Focus Group Discussions Research Articles

Community Engagement and Collaboration between Researchers and Community Stakeholders for Schistosomiasis and Malaria Projects in Ingwavuma, uMkhanyakude District, KwaZulu-Natal.

Community engagement is a multiphase process that is crucial for successful community-based health interventions. This study investigates the collaborative phase of community engagement, specifically within a co-developed framework implemented in uMkhanyakude District, South Africa. A qualitative case study approach was employed to explore the experiences of key community stakeholders during the collaborative phase of project implementation. Data collection involved key informant interviews, focus group discussions, and direct observation. The findings demonstrate the potential for effective collaboration among village headmen, community advisory board members, and community research assistants to address local health challenges. Community research assistants played a particularly valuable role in facilitating participatory research and hands-on engagement with researchers. However, several barriers hindered the collaborative process, including demanding work conditions, communication issues regarding compensation, inappropriate behavior from the research team, and culturally insensitive interactions. While community-based participatory research offers a promising collaborative approach for addressing health issues, a careful consideration of local socio-cultural dynamics is essential to avoid misunderstandings and overcome potential barriers. Addressing these challenges is crucial to ensuring that collaborative partnerships effectively empower communities and achieve sustainable improvements in health outcomes.

Peer-led recovery groups for people with psychosis in South Africa (PRIZE): Results of a randomized controlled feasibility trial.

The aims of this feasibility trial were to assess the acceptability and feasibility of peer-led recovery groups for people with psychosis in a low-resource South African setting, to assess the feasibility of trial methods, and to determine key parameters in preparation for a definitive trial. The design was an individually randomised feasibility trial comparing recovery groups in addition to treatment as usual (TAU) with TAU alone. Ninety-two isiXhosa-speaking people with psychosis and forty-seven linked caregivers were recruited from primary care clinics and randomly allocated to trial arms in a 1:1 allocation ratio. TAU comprised anti-psychotic medication delivered in primary care. The intervention arm comprised six recovery groups including service users and caregivers. Two-hour recovery group sessions were delivered weekly in a 2-month auxiliary social worker (ASW)-led phase, then a 3-month peer-led phase. To explore acceptability and feasibility, a mixed methods process evaluation included 25 in-depth interviews and 2 focus group discussions at 5months with service users, caregivers and implementers, and quantitative data collection including attendance and facilitator competence. To explore potential effectiveness, quantitative outcome data (functioning, relapse, unmet needs, personal recovery, stigma, health service use, medication adherence and caregiver burden) were collected at baseline, 2months and 5months post randomisation. Trial registration: PACTR202202482587686. Qualitative interviews revealed that recovery groups were broadly acceptable with most participants finding groups to be an enjoyable opportunity for social interaction, and joint problem-solving. Peer facilitation was a positive experience; however a minority of participants did not value expertise by lived experience to the same degree as expertise of professional facilitators. Attendance was moderate in the ASW-led phase (participants attended 59% sessions on average) and decreased in the peer-led phase (41% on average). Participants desired a greater focus on productive activities and financial security. Recovery groups appeared to positively impact on relapse. Relapse occurred in 1 (2.2%) of 46 participants in the recovery group arm compared to 8 (17.4%) of 46 participants in the control arm (risk difference -0.15 [95% CI: -0.26; -0.05]). Recovery groups also impacted on the number of days in the last month totally unable to work (mean 1.4days recovery groups vs 7.7days control; adjusted mean difference -6.3 [95%CI: -12.2; -0.3]). There were no effects on other outcomes. Peer-led recovery groups for people with psychosis in South Africa are potentially acceptable, feasible and effective. A larger trial, incorporating amendments such as increased support for peer facilitators, is needed to demonstrate intervention effectiveness definitively.

A ‘translation’ perspective on socio-ecological displacement: insights from the 2014 Tokwe-Mukorsi flood in Zimbabwe

With socio-ecological displacement increasingly becoming an existential threat to many communities worldwide, there is a need for deepened understanding of salient socio-political dynamics that complicate displacement processes. Such understanding is crucial for reducing the risks associated with relocation as well as enhancing relocation management and building resilience among victims. This article utilises the concept of ‘translation’ in Actor-Network Theory (ANT) to examine the socio-political dynamics that characterised the 2014 Tokwe-Mukorsi forced displacement of over 3000 rural households in Southern Zimbabwe. Drawing on the narrations of victims in focus group discussions and of government officials (key-informants), as well as on relevant secondary data, the article engages the shifts in position by the dominant actor in the displacement and relocation processes, not to mention the imposition of new interpretations of reality, including the redefinition and distribution of roles, with a view to highlighting the ultimate determinants of resettlement outcomes. The paper found, in the main, that the power struggles between protagonists and the impact of those struggles on the relocation process, as well as the state’s dominance, ultimately exacerbated the victims’ distress.

