Women's University in Africa

The discourse on indigenous knowledge has incited a debate of epic proportions across the world over the years. In Africa, especially in the sub-Saharan region, while the so-called indigenous communities have always found value in their own local forms of knowledge, the colonial administration and its associates viewed indigenous knowledge as unscientific, illogical, anti-development, and/or ungodly. The status and importance of indigenous knowledge has changed in the wake of the landmark 1997 Global Knowledge Conference in Toronto, which emphasised the urgent need to learn, preserve, and exchange indigenous knowledge. Yet, even with this burgeoning interest and surging call, little has been done, especially in sub-Saharan Africa, to guarantee the maximum exploitation of indigenous knowledge for the common good. In view of this realisation, this paper discusses how indigenous knowledge can and should both act as a tool for promoting the teaching/learning process in Africa's public education and address the inexorably enigmatic amalgam of complex problems and cataclysms haunting the world.

BACKGROUND: There are few accounts of evidence-based interventions for depression and other common mental disorders (CMDs) in primary care in low-income countries. The Friendship Bench Project is a collaborative care mental health intervention in primary care in Harare for CMDs which began as a pilot in 2006. CASE PRESENTATION: We employed a mixture of quantitative and qualitative approaches to investigate the project's acceptability and implementation, 4-8 years after the initial pilot study. We carried out basic descriptive analyses of routine data on attendance collected between 2010 and 2014. We also conducted five focus group discussions (FGDs) with LHWs in 2013 and 12 in-depth interviews, six with staff and six with patients, to explore experiences of the intervention, which we analysed using grounded theory. Results show that the intervention appears highly acceptable as evidenced by a consistent number of visits between 2010 and 2014 (mean 505 per year, SD 132); by the finding that the same team of female community LHWs employed as government health promoters continue to deliver assessment and problem-solving therapy, and the perceived positive benefits expressed by those interviewed. Clients described feeling 'relieved and relaxed' after therapy, and having their 'mind opened', and LHWs describing satisfaction from being agents of change. Characteristics of the LHWs (status in the community, maturity, trustworthiness), and of the intervention (use of locally validated symptom screen, perceived relevance of problem-solving therapy) and continuity of the LHW team appeared crucial. Challenges to implementation included the LHWs ongoing need for weekly supervision despite years of experience; the supervisors need for supervision for herself; training needs in managing suicidal and hostile clients; poor documentation; lack of follow-up of depressed clients; and poor access to antidepressants. CONCLUSIONS: This case study shows that a collaborative care intervention for CMDs is positively received by patients, rewarding for LHWs to deliver, and can be sustained over time at low cost. Next steps include evaluation of the impact of the intervention through a randomised trial, and testing of a technological platform for supporting supervision and monitoring clients' attendance.

Financial institutions play a pivotal role in the efficient allocation of capital resources. However, some households and firms may be excluded from formal financial markets due to asymmetric information and market imperfections, thereby adversely affecting equitable income distribution. On the other hand, among other things, access to finance is viewed as one of the key tools to fight poverty. This study develops a novel double FFI Model and applies the structural equation modelling to simultaneously analyze the interaction between financial technology, financial inclusion, and income inequality in a panel of 25 African countries over the periods 2011, 2014, and 2017. The results show that financial inclusion mediates the financial technology-income inequality relationship thus playing a fundamental role in reducing income inequality in Africa. On the policy front, the study urges African policymakers and regulators to craft policies that enhance Fintech developments and financial inclusion.

