Background: Depression is a common condition that may lead to suicide at its worst. It is considered one of the primary causes of morbidity globally. Among the urological causes of depression is benign prostatic enlargement (BPE).Aim: To determine the prevalence and factors associated with depressive symptoms among BPE patients.Setting: This study was conducted in the Urology and Family Medicine Clinic at the Aga Khan University Hospital, Nairobi and Urology clinic at the Aga Khan Hospital Mombasa.Methods: The study was a cross-sectional design recruiting 308 males above the age of 40. Patient Health Questionnaire-9 and International Prostate Symptom Score (IPSS) were used to assess depressive symptoms and lower urinary tract symptoms (LUTS), respectively. Association between depressive symptoms and LUTS was determined. Factors associated with depressive symptoms were analysed by logistic regression.Results: Prevalence of depressive symptoms among patients with symptomatic benign prostatic enlargement (sBPE) was 42.90%. Factors associated with depressive symptoms included comorbid conditions, medication side effects, reduced libido, alcohol use, disturbed sleep at night and anxiety in regard to the prostate condition.Conclusion: There is a high prevalence of depressive symptoms among men with BPE. Assessment and early intervention for depressive symptoms among men with BPE should be initiated before clinical depression sets in.Contribution: The study has created a knowledge base on factors associated with depressive symptoms among men with sBPE in the African context.

Background: There is a significant shortage of healthcare workforce globally. In order to achieve Universal Healthcare coverage, governments need to enhance their community-based healthcare provider programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective, however their needs remain unmet hence their high attrition rates.Methods: This study adopted an exploratory mixed methods qualitative approach including Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). Using a semi-structured questionnaire, out of the 17 Community Health Units (CHUs), we conducted 10 FGDs based on the number of CHUs in each of the two sub-counties, three from Rabai Sub-county and seven from Kaloleni Sub-county. We conducted 10 key-informant interviews from participants who included County and sub -county Ministry of Health (MOH) and Ministry of Agriculture (MOA) officials as well as multi-lateral stakeholders’ representatives from Kaloleni and Rabai sub-counties. Data was audio-recorded and transcribed verbatim. Transcripts were analysed using NVivo qualitative data software version 10. Researcher triangulation supported the first round of analysis of the data in this study. Data was mapped and findings interpreted using a theory driven analysis based on the Ultra-Poverty Graduation (UPG) model. Results: The results are presented using the Ultra Poverty Graduation (UPG) model, which involves a six-step intervention. It consists of the provision of asset transfer of an in-kind good such as poultry or livestock, weekly stipends with consumption support to stabilize consumption, hands-on training on how to care for assets and run a business, savings and financial support to build assets and instil financial discipline, healthcare provision and access and finally social integration.Conclusion: The results of this study provides a user-identified approach to identify and assess the strategic needs of CHVs for socio-economic empowerment. The study further applies a sustainable economic empowerment model to provide further understanding on how these needs can be addressed in order to enhance retention of CHVs.

Efforts to eliminate mother-to-child transmission of HIV in Tanzania are guided by a four-prong strategy advocated by the World Health Organization (WHO). Prong 2, prevention of unintended pregnancies among women living with HIV, has, however, received the least attention and contraceptive use to prevent unintended pregnancies remains low. This study explored the perceived barriers to the use of modern methods of contraception, and factors influencing contraceptive choice among HIV-positive women in urban Dar-es-Salaam, Tanzania. A qualitative multi-site study was conducted, utilising in-depth interviews and focus group discussions with 37 sexually active HIV-positive women aged between 20 and 44 years, attending three health facilities within Dar-es-Salaam. The theoretical framework was a patient centred model. Four barriers were identified: the influence of the women's spousal relationships; personal beliefs and the relationship of these in understanding her disease; the influence of the social demands on the woman and her relationships; and the importance of a woman's relationship with her healthcare provider/healthcare system. Being the bearers of bad news (HIV-positive status) the pregnant women experienced conflicts, violence, abandonment and rejection. The loss in negotiating power for the women was in relation to their intimate partners, but also in the patient-healthcare provider relationship. The role of the male partner as a barrier to contraceptive use cannot be understated. Therefore, the results suggest that healthcare providers should ensure patient-focused education and provide support that encompasses the importance of their relationships. Additional research is required to elucidate the functional association between contraceptive choices and personal and social relationships.