Challenges and coping strategies among caregivers of children with cancer receiving care at a national referral hospital in Kenya

BackgroundThe number of children diagnosed with cancer is expected to increase by 2050. The caring aspect of these children is usually left to members of the family, more so the mothers. Caregivers are usually faced with various challenges, such as financial issues, social stigma, and emotional and psychological issues. Caregivers use various coping strategies to manage the challenges they experience in the caring process, which can be positive or negative coping strategies.ObjectiveTo explore the challenges and coping strategies of caregivers of children with cancer receiving care at a national referral hospital in Kenya.MethodsThis study employed a descriptive phenomenological approach to explore the challenges and coping strategies of caregivers of children with cancer receiving treatment at a national referral hospital in Kenya. Purposive and snowball sampling techniques were used to select 44 participants for five focus group discussions (FGDs) conducted between October and December 2023. The data were analysed via inductive thematic analysis.ResultsFour themes arose from the challenges experienced, which included psychological, financial, treatment-related, and social/family-related issues. These eleven subthemes included stress, depression, lack of transport, lack of food, loss of employment, treatment delays, and marital issues, among others. Two themes related to coping strategies were positive adaptation and denial, which were highlighted as negative coping strategies. Positive coping included praying, crying, talking to people, and seeking help.ConclusionCaregivers of children with cancer undergo various challenges and apply various coping strategies to try and adapt to their new normal. Reinforcing positive coping strategies and helping caregivers utilize other coping strategies, such as the use of support groups, could help them better care for their children.

Strengthen farmers' fertilizer self-sufficiency in the tourist area with a reduce-reuse-recycle system

Mining activities at Tebing Breksi are a vital source of income for the community in Sambirejo village, Sleman Regency, Yogyakarta. However, these activities have caused several environmental issues, such as lowered pH levels, reduced soil fertility, shallow soil profiles, and water scarcity. Additionally, mining has led to biodiversity loss and land degradation, making post-mining reclamation essential to restore the area's environmental and social functions. This project aimed to enhance the community’s skills in soil analysis and the production of liquid organic fertilizer using effective methods. The activities took place in the Tebing Breksi tourist area, located in Nglengkong, Sambirejo Village, Prambanan District, Sleman Regency. The project included a Focus Group Discussion (FGD), soil fertility analysis using test kits, and the creation of liquid organic fertilizer from household waste. During the FGD, it was discovered that the local community had not received prior training on producing fertilizer from household and organic waste. Until then, they relied on expensive commercial fertilizers to quickly stabilize soil pH. Through this training, the community learned how to perform rapid soil chemical analysis and produce liquid organic fertilizer independently. As a result, they can now apply the fertilizer locally, improving soil conditions and reducing their reliance on costly commercial products.

Comprehensive Analysis of the Transport Sector in Narayanganj City: Existing Scenario and Way Forward

This study examines transportation issues in Narayanganj City Corporation, one of the densely populated cities in Bangladesh. It examines the Chashara intersection which is a major intersection within the city, suffers from ever worsening traffic and poor infrastructure. Using qualitative research methods, information was obtained through field surveys, observation as well as four focus group discussions with residents aged 20-50 years mainly students, urban dwellers experts. Some of the problems that emerged from the study include poor traffic control, limited road construction and maintenance. The findings also highlight significant challenges, including poor traffic management, insufficient road networks, and inefficient regulation of transport services, notably the prevalence of auto-rickshaws contributing to the congestion. The study identifies the Chashara intersection as a critical area requiring urgent intervention. Proposed solutions emphasize the introduction of alternative routes to alleviate bottlenecks, stricter regulation of auto-rickshaw operations, and the implementation of congestion pricing mechanisms to manage traffic flow. These recommendations aim to provide a strategic framework for improving urban mobility and ensuring sustainable development in the transportation sector of Narayanganj. The need for immediate, coordinated efforts from local authorities and urban planners is underscored, as addressing these issues is essential for enhancing the city’s livability and accommodating future growth.