OBJECTIVE: To document the lived experiences of people with both poor mental health and suboptimal adherence to antiretroviral therapy in high HIV prevalence settings. METHODS: In-depth qualitative interviews were conducted with 47 (female = 31) HIV-positive adults who scored above the cut-point on a locally validated scale for common mental disorders (CMDs). Purposive sampling was used to recruit participants with evidence of poor adherence. Six additional key informant interviews (female = 6) were conducted with healthcare workers. Data were collected and analysed inductively by an interdisciplinary coding team. RESULTS: The major challenges faced by participants were stressors (poverty, stigma, marital problems) and symptoms of CMDs ('thinking too much', changes to appetite and sleep, 'burdened heart' and low energy levels). Thinking too much, which appears closely related to rumination, was the symptom with the greatest negative impact on adherence to antiretroviral therapy among HIV-positive adults with CMDs. In turn, thinking too much was commonly triggered by the stressors faced by people living with HIV/AIDS, especially poverty. Finally, participants desired private counselling, access to income-generating activities and family engagement in mental health care. CONCLUSIONS: Better understanding of the local expression of mental disorders and of underlying stressors can inform the development of culturally sensitive interventions to reduce CMDs and poor adherence to antiretroviral therapy.

Abstract Originally conceptualized by the philosopher, Miranda Fricker, epistemic injustice—unfair treatment of individuals and groups in knowledge‐related and communicative practices—is increasingly being employed to delineate individual and collective injustice in healthcare, information sciences, education and sustainable development. Embedded in many other forms of social injustice and inequality, epistemic injustice is a particularly serious problem for sustainable development, undermining the global community's ability to deal with ‘wicked’ problems. Building on the more conceptually developed, philosophical framework of epistemic injustice and recent research from other fields, this article develops a holistic action‐oriented framework of epistemic justice, namely fair treatment in knowledge‐related and communicative practices, for sustainable development and beyond. It also adds to the current framework of individual and collective injustice by including a range of new insights on structural and systemic epistemic injustice, such as linguistic injustice and epistemicide.

BACKGROUND: This study is coming against the background of people with epilepsy who are abandoning anti-epilepsy medication in developing countries, such as Zimbabwe. AIM: The aim of this article was therefore to review the general side effects and challenges associated with these anti-epilepsy medications. SETTING: The researchers reviewed literature related to the general side effects, psychological, social and economic challenges associated with anti- epilepsy medication. METHODS: To answer the research questions, the researchers used a narrative approach. RESULTS: Findings of the study reflected that the general side effects associated with anti- epilepsy medication include feelings of tiredness, stomach upset, dizziness or blurred vision, which usually happen during the first weeks of taking medicines. Psychologically, an individual with epilepsy may suffer cognitive problems that are associated with thinking, remembering, paying attention or concentrating and finding the right words to use. Socially, people with epilepsy experience social isolation, dependent behaviour, low rates of marriages, unemployment and reduced quality of life. Using anti-epilepsy medication is also associated with economic challenges. CONCLUSION: The researchers concluded that some people with epilepsy have discontinued using anti-epilepsy medications because of these side effects and challenges.

Inclusive education (IE) is a global restructuring strategy envisioned to embrace learners with different abilities in mainstream schools. Previous research shows that parent and teacher inclusive education perceptions depend largely on their experiences of IE. This study examined parent and teacher perception of IE in the context Zimbabwean primary education. Data were collected from 12 parents and12 teachers of learners in IE. Results indicated that participants’ perceptions of IE divide into three main categories; i.e. positive, mixed and negative perceptions for various reasons. The results were presented in a tree diagram and a model and discussed with potential implications for various stakeholders.

The concept of the best interests of the child in Zimbabwe must be considered not just at the level of the formal law, but also at the level of the ‘living law’ or the practices of the people. The formal law of custody focuses on the nuclear family and favours the mother, while in the living law, the best interests of the child are usually perceived to be congruent with those of the extended family, and the father's family is favoured. This produces a tension between the law and practice. The concept of the best interests of the child in custody decisions in practice is usually related to two basic issues: school and sadza. Sadza, which is the staple food of Zimbabwe, represents the child's immediate physical needs. School represents the child's long-term interests, which include education so that s/he can be self-supporting and a good relationship with the extended family. In conclusion, it is suggested that the study of the concept of the best interests of the child in its cultural context should include consideration of two key concepts, world view and possibility: world view in the sense that spiritual beliefs and values influence the content of the concept of the child's best inrercsts and possibility in the sense that the perception of a child's best interests differs according to the opportunities and resources available to him.

