Focus Group Discussions Participants Research Articles

Determinants of land management technology adoptions by rural households in the Goyrie watershed of southern Ethiopia: Multivariate probit modeling estimation

Land management technology (LMT) adoption is one of Ethiopia's crucial strategies to combat soil depletion and promote agricultural production. However, there is scant information concerning the intensity, interdependent nature, and households' decision to adopt multiple LMTs. Thus, the purpose of this study is to identify factors influencing households' decisions to adopt multiple LMTs and the intensity and interdependency of the technologies in the Goyrie watershed of southern Ethiopia. The data was collected from 291 randomly selected household heads, focus group discussion participants, and key informant interview respondents. The quantitative data was analyzed using descriptive statistics and econometric methods like multivariate probit and ordered probit modeling, while the qualitative data was presented through content analysis. The result indicated that more than half of respondents (67 %) applied one or two LMTs. The highest complementary effects were observed in mixed soil bunds with desho grasses and manure applications. However, soil bunds and fanya-juu, manure application and agroforestry showed interchangeability with one another. Sex, education, family size, landholding size, access to development agents and credit institutions, training, and village membership increased the probability of adopting multiple LMTs, whereas age, land rent, and crop sharing discouraged the likelihood of households' decisions to adopt LMT. The results of the ordered probit model revealed that village membership and contact with extension agents highly encouraged the intensity of LMT adoptions. Thus, policymakers and planners should consider social, institutional, human asset, and technological related factors to increase adoption rates and intensity of land management technologies.

Prevalence, perceptions and associated factors of health insurance enrollment among older persons in selected cash grant communities in Ghana: a cross-sectional mixed method

BackgroundUniversal Health Coverage has been openly recognized in the United Nations health-related Sustainable Development Goals by 2030, though missing under the Millennium Development Goals. Ghana implemented the National Health Insurance Scheme programme in 2004 to improve financial access to healthcare for its citizens. This programme targeting low-income individuals and households includes an Exempt policy for older persons and indigents. Despite population ageing, evidence of the participation and perceptions of older persons in the scheme in cash grant communities is unknown. Hence, this paper examined the prevalence, perceptions and factors associated with health insurance enrollment among older persons in cash grant communities in Ghana.MethodsData were from a cross-sectional household survey of 400 older persons(60 + years) and eight FGDs between 2017 and 2018. For the survey, stratified and simple random sampling techniques were utilised in selecting participants. Purposive and stratified sampling techniques were employed in selecting the focus group discussion participants. Data analyses included descriptive, modified Poisson regression approach tested at a p-value of 0.05 and thematic analysis. Stata and Atlas-ti software were used in data management and analyses.ResultsThe mean age was 73.7 years. 59.3% were females, 56.5% resided in rural communities, while 34.5% had no formal education. Two-thirds were into agriculture. Three-fourth had non-communicable diseases. Health insurance coverage was 60%, and mainly achieved as Exempt by age. Being a female [Adjusted Prevalence Ratio (APR) 1.29, 95%CI:1.00–1.67], having self-rated health status as bad [APR = 1.34, 95%CI:1.09–1.64] and hospital healthcare utilisation [APR = 1.49, 95%CI:1.28–1.75] were positively significantly associated with health insurance enrollment respectively. Occupation in Agriculture reduced insurance enrollment by 20.0%. Cited reasons for poor perceptions of the scheme included technological challenges and unsatisfactory services.ConclusionHealth insurance enrollment among older persons in cash grant communities is still not universal. Addressing identified challenges and integrating the views of older persons into the programme have positive implications for securing universal health coverage by 2030.

