Communication of reproductive health information to the rural girl child in Filabusi, Zimbabwe.

Background: Despite a number of programs aimed at the transfer of reproductive health information, adolescents in Zimbabwe still face unprecedented reproductive challenges. Objectives: The study sought to explore adolescent girls’ knowledge of their sexual and reproductive health; the factors that influence their sexual behaviors and to determine the extent to which adolescents had access to sexual and reproductive health information. Methods: The case study methodology was used for the study. The interpretive paradigm was used as the methodological theory and Grunig’s model of excellence in communication was used as the substantive theory. Data was obtained through the use of focus group discussions and indepth interviews. Results: Although adolescents knew the different types of sexually transmitted diseases and were aware of the consequences of engaging in risky sexual behaviors, they engaged in health behaviors which had potential for serious consequences. The study established that adolescents did not have adequate access to sexual and reproductive health information. Sexual issues were not adequately addressed both at school and at home. Conclusion: Adolescents lack adequate access to reproductive health information and there is need for effective communication programs that contribute towards the understanding of communicated messages by audiences and the understanding of audiences by communicators.

Reproductive decisions of couples living with HIV in Malawi: What can we learn for future policy and research studies?

Background The rapid scale-up of free antiretroviral therapy has lead to decline in adult mortality at the population level and reduction of vertical transmission. Consequently, some couples living with HIV are maintaining their reproductive decisions; marrying and having children. This paper analyses policies and guidelines on HIV, AIDS and sexual and reproductive health in Malawi for content on marriage and childbearing for couples living with HIV. Methods A qualitative study using interpretive policy analysis approach was conducted from July to December 2010 in two phases. First, data on access to HIV, AIDS and sexual and reproductive health services were collected using in-depth interviews with twenty couples purposively sampled in matrilineal Chiradzulu and patrilineal Chikhwawa communities. Secondly, data were collected from Malawi policies and guidelines on HIV, AIDS and sexual and reproductive health. The documents were reviewed for content on marriage and childbearing for couples living with HIV. Data were analysed using framework approach for applied policy analysis. Results Four categories emerged from each phase. From the study, we extracted health workers attitudes, weak linkage between HIV, AIDS and sexual and reproductive health services, contradictory messages between media and the hospitals and lack of information as factors directly related to guidelines and policies. Analysis of guidelines and policies showed nonprescriptiveness on issues of HIV, AIDS and reproduction: they do not reflect the social cultural experiences of couples living with HIV. In addition, there is; lack of clinical guidelines, external influence on adoption of the policies and guidelines and weak linkages between HIV and AIDS and sexual and reproductive health services. Conclusion This synthesis along with more detailed findings which are reported in other published articles, provide a strong basis for updating the policies and development of easy-to-follow guidelines in order to effectively provide services to couples living with HIV in Malawi.