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Little is known about the prevalence of post-traumatic stress disorder (PTSD) in emerging adults living with HIV in low-income countries.
Aims
Determine prevalence of trauma exposure, prevalence of probable PTSD and conditional prevalence of probable PTSD for different traumatic events; and better understand the experiences of individuals with HIV and PTSD.
Method
This mixed method study used secondary data from a cross-sectional survey of people (N = 222) aged 18 to 29 living with HIV in Zimbabwe and primary qualitative data collection. The PTSD Checklist for DSM-5 (PCL-5) and the Life Events Checklist for DSM-5 (LEC-5) were used to measure PTSD and exposure to traumatic events, both translated to Shona. In-depth interviews (n = 8) with participants who met the criteria for probable PTSD were analysed using thematic analysis.
Results
In all, 68.3% [95% CI (61.4–74.1)] of participants reported exposure to at least one traumatic event. The observed prevalence of probable PTSD was 8.6% [95% CI (5.2–13.0)], most observed following exposure to fire or explosion 29.0% [95% CI (13.0–45.0)] and sexual assault 27.8% [95% CI (7.2–48.7)]. Probable PTSD was also more prevalent following multiple exposure to trauma; four and six events, N = 4 (21%) [95% CI (5.1–8.8)] each, two and three events N = 3 (15.7%) [95% CI (5.9–9.2)] each, and five events N = 1 (5.4%) [95% CI (7.5–9.6)]. Qualitative results indicated that HIV stigma exacerbated psychological distress from trauma.
Conclusions
Despite trauma exposure being common, prevalence of probable PTSD was not high, but was higher in those with multiple exposures. Participants described coping strategies, including social support and religious thinking.
Systematic priority setting is necessary for achieving high-quality healthcare using limited resources in low- and middle-income countries. Health technology assessment (HTA) is a tool that can be used for systematic priority setting. The objective of this study was to conduct a stakeholder and situational analysis of HTA in Zimbabwe.
Methods
We identified and analyzed stakeholders using the International Decision Support Initiative checklist. The identified stakeholders were invited to an HTA workshop convened at the University of Zimbabwe. We used an existing HTA situational analysis questionnaire to ask for participants’ views on the need, demand, and supply of HTA. A follow-up survey was done among representatives of stakeholder organizations that failed to attend the workshop. We reviewed two health policy documents relevant to the HTA. Qualitative data from the survey and document review were analyzed using thematic analysis.
Results
Forty-eight organizations were identified as stakeholders for HTA in Zimbabwe. A total of 41 respondents from these stakeholder organizations participated in the survey. Respondents highlighted that the HTA was needed for transparent decision making. The demand for HTA-related evidence was high except for the health economic and ethics dimensions, perhaps reflecting a lack of awareness. Ministry of Health was listed as a major supplier of HTA data.
Conclusions
There is no formal HTA agency in the Zimbabwe healthcare system. Various institutions make decisions on prioritization, procurement, and coverage of health services. The activities undertaken by these organizations provide context for the institutionalization of HTA in Zimbabwe.
During the Nigerian Civil War, France became the main supplier of military assistance to the secessionist Biafra. In a neo-imperial pursuit to weaken the potential regional hegemon Nigeria, it secretly provided arms and ammunition to the Biafrans in collusion with Côte d'Ivoire and Gabon. Yet the driving force behind this Franco-African arms triangle was not the Elysée, but the Ivorian president Félix Houphouët-Boigny. Newly unearthed documentary evidence from French archives enables this article to break new historiographical ground: firstly, to show the Elysée's sheer reluctance to militarily assist Biafra and lack of a coherent policy in doing so; secondly, to confirm Houphouët-Boigny as the “mastermind” behind the arming of Biafra, as well as to identify his Cold War motivations; thirdly, to uncover Gabonese president Omar Bongo's increasing agency and influence in the scheme; fourthly, to demonstrate that it was the Ivorian and Gabonese presidents who transformed the arms triangle into a square by bringing the Rhodesians and, especially, the South Africans in; and, finally, to retrace the emergence and functioning of the “African-French” military assistance to Biafra at the policy level not only from Paris's, but also Abidjan's and Libreville's perspectives.
During Zimbabwe's war of liberation (1965–80), fought between Zimbabwean nationalists and the minority-white Rhodesian settler-colonial regime, thousands of black soldiers volunteered for and served in the Rhodesian Army. This seeming paradox has often been noted by scholars and military researchers, yet little has been heard from black Rhodesian veterans themselves. Drawing from original interviews with black Rhodesian veterans and extensive archival research, M. T. Howard tackles the question of why so many black soldiers fought steadfastly and effectively for the Rhodesian Army, demonstrating that they felt loyalty to their comrades and regiments and not the Smith regime. Howard also shows that units in which black soldiers served – particularly the Rhodesian African Rifles – were fundamental to the Rhodesian counter-insurgency campaign. Highlighting the pivotal role black Rhodesian veterans played during both the war and the tumultuous early years of independence, this is a crucial contribution to the study of Zimbabwean decolonisation.
The doctrine of subrogation, like many other legal principles in Zimbabwean insurance law, has evolved with changing times. The position in Zimbabwe (which was adopted from English law) is that a subrogated insurer who intends to enforce the insured's right to recover compensation for the insured loss from a third party can only do so in the name of the insured. The reason is that the insured is the custodian of legal rights against the third party; the insurer's rights only relate to the insured and not the third party. This research discusses legal developments in South African law and how they may be adopted in Zimbabwe in order to advance the rights of the parties in subrogation proceedings.
