Strategies to incorporate empowerment programmes for PMTCT initiatives among multicultural rural women in Zimbabwe

Abstract

HIV and AIDS as one of the leading causes of maternal death worldwide, has got devastating effects that have destroyed the socio-economic fabric. Prevention of Mother-to-Child-Transmission (PMTCT) programmes have been and are still being implemented worldwide but many countries have not yet attained zero prevalence rate of HIV-related maternal and infant mortality. This has motivated the researcher of this study to unearth the strategies that may be employed in women empowerment to alleviate mother-to-child transmission of HIV. The study aimed to explore strategies that can be utilised in incorporating empowerment programmes in PMTCT initiatives from a community psychology perspective. A mixed-method approach was utilised in gathering data from 4 rural districts in Zimbabwe. The study population comprised of permanent rural residents within the age ranges of 15 – 60 from different cultures, community gatekeepers and professionals working within those communities. Proportional stratified random sampling was employed in selecting 200 community members for quantitative data collection, quota sampling was used for selecting participants for 8 focus group discussions and purposive sampling was utilised for selecting 20 community gatekeepers and 20 professionals for semi-structured interviews. Data analysis was conducted using SPSS version 20.0 and thematic analysis. Findings revealed that efforts are being put toward eradicating HIV-related maternal and infant death but some stumbling blocks make women, the primary contributors to the fruition of such initiatives, less active. The impeding factors raised included lack of formal education, harmful cultural or religious beliefs and practices, limited or distorted knowledge about PMTCT, lack of rural women’s economic empowerment, low male partner involvement, lack of adequate personnel, distant or lack of antenatal clinics, poor relations between health professionals and the community as well as stigma and discrimination of HIV positive pregnant women by health professionals or significant others. In light of this, and according to the empowerment theory from community psychology, strategies were proposed targeting women empowerment concerning their sexual reproductive health. Emphasis was put on making use of locally available resources in addressing the devastating effects of HIV and AIDS especially on women and their unborn babies. Lastly, an integrated women empowerment PMTCT model was proposed.

I-HIV ne-AIDS njengenye yezimbangela ezihamba phambili zokufa komama emhlabeni jikelele, ithole imiphumela emibi ecekele phansi isimo senhlalo nezomnotho. Izinhlelo zokuvimbela ukudluliselwa kwegciwane lisuka kumama liye enganeni (PMTCT) seziqalile ukusetshenziswa futhi zisasetshenziswa emhlabeni wonke kepha amazwe amaningi awakasitholi isibalo sokushona kwabantu besifazane kanye nezinsana okuhlobene ne-HIV. Lokhu kugqugquzele umcwaningi walolu cwaningo ukuba avumbulule amasu angahle asetshenziswe ekunikeni amandla abesifazane ukunciphisa ukudluliswa kwegciwane lesandulela ngculaza lisuka kumama liye enganeni. Lolu cwaningo luhlose ukuhlola amasu angasetshenziswa ukufaka izinhlelo zokunika amandla ezinhlelweni ze-PMTCT ngombono womqondo womphakathi. Kusetshenziswe indlela yezindlela ezixubile ekuqoqeni idatha kusuka ezifundeni ezine zasemakhaya eZimbabwe. Isibalo sabantu abafundayo sasinabahlali basemaphandleni abanomphela abaphakathi kweminyaka yobudala eyi-15 - 60 abavela kumasiko ehlukene, abagcini bamasango omphakathi kanye nochwepheshe abasebenza kuleyo miphakathi. Isampuli ehlukaniswe ngokungahleliwe isetshenziselwe ukukhetha amalungu omphakathi angama-200 ekuqoqeni idatha, inani lesampula lisetshenziselwe ukukhetha ababambiqhaza ezingxoxweni zeqembu ezi-8 kanye nesampula elihloselwe ukusetshenziselwa ukukhetha abalindisango bomphakathi abangama-20 kanye nabachwepheshe abangama-20 bezingxoxo ezihleleke kancane. Ukuhlaziywa kwedatha kwenziwa kusetshenziswa uhlobo lwe-SPSS 20.0 nokuhlaziywa kwe-thematic. Okutholakele kuveze ukuthi kwenziwa imizamo yokuqeda ukufa komama nezinsana okuhlobene ne-HIV kodwa ezinye izikhubekiso zenza abesifazane, ababambe iqhaza elikhulu ekutholeni lezi zinhlelo, bangasebenzi. Izithiyo eziphakanyisiwe zibandakanya ukungabi bikho kwemfundo esemthethweni, izinkolelo nemikhuba eyingozi yamasiko noma yezenkolo, ulwazi olunqunyelwe noma oluphazamisekile nge-PMTCT, ukungabi namandla okufukulwa kwabesifazane emaphandleni, ukuzibandakanya kwabesilisa abancane, ukungabi nabasebenzi abenele, ukude noma ukungabi khona kwemitholampilo yabakhulelwe, abampofu ubudlelwano phakathi kwabasebenzi bezempilo kanye nomphakathi kanye nokucwaswa nokubandlululwa kwabesifazane abakhulelwe abane-HIV ngabasebenzi bezempilo noma abanye ababalulekile. Ngenxa yalokhu, nangokuya ngomqondo wokuhlomisa ovela kwezengqondo emphakathini, kwaphakanyiswa amasu abhekiswe ekufukulweni kwabantu besifazane maqondana nempilo yabo yokuzala ngokocansi. Kwagcizelelwa ukusebenzisa izinsiza ezikhona endaweni ukubhekana nemiphumela emibi ye-HIV ne-AIDS ikakhulukazi kwabesifazane nasezinsaneni zabo ezingakazalwa. Okokugcina, kwaphakanyiswa imodeli edidiyelwe yokufukula abesifazane nge-PMTCT.