A fundamental concern of agricultural development is the efficient marketing of goods and services. This paper examines the determinants of market participation and marketing channel choice decisions by small scale sorghum farmers using a case comprising 380 households from five Wards in the mid Zambezi Valley of Zimbabwe. Mixed data collection approaches including a questionnaire, observations and focus group discussions were used. Secondary data triangulated and validated farmers’ responses. A double hurdle based on probit and multinomial logit regression models was applied to the two decision making stages. Ninety six percent of the sampled farmers participated in some market as influenced by payment time, number of buyers in the market, age of principal decision maker and distance to market. Three marketing channels were isolated as local, traders and a combination. The local marketing channel dominates due to its convenience and relatively lower transaction costs. Using the local market option as the referent category, weighted average market price of sorghum, number of buyers in the market, distance to the market, dependency ratio and household income are the most robust determinants of marketing channel selection. Sorghum marketing channel options are limited for small scale farmers in Zimbabwe. Strengthening cooperative based and extension anchored marketing can reduce the risks associated with relating to external traders who usually exploit farmers for price, payment time and quality requirements. Decentralisation of the sorghum markets and promotion of value addition activities in the sorghum value chain is likely to reduce transaction costs and increase the market size.

OBJECTIVE: Rapid Recommendation. SETTING: Primary studies reporting patient-reported outcomes relevant to decision-making regarding ART in any clinical and geographical setting. PARTICIPANTS: Women living with HIV who are pregnant, postpartum or considering pregnancy. OUTCOME MEASURES: Quantitative measurements and qualitative descriptions of values and preferences in relation to ART during pregnancy. We also included studies on women's reported barriers and facilitators to adherence. We excluded studies correlating objective measures (eg, CD4 count) with adherence, or reporting only outcomes which are not expected to differ between ART alternatives (eg, access to services, knowledge about ART). RESULTS: We included 15 qualitative studies reporting values and preferences about ART in the peripartum period; no study directly studied choice of ART therapy during pregnancy. Six themes emerged: a desire to reduce vertical transmission (nine studies), desire for child to be healthy (five studies), concern about side effects to the child (eight studies), desire for oneself to be healthy (five studies), distress about side effect to oneself (10 studies) and pill burden (two studies). None of the studies weighed the relative importance of these outcomes directly, but pill burden/medication complexity appears to be a lower priority for most women compared with other factors. Overall, the body of evidence was at low risk of bias, with minor limitations. CONCLUSIONS: Women who are or may become pregnant and who are considering ART appear to place a high value on both their own and their children's health. Evidence on the relative importance between these values when choosing between ART regimens is uncertain. There is variability in individual values and preferences among women. This highlights the importance of an individualised women-centred approach, such as shared decision-making when choosing between ART alternatives. TRIAL REGISTRATION NUMBER: International Prospective Register of Systematic Reviews:CRD42017057157.

Gender-based violence is violence directed against any person on the basis of gender, including acts that inflict physical, mental or sexual harm or threats of such acts. Although any person is a risk, women and girls are the primary victims of gender-based violence. Informed by womanist theory, this paper reports on a qualitative study of gender-based violence in Zimbabwean primary schools. Participants were twenty girls who had been victims of gender-based violence enrolled in primary schools in the Harare and Marondera districts of Zimbabwe selected by purposeful sampling and a chain referral. Data was gathered by semi-structured interviews and visual tools. Findings provide a comprehensive picture of gender-based violence in primary schools. This is manifested in acts of physical violence, particularly the unsanctioned use of corporal punishment, psychological violence and sexual abuse. School grounds harbour unsafe and poorly supervised areas where violence may occur and reporting routes for incident are ineffective. Perpetrators include teaching and non-teaching staff and peers. An insidious form of gender-based violence is embedded in child labour practices in the school and the community. Gender-based violence damages girls’ health, social and psychological development and impedes learning. Further, gender-based violence is perpetuated by a culture of silence informally maintained by victims, teachers, peers and parent and by the school’s weak compliance with protective policies.

