A community-based intervention for improving utilization of medical services by rape survivors in refugee camps in Zambia

Background: Rape is the most common form of violence in conflict and refugee situations but because of the associated stigma few cases are reported. This study assessed the outcome of an intervention targeted at women groups on the utilization of medical services by rape survivors in refugee camps in Zambia.Methods: A prospective quasi-experimental community-based intervention study was carried out in two refugee camps allocated into intervention and comparison areas. The intervention was participatory education sessions for women groups. Data was collected using the clinic records and the main outcome was the number of rape survivors who utilized and completed medical services provided at the camp clinics. Univariate, bivariate and multivariate analyses were carried out with level of significance set at 5%.Results: The proportion of the rape survivors who accessed medical care within 72 hours increased significantly from 41.2% to 84.8% in the intervention area but from 31.1% to 38.9% in the comparison area, (p=0.005). Those who completed their medical treatment and the follow-up visits increased significantly from 42.8% to 94.8% in intervention area but reduced from 38.5% to 21.4% in the comparison area, (p=0.002). Being resident in the intervention area predicted the utilization of medical services, [OR: 3.15; 95%CI: 1.955-5.681], p=0.002. Conclusion: Community-based intervention using participatory women's group discussion had a significant impact on increasing the utilization of medical services by rape survivors and should be considered for scaling up as a key intervention for increasing utilization of medical services for rape survivors especially in refugee situations

African primary care research: participatory action research

This article is part of the series on African primary care research and focuses on participatory action research. The article gives an overview of the emancipatory-critical research paradigm; the key characteristics and different types of participatory action research. Following this it describes in detail the methodological issues involved in professional participatory action research and running a cooperative inquiry group. The article is intended to help students with writing their research proposal

African primary care research: reviewing the literature

This is the second article in the series on African primary care research. The article focuses on how to search for relevant evidence in the published literature that can be used in the develop -ment of a research proposal. The article addresses the style of writing required and the nature of the arguments for the social and scientific value of the proposed study; as well as the use of literature in conceptual frameworks and in the methods. Finally; the article looks at how to keep track of the literature used and to reference it appropriately

PURE ifying Research on Chronic Non-Communicable Diseases in South Africa

Chronic non-communicable diseases (NCDs) such as diabetes; cardiovascular disease (CVD) and cancers are a major public health problem. In an effort to increase awareness about the behavioural risk factors for NCDs a community-based project was implemented in Khayelitsha. Informed by the results of this study the School of Public Health at the University of the Western Cape joined the Prospective Urban and Rural Epidemiology (PURE) study in January 2009. The study seeks to scientifically document the root-causes of the traditional risk factors for NCDs by following-up adults aged 30 to 75 years for 12 to 15 years and collecting individual-; household-; community- and national-level information. Responding effectively to the growing burden of NCDs incorporates addressing societal and biological pathways from environmental causes to primordial predispositions and adequately managing the primary risk factors

Researching to Make a Difference: Possibilities for Social Science Research in the Age of AIDS

HIV and AIDS is recognized as one of the most devastating pandemics of sub-Saharan Africa; and South Africa in particular; with adverse effect on individuals; families; schools; communities and society at large. Research is therefore required to provide a deeper understanding of the complexities of HIV and AIDS in order to mitigate the effect of the pandemic. Much of the excellent research that has been done has been undertaken within a positivist paradigm and has focused on the biomedical aspects of HIV and AIDS; as well as the social aspects of the pandemic. This theoretical position paper draws on various projects in the field of HIV and AIDS education in rural KwaZulu-Natal to argue that more social science research should be framed within a participatory research paradigm; foregrounding participant engagement and process; and which simultaneously has a 'research-as-intervention' focus. Such research adheres to the requirement of knowledge production; but also engages the participants as knowledge producers who; through the research process; are enabled to shift towards taking up their own agency. Reflecting on the findings from the various projects suggests that visual participatory methodologies are particularly useful when working with marginalized persons whose voices are seldom heard especially when exploring topics which are difficult to discuss. Furthermore; it brings issues to the fore and opens up debate; while at the same time democratizing research and allowing universities to take up their social responsibility and to contribute towards making a difference in the communities they serve

Medical Student Participation in Community-based Experiential Learning: Reflections From First Exposure to Making the Diagnosis

Background: Fifth-year medical students from the University of Pretoria participated in a four-week rotation in the primary care clinics of a large metropolitan centre. An academic service-learning (ASL) approach was introduced into this rotation to improve the integration of theoretical learning and clinical practice through relevant community service and structured reflection.Methods: Students wrote semi-structured reflective journals as a means to gaining greater insight into their learning experiences. These reflections were analysed qualitatively with a view to improving the community-based curriculum.Results: Four major themes were identified: expectations and the reality of primary care; service and learning; becoming a doctor; and making a difference.Conclusion: While students gained a deeper insight into their development as clinicians; using an ASL approach also assisted the faculty in making an informed educational diagnosis of the curriculum