Influence of economic factors on feacal emptying, conveyance and disposal:

Safe management of faecal waste is one of the Sustainable Development Goals (SDGs) which envisions safe sanitation for all. However, although efforts to improve sanitation conditions in slums have been made, faecal emptying, conveyance and disposal still remain a challenge endangering the health of the public. The study examined the influence of economic factors on faecal emptying, conveyance and disposal in on-site sanitation facilities in Meru slums. A convergent design with a mixed methods approach was adopted. Quantitative data was collected using structured questionnaires from a sample of 228 household heads selected using cluster and proportionate simple random sampling techniques. Correlation and regression analysis was carried out to ascertain the association between emptying, conveyance and disposal of faecal waste and the economic factors. Qualitative data was gathered using focus group discussion participants with eight (8) who included four (4) pit operators, 3 household heads and 1 Public Health Officer (PHO) and results analyzed thematically. Findings showed that only 31% of slum dwellers emptied latrine pits and that manual emptying was more common (84%) than mechanical emptying because of its cost efficiency, reliability and the effectiveness in handling plastics, glasses, metal pieces, diapers and sanitary pads contained in pits. Increased cost constrained faecal emptying, conveyance, and disposal (r=0.499, p-value=0.000). Residents who were able to pay for faecal handling services were more likely to practice hygienic faecal emptying, conveyance, and disposal (r=0.524, p-value=0.000). Low level of income for majority of slum dwellers influenced the design of the latrines adopted. Emptying faeces from poorly designed pit latrines was more expensive due to operators’ safety concerns. The study concluded that the inability to meet the costs associated with faecal emptying, conveyance and disposal services facilitated poor sanitation status in slums. There is need to sensitize the slum community on the benefits of practicing safe management of faecal waste. The study recommended development of government policies to regulate mechanical emptying conveyance and disposal of faecal matter.

Exploring community behaviours and stakeholder challenges in engaging communities with dengue prevention behaviour in Malaysia: implementation research for a qualitative study with a community-based participatory research design

ObjectivesTo use a community-based participatory research (CBPR) design to explore local community behaviours and stakeholders’ challenges in engaging communities in dengue prevention behaviours in Hulu Langat, Selangor, Malaysia.DesignThis CBPR design...

Bicycle Opportunity Spectrum: a framework for classifying and categorizing the different landscapes for cycling

ABSTRACT There is cycling leisure in various landscapes where different management challenges emerge needing unique, context-specific strategies. Managers must be critical of these landscape nuances to produce suitable planning directives corresponding to the case of these certain environments. In this study, the Recreation Opportunity Spectrum (ROS) was adapted to the bike activity to create a Bicycle Opportunity Spectrum (BOS) framework. These cycling landscapes were processed into a regional-scale tool based on the compatibilities between landscape types and cyclist needs to produce satisfactory experiences. The development of the tool was based on diverse cycling experiences elaborated during focus group discussions (FGDs). This resulted in a framework of four landscape classifications (Urban, Rural, Natural with Road, and Natural with Trail) and criteria of seven (Bike Route, Path Remoteness, Infrastructure Development, Viewshed, Path Interactivity, Support Facilities and Services, and Pathway Management). The framework was tested by evaluating the cycling landscapes of Taichung City, Taiwan. The results, validated by the FGD participants verified the fitness of the BOS towards evaluating bikeways, creating a tool for bikeway management applicable to various landscape classes.

Barriers to contraceptive use in humanitarian settings: Experiences of South Sudanese refugee women living in Adjumani district, Uganda; an exploratory qualitative study.

Contraceptive use can be lifesaving, empowering and cost-effective for women and girls. Access to contraception is still challenging to female refugees due to several barriers including language, low educational level, lack of information, influence by family members, limited income, cultural and religious norms. This study explored barriers to contraceptive use among South Sudanese refugee women living in Adjumani district, Uganda. An exploratory study design using qualitative methods were employed involving women of reproductive age (15-49 years). Purposive sampling was used to select participants for Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) from three settlements in Adjumani district. We conducted four FGDs, each consisting of 8 participants. We also conducted fourteen in-depth interviews (IDIs) with women of reproductive age. The IDI and FGD guides were translated into local languages before they were used to collect data. The interviews were recorded, transcribed verbatim and translated into English. Audio recordings were labeled before being translated back to English. Deductive, team-based coding was implemented, and a codebook developed. Transcripts were entered, and data coded using Atlas ti version 14. Data were analyzed using content analysis to produce the final outputs for the study. The study found several challenges to contraceptive use. These included gender dynamics, socially constructed myths on contraceptive use, cultural norms, limited knowledge about contraceptives, men's negative attitudes, antagonism of contraceptive use by leaders and reprisal of women who use contraception. The study concluded that there is need for community strategies to break down the barriers to contraception utilization among refugee women. Such strategies should involve men and women alongside gatekeepers to enhance sustainability.

