Globally, Gender-Based Violence and Femicide (GBVF) remains a multifaceted social issue in the 21st century. Despite the ratification of international treaties and national laws, South Africa continues to have alarmingly high levels of GBVF, which were worsened during the Covid-19 national lockdown. The 2020 crime statistics reported that one in five South African women were victims of GBVF and South African Police Services (SAPS) data from 2015 to 2020 showed that seven women are killed daily nationwide. Despite copious studies on GBVF, the voices of local community members and activists as key collaborators in such research have been excluded. Therefore, this study used a mixed methods approach to determine the known interventions to decrease or eliminate GBVF and their effectiveness in seven communities across South Africa. The study included 191 participants in a survey for the quantitative aspect as well as a qualitative aspect of the study. Community members participated in gender-specific focus group discussions, while activists had a focus group of their own to obtain data on interventions. Our findings showed that three main forms of interventions existed in South Africa, viz. government-led campaigns that normally occurred during the 16 days of activism against violence towards women and children, community-led campaigns in response to GBVF cases reported in the media as well as NGO-led initiatives to support GBV survivors. However, these interventions were stifled by the social and cultural stigma against reporting GBVF, a lack of sustainability, decreased visibility, poor organisation and management as well as a lack of funding. Therefore, our findings show that while the South African government has made strides in its efforts to eliminate GBVF, there are no sustainable community level programming and interventions aimed at changing social norms and toxic masculinity that perpetuate GBVF. In conclusion, we recommend that efforts be made to implement intervention initiatives that go beyond creating awareness on GBVF, but partner with local NGO-led organizations to engage in programming and intervention that is aimed at changing social norms.

BACKGROUND: Community health workers (CHWs) bridge the primary health care (PHC) system and communities by providing care in the household. In Malawi, few studies have examined the perspective of users of household-level CHW services, in remote areas, to understand CHW\'s role in community-based PHC.
OBJECTIVE: To explore perspectives of community and facility stakeholders on the enablers and challenges of the CHW role in community-based PHC in Neno District.
METHODS: The study was conducted in the Neno District health facilities, namely, Ligowe, Dambe, Chifunga, and Zalewa.
METHODS: We conducted eight focus group discussions (FGDs) with purposively sampled community members and conveniently sampled facility stakeholders. Data were transcribed and analysed thematically through an adapted COM-B model of behaviour change.
RESULTS: Three main themes of perceived behaviour change within the CHW role were identified: (1) capacity - the CHW programme aids health education and promotion within the community; (2) opportunity - the CHW programme facilitates community-based PHC and linkage to the facility; and (3) motivation - the CHW programme enablers and challenges in providing community-based PHC.
CONCLUSIONS: Community health workers enrich community-based PHC delivery through health education, timely access to care, and linking communities to the facility. Optimising workload and programme support is critical for the help of CHWs. Further studies are required to address programme and cultural challenges to enhance positive health-seeking behaviours.Contribution: This study provides contextual knowledge for further research on bringing together spiritual and formal health practices and considering the cultural background when planning for health interventions in remote areas.

BACKGROUND: COVID-19 is still a disease of global public health importance which requires long term application of control measures as millions of new infections or re-infections and thousands of related deaths still occur worldwide and the risk of an upsurge from new strains of the virus continues to be a threat. The decrease in the use of and non-use of preventive public health measures are among the factors fuelling the disease. The (previous) experiences and perceptions of people regarding the COVID-19 pandemic, COVID-19 vaccination, and the vaccination process are factors that will influence subsequent use of preventive/control measures. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the community members in Ebonyi state, Nigeria.
METHODS: We conducted an analytical cross-sectional study between March 12 and May 9, 2022 among all consenting/assenting community members aged 15 years and above in 28 randomly selected geographical clusters. A structured interviewer-administered electronic questionnaire in KoBoCollect installed in android devices was used to collect data which was analysed using descriptive statistics and bivariate and multivariate generalized estimating equations.
RESULTS: Of the 10,825 community members surveyed: only 31.6% had strong COVID-19 experience and perception, 72.2% had good COVID-19 vaccination expectation and perception, and only 54.2% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent/level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of attitude towards COVID-19 and COVID-19 vaccination and level of knowledge about COVID-19. Other important predictors were marital status, educational level, and main occupation.
CONCLUSIONS: This study\'s evidence, including the identified predictors, will inform subsequent policy actions regarding COVID-19 in the strategies to improve the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of community members (and their use of preventive/control measures) in Ebonyi state and Nigeria, and other similar contexts. It will also inform future policy actions/strategies regarding similar diseases.