The explosion of COVID-19 pandemic on the global scene has redefined human interaction in a manner that is unprecedented. Religious practices have also been challenged globally as the new norm of social distancing and lockdown become the new normal strictly enforced by state apparatus. Freedom of association that underpins the hallmark of worshipping has thus been put to a halt. Churches then have to negotiate and create a new norm under such unchartered territories. This paper raises the key question around the new forms of exclusivity that is being brought by the pandemic in the operations of the church and how the church is attempting to deal with this. Using mostly virtual interviews with different representatives of selected churches in Harare and Marondera, the researchers investigated how the churches are adapting to the new social order. The paper demonstrated how COVID-19 lockdown has affected the operations of churches in Zimbabwe. Key policy pronunciations of social distancing and staying at home had direct and indirect implications on church members as well the administration of the church. Though the paper showed that adoption of digital platforms to communicate emerged as the most obvious option, there are some challenges that were highlighted. The paper also concludes that the church regrets the way it was “side-lined” in the promulgation of the policy position on Covid-19. There was a strong sentiment that the state could have engaged the church more as they also had the capacity to provide solutions to the problem.

BACKGROUND: HPTN 046 compared the efficacy and safety of infant nevirapine (NVP) among HIV-exposed breastfed infants randomized at 6 weeks to 6 months to t NVP or placebo to prevent postnatal infection: we report final 18-month outcomes. METHODS: Randomized, placebo-controlled trial in 4 African countries. Infant diagnostic HIV testing was performed regularly from birth through 18 months. Kaplan-Meier analysis was used to assess 18-month cumulative infant HIV infection, HIV infection/or death, and mortality rates. RESULTS: Between 6 weeks and 6 months, postnatal HIV infection rates were significantly lower among infants receiving daily NVP from 6 weeks to 6 months 1.1% [95% confidence interval (CI): 0.2% to 1.8%], compared with placebo 2.4% (95% CI: 1.3% to 2.6%), P = 0.049, but not significantly lower thereafter. Eighteen-month postnatal infection rates were low: 2.2% (95% CI: 1.1% to 3.3%) versus 3.1% (95% CI: 1.9% to 4.4%), respectively, P = 0.28. Mortality and HIV infection/death did not differ between arms at any age. Infants of women receiving antiretroviral therapy (ART) for their own health had the lowest 18-month postnatal infection rates (0.5%, 95% CI: 0.0% to 1.1%). However, HIV infection/death rates at 18 months were not significantly different for infants of mothers on ART (3.7%, 95% CI: 1.9% to 5.5%), and infants of mothers with CD4 counts of ≥ 350 cells per cubic millimeter not receiving ART (4.8%, 95% CI: 2.7% to 6.8%; P = 0.46). There were no differences in adverse events between study arms. CONCLUSIONS: This trial demonstrated early but not late differences in postnatal HIV transmission among infants randomized at age 6 weeks to extended NVP or placebo, underscoring the importance of continued prophylaxis throughout breastfeeding.

