Knowledge and practices related to sexually transmitted infections among women of reproductive age living in Katanga slum, Kampala, Uganda.

Background: Sexually transmitted infections (STIs) still stand as one of the commonest health problems affecting women of reproductive age. The knowledge and practices of STIs, among susceptible populations such as women of reproductive age, living in slums like Katanga in Kampala Uganda need to be established. Methods: This was a cross- sectional study with 339 participants in Katanga slum. Data was collected using an interviewer administered questionnaire, entered and analysed using SPSS version 17.0. Data was summarized using frequencies for categorical data and medians for continuous data. Results: Majority of the participants (71.9%) were ≥25years with a mean age of 28.0(SD ±7.0) years. The commonest symptoms known to the participants were genital itching (60%) and genital rash (14.5%). Most mentioned multiple partners (63.7%) and unprotected sex (50.7%) as predisposing factors to STIs. Knowledge on methods of prevention was high (92.3%) however, 18.8% were found positive for STIs using the syndromic approach and 82% mentioned having suffered from STIs in the past 6 months more than once. Conclusion: Most participants did not know about the systemic effects of STIs to their health and did not follow the appropriate behavior patterns despite being knowledgeable about the various methods of prevention of STIs.

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.

Sociodemographic factors influencing adherence to antenatal iron supplementation recommendations among pregnant women in Malawi: Analysis of data from the 2010 Malawi Demographic and Health Survey

Background and Aim: Maternal morbidity and mortality statistics remain unacceptably high in Malawi. Prominent among the risk factors in the country is anaemia in pregnancy, which generally results from nutritional inadequacy (particularly iron deficiency) and malaria, among other factors. This warrants concerted efforts to increase iron intake among reproductive-age women. This study, among women in Malawi, examined factors determining intake of supplemental iron for at least 90 days during pregnancy. Methods: A weighted sample of 10,750 women (46.7%), from the 23,020 respondents of the 2010 Malawi Demographic and Health Survey (MDHS), were utilized for the study. Univariate, bivariate, and regression techniques were employed. While univariate analysis revealed the percent distributions of all variables, bivariate analysis was used to examine the relationships between individual independent variables and adherence to iron supplementation. Chi-square tests of independence were conducted for categorical variables, with the significance level set at P < 0.05. Two binary logistic regression models were used to evaluate the net effect of independent variables on iron supplementation adherence. Results: Thirty-seven percent of the women adhered to the iron supplementation recommendations during pregnancy. Multivariate analysis indicated that younger age, urban residence, higher education, higher wealth status, and attending antenatal care during the first trimester were significantly associated with increased odds of taking iron supplementation for 90 days or more during pregnancy (P < 0.01). Conclusions: The results indicate low adherence to the World Health Organization’s iron supplementation recommendations among pregnant women in Malawi, and this contributes to negative health outcomes for both mothers and children. Focusing on education interventions that target populations with low rates of iron supplement intake, including campaigns to increase the number of women who attend antenatal care clinics in the first trimester, are recommended to increase adherence to iron supplementation recommendations.

Influence of Habitat on the Reproductive Ecology of the Amazonian Palm, Mauritia flexuosa, in Roraima, Brazil

Although Mauritia flexuosa (Arecaceae) plays a pivotal role in the ecology and economy of the Amazon, and occurs in a variety of habitats, little is known about the influence of habitat on the reproductive biology of this palm. My dissertation focuses on the reproductive biology of M. flexuosa in three habitats in Roraima, Brazil: undisturbed forest, undisturbed forest-savanna ecotone, and savanna disturbed by plantations of the exotic tree, Acacia mangium. First, I calculated sex ratios and linked precipitation patterns with phenology. Sex ratios were female-biased. Precipitation was negatively associated with flowering, and positively associated with fruiting. Habitat appears to have no significant influence on phenology of M. flexuosa, although short-term climate variation may affect phenology of this species. Second, I examined floral biology, observed floral visitors, and performed exclusion experiments to determine the pollination system of M. flexuosa. Fruit set did not differ significantly between the visitor exclusion treatment and the control, but was significantly lowest in the wind + visitor exclusion treatment, suggesting that this dioecious palm is anemophilous, independent of habitat. Third, I identified the abiotic and biotic factors explaining variation in fruit mass, seed mass, seed number per fruit, and total fruit yield among habitats. Soil moisture and flooding during the wet season were the best predictors of fruit and seed output. The number of leaves, diameter at breast height, and height were all accurate predictors of reproductive output, but crown volume did not accurately predict fruit yields. Results re-evaluate traditional assumptions about wind-pollination in the tropics, and highlight abiotic and biotic factors responsible for variation in reproductive output of M. flexuosa, with implications for effective management of this palm. Finally, I interviewed harvesters and vendors to document the traditional knowledge and market dynamics of the fruit of M. flexuosa, buriti. Traditional knowledge corroborated results from scientific studies. Vendors argued that the price of buriti must increase, and must fluctuate with varying supply. With appropriate economic incentives to vendors/harvesters, Roraima may expand its market infrastructure for buriti, effectively stimulating the regional economy and practicing sustainable harvesting.

Pollination, herbivory, and habitat fragmentation: Their effects on the reproductive fitness of Angadenia berteroi, a native perennial plant of the south Florida pine rocklands

Angadenia berteroi is a tropical perennial subshrub of the pine rocklands with large yellow flowers that set very few fruits. My dissertation seeks to elucidate the factors that affect the reproductive fitness of Angadenia berteroi a native species of the south Florida pine rocklands. I provide novel information on the pollination biology of this native species. I also assess the effects of herbivory on growth and the reproductive success of A. berteroi. Finally, I elucidate how habitat fragmentation and quality are correlated with reproductive fitness of this native perennial plant.^ Using a novel experimental approach, I determined the most effective pollinator group. I used nylon fishing line of widths corresponding to proboscis diameter of the major groups of visitors to examine pollen removal and deposition. In the field, I estimated visitation frequency and efficacy of each pollinator type. Using potted plants, I exposed flowers to single visit from different types of pollinators to measure fruit set. I performed artificial defoliation with scissors on plants growing in the greenhouse to assess the effects of defoliation before flowering as well as during flowering. Additionally, I used structural equation modelling (SEM) to elucidate how A. berteroi reproductive fitness was affected by habitat fragmentation and quality. ^ My experiments provide evidence that Angadenia berteroi is specialized for bee pollination; though butterflies, skippers and others also visit its flowers, A. berteroi is exclusively pollinated by two native bees of the South Florida pine rocklands . This research also demonstrated that herbivory by the oleander moth may have direct and indirect effects on Angadenia berteroi growth and reproductive success. The SEM results suggested that habitat quality (litter depth and subcanopy cover) may favor reproduction in native species of the South Florida pine rocklands that are properly maintained by periodic fires and exotic control. Insights from this threatened and charismatic species may provide impetus to properly manage remaining pine rocklands in South Florida for this and other endemic understory species.^