Youth migration and access to health services in a trading centre in southern Uganda: A qualitative exploration

Diop, Zeynab B.; Bernays, Sarah; Tumwesige, Edward; Asiimwe, Allen; Kawuma, Rachel; Seeley, Janet

doi:10.1080/17441692.2023.2191689

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…Prior research shows that young people mainly migrate to seek for employment or education ( 2 , 3 , 31 , 32 ) and this becomes their primary focus putting other needs, including their health, second. Coupled with this, migrants face unique barriers to accessing health care including the inability to speak the native language and lack of knowledge about existing services ( 10 , 13 , 17 , 33 ). As a result, they are likely to be less pro-active in accessing health services even when they are within their reach.…”

Section: Discussionmentioning

confidence: 99%

“…One of the towns (A) is located on the main transnational highway to neighbouring countries like Rwanda and Democratic republic of Congo ( 17 , 20 ) and provides a popular stop over for long distance trucks mostly moving from Mombasa port to these countries. People of various backgrounds from within Uganda and neighbouring countries move to this town.…”

Section: Methodsmentioning

confidence: 99%

“…We set out to design and test an intervention that can improve access to and utilization of SRH services among young migrants. Between 2017 and 2019, formative research was conducted in South Africa and Uganda to investigate the experiences of young people moving to small towns from rural settings in relation to HIV risk, prevention and treatment seeking behaviour (17)(18)(19). As one of the outputs from this study, the young people contributed to suggestions to a co-designed intervention, which was later named "Lending a Hand", aimed at tackling their needs.…”

Section: Introductionmentioning

confidence: 99%

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Gendered risks: access to and utilization of sexual and reproductive health services among young migrants in Southwestern Uganda: the role of the ‘lending a hand’ intervention

Kawuma,

Tumwesige,

Asiimwe

et al. 2024

Front. Reprod. Health

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IntroductionYoung migrants may engage in risky behaviours due to social, economic, and psychological challenges as they try to “get by” in their new host communities. This can result in unintended pregnancies, sexually transmitted infections including HIV, and poor mental health outcomes.During a study to test the feasibility and acceptability of an early intervention to reduce the harm of patterns of risk associated with migration, we assessed access to and utilization of sexual and reproductive health services (SRH) among recent migrants (14–24 years) in south-western Uganda.MethodsThe intervention conducted in 2022/23 involved training peer supporters to provide referral advice and support to young people. Between March–November 2022, 20 young migrants (11 males and 9 females) were purposively selected to participate in two in-depth interviews each to explore their experiences during the intervention. Data were analysed thematically.ResultsWomen engaged in transactional sex to supplement their low pay while men got involved in risky behaviour once they had earned some money. Many suffered from sexually transmitted infections-related symptoms, were at risk for HIV infection and some women had fears of unwanted pregnancy. While some tried to seek for SRH services from public facilities, poor health service delivery such as long queues and shortages of drugs, discouraged them from going there. Young people tried to access treatment from private facilities but could not afford the costs. The intervention increased knowledge about SRH and supported young people to access services from the public health facilities at no cost thus increasing utilization.ConclusionSexual health risks were experienced differently by women and men. The women were likely to experience symptoms related to sexually transmitted infections (including HIV) much earlier than men and this could increase their likelihood to engage with SRH services. The intervention served to increase men's readiness to access SRH services by providing them at a time and place that is convenient. Recognizing the different risk profiles of young people is important in tailoring appropriate interventions to promote equitable access and utilization of SRH services for both genders in this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gendered risks: access to and utilization of sexual and reproductive health services among young migrants in Southwestern Uganda: the role of the ‘lending a hand’ intervention

Kawuma,

Tumwesige,

Asiimwe

et al. 2024

Front. Reprod. Health

Self Cite

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“…42 Study clinics were selected purposefully in consultation with the District and Sub-District WBPHCOT managers to include HIV hotspots, prioritizing areas where WBPHCOTs were reaching households in informal settlements, which include mobile populations and undocumented migrants, a population less likely to engage in healthcare services. 43–46 Six facilities were selected: 3 in Region A and 3 in Region G. Region A is the northern region of Johannesburg, encompassing industrial business areas, growing residential areas, and the densely populated informal settlements of Diepsloot and Ivory Park. Region G is the southernmost and second most populated region of the city with several middle-income townships and one of the largest informal settlements in South Africa, Orange Farm.…”

Section: Methodsmentioning

confidence: 99%

Results of the Sukuma Ndoda (“Stand up, Man”) HIV Self-Screening and Assisted Linkage to Care Project in Johannesburg: A Quasi-Experimental Pre–Post Evaluation

Lippman,

Grignon,

Ditshwane

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: HIV testing rates among South African men lag behind rates for women and national targets. Community-based HIV self-screening (HIVSS) distribution and follow-up by community health workers (CHWs) is a scalable option to increase testing coverage, diagnosis, and treatment initiation. We provided HIVSS and assisted linkage to care to men not recently tested (within the past 12 months) residing in high-HIV-burden areas of Johannesburg. Methods: CHWs distributed HIVSS in 6 clinic catchment areas. Follow-up to encourage confirmatory testing and antiretroviral therapy initiation was conducted through personal support (PS) or an automated short message service (SMS) follow-up and linkage system in 3 clinic areas each. Using a quasi-experimental pre–post design, we compared differences in the proportion of men testing in the clinic catchment areas during the HIVSS campaign (June–August 2019) to the 3 months prior (March–May 2019) and compared treatment initiations by assisted linkage strategy. Results: Among 4793 participants accepting HIVSS, 62% had never tested. Among 3993 participants with follow-up data, 90.6% reported using their HIVSS kit. Testing coverage among men increased by 156%, from under 4% when only clinic-based HIV testing services were available to 9.5% when HIVSS and HIV testing services were available (z = −11.6; P < 0.01). Reported test use was higher for men followed through PS (99% vs. 68% in SMS); however, significantly more men reported reactive self-test results in the SMS group compared with PS (6.4% vs. 2.0%), resulting in more antiretroviral therapy initiations in the SMS group compared with PS (23 vs. 9; P < 0.01). Conclusions: CHW HIVSS distribution significantly increases testing among men. While PS enabled personalized follow-up, reporting differences indicate SMS is more acceptable and better aligned with expectations of privacy associated with HIVSS.

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`I now have so many friends!’ how young migrants describe their quest to belong in a town in southern Uganda

Seeley,

Kawuma,

Tumwesige

et al. 2023

International Journal of Adolescence and Youth

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Youth migration and access to health services in a trading centre in southern Uganda: A qualitative exploration

Cited by 4 publications

References 26 publications

Gendered risks: access to and utilization of sexual and reproductive health services among young migrants in Southwestern Uganda: the role of the ‘lending a hand’ intervention

Gendered risks: access to and utilization of sexual and reproductive health services among young migrants in Southwestern Uganda: the role of the ‘lending a hand’ intervention

Results of the Sukuma Ndoda (“Stand up, Man”) HIV Self-Screening and Assisted Linkage to Care Project in Johannesburg: A Quasi-Experimental Pre–Post Evaluation

`I now have so many friends!’ how young migrants describe their quest to belong in a town in southern Uganda

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