Future Perspectives on Communication Management for Promoting Tourism in Chachoengsao Province (2024-2027)

Purpose: This research aims to examine the communication management strategies employed to promote tourism in Chachoengsao Province from 2567 to 2570 and to elucidate the future perspectives of communication management within the framework of the theory of global unity, encompassing the concept of "one species, one society, one culture, one language, and one religion". Theoretical Framework: This study employs communication theory, theory of management, particularly the POSDCoRB theory, providing a comprehensive framework for contemporary management. Design/Methodology/Approach: This research employs a mixed methods design, combining qualitative insights from focus group discussions with expert opinions gathered through the Delphi Technique. The study focuses on tourism communication management in Chachoengsao Province, utilizing a sample of 91 participants for focus group discussions and engaging 14 experienced professionals in tourism and communication management for the Delphi Technique. The research employs a variety of data collection tools, including interviews, open-ended questionnaires, and closed-ended questionnaires, and utilizes content analysis, median values, and interquartile range calculations for data analysis. Finding: The study findings reveal that 1) Chachoengsao Province boasts a variety of tourist attractions spread across its 11 districts 2) Tourism promotion through integrated advertising and public relations communication management involves various channels, including: (1) Online Channel which are communication initiated by tourists, influencers, and relevant organizations through platforms such as websites, Facebook, and Instagram. (2) Offline channels encompass a variety of traditional methods for promoting tourism, including vinyl banners, billboard advertising, mobile advertising, roadside banners, word-of-mouth, and cultural and traditional heritage events and activities. Research Practical and Social Implication: In the future, tourism communication management in Chachoengsao Province should strategically embrace modern and expansive approaches. This includes implementing contemporary and wide-reaching tourism communication methods, such as: Organizing Online Events, Metaverse Technology, Artificial Intelligence (AI), Virtual Reality (VR) and Augmented Reality (AR) Technologies, Web 3.0 Technology, Customer 360º Technology, Internet of Things (IoT), 3D Printing and Blockchain Technology 3) Experts have the following consensus opinions as in projecting the future vision of tourism communication management in Chachoengsao Province (2024-2027), it is envisioned to be carried out through the concept of oneness, encompassing physical oneness, biological oneness, psychological oneness, and sociological oneness. This will leverage the province's potential across various aspects, including infrastructure, transportation, cultural heritage related to tourism, economic positioning, livability, and the residents' love for their province Originality/Value: In this process, the planning stage is crucial, requiring clarity and precision. Additionally, effective tourism communication management in Chachoengsao Province will rely on an understanding of political strategies, laws, regulations, and alignment with the opinions of the local population. Two-way communication channels, especially online platforms such as websites, social media (Facebook, Instagram, Twitter, LINE OA, TikTok, Pantip, LinkedIn, YouTube), and advanced technologies including AI, touchless payment systems, and smart tourism concepts.

Metode Participatory Action Research dalam Pemberdayaan Pengrajin Batik Berbasis Budaya Lokal

This article specifically examines how the Participatory Action Research (PAR) method is applied in empowering local culture-based batik craftsmen in Kamonji Village, West Palu District, Palu City. In applying the PAR method, several techniques are used, including: observation, focus group discussion (FGD), sharing knowledge, in-depth interviews, training, and documentation. In the FGD, the batik craftsman community, as well as participants, can critique their social conditions, making them aware of the problems, needs, potential, and efforts to solve them in a participatory manner with the parties involved in the transformation effort. FGD participants recommended holding printed batik-making training activities to strengthen batik-making skills. This is considered more effective, efficient, and economically profitable compared to woven batik. Additionally, it can meet the need for developing local culture-based souvenirs in Palu City. This recommendation was followed up with training in making printed batik and sharing follow-up plans.

