Nyangulu Mtemwa, Aholou Tiffiany, Thorsen Viva, Ebrahim Shahul, Nkhoma Ernest, Payesa Chipiliro, Chipungu Getrude, Kalua Masozie, van 't Pad Bosch Jeroen, Gibson Hannah, Buie Verita, Sindani Fidelis, Dale Helen, Behel Stephanie, Hassan Rashida, Maida Alice, Grabbe Kristina
US Centers for Disease Control and Prevention, Lilongwe, Malawi.
Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, USA.
J Epidemiol Glob Health. 2024 Dec;14(4):1545-1554. doi: 10.1007/s44197-024-00306-5. Epub 2024 Oct 10.
In Malawi approximately, 88.3% people living with HIV are aware of their HIV status. Significant gaps are among men aged 15-34 years; only 72% know their HIV status. To reach men, Jhpiego, in collaboration with the Ministry of Health (MOH), implemented the Men's Mobile Wellness Clinic (MMWC) at workplace settings in Blantyre, Malawi between October 2019 and March 2020.
We conducted a descriptive qualitative study to understand motivators and barriers to MMWC service uptake by employees and employers. Primary data was drawn from in-depth telephone interviews from four study populations: employers who accepted or declined to host the MMWC at their worksite, and employees who accessed or did not access the services. We performed a thematic analysis using Nvivo 12 software to identify patterns and themes across the dataset.
Main reasons given for using the service among male employees were a desire to know their health status, availability of free health services at the workplace, and good quality services offered by MMWC staff, and support from their supervisor. Men who did not access services stated reasons such as work-clinic scheduling conflicts, lack of adequate promotion of the service, and miscommunication on the criteria about who should attend the MMWC. Employers who accepted to host the MMWC stated convenience and employee's rights to know their health status. Those who declined either stated that employees did not want the services or COVID-19 preventive measures by the MOH between October 2019 and March 2020 restricted participation.
This study underscores the potential utility of MMWC services including HIV testing among men. The desire to know their health status, availability of free MMWC services at the workplace, good quality services offered by MMWC staff, and the endorsement of MMWC by supervisors were main motivators to access the MMWC services. Sensitizing supervisors and employees about the benefits of the MMWC services, strengthening demand creation, and clarifying eligibility are important to facilitate MMWC uptake among men in Malawi.
在马拉维，约88.3%的艾滋病毒感染者知晓自己的感染状况。15至34岁男性群体中存在显著差距，只有72%的人知道自己的艾滋病毒感染状况。为了覆盖男性群体，杰hpiego与卫生部合作，于2019年10月至2020年3月在马拉维布兰太尔的工作场所设立了男性移动健康诊所（MMWC）。
我们开展了一项描述性定性研究，以了解员工和雇主接受MMWC服务的动机和障碍。主要数据来自对四类研究人群的深入电话访谈：在工作场所接受或拒绝主办MMWC的雇主，以及接受或未接受服务的员工。我们使用Nvivo 12软件进行主题分析，以识别数据集中的模式和主题。
男性员工使用该服务的主要原因包括希望了解自己的健康状况、工作场所提供免费健康服务、MMWC工作人员提供的优质服务以及主管的支持。未接受服务的男性表示的原因包括工作与诊所的时间安排冲突、对该服务的宣传不足以及关于谁应参加MMWC的标准沟通不畅。接受主办MMWC的雇主表示方便以及员工有权了解自己的健康状况。拒绝的雇主则表示员工不想要这些服务，或者2019年10月至2020年3月期间卫生部的新冠疫情预防措施限制了参与。
本研究强调了MMWC服务在男性中开展艾滋病毒检测等方面的潜在效用。了解自己健康状况的愿望、工作场所提供免费的MMWC服务、MMWC工作人员提供的优质服务以及主管对MMWC的认可，是促使人们接受MMWC服务的主要动机。提高主管和员工对MMWC服务益处的认识、加强需求创造以及明确资格标准，对于促进马拉维男性接受MMWC服务至关重要。
