Strategies to facilitate safe sexual practices in adolescents through integrated health systems in selected districts of Zimbabwe: a mixed method study protocol

Abstract

Background Zimbabwe has the highest teenage pregnancy rate in Sub Saharan Africa. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence in adolescents that are from tribes that perform cultural initiations and subscribe to certain norms are higher than the national prevalence which is estimated at 12% (18 and 13.6% respectively) in Zimbabwe. Indigenous Health Systems (IHSs) and Modern Health Systems (MHSs) in Zimbabwe run parallel thereby introducing challenges in the management of adolescent sexual health due to conflicts. This study seeks to develop strategies that will facilitate the integration of IHSs and MHS in Mberengwa and Umguza districts. Methods This research will be conducted in two phases. The first phase would utilise a concurrent triangulation mixed methods design with both qualitative and quantitative approaches. The findings from the qualitative and quantitative approaches would be merged through a comparison of findings side by side. The second phase would focus on the development and validation of strategies that would facilitate the integration of IHSs and MHSs. The Strength, Weakness, Opportunity and Threat (SWOT) analysis would be applied on interfaced findings from phase one. The Basic Logic and the Build, Overcome, Explore and Minimise (BOEM) models would then be used to develop strategies based on the SWOT findings. The developed strategies would be validated through the application of Delphi technique and administration of checklist to selected key stakeholders through organised workshops. Discussion There have been no known studies found in the literature that explores the possibility and developed strategies of integrating IHSs and MHSs so as to promote safe sexual practices in adolescents. Most programs on sexual health have ignored the role of IHSs and MHSs in influencing safe sexual practices leading to them failing to attain desired goals. A lot of emphases has been targeted at minimising the spread of Sexually Transmitted Infections (STIs) through advocating for utilisation MHSs rather than focussing on an integrating systems that are meant to manage Adolescent Sexual Health (ASH) related issues. The study protocol was approved by the University of Venda Ethics Committee Registration (SHS/19/PH/17/2608) on the 26th of August 2019.

Traditional and health practitioners perspective on traditional medicine utilisation during antenatal care in Bulilima, Plumtree, Zimbabwe

“…In research there is need that findings of qualitative studies be put into context and be confirmed by other authors (Creswell, 2013,Nunu et al, 2020, Tobin and Begley, 2004. Though the findings of a qualitative study maybe unique, ideas could be applicable to other different study settings (Creswell, 2013,Nunu et al, 2020, Tobin and Begley, 2004. High levels of objectivity and honesty were observed in collecting, analysing and interpretation of the data.…”

“…This is a process that is implemented to ensure that the whole inquiry process yields robust and accurate findings (Nunu et al, 2020). The following were taken into consideration during the conceptualisation and implementation of the research inquiry:…”

“…To ensure that the research methods that were used would provide trustworthy information (Nunu et al, 2020), a research proposal was reviewed by the Department of the Environmental Science and the National University of Science and Technology where the research is affiliated to, independent reviewers reviewed the proposal and made recommendations that were taken into consideration (on the research, data collection and analysis tools). The proposal was further reviewed by the Ministry of Health and Child Care of Zimbabwe before permission was granted to conduct the study.…”

“…Zimbabwe has two recognised health systems that were adopted after independence in 1980 (Nunu et al, 2020). These are: the traditional health systems that are mannered by herbalists, traditional healers and traditional attendants as guided by different cultural norms and practices (Nunu et al, 2020, Mposhi et al, 2013: the modern health system that is mannered by professionally trained health service providers and services obtainable in designated health facilities (Mposhi et al, 2013, Nunu et al, 2020, Nunu et al, 2019. It has been reported that most health service users prefer to utilise the traditional health system particularly in rural areas and other resource poor setting s in the country as it is cheap and readily available at their local communities (Magaisa, 2007).…”

“…Over 60% of the Zimbabwean population resides in rural areas which are characterised by underdevelopment in comparison to the urban setup (Nyazema, 2010, Sanders, 1990). There has however been conflict between traditional health practitioners and modern health service providers about the boundaries and concerns of safety in as far as traditional medicine utilisation by patients is concerned leading to differing views and the parallel running of these services (Nunu et al, 2020, Mutambirwa, 1989, Waite, 2000. This study therefore seeks to explore traditional and health practitioner's perspectives on traditional medicine utilisation during antenatal care among women in Bulilima District, Plumtree, Zimbabwe.…”