Artificial intelligence (AI) in Ukrainian Higher Education: A Comprehensive Study of Stakeholder Attitudes, Expectations and Concerns

This study examines stakeholders’ attitudes toward Artificial intelligence (AI) tools in Ukrainian higher education institutions, employing a comprehensive mixed-methods approach. The research combines qualitative focus group discussions, which involved a diverse range of participants, and a quantitative survey questionnaire distributed to a sizeable cohort. The quantitative data reveals a noteworthy trend, with a majority of stakeholders expressing positive attitudes toward AI integration, emphasising its potential for personalised learning and real-time feedback. This positive sentiment, however, is tempered by identified concerns, notably surrounding the accuracy of AI-generated content. The study establishes a connection with existing literature, affirming the widespread acceptance and benefits of AI in education. For a more nuanced understanding, a detailed breakdown of these quantitative results sheds light on the extent and distribution of stakeholder attitudes and concerns. Moreover, the qualitative component delves deeper into stakeholders’ perspectives, capturing the richness of their expressions. Concrete examples and direct quotes from participants in focus group discussions provide a qualitative dimension to the study’s findings, offering insights into the nuances of stakeholders’ viewpoints. To address these concerns, the research emphasises the need for tailored intervention plans, focusing on content quality, ethical implications and comprehensive training. These recommendations are rooted in a thorough analysis of both quantitative and qualitative data, providing practical insights for policymakers and institutions. In particular, the study highlights the importance of inclusive decision-making and targeted communication strategies, recognising role-based and age-related variations among stakeholders. By adopting a holistic approach to AI integration and acknowledging the interrelationships between attitudes, perceptions, expectations and concerns, this research provides a comprehensive guide for effectively leveraging AI while addressing associated concerns in higher education institutions.

People living with HIV’s perspectives of acceptability of fee for home delivery of ART: a qualitative study

IntroductionSignificant progress has been made in the HIV response in South Africa; however, gaps remain in ensuring engagement in care to support life-long medication adherence and viral suppression. The National Department of Health (NDoH) has introduced community-based and clinic-based HIV differentiated service delivery (DSD) models to tackle suboptimal adherence and retention in care. Nevertheless, differentiated care models require adaptation to better serve clients who struggle with adherence. There is limited research on the acceptability of fee for home delivery of ART in resource-constrained settings. The current study investigates the acceptability of fee for home delivery of ART among people living with HIV in South Africa.MethodsTwo mixed-gender focus group discussions (FGDs) took place between June and November 2019, consisting of 10 participants in each group. A purposive sampling strategy was employed to identify and select 10 people living with HIV who were ART-eligible but not in care, and 10 people living with HIV who were currently taking ART and in care. Participants were grouped according to their treatment status. A coding framework, informed by a priori categories and derived from topics in the interview guide, was developed and utilized to facilitate analysis.ResultsParticipants expressed enthusiasm for having ART home-delivered, as it would save the time spent waiting in long queues at the clinic. However, some participants raised concerns about potential payment difficulties due to high unemployment rates in the community. Some participants believed this would be acceptable, as patients already incur costs for travel and food when visiting the clinic. Participants in both FGDs expressed strong concerns about home delivery of their ART based on fear of accidental disclosure, especially for those who have not disclosed to their immediate families and partners.ConclusionOur study suggests that charging a fee for home delivery is an acceptable and innovative approach to supporting PLHIV in maintaining adherence to their medication and remaining in care.

Community perceptions and experiences on caring for the premature babies in Arba Minch health and demographic surveillance site, southern Ethiopia: Interpretive Husserlian phenomenological study.