Development and feasibility testing of a time-restricted eating intervention for women living with overweight/obesity and HIV in a resource-limited setting of South Africa

BackgroundHuman Immunodeficiency Virus (HIV) and type 2 diabetes (T2D) are amongst the leading causes of death in South Africa. The preferred first-line anti-retroviral treatment contains dolutegravir (DTG), shown to increase body weight, may compound the already high rates of obesity and associated risk for T2D. South Africa has widespread food insecurity, making traditional dietary strategies difficult to implement. Time-restricted eating (TRE) may be an appropriate intervention in resource-limited communities.MethodsThis article outlines the development and feasibility testing of a TRE intervention to inform the design of a TRE randomised controlled trial in women (20–45 years old) living with overweight/obesity and HIV, receiving DTG-based treatment from a resource-limited community in Cape Town, South Africa. Factors influencing TRE adoption were identified using the Capability, Opportunity, Motivation – Behaviour model and the Theoretical Domains Framework, combining in-depth interviews (IDIs) and focus group discussions. Participants from the IDIs went on to participate in a single arm 4-week TRE pilot trial where feasibility was explored in terms of reach, acceptability, applicability, and implementation integrity. An iterative, thematic analysis approach was employed to analyse the qualitative data.ResultsParticipants included 33 isiXhosa-speaking women (mean age 37.1 years, mean BMI 35.9 kg/m2). Thematic analysis identified psychological capability (knowledge of fasting), social influences (cultural preferences, family support), and reflective motivation (awareness of weight, health impact, motivation for TRE) as key factors influencing adoption of TRE for weight management. In a 4-week TRE pilot trial (n = 12), retention was 100%. Positive outcomes perceived included improved energy, appetite control and weight loss. TRE was perceived as acceptable, easy, and enjoyable. Family support facilitated adherence, while habitual and social eating and drinking practices were barriers. Compliance was high, aided by self-selected eating times, reminders, and weekly calls. Recommendations included the incorporation of dietary education sessions and text messages to provide additional support and reminders.ConclusionsThis study indicates that TRE is a feasible weight management strategy in women living with overweight/obesity and HIV, receiving DTG-based treatment in a resource-limited community. These findings will ensure that the forthcoming TRE randomised controlled trial is adapted and optimised to the local South African context.

Preservation of arts and culture through edutourism village of Mentaraman in Malang East Java

There are many kinds of community efforts in preserving their local culture, one of which is to carry out routine activities that are integrated with the village celebration agenda so that they become a medium for demonstrating the performance of their local cultural arts potential. This Community Service (PkM) activity aims to package cultural preservation efforts through the formation of an educational tourism village (eduwisata). The location is in the village of Mentaraman, Pagelaran Village, Malang Regency, East Java. The stages used were identification of potential and problems, Focus Group Discussions (FGDs), program preparation, socialisation, and trial visits. Analysis of the results used the 6P simultaneous stage. The results of the community service programme are in the form of a tourism package document supported by an increase in skills and a variety of performing arts as well as the involvement of local communities in management. Recommendations include the need to increase the capacity of local tour guides, the participation of artists, and the use of information technology to support digital-based promotions.

Digital competency among the aged entrepreneurs under the silver economy with soft power in Thailand

The rise of the elderly in Thailand experiencing a significant demographic transformation resulted in a growing senior population to become a super-aged society by 2030. This affacted the demand for “silver economy in Thailand. The objectives are to study (1) the overview of digital competency among the aged entrepreneurs under the silver economy with soft power; and (2) the mechanism for digital competency empowerment among the aged entrepreneurs under the silver economy with soft power in Thailand. Mixed-research method was employed by quantitative (survey questionnaire) and qualitative (Focus group discussion and interview) with a total of 100 samples and 15 key informants involved: the government workers, the aged entrepreneurs, the private & industrial workers, the digital competency expertise, the elderly expertise, and the community leaders. Two main results reflected the objectives accordingly: 1) the overview of digital competency summarized from survey questionnaire found most of the positive factors as follow; 1.1) positive attitude toward digital competency even of their quite low educational background; 1.2) their positive practical existing skilled in digital competency : digital communication, digital media production, privacy, security, analytic thinking skills that can be well applied with their silver economy’s activities. 2) the mechanism for digital competency empowerment among the aged entrepreneurs found most urgent needs in more closed collaboration among all relevant sectors, starting from the lead government sector, private sector, and the local sectors to help expanding all kinds of empowerment activities. Deepen links by driving more inter-sectoral mechanism, resources sharing, regular consultation for internship, apprenticeship, on-site training, employment, market outlet and other schemes with equity, quality and sustainable practices.

