ABSTRACT
Objective: This study explored the challenges that older women from selected sites in Botswana face in accessing services that address sexual and reproductive health (SRH) and family planning (FP) needs. Design; setting and subjects: Two rural and two urban health districts were randomly selected for the study. A statistically determined sample of 454 older women was allocated to the different districts (strata); using probability proportional to size. Outcome measures: The study estimated the percentage use of sexual and reproductive health services (including family planning services); unmet need for family planning and factors inhibiting use of these services. Results: The study revealed that 25 of the older women used some type of FP method. Of this number; 67.9 were aged 50-59 years; 17.4 60-69 years; 10.1 70-79 years; and 72 had unmet needs for FP. The older women used natural FP methods mainly. The main SRH services used by them were screening for human immunodeficiency virus/acquired immune deficiency syndrome; sexually transmitted infections and cervical cancer. Obstacles to accessing SRH and FP services were found to include illiteracy; lack of education; financial constraints; a perception that healthcare planners limited SRH needs to antenatal and obstetrical services; a cultural reluctance to discuss SRH in public and domestic issues.Conclusion: The study recommends comprehensive public health education for older women on human sexuality and fertility; contraceptive use; access to services; effective training programmes for healthcare providers on how to deal with older women's issues and better access to STI and cervical cancer screening services
Subject(s)
Health Planning , Health Services for the Aged , Multiphasic Screening , Reproductive Health , Sex Education , Women , Women's Health ServicesABSTRACT
Background: Caregivers; when providing care under the community home-based care (CHBC) programme; experience many burdens of a physical; emotional; financial or social nature. However; these problems are hardly ever considered by the planners of CHBC programmes. A comprehensive overview of the experiences of caregivers is desirable to help policy makers and public health planners formulate intervention measures to address caregivers' burdens. Methods: The sample size calculator programme that allows for 95 confidence (and an error margin of 4) was used: the estimated sample size for the study was 272. This number was derived from the eight sampled CHBC groups using probability proportional to size. Simple random sampling was employed in identifying the specific caregivers to be interviewed. Questionnaires were administered on this selected sample at their homes or CHBC headquarters by trained research assistants who ensured that all ethical considerations were observed. In the end; 169 caregivers responded within the study period. Results: The study shows that very little support is given to caregivers. In addition; while men's burdens are mainly economic; those of women are overwhelmingly emotional. Furthermore; there is an insignificant association between caregivers' expected and received support while providing care to people living with HIV/AIDS. Conclusion: The study concludes that; to reduce caregivers' burdens; a comprehensive CHBC programme; that will ensure that the role of CHBC caregivers is adequately recognised by the government and community; is needed