Premature birth is the leading cause of under-5 child mortality, accounting for 18%. More attention is needed for premature babies. Myths, misconceptions, and negative attitudes stigmatize premature births and slow prevention and care efforts. In Ethiopia, studies have been conducted on premature birth and its risk factors. However, there is a lack of evidence regarding the perceived causes of premature birth, caring aspects, and community challenges. This qualitative study aims to address these research gaps. This interpretive Husserlian phenomenological study was conducted from January 1-30, 2022. Purposive sampling was used to recruit 32 participants for focus group discussions and 10 participants for in-depth interviews. Participants included women, grandmothers, grandfathers, men, traditional birth attendants, and traditional healers. Interview and focus group data were analyzed using NVivo 12 Plus software and a thematic content analysis approach. In this study, the participants recognized premature babies by physical features such as transparent and bloody bodies, small and weak bodies, a limited range of motion, and bizarre behaviors. They perceived the causes of premature birth to be being young, carrying heavily loaded materials, accidents, illnesses, sin, social influence, and witchcraft. Participants provide warmth to premature babies by wearing cotton wool, making skin-to-skin contact, exposing to sunlight, and wrapping them in clothes. They also feed them boiled alcohol, muk, and formula, as well as fresh cow milk and butter. They frequently bathe the babies, wash and change their clothes, limit visits, and provide physical protection. The main challenges that the women faced were difficulty feeding and bathing the babies, limited social participation, psychosocial and economic impact, spirituality, and husband negligence. The community has a gap in providing care for premature babies, and women with premature babies face many challenges. Therefore, we need to raise awareness of accurate information about the causes and care of premature babies, and we need to support women who have premature babies.

Factors influencing the uptake and utilization of cervical cancer screening services among women attending public health centers in Addis Ababa, Ethiopia: mixed methods study

BackgroundCervical cancer is the second cause of cancer deaths among Ethiopian women. Despite multifaceted government efforts, the uptake and utilization of cervical cancer screening remain very low. This study aimed to assess factors influencing the uptake and utilization of cervical cancer screening at public health centers in Addis Ababa.MethodsA convergent parallel mixed-method study was employed to collect data through eight focus group discussions with 66 women purposively recruited from outpatient clinics, and cross-sectional face-to-face exit interviews with 80 women attending cervical cancer clinics in four high-patient volume health centers. The group interviews were tape-recorded, transcribed in Amharic, translated into English, and a thematic analysis approach was used in the analysis. Exit interview data were collected using a structured questionnaire in the Open Data Kit tool on an android tablet. STATA version 17 was used for descriptive and inferential data analyses. Statistical significance was set at p < 0.05.ResultsThe majority of focus group discussion participants had lack of knowledge of cervical cancer and its screening services. The major barriers to the uptake of screening were inadequate public awareness, fear of the procedure, embarrassment, provider’s gender, lack of male partner support, and childcare. Women aged 40 years and above were 13.9 times more likely to utilize cervical cancer screening than those under 30 years (AOR = 13.85; 95% CI: 1.40, 136.74). There was a strong preference for a female provider (AOR = 7.07; 95% CI: 1.53, 32.75) among women screened after attending antiretroviral therapy clinics and those screened due to abnormal vaginal bleeding than women referred from family planning clinics (AOR = 6.87; 95% CI: 1.02, 46.44). Safety of screening was negatively associated with women aged 30–39 (AOR = 0.045; 95% CI: 0.003, 0.696), and those who attended primary education, and secondary education and above, (AOR = 0.016; 95% CI: 0.001, 0.262), and (AOR = 0.054; 95% CI: 0.004, 0.724), respectively.ConclusionsThe study identified low public awareness, inadequate provider preference, safety concerns, and poor male partner support for cervical cancer screening. We recommend the decision-makers enhance public messages, maintain provider choices, ensure safety, and engage males to improve the uptake and utilization of cervical cancer screening.

2827. A mixed-methods analysis of provider-documented and patient-reported urinary tract infection symptoms among Veterans with neurogenic bladder