Perception, problems, and risks to climate change adaptation: A study adjacent to sundarbans mangrove forest, Bangladesh

The south-western coastal area of Bangladesh proximity to Sundarbans is a hot spot of climate change. The perception and problems along with associated risks to the adaptation of climate change are not well understood. However, the present study was conducted in 2020–2021 through a multistage sampling technique, questionnaire survey, and focus group discussions (FGD). In addition, the Likert scale and the INFORM model are used to understand perceptions, problems, and extent of risks response to climate change adaptation in the study area. This study illustrates that early-aged illiterate, medium families (5–7 in numbers) and $ 18.45–$ 36.88 per month income level are more susceptible to the adaptation of climate change. The majority of the respondents are dependent on natural resources, such as rainwater (67.3%), dried leaves (65.4%, and fishing from Sundarbans (80.6%). Besides, most of the respondents experienced disasters (66.7%), water logging and salinity (65.05%), waterborne diseases (89.5%), and monetary problems (81%), which forced them to stay in a more critical lifestyle. The perception level was high in the unconcerned level (77.15%) followed by concerned (11.4%) and very concerned (9.5%), while only 1.95% showed neutral and none of them were very concerned. Likewise, in the study region, respondents are confronted with a variety of risks and exposure (42%), vulnerabilities (33%), and lack of capacity (25%). Also, significant differences in perception level and no significant differences were observed in risk level in this study. These findings insights into the necessity of educational and financial interventions to optimize identified risks and problems and increase the perception level of effective policy-making processes and adaptation strategies to the adaptation of climate change.

Co-designing an interprofessional digital education resource on delirium: a student-led approach

BackgroundInterprofessional education is crucial for healthcare students to develop collaborative skills and provide effective patient care. However, opportunities for interprofessional learning are often limited in healthcare curricula. The present study aimed to engage students from different health professions in co-designing an educational resource on delirium recognition and management through an interprofessional lens and explore their experiences of this process.MethodsTwo co-design workshops were conducted with students from medicine, nursing, pharmacy, and occupational therapy programmes at two universities across the island of Ireland. Focus groups were held following these workshops to explore students’ experiences of the co-design process. The workshops involved a range of activities, including theme generation, scenario development, resource creation (podcasts, simulations), and focus group discussions. Data from focus groups were analysed thematically.ResultsA total of 19 students participated across the two workshops. Three themes were identified: (1) Relationship development, where students identified the benefits of co-creating the resource and valued the flexibility, collaboration, and social aspects of the co-design approach; (2) Interprofessional collaboration, which challenged students’ assumptions about other disciplines, fostered teamwork and communication, and highlighted the need for early and continuous interprofessional learning; (3) Professional growth, with students reporting increased confidence in managing delirium, working with other professions, and engaging in novel experiences like podcasting and simulation.ConclusionsThe co-design process facilitated interprofessional collaboration, peer learning, and personal growth among healthcare students. Students appreciated the opportunity to co-create an educational resource while developing interprofessional skills. The study demonstrates the potential of co-design as a methodology for enhancing interprofessional education and promoting effective teamwork in healthcare.

‘There is so much we can learn from the mistakes of Covid-19’: service provider recommendations for more accessible crisis communication in multicultural Australia

ABSTRACT This paper presents the findings of a qualitative, reflexive investigation into the challenges facing Australia’s migrant and refugee communities when engaging with mediated communication during global crisis events. Informed through a Culture-Centred Approach, I present an interpretive thematic analysis of interview and focus group discussion with 16 service providers and community leaders who supported migrant and refugee communities during the Covid-19 pandemic in Melbourne, Australia. Participants discussed significant problems concerning the accessibility of Covid-related communication, noting numerous health equity implications, which many described as heightened for migrant and/or refugee communities with disabilities. These findings lend further credence to calls for more intersectional and participatory research and practice approaches, with participants advocating strategies that centre the embodied expertise of people with direct experience of both racialised exclusion and health inequity. I discuss these recommendations with careful consideration of documented challenges in global efforts to inform crisis communication scholarship, policy, and practice.