We investigated the involvement of community members in response to the Ebola Virus Disease (EVD) epidemic in the North Kivu and Ituri provinces of the Democratic Republic of Congo. This cross-sectional study, conducted using mixed methods of data collection, included a uniformly structured questionnaire survey, which was administered to 800 randomly selected adults (aged ≥ 18 years). Further, we used qualitative tools of inquiry-focus group discussions (FGD) and in-depth interviews (IDI)-to guide the context of the information collected in the survey. Community leaders, religious leaders, and Ebola survivors were interviewed using the IDI guide, while young men (≤ 30 years), young women (≤30 years), adult community males (<30 years), and adult community females (<30 years) were in separate FGD sessions. The results revealed that the urban area was the most affected by the epidemic (79.2%) compared to 20.8% in rural areas. The χ2 calculated was 18.183 (P<0.001). Community members exhibited varying degrees of involvement in response to the EVD epidemic in the two provinces. Community members were mostly engaged in information dissemination. However, they believe they could have contributed more if they had been fully engaged. These findings were derived from the qualitative data. The study contributes to evidence on how community involvement could help response to public health events globally, hence this study provides valuable insights for future public health interventions and response.

UNASSIGNED: Early detection and prevention of diseases can reduce morbidity, mortality, and economic burden. There is need to assess the utilization of preventive services for common chronic diseases, cancers, and vaccinations. This study aimed to estimate the prevalence and sequence of utilization of preventive services for common chronic diseases, cancers, and vaccinations in addition to exploring community perspectives on these services.
UNASSIGNED: This study was a cross-sectional survey, which was conducted at primary healthcare centers in Prince Sultan Military Medical City covering Riyadh region from October 2022 to January 2023. The study used a self-administered questionnaire to collect data from attendees aged 18 years and older, focusing on the utilization of eight preventive services (blood glucose testing, blood pressure measurement, cholesterol testing, screening for breast cancer, screening for cervical cancer, screening for colorectal cancer, screening for prostate cancer, and flu and pneumococcal vaccines). Descriptive statistics of the study were reported in frequencies and percentages. Chi-square test was used to assess association between outcome variables.
UNASSIGNED: Participants were mostly married and had a higher educational degree. However, a considerable number is not accessing primary healthcare services regularly. The results showed that the rate of utilizing preventive services was as follows: blood pressure screening (91%), blood glucose testing (72%), cholesterol testing (65.8%), vaccination utilization (39.5%), breast cancer screening (8%), prostate cancer screening (4.6%), colon cancer screening (4.2%), and least utilized was cervical cancer screening with frequency of (3%).
UNASSIGNED: The results underscore the importance of increasing awareness and accessibility of primary healthcare services to promote better health outcomes in the region.

Substance use is a major public health issue in South Africa. Cocktails, containing two or more low-quality substances, have been reported. Nyaope is one of the most popular and is widely available. It has a significant impact on users and communities. The aim of this study was to explore community members\' perceptions of the potential contributors to Nyaope use and dependency.
This was an exploratory descriptive qualitative study that conducted three focus group interviews with 29 community members. A maximum variation sample was used. Data were analysed using the framework method, assisted by Atlas-ti.
Seven main themes were identified, namely unfavourable home environments, distrust between community members and the local police, easy access to Nyaope at school, inadequate social services, lack of religious or spiritual drive, unfavourable community environments and the effects of Nyaope on users.
The factors identified, were used to construct an emerging model of how Nyaope use is driven in Tshwane. It is clear that a multisectoral response is required involving health and social services, basic education, policing and community leadership. Further research will explore the views of family members and users and quantify the importance of the factors identified.Contribution: This study showed that rather than a simple linear chain of events, Nyaope use is enabled by a complex system of interconnected elements. According to the respondents, variables in the community at large, the school, the home and the specific user all have a role in Nyaope usage and dependency.

Autistic youth and adults are more likely to experience psychiatric symptoms (e.g. depression, anxiety) and to use psychiatric services than non-autistic people, yet research on evidence-based approaches to enhance psychiatric care for autistic people is limited. Measurement-based care is an evidence-based approach to psychotherapy that improves outcomes for clients, clinicians, and organizations by routinely administering and evaluating measures to clients. Despite this, research on measurement-based care systems for autistic clients is sparse. To address this gap, we developed an autism-adapted measurement-based care (MBC-AUT) system for and with autistic people and pilot tested the system in an outpatient psychiatry clinic to investigate the preliminary feasibility, acceptability, benefits, and barriers to this system for clients and clinicians. Findings suggested that the MBC-AUT system was a feasible and acceptable system for the first 18 autistic youth, their caregivers, and autistic adults to use the system. In semi-structured interviews, clients and clinicians discussed the benefits of the MBC-AUT system to various therapeutic processes, as well as several important barriers to the use of the system. We offer potential solutions to address these barriers and to reduce client and clinician burden, and propose future directions for this line of research to increase access to more autistic people. As autistic clients continue to seek psychological services amid social landscapes of increasing complexity (e.g. COVID-19 pandemic), efforts to enhance the delivery of psychotherapy for this population are critical.