Abstract Background Urinary tract infections (UTI) are common in patients with neurogenic bladder (NB). Non-specific symptoms are frequent in this population, and may lead to inappropriate UTI diagnosis in patients who have asymptomatic bacteriuria. Characterization of patient-reported symptoms can inform interventions to promote appropriate UTI diagnosis. Methods Mixed methods study of adults with NB due to spinal cord injury/disorder (SCI/D), multiple sclerosis (MS), or Parkinson’s Disease (PD) and encounters with a UTI diagnosis (via ICD10). Provider-documented symptoms were collected from chart review of 198 encounters at 4 Veterans Affairs medical centers (VAMCs) between 2017-2018. Eleven virtual focus group discussions (FGDs) were conducted between May 2021 and May 2022 with patients from the chart review cohort with a UTI encounter in the prior year. Discussions were recorded, transcribed, and coded. Thematic analysis identified key concepts about symptoms and informed comparisons to provider-documented data from chart review. Results Provider-documented (n=198 encounters; SCI/D 51%, MS 20%, PD 28%) and patient-reported (n=23 FGD participants; SCI/D 78%; MS 18.5%) symptoms are in Table 1. Similar to providers, most patients noted urine changes as UTI symptoms (“cloudy” and “smelly” urine). Only 12% of encounters had provider-documented altered mental status, but this was commonly described in FGDs (“brain fog”). Only 25% of encounters had provider-documented dysuria or pelvic pain, but this was also frequently noted in FGDs (“sitting on a stick”). Several patients felt providers ignored their symptoms, particularly when they did not have fever, which may affect provider documentation. Nearly all patients noted diminished quality of life from UTI symptoms, such as difficulty engaging in social activities and psychosocial impacts from worsened mobility and functioning. Conclusion Both providers and patients attributed non-specific symptoms like urine changes to UTI, but there was discordance in recognition and reporting of other UTI symptoms. Optimizing care for patients with NB could involve patient and provider education on alternate sources of non-specific symptoms, interventions to improve communication about symptoms, and better assessment of quality of life impacts. Disclosures All Authors: No reported disclosures

DEVELOPMENT AND EFFECTIVENESS OF DIGITAL APPLICATION AS THE NEW SYSTEM TO ORGANIZE PRACTICUM MATERIALS AT SCHOOL OF PROSTHETICS ORTHOTICS IN POLYTECHNIC HEALTH SCIENCES JAKARTA I

Introduction: The Prosthetic Orthotics (PO) School at Health Polytechnic Jakarta I relies on practical skills and various materials in its labs/workshops for device fabrication. To enhance logistics management, this study proposes a new digital application leveraging digital technology's efficiency. The aim is to improve the organization of logistics at the PO school, given the diversity and volume of practicum materials. The study involves developing and evaluating the effectiveness of the new digital application. Method: Using a mixed methods approach, the study employed a focus group discussion (FGD) to gather insights from managerial-level participants and student users. FGD participants discussed the expected design, features, and functions of the new digital management system, as they are actively involved in logistic management. The study also evaluated the new system by comparing it with the old manual system. Results and Conclusion: Participants expressed expectations for a digital application with user-friendly features, easy gadget access, access authorization, automation of stock tracking, and a warning system for stock shortages. The developed digital management system aligned with these expectations and demonstrated superior effectiveness when compared to the manual system in managing a diverse range of practicum materials at the PO School of Health Polytechnic Jakarta I. Time constraints during the COVID-19 lockdown limited the elaboration of additional key features, suggesting a need for future studies to explore other aspects based on the school's evolving needs.

Climatic extremes’ resilient livelihoods of rural households in the Eastern Ethiopia

Climate change is affirmed as a major challenge to global food security in the twenty-first century and a threat to availability of adequate food for the population. This study was conducted to analyze rural households’ vulnerability to climatic extremes, and their resilience capacities in the eastern Ethiopia. The study employed both quantitative and qualitative methods of data, and analysis to achieve the objectives. While 397 sample households were randomly selected for household survey, key informants and focus group discussion participants were purposively selected. To analyze the quantitative data, both descriptive and inferential statistics were employed while thematic content analysis was employed to analyze the qualitative data. Rainfall variability, increase in local temperature, frequent drought, irregularity in rainfall, and pest infestation were identified as the key climatic extremes in the study area. The findings of the study asserted that rural local households in the study area have very high vulnerability to climatic extremes underpinned by their dependence on rain-fed farming. Reduction in crop yield (93%), and decline in production and productivity of livestock (91%) were confirmed as the major impacts of climatic extremes in the study area. Contrary to very high vulnerability to climatic vulnerability, local farming households’ resilience capacities were confirmed to be very poor. Moreover, the overall resilience capacity index was 0.44, which is below the minimum threshold and underpinned by low absorptive (0.45), low adaptive (0.47), and low transformative (0.4) capacity of farmers. Furthermore, the indexes derived from the five resilience building blocks imply that the level of household resilience is still poor (0.47). The very high vulnerability to extreme climate conditions and the very low livelihood resilience of rural farmers requires integrated strategies to reduce vulnerability and enhance livelihood resilience by governmental and non-governmental organizations. More importantly, it is worth to initiate rural livelihoods diversification and sustainable natural resource conservation, and management strategies. Above all, it is worth to integrate climate-resilient social protection programs into rural poverty reduction policies at national, regional, and local levels to reduce vulnerability, and enhance resilience of rural households in the study area.