Barriers and enablers to utilisation of postpartum long-acting reversible contraception in Eastern Uganda: a qualitative study

IntroductionIn Uganda, although most women wish to delay or prevent future pregnancies, uptake of postpartum family planning (PPFP) is low. We explored behavioural factors influencing the utilisation of postpartum long-acting reversible contraceptives (LARCs) in Eastern Uganda.MethodsWe conducted a qualitative study in two districts of Eastern Uganda. We conducted 20 in-depth interviews and three focus group discussions with postpartum women, male partners, midwives, and village health team members. We analysed transcripts using framework analysis, based on the COM-B framework.ResultsThe use of immediate postpartum LARC was affected by the capabilities of women in terms of their knowledge and misconceptions. Limited capabilities of health workers to provide counselling and insert IUDs, as well as shortages of implants, reduced the physical opportunites for women to access PPFP. Social opportunities for women were limited because men wanted to be involved in the decision but rarely had time to accompany their partners to health facilities, and health workers often appeared too stressed. Men also feared that PPFP would enable their partners to be unfaithful. Motivation to take up immediate postpartum LARC included the desire to space births, preference for contraceptive implants over intra uterine devices (IUD) at the 6-week postpartum period, resumption of sex and menses, partner support, and perceived effectiveness of postpartum contraception. Participants thought that uptake of immediate postpartum LARC could be improved by health education and outreach visits, male involvement and couples’ counselling in antenatal clinic appointments, and enabling switching between family planning methods (in case of side-effects) .ConclusionLow uptake of PPFP was caused by inadequate knowledge and misconceptions about LARC by women and their partners, insufficient numbers of midwives trained to provide PPFP, stock-outs of PPFP methods, and few social opportunities for couples to be counselled together. These factors could be addressed by scaling up effective, low cost and innovative ways to provide health education (such as films), involving men in decision-making, as well as training more midwives to provide PPFP services, and ensuring that they have sufficient time and supplies.

Tech vs. Tradition: ChatGPT and Mindfulness in Enhancing Older Adults' Emotional Health.

To improve older adults' mental health, this study compared the effects of AI chatbots, such as ChatGPT 3.0, with traditional mindfulness therapies on loneliness and depression in older adults. Despite interest in AI as a complementary tool, empirical evidence on its impact remains limited. For an eight-week intervention, older adult participants from two nursing homes in Hangzhou were assigned to groups focused on mindfulness (group sessions) and chatting (one-on-one ChatGPT). Following the intervention, participants engaged in a researcher-led focus group discussion. After 8 weeks, tension had decreased significantly (p < 0.05) in the Mindfulness group of older adults, and there was no significant difference between the effects of ChatGPT and mindfulness on the emotional intervention of older adults. Findings indicated three themes, including (1) personal experience, reflecting older adults' use of AI technology and mindfulness; (2) attitudes and perspectives on the experiment's desirability and insufficiencies; and (3) needs and expectations for future AI and mindfulness developments, including usability and functional preferences. Similar to mindfulness practice, ChatGPT interactions helped older adults feel less depressed and might eventually reduce costs by replacing mindfulness. In the future, AI can be integrated with conventional techniques to improve interaction by giving AI a more human-like appearance.

How do pig veterinarians view technology-assisted data utilisation for pig health and welfare management? A qualitative study in Spain, the Netherlands, and Ireland

