Njoku Ola Ama

Exploring the challenges facing women entrepreneurs in informal cross-border trade in Botswana

Purpose – This paper aims to look at Botswana women entrepreneurs involved in informal cross-border trade (ICBT). It addresses the following questions: What is the nature of the entrepreneurship activities that the women engage in, the funding sources and profitability of the businesses? How has the business helped to enhance women’s economic empowerment? What are the factors that influence participation of women in these businesses and their challenges? Design/methodology/approach – The study used both qualitative and quantitative methods in studying the challenges faced by Botswana women entrepreneurs in ICBT. A sample of 319 women were identified for study using a combination of the systematic sampling method and snowball techniques. Questionnaires were administered on the sampled women by trained research assistants. In addition, key informant interviews and focus group discussion were conducted on selected women entrepreneurs and key personnel from the Ministry of Trade and Industry, Customs and Immi...

Challenges faced by older women in Botswana in accessing services that address sexual and reproductive health, and family planning needs, in Botswana

Abstract Objective: This study explored the challenges that older women from selected sites in Botswana face in accessing services that address sexual and reproductive health (SRH) and family planning (FP) needs. Design, setting and subjects: Two rural and two urban health districts were randomly selected for the study. A statistically determined sample of 454 older women was allocated to the different districts (strata), using probability proportional to size. Outcome measures: The study estimated the percentage use of sexual and reproductive health services (including family planning services), unmet need for family planning and factors inhibiting use of these services. Results: The study revealed that 25% of the older women used some type of FP method. Of this number, 67.9% were aged 50–59 years, 17.4% 60–69 years, 10.1% 70–79 years, and 72% had unmet needs for FP. The older women used natural FP methods mainly. The main SRH services used by them were screening for human immunodeficiency virus/acquired immune deficiency syndrome, sexually transmitted infections and cervical cancer. Obstacles to accessing SRH and FP services were found to include illiteracy, lack of education, financial constraints, a perception that healthcare planners limited SRH needs to antenatal and obstetrical services, a cultural reluctance to discuss SRH in public and domestic issues. Conclusion: The study recommends comprehensive public health education for older women on human sexuality and fertility, contraceptive use, access to services, effective training programmes for healthcare providers on how to deal with older womens issues and better access to STI and cervical cancer screening services.

Socio-Economic and Demographic Determinants of HIV Status among HIV Infected Older Adults (50-64 Years) In Botswana: Evidence From 2013Botswana AIDS Impact Survey (BAIS IV)

A stratified two-stage probability sample design was used in selecting a total of 459 Enumeration areas and 8,275 households drawn systematically for the study with the aim to describe the characteristics of the HIV infected older adults in Botswana and determine how the HIV status of the older adults is influenced by their socio-economic and demographic characteristics. Household and the individual questionnaires developed using the opinions of professionals, users of statistics, as well as experiences from the pre-test formed the instrument for the study. The results revealed that 23.2% of the older adults 50-64 years (25.5%, males and 21.5%, females) were HIV positive. An overwhelming majority of the males (88.7%) and females (83.3%) had either no education or primary education. About half of the males (50.9%) and 19% of the females were married while the majority of the females (43.9%) were never married. All the socio-economic and demographic variables significantly (p<0.01) predicted the probability of an older adult being HIV positive. The older adults with secondary education and higher education were respectively, 65.5 times and 1.8 times more likely to be HIV positive. Type of locality had significant impact in the determination of HIV status of the older adults. There are significant association between the socio-economic, demographic variables and the risk behaviours (use of condom and adherence to ARV treatment). Education, focusing on prevention and education initiatives for HIV and AIDS, including peer education, media awareness campaigns, group workshops, publications for mass consumption, individual and couple counselling is very much desired and should be provided to the older adults.

HIV-related knowledge and practices: a cross-sectional study among adults aged 50 years and above in Botswana

Background: Older adults in Botswana have been shown to be sexually active and engage in risky sexual activities that make them vulnerable to HIV infection. In order to implement meaningful interventions to address older adults’ HIV and AIDS concerns it is important to understand how much knowledge they have concerning HIV and AIDS and practices. This study explored the knowledge of HIV and AIDS and sexual practices of 609 older adults in Botswana. Methods: The study was cross-sectional and used a survey design. A total of 609 older adults were recruited using respondent-driven sampling (RDS) from four purposively selected health districts and interviewed on their individual HIV and AIDS-related knowledge and practices. Data were analysed using descriptive statistics and multivariate logistic regression. Results: Although knowledge of HIV and AIDS was high (95.7%), knowledge of HIV infection through blood transfusion, transmission from mother to child, or sharing needles or syringes was lacking. Only 72% of males and 23.2% of females know that having fewer partners and avoiding blood transfusions (71% of males and 44.3% of females) can minimise risks of HIV infection. Age, marital status and employment status significantly predicted knowledge of transmission (p < 0.05), while sex significantly predicted knowledge of prevention and control methods. Conclusion: The study concludes that age-appropriate and culturally relevant education and training of older adults are necessary for the prevention and control of HIV infection.

Healthcare providers’ (HCPs) attitude towards older adults with HIV and AIDS in Botswana

This study obtained the views of a random sample of 164 healthcare practitioners on their attitudes to older adults with HIV and AIDS. It shows that although the knowledge of protective measures to avoid HIV infection, mode of transmission and stigmatization are high among the healthcare providers (HCPs), yet the majority of them (76.2% of medical officers, 80.4% of nurses and 93.3% of others) are aware of discrimination against people living with HIV (PLHIV). Attitudes of HCPs to older adults with HIV with respect to quality of life, tolerance, education and training, support and treatment of PLHIV are positive, but they significantly differ on issues of blame and sexual attitude of the PLHIV. There is very little engagement between the HCPs and the older adults on their sexual characteristics which can be attributed to the low literacy of the PLHIV. The study recommends appropriate education and counselling, more awareness creation of HIV, its mode of infection, prevention and treatment among HCPs, to eliminate the fears associated with HIV and AIDS. Health facility policies and stringent laws against discrimination need to be put in place. Key words: People living with HIV (PLHIV), healthcare providers, attitude, older adults, HIV, AIDS

Knowledge and utilization of voluntary counselling and testing services for HIV by older adults (50 years and over) in Botswana

The study explored the knowledge and use of Voluntary Counselling and Testing (VCT) services by a stratified random sample of 609 older adults from four purposively selected districts in Botswana. Only 76.8% of the older adults had taken an HIV test and 51.6% of this number actually requested the test (client initiated). More than 20% have engaged in a sexual relationship with a person whose HIV status they did not know. While 91% of older adults indicated that everyone should undergo HIV test and 96.2% know where to get the HIV test but less than 16% of them know that people who have unprotected sex, people who think they have sex with HIV infected persons and people who have direct dealings with needles and tattoos should be tested. The identified main barriers to taking HIV test were not feeling at risk of HIV infection (76.8%), fear of testing positive because of the reactions of partner(s) (10.9%), and fear of testing positive because others will judge / treat them badly (8%) were. The study shows that being educated, older than 59 years, married, female, coming from a rural location and having a negative HIV status increase the likelihood of intention to use VCT services. The study recommends that education, which targets the needs of older adults, about HIV and AIDS and VCT needs to be improved in order to enhance the uptake of VCT services, an essential step for the initiation of treatment. In addition, home-based, door-to-door HIV testing, which will increase the number of older adults to be tested, and create opportunities for increased knowledge of HIV transmission, prevention and care through provision of correct information to older adults in their homes should be instituted.