively easy-to-administer alternative measures to ensure timely identification of poor adherence to ART among adolescents, particularly in settings where virologic monitoring is limited. ALHIV displayed distinct adherence behaviour patterns over time, which provides an opportunity to identify and target specific sub-groups of ALHIV in need of adherence support interventions. The multiple barriers identified and their pathways to longitudinal adherence trajectories present another opportunity to tailor care to specific groups of ALHIV, possibly informing differentiated service delivery to different sub-groups of ALHIV. Government-provided social protection and strategies to address psychological well-being can be key add-on support provisions to enhance the effectiveness of ART treatment among ALHIV in low-resource settings. Overall, this PhD demonstrates the need to shift from a one-size-fits-all model of care to customised HIV care and combine biomedical with psychosocial and structural interventions to address the needs of distinct groups of ALHIV.
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    Barriers to gender-based violence care: a qualitative study of migrant and refugee women
    (2024) Bradley, Kathleen; Knight, Lucia; Dutton, Jessica
    South Africa has long served as a destination for migrants from sub-Saharan African nations, with a growing proportion of this population being women in recent years. Female migrants experience an increased risk for gender-based violence (GBV) during the migratory journey and upon resettlement. Accessible and culturally sensitive health, psychosocial, and justice services are necessary to promote holistic recovery for survivors. However, numerous barriers, influenced by widespread xenophobia and increasingly restrictive immigration legislation, have limited this population's access to care. The study aims to explore the barriers encountered by female migrants when accessing care services following experiences of GBV. This qualitative, exploratory study was conducted in Cape Town, South Africa between June and December 2023. Participants were purposively sampled and recruited in partnership with a local migrant organization. Their countries of origin included Burundi, the Democratic Republic of Congo, and Zimbabwe. Data was collected through face-to-face, semi-structured in-depth interviews with 12 female migrants and four key informant (KI) service providers. Interviews explored women's experiences of accessing and utilizing post-violence care services. Inductive thematic analysis guided the study. Data analysis revealed that within a context of xenophobic discrimination and economic instability, female migrants face multiple obstacles in the accessibility and acceptability of post-violence care services. Notable themes in accessibility include a lack of access to information deriving from participants' severe levels of isolation and language barriers. This is compounded by social inaccessibility due to cultural norms against reporting GBV and bureaucratic inaccessibility from prolonged documentation processes. Acceptability of services found multiple reports of xenophobic treatment and victim-blaming behaviour from service providers which impacted women's willingness to seek care. However, many still expressed generally positive sentiments about the progressive nature of social services in South Africa in contrast to their home countries. A lack of information about available postviolence resources, language and cultural barriers, as well as bureaucratic challenges, are limiting the migrant woman's ability to seek help following instances of GBV in Cape Town. Findings demonstrate how non-governmental organizations and individual citizens are currently filling a gap in referrals and service provision raising concerns about sustainability. Advocacy and government intervention are necessary to ensure post-violence care services can adequately meet the needs of migrant women. This mini-dissertation is comprised of two components; Part A is the research protocol for how the study was conducted and Part B in a journal manuscript detailing the process and findings of the study.