BackgroundApplication of data-driven strategies may support veterinarians’ decision-making, benefitting pig disease prevention and control. However, little is known about veterinarians’ need for data utilisation to support their decision-making process. The current study used qualitative methods, specifically focus group discussions, to explore veterinarians’ views on data utilisation and their need for data tools in relation to pig health and welfare management in Spain, the Netherlands, and Ireland.ResultsGenerally, veterinarians pointed out the potential benefits of using technology for pig health and welfare management, but data is not yet structurally available to support their decision-making. Veterinarians pointed out the challenge of collecting, recording, and accessing data in a consistent and timely manner. Besides, the reliability, standardisation, and the context of data were identified as important factors affecting the efficiency and effectiveness of data utilisation by veterinarians. A user-friendly, adaptable, and integrated data tool was regarded as potentially helpful for veterinarians’ daily work and supporting their decision-making. Specifically, veterinarians, particularly independent veterinary practitioners, noted a need for easy access to pig information. Veterinarians such as those working for integrated companies, corporate veterinarians, and independent veterinary practitioners expressed their need for data tools that provide useful information to monitor pig health and welfare in real-time, to visualise the prevalence of endemic disease based on a shared report between farmers, veterinarians, and other professional parties, to support decision-making, and to receive early warnings for disease prevention and control.ConclusionsIt is concluded that the management of pig health and welfare may benefit from data utilisation if the quality of data can be assured, the data tools can meet veterinarians’ needs for decision-making, and the collaboration of sharing data and using data between farmers, veterinarians, and other professional parties can be enhanced. Nevertheless, several notable technical and institutional barriers still exist, which need to be overcome.

Food choice, embodied knowledge and circumscribed agency: factors influencing adolescent girls' and boys' dietary practices in three states in northern Nigeria.

The objective of this study was to explore adolescent dietary practices, related norms and acceptable communication platforms in northern Nigeria to inform future nutrition project design. This was a qualitative formative research study. We used purposive sampling and conducted thirty focus group discussions with male and female adolescents aged 10-14 and 15-19 years (n 180) and six with adult influencers (n 36). We also administered a 24-h dietary recall with the adolescents using the Diet Quality Questionnaire. The study was conducted in urban and rural areas in three states in northern Nigeria. Adolescents reported consuming six nutritious food groups the previous day on average. However, there was a wide disparity and only half consumed all five recommended food groups. Adolescents' food choices were influenced by perceptions of the functional and physical benefits of nutritious foods and preferences for satisfying foods. Diverse foods were available in the food environment, but affordability constrained access to nutritious foods. Limited access to income and gender norms constrained adolescent agency over food choice. Girls, particularly those who were pregnant, had less agency related to food than boys. Adolescents thought that peers should be reached through group discussions, radio and phones, among other communication platforms. Adolescents consumed relatively diverse diets. Adolescent food choice was influenced by their embodied experience and knowledge related to nutrition and taste, home food environment and circumscribed agency. Opportunities exist to support healthy diets for adolescents by strengthening adolescents' embodied knowledge, food environments and social support.

Community perspectives of Ebola Viral Disease in high-risk transmission border regions of Tanzania: a qualitative inquiry

BackgroundTanzania faces ever-rising concerns due to the recurrence of the Ebola Virus Disease (EVD) in neighbouring Democratic Republic of Congo (DRC) and Uganda. This necessitates a better understanding of the community perspectives in high-risk regions for effective risk communication and preparedness.MethodsThis rapid ethnographic assessment study used explorative qualitative methods to collect data. People from diverse backgrounds participated in 59 in-depth interviews, 57 Key Informant interviews, and 35 focus group discussions. Data was analysed using a thematic analysis approach.FindingThe study revealed existence of awareness of EVD and its symptoms, with radio and television being the main sources of information. However, there were varied perceptions of EVD’s cause and transmission, some attributed it to bats, monkeys, and wild animal meat, while others associated it with high fever, a dirty environment, changing dietary patterns, and the COVID-19 virus. Physical contact with an infected person’s body fluids and eating meat from infected animals were perceived as EVD transmission routes. Women, school children, boda-boda (motorcycle) riders, and fishermen were considered the most susceptible to EVD infections due to their daily activities. Preventive measures included avoiding physical contact, touching fluids, and refraining from eating wild animal meat. Prompt reporting of suspected cases to health facilities was deemed crucial for earlier outbreak identification and containment.ConclusionThe high-risk regions of Tanzania had a high level of awareness and perceived susceptibility to EVD, coupled with varying degrees of misperception about the etiology and its transmission. To improve community perspectives and preparedness in the case of an outbreak, there is a need for ongoing risk communication and participation in EVD prevention and responses.

Barriers and enablers that influence the uptake of HIV testing among heterosexual migrants in the Netherlands.