INTRODUCTION: Few people with mental disorders in low and middle-income countries (LMICs) receive treatment, in part because mental disorders are highly stigmatized and do not enjoy priority and resources commensurate with their burden on society. Advocacy has been proposed as a means of building political will and community support for mental health and reducing stigma, but few studies have explored the practice and promise of advocacy in LMICs. METHODS: We conducted 30 semi-structured interviews with leaders in health and mental health in Zimbabwe to explore key stakeholder perceptions on the challenges and opportunities of the country's mental health system. We coded the transcripts using the constant comparative method, informed by principles of grounded theory. Few interview questions directly concerned advocacy, yet in our analysis, advocacy emerged as a prominent, cross-cutting theme across participants and interview questions. RESULTS: Two thirds of the respondents discussed advocacy, often in depth, returning to the concept throughout the interview and emphasizing their belief in advocacy's importance. Participants described six distinct components of advocacy: the advocates, to whom they advocate ("targets"), what they advocate for ("asks"), how advocates reach their targets ("access"), how they make their asks ("arguments"), and the results of their advocacy ("outcomes"). DISCUSSION: Despite their perception that mental health is widely misunderstood and under-appreciated in Zimbabwe, respondents expressed optimism that strategically speaking out can reduce stigma and increase access to care. Key issues included navigating hierarchies, empowering service users to advocate, and integrating mental health with other health initiatives. Understanding stakeholder perceptions sets the stage for targeted development of mental health advocacy in Zimbabwe and other LMICs.

Spinacia oleracea L. (baby spinach) is a relatively new leaf vegetable crop in Zimbabwe, so the agronomic performance is unknown. A 3-year field experiment was done at the Seke Teachers College research farm, Zimbabwe. The research evaluated the response of baby spinach to different types of organic manure sources, days after fertilizer application (DAS), and growing season. A 3 × 2 factorial in a completely randomized block design (CRBD) with three replicates was used. Baby spinach cultivar, Dash, was grown on three organic manures (goat applied at 14.894 t ha−1, cattle at 17.789 t ha−1, and poultry at 13.807 t ha−1) in winter 2018, 2019, and 2020. Compound D (7% N, 14% P, and 7% K) at 300 kg ha−1 was included as a control. Crop growth rate, leaf area index, leaf area ratio, net assimilation rate, total dry matter production, and harvest index were measured on 7-day intervals from 14 to 35 days after transplanting. Analysis of variance (ANOVA) to compare the effects of the treatments on the baby spinach growth parameters was done. Significant <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mfenced open="(" close=")" separators="|"> <a:mrow> <a:mtext>p</a:mtext> <a:mo>&lt;</a:mo> <a:mtext>0.</a:mtext> <a:mn>05</a:mn> </a:mrow> </a:mfenced> </a:math> interactions on the type of organic manure × DAS × growing season were observed on all the measured response variables. There were varied effects of organic manures on growth performance at 14 to 28 DAS where poultry manure had higher growth performance compared to cattle and goat manure. Generally, there was a significant <f:math xmlns:f="http://www.w3.org/1998/Math/MathML" id="M2"> <f:mfenced open="(" close=")" separators="|"> <f:mrow> <f:mtext>p</f:mtext> <f:mo>&lt;</f:mo> <f:mtext>0.</f:mtext> <f:mn>05</f:mn> </f:mrow> </f:mfenced> </f:math> gradual increase in growth from 14 to 35 DAS on the organic manures and a decline from day 28 to 35 DAS under compound D. Low quality (large C/N) cattle and goat manure had lower effects than high quality (small C/N) poultry manure at early growth stages of the baby spinach. Unlike compound D, organic manure continuously supplied adequate nutrients throughout the life cycle (35 DAS) of the baby spinach.

The paper interrogates the resilience of female sex workers in the wake of COVID-19 in Zimbabwe. The paper draws literature from global, regional and national perspectives using the resilience theory. Major findings reveal that the COVID-19 lockdown measures have disrupted the livelihoods of female sex workers. Hence, female sex workers have resorted to online sex work and some entrepreneurship. There has also been consistent breaching of the lockdown regulations in a bid to make ends meet. Therefore, the study concludes by recommending the need to extend social protection floors to this vulnerable group.

Gusii patterns of reproduction and child care evolved in an agrarian setting in which land was abundant and children were scarce. With land now scarce and children abundant, parents continue to be resourceful and strategic in their infant care, but they have not altered their reproductive goals.