To investigate the association between individual and community-level measures of HIV stigma and HIV incidence within the 21 communities participating in the HPTN (071) PopART trial in Zambia and South Africa.
Secondary analysis of data from a population-based cohort followed-up over 36 months between 2013 and 2018. The outcome was rate of incident HIV infection among individuals who were HIV negative at cohort entry. Individual-level exposures, measured in a random sample of all participants, were: (1) perception of stigma in the community, (2) perception of stigma in health settings and (3) fear and judgement towards people living with HIV. Individual-level analyses were conducted with adjusted, individual-level Poisson regression. Community-level HIV stigma exposures drew on data reported by people living with HIV, health workers and community members. We used linear regression to explore the association between HIV stigma and community-level HIV incidence.
Among 8172 individuals who were HIV negative and answered individual-level stigma questions at enrolment to the cohort, there was no evidence of a statistically significant association between any domain of HIV stigma and risk of incident HIV infection. Among the full cohort of 26,110 individuals among whom HIV incidence was measured, there was no evidence that community-level HIV incidence was associated with any domain of HIV stigma.
HIV stigma is often cited as a barrier to the effectiveness of HIV prevention programming. However, in the setting for the HPTN 071 \"PopART trial,\" measured stigma alone was not associated with the risk of HIV infection.

This study investigated the forms of decentralization and how they can bring about educational accountability in Tanzania. Open-ended questionnaires, interviews, focus group discussions and documentary reviews were methods for data collection. The findings indicate that the school committee as a representative organ of the community and parents in a decentralized educational management system, succeeded in improving the attendance rate, maintaining discipline, and controlling truancy among pupils. The findings also indicate that the teachers and school committee members appreciated the financial transparency in their schools. However, teachers commented that school committee members concentrated their attention on the Primary School Leaving Examinations (PSLE) and financial matters without ensuring that schools improve the environment in which education is provided for teachers to be accountable for the pupils\' learning. Further, it was, found that financial contributions from the parents and community members were a challenge because of a lack of awareness of the importance of education for their children. It is argued in this paper that although financial contributions from the community members are necessary for the school development plans, the government needs to play a leading role in the provision of education to safeguard the poor and fight inequality in education.

UNASSIGNED: the 2014 Ebola virus disease (EVD) outbreak in Nigeria has further raised the awareness of health-care workers (HCWs) and community members (MCs) on the threat posed by infectious diseases and the need for improvement on infection control practices. However, awareness of dangers of increasing incidences of antimicrobial resistance (AMR) in hospitals and communities remained low.
UNASSIGNED: a cross-sectional survey of awareness of 195 HCWs and 265 MCs toward EVD and AMR was conducted through a structured questionnaire.
UNASSIGNED: majority of HCWs (95.4%) and MCs (82.8%) still have knowledge of EVD´s danger and give reasons like its unique way of killing and unavailability of drugs for their awareness. Only 17.2% of MCs are aware of AMR as a problem, and only 3.4% of MCs and 10.3% of HCWs agreed that AMR is more dangerous than EVD. On the contrary, 76.4% of doctors, 95.1% nurses, 67.9% laboratory scientists, 66.7% pharmacists, 77.4% students and 100% of civil servants, drivers and religious leaders believed that EVD is more horrific and spread faster. They both attributed the rapid awareness of EVD in Nigeria, despite being new at the time of the outbreak, to the seriousness with which stakeholders and the media fought EVD, the gesture AMR is yet to receive. Though both HCWs and MCs agreed that prevention, not treatment is the best option to tackle Ebola like-diseases, but surprisingly, about 37% and 65% of HCWs and MCs respectively, still believe that traditional medicines can be used to treat Ebola related illnesses.
UNASSIGNED: AMR awareness remains low among MCs and some HCWs when compared with EVD. It is recommended that efforts put in place during EVD outbreak by all stakeholders and the media need to be doubled to increase the knowledge of both HCWs and MCs toward AMR.