Muzyamba Choolwe, Groot Wim, Tomini Sonila, Pavlova Milena
Maastricht Graduate School of Governance/UNU-Merit, Maastricht University, Maastricht, The Netherlands.
Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands.
BMC Health Serv Res. 2018 Mar 2;18(1):155. doi: 10.1186/s12913-018-2959-3.
Research has shown that community mobilization is a useful strategy in promoting maternal care of HIV negative women in resource poor settings; however, similar evidence for women living with HIV is missing. Therefore, in this study we provide this evidence by exploring the relevance of community mobilization in the promotion of maternal health care among women living with HIV in resource-poor settings by using Mfuwe, a rural district in Zambia as a case study.
By relying on Focus Group Discussions (FGDs), qualitative data were collected from Mfuwe, Zambia. The data were digitally recorded, transcribed and later translated from CheChewa (local language) to English. We relied on Thematic analysis to analyze the data.
By focusing on community mobilization, our results showed that within their social fabrics, resource-poor communities often contain unrecognized and sometimes ignored strategies which are contextually-feasible and have been used for generations to promote maternal care for HIV positive women. Further, it was evident that although the three forms of community mobilization were largely and uniquely useful in promoting maternal health care of women living with HIV, they also presented unique and various shortcomings.
We demonstrated that community mobilization was largely and often characterized as a force for good (e.g. providing support, improving access to maternal care etc.) and sometimes for bad (e.g. reinforced harmful misconceptions, superstition and stigma). Thus we recommend that community mobilization needs to be factored into maternal health care policies for HIV positive women in resource poor settings either to optimize their potential benefits or to minimize their potential harm.
研究表明,社区动员是在资源匮乏地区促进艾滋病毒阴性妇女孕产妇保健的一项有用策略;然而,针对感染艾滋病毒妇女的类似证据却缺失。因此,在本研究中,我们以赞比亚的一个农村地区姆富韦为例,通过探讨社区动员在资源匮乏地区促进感染艾滋病毒妇女孕产妇保健方面的相关性,来提供这一证据。
通过焦点小组讨论(FGD),从赞比亚的姆富韦收集定性数据。数据进行了数字记录、转录,随后从奇切瓦语(当地语言)翻译成英语。我们依靠主题分析来分析数据。
通过关注社区动员,我们的结果表明,在其社会结构中,资源匮乏社区往往包含一些未被认识且有时被忽视的策略,这些策略在当地可行,并且世代相传用于促进对艾滋病毒阳性妇女的孕产妇保健。此外,很明显,尽管三种社区动员形式在促进感染艾滋病毒妇女的孕产妇保健方面在很大程度上且独特地有用,但它们也存在独特且多样的缺点。
我们证明,社区动员在很大程度上往往被视为一股有益力量(例如提供支持、改善孕产妇保健服务的可及性等),但有时也是有害力量(例如强化有害的误解、迷信和耻辱感)。因此,我们建议,在资源匮乏地区,针对艾滋病毒阳性妇女的孕产妇保健政策需要考虑社区动员因素,以优化其潜在益处或尽量减少其潜在危害。