This article presents some of the legal, social, cultural, and practical constraints facing women who attempt to enforce their right to maintenance (child support) payments in southern Africa. It is based on research by the Women and Law in Southern Africa Trust, a network of women who research women's legal rights in six countries: Botswana, Lesotho, Mozambique, Swaziland, Zambia, and Zimbabwe. Statutes in all countries in the region provide that a man must support his legitimate and illegitimate children; there are, however, weaknesses in the laws on the books. The social and cultural constraints that influence the enforcement of maintenance laws include women's lack of knowledge of the law, attitudes toward child support influenced by customary law, allegations of women's abuse of maintenance payments, financial and practical problems, and fear of physical violence or other forms of retribution. Maintenance laws are relevant to family planning in that if such laws were more effectively enforced, so that the financial burden of children were more equally shared between women and men, men would have a financial stake in controlling their fertility.

Malaria remains a public health problem decimating vulnerable populace especially in resource-constrained areas in Zimbabwe. Significant progress towards malaria elimination has beenik made in the previous decades through intensified and improved malaria control measures such as indoor residual spraying (IRS), distribution of long-lasting insecticidal nets (LLIN), artemisinin-based combination therapy and administration of intermittent preventive treatment in pregnancy. However, the outbreak of pandemics like coronavirus disease (COVID-19), cyclones and tropical storms, lack of funding, porous political environment, dearth of resources for vector control, changes in vector behaviour, vector resistance to insecticides, community behavioural change and lack of feasible and sustainable digital technologies for managing malaria control interventions retards progress made towards malaria elimination. Also, arbitrary political environment and unstable economic situation often interfere with health programmes which subsequently lead to malaria outbreaks. Most recently, the country recorded a sharp increase in malaria incidences in malaria-endemic areas especially during the pandemic due to some factors such as movement restrictions, temporary cancellation of IRS activities, delayed delivery of IRS chemicals and recursive lockdown. Therefore, we propose ways to mitigate future malaria outbreaks and advocate for reconsidering malaria elimination strategies to addresses emerging challenges in eradicating malaria in Zimbabwe.

OBJECTIVE: To estimate the effect of providing women with a latex diaphragm, lubricant gel, and male condoms (intervention) compared with condoms alone (control) on human papillomavirus (HPV) incidence and clearance. METHODS: Participants were 2,040 human immunodeficiency virus (HIV)-negative Zimbabwean women enrolled in a randomized trial estimating the effect of the intervention on HIV acquisition. Clinicians collected cervical samples for HPV testing at baseline, 12 months, and exit. L1 consensus polymerase chain reaction primers were used to determine HPV presence and type. RESULTS: We found no differences in the following outcomes: HPV prevalence at the time of the first postenrollment HPV test (intention-to-treat analysis, relative risk [RR] 1.02, 95% confidence interval [CI] 0.90-1.16); HPV incidence at 12 months among women HPV-negative at baseline (RR 0.95, 95% CI 0.80-1.14); and HPV clearance at 12 months among women HPV-positive at baseline (RR 0.80, 95% CI 0.61-1.05). Clearance of HPV type 58 was lower in the intervention group at 12 months (RR 0.67, 95% CI 0.48-0.92), but not at exit (RR 0.93, 95% CI 0.75-1.16); clearance of HPV type 18 was lower in the intervention group at exit (RR 0.55, 95% CI 0.33-0.89), but not at 12 months (RR 0.55, 95% CI 0.29-1.05). Women reporting diaphragm/gel use at 100% of prior sex acts had a lower likelihood of having one or more new HPV types detected at 12 months (RR 0.75, 95% CI 0.58-0.96) and exit (RR 0.77, 95% CI 0.59-0.99). CONCLUSION: Among women receiving risk reduction counseling and condoms in an HIV prevention program, diaphragm plus lubricant gel provision did not affect HPV incidence or clearance. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00121459 LEVEL OF EVIDENCE: I.