Qualitative study of the stigma associated with the lived experiences of Buruli ulcer disease among patients in Nigeria

Abstract Background Buruli ulcer disease (BUD) is a neglected tropical disease of the skin, subcutaneous tissue and bone caused by Mycobacterium ulcerans, with various disabling and stigmatising sequelae. Patients face a range of adverse impacts owing to the disease as most are unable to relate effectively with their communities, battling stigma and fear of discrimination. This study aimed to explore the stigma associated with the lived experiences of BUD in patients in Nigeria. Methods This was a cross-sectional qualitative study that employed a focus group discussion (FGD) and key informant interviews in Enugu State, Nigeria. A random sampling of communities was followed by a purposive selection of FGD participants and key informants. A total of six key informants and eight FGD participants took part in the study. Data were collected over 6 wk from December 2022 to February 2023. The NVivo application was used to analyse transcripts and compute themes of quotes. Results Patients experienced stigma owing to the condition. The most reported experiences by participants were shame and culpability, isolation and social exclusion, including maltreatment from family members. Conclusions Identifying the stigma experienced by patients owing to BUD helps in the provision of psychosocial management services and support for patients.

Teachers’ Articulation in Implementing Biology Laboratory Courses in an Online Distance Learning Mode

&lt;p style="text-align: justify;"&gt;Biology laboratory courses (BLC) are designed to enhance and concretize students’ understanding of biology concepts. However, due to threats posed by the COVID-19 pandemic, education institutions were compelled to devise methods for teaching outside of laboratory structures and in a distant learning format. This phenomenological research explored the teachers’ articulation in the delivery of online distance learning (ODL) in BLC. Specifically, this study identified various methods and alternatives employed by biology teachers in conducting laboratory activities. Purposive sampling was used to select participants in survey, interview, and focus group discussion. The data were analyzed using thematic analysis. The study revealed that teachers articulate the delivery of online biology laboratory courses by employing different instructional practices in the three areas of learning experience: planning, implementing, and assessing stages. The results provide practical implications for the improvement of biology instruction and recommendations to support the delivery of flexible learning modalities during educational disruptions.&lt;/p&gt;

Defining Feasibility as a Criterion for Essential Surgery: A Qualitative Study with Global Children's Surgery Experts.

The Disease Control Priorities (DCP-3) group defines surgery as essential if it addresses a significant burden, is cost-effective, and is feasible-yet the feasibility component remains largely unexplored. The aim of this study was to develop a precise definition of feasibility for essential surgical procedures for children. Four online focus group discussions (FGDs) were organized among 19 global children's surgery providers with experience of working in low- and lower-middle-income countries (LMICs), representing 10 countries. FGDs were transcribed verbatim, and qualitative data analysis was performed. Codes, categories, themes, and subthemes were identified. Six determinants of feasibility were identified, including: adequate human resources; adequate material resources; procedure and disease complexity; team commitment and understanding of their setting; timely access to care; and the ability to monitor and achieve good outcomes. Factors unique to feasibility of children's surgery included children's right to health and their reliance on adults for accessing safe and timely care; the need for specialist workforce; and children's unique perioperative care needs. FGD participants reported a greater need for task-sharing and shifting, creativity, and adaptability in resource-limited settings. Resource availability was seen to have a direct impact on decision-making and prioritization, e.g., saving a life versus achieving the best outcome. The identification of a precise definition of feasibility serves as a pivotal step in identifying a list of essential surgical procedures forchildren, which would serve as indicators of institutional surgical capacity for this age group.

"I was scared dating… who would take me with my status?"-Living with HIV in the era of UTT and U = U: A qualitative study in Johannesburg, South Africa.