Heterosexual migrant men and women in the Netherlands often face barriers to accessing health services, including HIV testing, that may lead to late-stage HIV diagnoses. This study explored factors of influence in the usage of HIV testing among heterosexual migrants. Qualitative evaluation with semi-structured interviews at the Amsterdam-based AIDS Healthcare Foundation (AHF) Checkpoint and one focus group discussion (FGD) conducted during June-July 2023 with 19 participants: interviews with 12 heterosexual migrants from low- or middle-income countries (LMICs) and FGD (n = 5) and interviews (n = 2) with 7 key informants from the (public) health sector. Recorded interviews were transcribed and thematically analyzed, using the framework of Andersen's Expanded Behavioral Model of Health Services Use. In total, 55 themes emerged from the interviews and the FGD. Examples include insufficient availability of information on HIV and testing services, and difficulty in accessing these services (e.g. the barrier of the online appointment system of the Centre for Sexual Health (CSH)). HIV test participants expressed free, rapid testing, no appointment required, and a positive experience during their HIV test as enablers to test in the future. Results from key informants showed that poor health literacy and lack of clarity on the healthcare system's guidelines were barriers for heterosexual migrants in accessing information on HIV and testing services. It also revealed past initiatives and interventions that were successful in reaching at-risk groups such as the integration of HIV testing into sexually transmitted infection (STI) testing, but that were subsequently discontinued due to financial constraints. Factors contributing to a low HIV test uptake were participants' perception of limited accessibility of CSH facilities, insufficient available information on HIV (testing) services, and low perception of HIV risk. Unclear policies on accessing HIV/STI testing services at CSHs, and potential missed opportunities for HIV testing at general practitioners were contributing factors identified by key informants.

Investigating the feasibility of agro-waste briquettes as a sustainable energy source in Borno state Nigeria as pathways for post-conflict and instability recovery

The growing energy demand and lack of access to clean energy sources call for the development of more energy for cooking in households, briquettes produced using agricultural materials and related biomass have the capacity for utilization as an energy source. This study aims to introduce briquettes as an alternative energy source for cooking within conflict-affected communities in Borno State, northeastern Nigeria, where factors relating to the high cost of charcoal, security constraints, and the environmental impact of tree cutting have sparked apprehension and raised concerns. The study demonstrates the likelihood of adopting briquettes as a cooking fuel alternative in communities recovering from insurgency. Using assessment tools such as household surveys, Key Informant Interviews (KIIs), and Focus Group Discussions (FGDs), involving a total of 536 questionnaires administered to respondents; KII was administered to 37 respondents and 9 FGDs with cooperatives and dealers in traditional fuel were conducted. From the results 73% of the community relies on charcoal as their primary fuel source, since the majority (68.7%) appeared to be low-income households, 24.1% reported that the high cost of charcoal is a major hindrance to continued usage. However, despite the communities showing potential in briquettes, only 3.7% are aware of briquettes as an alternative option for cooking energy indicating the adoption of briquettes being low in the region. A situational assessment was carried and sensitization strategies were recommended as means to enhance livelihoods and build resilience within the community.

Preventing occupational injuries in the informal construction industry: a study protocol for the development of a safety education intervention for bricklayers and carpenters in Osun State, Nigeria.

Occupational injuries are a growing public health problem. Approximately 1,000 workers die daily from occupational injuries globally. Artisans working in the informal sector of the construction industry in many low/middle income countries like Nigeria have a higher injury predisposition. This study will assess the determinants of occupational injuries and design a safety intervention for informal sector artisans in the Nigerian construction industry. A sequential mixed-methods design will be employed to study 840 bricklayers and carpenters (420 per artisan group) in Osun State, Nigeria. Quantitative data will be collected first while qualitative data will be collected thereafter. Thirdly, a modified Delphi-technique will be employed to co-design a safety education intervention. For the quantitative study, artisans will be recruited via multi-stage sampling and a semi-structured questionnaire will be administered to obtain information on artisans' socio-demographics, work-patterns and occupational injuries. A multivariable regression model will be used to determine the association between injury occurrence and independent variables. Twelve to sixteen focus group discussion (FGD) sessions will be conducted for artisans to obtain group perspectives about injuries and preferred safety training topics. From the FGD and quantitative study findings, a list of items for the safety training module will be compiled for the modified-Delphi process. Thereafter, the content validation index (CVI) will be derived and items with CVI of ≥0.80 will be included in the final safety training module. This paper describes the process required to assess the determinants of occupational injuries among artisans in the informal sector of the construction industry in Nigeria and further proposes the design of a context-relevant safety training intervention. The information from this study will be essential in promoting safe working environments for construction artisans.