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    Birth beyond borders: childbirth experiences of migrant women in Cape Town, South Africa
    (2025) Semenya, Mmapitsi; Knight, Lucia; Jessica, Dutton
    Background Childbirth is significant for women and how it unfolds can influence the outcome of labour and have lasting impacts on them. It is important for women to receive good quality care during this time of intense vulnerability. However, evidence suggests that women are at risk of disrespect and abuse during this phase. South Africa is a top destination for migrants from Africa and migrant women may be more likely to experience discrimination during childbirth. This study therefore aims to explore the childbirth experiences of migrant women and will contribute to our understanding of how to address their health care needs during childbirth. Methods The qualitative study was conducted in Cape Town, South Africa. Using an exploratory approach, participants were purposively sampled in collaboration with the Scalabrini Centre of Cape Town. The study included eight women from various African countries. Participants were interviewed using a semi-structured interview guide and thematic analysis was applied to the data. The reproductive justice framework was used to organise interview findings. Results The study revealed that migrant women had positive experiences during childbirth but also reported negative events. Women were satisfied with health care services in South Africa, compared to their countries of origin. Particularly that they didn't have to pay for services, health care workers (HCW) provided them with information about health care procedures and HCW were available to assist them when they needed help. Some women however, reported being neglected, treated unfairly and discriminated against. Some, especially negative experience, might have not been exclusive to migrant women but might have been worsened because of their migration status. Conclusion Women reported having positive childbirth experiences. However, the study also revealed that even though South African legislations protect migrant's right to health, migrant women still experience negative experiences during childbirth. Some negative experiences may have been heightened because of discrimination against migrants in public health care facilities. Therefore, it is essential that interventions are developed, such as the use of interpreters, to support migrant women during childbirth. Furthermore, healthcare workers must adhere to the already existing legislation, and migrant women must be provided with information on accessible channels to report any ill-treatment during childbirth.
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    It always has to come down to individual choice . Vaccination decision-making among privileged parents in South Africa
    (2024) Blumberg, Chevon; Knight, Lucia
    With most vaccine hesitancy research being performed in high income countries, little is understood about the phenomenon in low- and middle-income regions, including South Africa. Seeking to understand a gap in vaccine hesitancy research, this qualitative study examined the lived experiences and perspectives on vaccination, of parents from privileged communities, in the Western Cape, South Africa. Privilege was defined as individuals who have an educational level above high school, and through self-report had experienced no major financial difficulties, due to the COVID-19 pandemic or other reasons, that would have resulted in impact on standard of living, children's educational institution, or healthcare access. Conducted during the South African COVID-19 vaccine roll-out, from March to June 2022, the study explored how these parents make decisions about vaccination, including routine childhood vaccination, influenza and human papillomavirus vaccines, focusing on the COVID-19 vaccine. Analysis of transcripts from 14 semi-structured individual interviews was performed. Data were analysed using thematic analysis and framed within the structure of the socioecological model. Results of the study demonstrate that although privilege does not dictate whether or not an individual chooses to vaccinate, privilege impacts vaccination decision making and outcomes in both explicit and implicit ways, including lifestyle, accessibility, insight into the experience of less privileged individuals, and the entitlement of choice. Analysis of the data resulted in the classification of participants into three broad categories of vaccination decision-making processes: (1) the dutiful parent, (2) the sceptical parent, and (3) the uncertain parent. Within these categories, privilege occupies a particular place in the variable and nuanced differences in parents' vaccination decisionmaking processes. It is crucial to understand how privileged individuals determine health care choices, as these decisions can have far-reaching impacts on less privileged communities with more limited access to resources and health care
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    Social Support for Improved ART Adherence and Retention in Care among Older People Living with HIV in Urban South Africa: A Complex Balance between Disclosure and Stigma
    (Multidisciplinary Digital Publishing Institute, 2022-09-12) Knight, Lucia; Schatz, Enid
    The number of older people living with HIV (OPLWH) (aged 50-plus) in South Africa is increasing as people age with HIV or are newly infected. OPLWH are potentially vulnerable because of the intersection of age-related and HIV stigmas, co-morbidities, and lack of social support. Evidence from younger populations suggests that social support can improve ART adherence and retention in care. Further, HIV status disclosure plays a role in mediating social support and may reduce stigma by facilitating access to social support. This paper draws on qualitative research with OPLWH to explore the complex associations between disclosure, social support, and HIV stigma among OPLWH in urban Western Cape. The findings demonstrate that OPLWH receive most of their support from their family and this support can facilitate adherence to ART and retention in care. However, social support is facilitated by participants’ disclosure, thus, when perceived stigma limits disclosure, social support is less accessible. Gender, age, and pre-existing vulnerability also affect disclosure to and support from kin and community. Given that social support, particularly from family members, amplifies HIV care access and ART adherence, encouraging disclosure stimulating household HIV competency is likely to both address anticipated stigma and support improved OPLWH’s health outcomes.