South Africa rolled out Universal Test-and-Treat (UTT) in 2016, extending treatment eligibility to all persons living with HIV (PLHIV). We sought to understand how PLHIV in Johannesburg, South Africa, interpret and experience their HIV status, five years into the UTT era. In May 2021, we conducted in-depth interviews (IDI) (N = 27) with adult (≥18 years) PLHIV referred by HIV counsellors at three peri-urban primary healthcare clinics. We also conducted three focus group discussions (FGDs) (N = 27) with adult PLHIV recruited from clinics or from civil society organisations through snowball sampling. Follow-up interviews were conducted with 29 IDI and FGD participants. Participants were asked to reflect on their HIV diagnosis, what their HIV status meant to them and how, if at all, being HIV-positive affected their lives. Interviews and focus group discussions were audio-recorded, transcribed, translated to English, and analysed using a grounded theory approach. Participants perceived that HIV was common, that PLHIV could live a normal life with antiretroviral therapy (ART), and that ART was widely accessible. However, HIV elicited feelings of guilt and shame as a sexually transmitted disease. Participants used the language of "blame" in discussing HIV transmission, citing their own reckless behaviour or blaming their partner for infecting them. Participants feared transmitting HIV to others and felt responsible for avoiding transmission. To manage transmission anxiety, participants avoided sexual relationships, chose HIV-positive partners, and/or insisted on using condoms. Many participants feared-or had previously experienced-rejection by partners due to their HIV status and reported hiding their medication, avoiding disclosure, or avoiding relationships altogether. Most participants were not aware that undetectable HIV is untransmittable (U = U). Participants who were aware of U = U expressed less anxiety about transmitting HIV to others and greater confidence in having relationships. Despite perceiving HIV as a manageable chronic condition, PLHIV still faced transmission anxiety and fears of rejection by their partners. Disseminating information on U = U could reduce the psychosocial burdens of living with HIV, encourage open communication with partners, and remove barriers to HIV testing and treatment adherence.

Community knowledge, attitude, practices and beliefs associated with persistence of malaria transmission in North-western and Southern regions of Tanzania

BackgroundDespite significant decline in the past two decades, malaria is still a major public health concern in Tanzania; with over 93% of the population still at risk. Community knowledge, attitudes and practices (KAP), and beliefs are key in enhancing uptake and utilization of malaria control interventions, but there is a lack of information on their contribution to effective control of the disease. This study was undertaken to determine KAP and beliefs of community members and service providers on malaria, and how they might be associated with increased risk and persistence of the disease burden in North-western and Southern regions of Tanzania.MethodsThis was an exploratory study that used qualitative methods including 16 in-depth interviews (IDI) and 32 focus group discussions (FGDs) to collect data from health service providers and community members, respectively. The study was conducted from September to October 2017 and covered 16 villages within eight districts from four regions of mainland Tanzania (Geita, Kigoma, Mtwara and Ruvuma) with persistently high malaria transmission for more than two decades.ResultsMost of the participants had good knowledge of malaria and how it is transmitted but some FGD participants did not know the actual cause of malaria, and thought that it is caused by bathing and drinking un-boiled water, or consuming contaminated food that has malaria parasites without warming it. Reported barriers to malaria prevention and control (by FGD and IDI participants) included shortage of qualified health workers, inefficient health financing, low care-seeking behaviour, consulting traditional healers, use of local herbs to treat malaria, poverty, increased breeding sites by socio-economic activities and misconceptions related to the use of bed nets and indoor residual spraying (IRS). Among the misconceptions, some participants believed that bed nets provided for free by the government came with bedbugs while others reported that free bed nets caused impotence among men.ConclusionDespite good knowledge of malaria, several risk factors, such as socio-economic and behavioural issues, and misconceptions related to the use of bed nets and IRS were reported. Other key factors included unavailability or limited access to health services, poor health financing and economic activities that potentially contributed to persistence of malaria burden in these regions. Relevant policies and targeted malaria interventions, focusing on understanding socio-cultural factors, should be implemented to reduce and finally eliminate the disease in the study regions and others with persistent transmission.