Sexual health, research and crocodiles: reflections on a Zambian field trip

December 14, 2010

Posted by Ian Hodgson

Senior Research Officer, International HIV/AIDS Alliance

A number of research projects with which the Alliance is engaged are now entering the final stages of data collection and analysis. Following a recent trip to Zambia in connection with one of the larger Africa Regional Programme funded research studies (with some links with ‘Evidence for Action’), I came back with optimism that this particular project was on track to finish at the beginning of 2011, and a new acquaintance with baby crocodiles.

The sexual and reproductive health needs of young people living with HIV attract scant attention in many regions where HIV prevalence is high. A Zambian study – which the Alliance is leading  in collaboration with local agencies – is gathering key qualitative data that could throw some light on respondents’ own perceptions of their lives.

The research will also provide key insights into how effective current services are in providing support around treatment, family planning and general sexual health (people living with HIV are more vulnerable to STIs for example).

The data gathered from the study is essentially text-based. The qualitative nature of this approach is conceptually distinct to other research designs (perhaps the best example of contrasting approach would be a randomised-controlled trial).

Qualitative research aims to understand a person’s lived experience: what do they see? What do they understand? How do they relate to others? Findings are not generalised (samples are not randomised, and often small), but instead are much more person-centred.

A teenage view

Around 60 interviews and focus groups have been undertaken in three areas of Zambia and he data collected so far gives an intriguing insight into people’s experiences. For example, one 14-year old girl living with HIV confirmed that there is a need for expanding information and support services, “We are not taught anything about prevention of pregnancy, safer sex, safe motherhood or child spacing. I would really love to learn more about these things”.

“The doctor did not directly explain things to me” said a 15-year-old teenager, commenting on the lack of engagement with medical staff, “I wish he had. He was only talking to my mother.”

Another teenager noted how to many young people, treatment clinics are not simply somewhere to collect tablets, “Here at the centre”, he said “we have workshops and they teach us a lot of things such as the ‘adventure of life’”.

Hopes for the future

Focused qualitative analysis of the entire dataset commences shortly, and the study is due to complete by the end of January 2011. Findings are expected to be disseminated during February 2011, hopefully with a significant impact on programming as support for this group is (necessarily) scaled up.

Providing support for the study from the UK has been largely successful, local Alliance staff have been instrumental in ensuring that the data are collected, and liaising with research assistants employed for the study. Visits by the Principal Investigator to the region are essential however, moving things along and meeting with the advisory group during this trip were necessary and crucial to ensure that partnership and networking are maximised.

A snappy response

And the baby crocodiles? The hotel fish pond boasts these impressive, albeit compact, beasts.  Watching them lounging on a small stone island in the pond’s centre, I couldn’t help thinking about how prevention (moving them to a zoo, while they’re still small) is a much better option than delaying, and acting only when guests are being chased around the patio by horse-sized monsters.

A lesson for public health perhaps.

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