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    Stories from the edge
    (2025) Hartley, Felicity; Passmore, Jo-Ann; Mackenny, Virginia; Knight, Lucia
    Background: Discussing sexual health (SH) is often awkward and taboo due to societal and cultural factors. Sexually transmitted infections (STIs) and unintended pregnancies significantly impacts the health and lives of young women (YW). Visual arts-based approaches have been positively used for promoting embodied recall, overcoming language barriers to assist sensitive research and facilitate language-led data gathering. This participatory qualitative study investigates what the novel non-verbal painting process, Stories from the Edge (SFTE), brings to communication amongst a group of YW when talking about their sexual relationships and SH service seeking experiences. SFTE asks how it may enrich dialogues in in-depth interviews (IDIs) and focus group discussions (FGD). Method: Seven isiXhosa YW aged 21 -25 years were recruited to participate in a 6-11 session art-based study where they painted their SH experiences. The data set for the study included multiple large paintings, IDIs, an FGD, and informal discussions. All data including verbal discussions and interviews was recorded and translated where necessary, transcribed and thematically analysed. Results: The YW expressed that painting their SFTE provided an opportunity to express complex emotional experiences of intimate relationships which they found too hard to articulate verbally. Through the process they gained a deeper understanding of themselves and their emerging self-agency within their intimate relationships, and when accessing SH services. Inductive thematic analysis of verbal IDIs, FGD and informal discussions revealed key influences on communication about their intimate relationships and accessing SH services. Closer interpersonal relationships (family, partners, peers) emerged as the most significant contributors to their attitudes and practices, more than the socio-cultural (school and non-governmental organizations) or organizational (health care providers) spheres in their environment. As YW transitioned from adolescence to early adulthood, partners and friends assumed increasing importance. The desire for improved communication about sex, and relationships with those closest to them and when accessing SH services, was mediated by YW's confidence in their own self-agency and the power dynamics within these relationships. Conclusion: The SFTE visual art-based method facilitated the YW in recalling and voicing their SH experiences more comprehensively than language-only led research and promoted their own self-agency. The study underscores the importance of building communication skills of YW to enable them to speak confidently about their needs and desires within their intimate partnerships and when accessing SH service care.
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    Youth perceptions (18-24) on the role of youth clubs in delivering family planning information and services in Blantyre district, Malawi
    (2024) Makamo, Nancy; Knight, Lucia; Swartz Alison
    Background: Unmet need for family planning is a significant health problem for youth in Malawi. In order to promote family planning uptake, youth clubs were established to provide a safe and friendly environment for the youth to access sexual and reproductive health information and services. Although these tailored youth clubs exist, evidence on family planning utilisation in this population has been collected in clinics and hospitals rather than youth clubs. This study explored the perspectives of the youth on the role of youth clubs in delivering family planning information and services including condom distribution. Methods: An exploratory qualitative study design was used for this study. Four focus group discussions and ten semi-structured interviews were used to collect information from young boys and girls aged between 18 – 24. Participants were purposively sampled and were asked to give a written consent before the commencement of the interviews. The discussions and semi-structured interviews were tape-recorded and transcribed verbatim. Transcripts were coded manually and analysed using thematic analysis. Results: Youth clubs played a role in creating awareness about family planning methods and promoting positive sexual and reproductive health wellbeing of young people. The youth identified effective facilitation skills, trained peer educators and dynamic collaborations with health service providers as the facilitators of smooth delivery of family planning information. The perceived barriers to the smooth delivery of family planning information in the clubs included limited availability of resources and religious/cultural biases. Conclusions: Youth clubs are crucial in empowering the youth with knowledge and understanding about family planning hence enabling them to make informed decisions about their sexual and reproductive health and wellbeing. Effective delivery of family planning information and services in youth clubs requires strong partnerships with relevant stakeholders such as local health service providers and non-governmental organisations through leveraging their expertise, resources and networks hence strengthening the impact of family planning initiatives.