Marvellous Mhloyi

Women and AIDS in Zimbabwe: the making of an epidemic.

As the AIDS epidemic in Africa assumes major proportions, the need to understand the social context in which heterosexual transmission occurs takes on urgent importance. In this article we explore how the intersection of traditional culture with the colonial legacy and present-day political economy has influenced family structure and sexual relations, and particularly the social position of women. Drawing on Zimbabwes historical experience, we show how land expropriation, rural impoverishment, and the forcible introduction of male migrant labor fostered new patterns of sexual relations, characterized by multiple partners. Traditional patriarchal values reinterpreted in European law resulted in further subjugation of women as even limited rights to ownership were withdrawn. For many women, sexual relations with men, either within marriage (for the majority) or outside, become inextricably linked to economic and social survival. In this setting, all sexually transmitted diseases became rampant, including genital ulcer, which facilitates transmission of the human immunodeficiency virus (HIV). Intervention programs to halt the spread of AIDS need to take into the account the epidemics historical roots and social nature. For example, efforts to reduce risk of HIV transmission should seek to expand womens limited options, both technically (e.g., by providing alternatives to condoms) and socially (e.g., by promoting employment).

The Impact of Family Planning on Women's Lives: Findings from the Women's Studies Project in Mali and Zimbabwe

This paper reports on the findings of the Womens Studies Project, a five-year research effort conducted by Family Health International and designed to study the impact of family planning on womens lives. Twenty-six field studies were conducted in ten countries, including the sub-Sahara countries of Mali and Zimbabwe. In Mali, researchers looked at the experiences of first-time contraceptive users and factors that influence decisions to continue or discontinue methods, including spousal approval. In Zimbabwe, studies focused on family planning as a factor in womens participation in the countrys economic development process. Researchers concluded that daftly planning is one of many strategies women can use to exercise autonomy in their lives. However, negative consequences of contraceptive use, such as community disapproval or husbands opposition may discourage women from taking control of their fertility. (Afr J Reprod Health 1999:3 [1]: 27-38) Key Words : Family planning, womens lives, Mali, Zimbabwe

Men's attitudes: A hindrance to the demand for voluntary medical male circumcision--a qualitative study in rural Mhondoro-Ngezi, Zimbabwe.

Male circumcision has witnessed a paradigm shift from being regarded as a religious and cultural practice to a global intervention strategy meant to curb transmission of HIV. This is particularly evident in sub-Saharan African countries where the HIV prevalence is greater than 15%. Zimbabwe adopted the voluntary medical male circumcision (VMMC) strategy in 2009; however, since then the uptake of the intervention has only 10% of the adult male population has reported having been circumcised. To better understand this limited uptake of VMMC, we conducted a qualitative study with uncircumcised men aged 15–79 years in Mhondoro-Ngezi, Zimbabwe. Through assessing mens attitudes towards VMMC in seven focus group discussions, conducted between July and August 2012, this article seeks to provide improved strategies for delivering this intervention in Zimbabwe. These data reveal that, in general, men have a negative attitude towards VMMC. Specific barriers to the uptake of VMMC included the perceived challenge to masculinity, post-circumcision stigma, lack of reliable and adequate information and perceptions about the appropriateness of VMMC. These results suggest that structural interventions aimed at reducing stigma related to circumcision, in addition to increased efforts to disseminate accurate information about VMMC, are required in order to dispel mens attitudes that hinder demand for VMMC.

When ''no'' means ''yes'': the gender implications of HIV programming in a Zimbabwean university.

Objectives: This study assessed the nature and extent of sexual risk-taking behavior by students in a Zimbabwean university and identified some of the sociocultural factors that facilitate sexual risk taking by female and male students. The main outcome measures of the study were condom use, number of sexual partners, and attitudes toward gender equity and equality. Methods: A cross-sectional design was used and a questionnaire was administered to 933 students. Information pertaining to students’ sexual practices, condom use practices, attitudes toward HIV testing, and their beliefs pertaining to women’s role in sexual decision making and a woman’s right to refuse sexual intercourse were among some of the variables assessed. Results: The vast majority of the university students (83%) are sexually experienced; only a third used condoms at their last sexual encounter; the use or nonuse of condoms was significantly associated with age, sex, marital status, and attitudes toward gender issues. There were also significant differences in the sexual behavior and attitudes of female and male students. Conclusion: Our study suggests that HIV prevention efforts targeted at university students need to incorporate a discussion of broader cultural beliefs, particularly those pertaining to gender role myths, if they are to be effective.

Home is best: Why women in rural Zimbabwe deliver in the community

Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening through a multi-donor pooled funding mechanism. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study we investigate why. We used twelve (12) focus group discussions with child-bearing women and eight (8) key informant interviews (KIIs). Four (4) were traditional birth attendants and four (4) were spiritual birth attendants. A thematic approach was used to analyse the data in Ethnography software. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. We conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. We recommend for increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public.