The chapter seeks to understand how the 2030 Agenda expressed through the Sustainable Development Goals (SDGs) and climate urbanism reconfigure urban planning and related processes in Zimbabwe. As discourses of climate change and sustainability have gained traction, urban planning plays a critical role in achieving carbon-free societies. Through the case study of three Zimbabwean cities (Harare, Bulawayo and Gweru), the chapter aims to highlight opportunities and challenges presented to urban planning by Agenda 2030. The chapter employs primary and secondary data sources to understand how urban planning in Africa, and particularly in Zimbabwe, is being shaped by the climate discourse. As such, the chapter contends that there is a seemingly discernible paradigm shift in terms of urban planning processes in Zimbabwe, which seems to be drifting towards a multilateral planning vision dominated by climate-centred urban planning policies. It must be noted that climate-centred urbanisation will be useful in future in curbing and dealing with pandemics like COVID-19. However, it should be noted that climate-centred urban planning processes seem to be more abstract thinking than operationalisation. Finally, the chapter suggests ways to promote a pragmatic shift from abstract thinking to operationalisation of climate-friendly urban planning.
The study looks at the defining features of various labour dispute resolution modes and their appropriateness in Zimbabwe. Researchers used a qualitative approach to collect and analyse data, drawing on a purposive sampling method to select and distribute open-ended questionnaires to 38 participants. The study established that the alternative dispute resolution (ADR) modes used in Zimbabwe are collective bargaining, conciliation, and arbitration, all formalised and regulated by the Labour Act (2015). Nevertheless, these ADR mechanisms have numerous flaws including, that they are not ‘culturally’ close to citizens, and as a result, access to justice is still a challenge, they are also expensive and cannot be easily understood by ordinary employees. Accordingly, the study recommends that the government amend the Labour Act (2015) to return to the old conciliation and arbitration system which was decentralised to the districts. When making the amendments to the Labour Act, the government should also consult with general employees and employers, because they are the victims of the current system. Furthermore, workers’ committees and trade unions should also be empowered to support and educate employees.
Exploring over a century of Zimbabwe's colonial and post-colonial history, Elijah Doro investigates the murky and noxious history of that powerful crop: tobacco. In a compelling narrative that debunks previous histories glorifying tobacco farming, Doro reveals the indelible marks that tobacco left on landscapes, communities, and people. Demonstrating that the history of tobacco farming is inseparable from that of colonial encounter, Doro outlines how tobacco became an institutionalised culture of production, which was linked to state power and natural ecosystems, and driven by a pernicious heritage of unbridled plunder. With the destruction of landscapes, the negative impacts of the export trade and the growing tobacco epidemic in Zimbabwe, tobacco farming has a long and varied legacy in southern African and across the world. Connecting the local to the global, and the environmental to the social, this book illuminates our understandings of environmental history, colonialism and sustainability.
The anti-colonial struggle staged in Zimbabwe against repressive British colonial rule depicted a liberation for equality, freedom and democracy. If Zimbabwe regularly held elections to choose alternative leaders from different political parties in different elections, allowing winners of a free and fair election to assume office; and in turn the winners of one election did not prevent the same competitive uncertainty from prevailing in the next election, the country would be democratic. However, there is no equivalence between elections and democracy. The minimalist conception of democracy is the indispensable institutional characteristic of electoral competition and its uncertainty. The maximalist notion requires extra-electoral imperatives for democracy to fully flourish, incorporating a wide range of types of institutions, processes and conditions to be present for a nation to be called a full democracy. Widespread election violence in 1980 dented Zimbabwe’s opportunity to develop ideal democratic cultures that embrace electoral democracy, government accountability and the rule of law. Post-war political, dissident and election violence proved to be Zimbabwe’s greatest political problem early on. Election and political violence, mhirizhonga or udlakela, largely amongst the Ndebele and Shona was a major concern characterised by intimidation, harassment, vandalism and murders.
The ramifications of election violence in Zimbabwe are huge and ongoing, and the loss of lives in the quest for democratic rights might be regarded as the foremost tragedy of post-colonial Zimbabwe. In this book, Vimbai Chaumba Kwashirai examines the prevalence of electoral violence in Zimbabwe from the early 1980s to the present day. With a range of rich examples, Kwashirai offers a nuanced analysis of the overt and covert forms of violence that have pervaded the country's general elections. While remaining attentive to the specifics of the Zimbabwean political landscape, Kwashirai addresses broader debates in African politics, and shows how insidious violence, ethnic tensions and the weakness of opposition parties serve to undermine democracy across Africa. Adopting an interdisciplinary approach, he explores the various ways in which violence can be understood and, crucially, how it might be prevented.
Nearly all contemporary countries were colonized at some point in their history by a foreign power, but do citizens resent their former metropoles for past colonial abuses? We exploit survey questions in which respondents were asked for their opinion of a named foreign country. Our analyses of responses from over ninety countries yield the surprising finding that today's citizens are more favourable toward their country's former colonizer – by 40 per cent of a standard deviation – than they are toward other countries. Contemporary monadic traits that make former metropoles liked around the world – especially their tendency to be democracies – as well as their relatively high volumes of trade with former colonies explain their popularity among citizens of their former colonies. We also illustrate and describe these patterns in two least-likely cases, Mexico and Zimbabwe. Our findings have important implications for understanding international soft power, an asset about which today's states care deeply.
This case study investigates strategies used by the NGO Leonard Cheshire Disability Zimbabwe (LCDZ) to promote the SRHRs of girls and young women with disabilities in Zimbabwe. The findings show that LCDZ employed a combination of six strategies. These are: (1) building practical knowledge on SRHRs; (2) increasing community awareness and sensitivity; (3) providing SRHRs-related education; (4) enhancing access to justice and related services for survivors of sexual violence; (5) delivering assistive devices; and (6) promoting the livelihoods and economic empowerment. LCDZ made use of multi-stakeholder partnerships to implement these strategies, leveraging complementary skills and experience in the promotion of SRHRs. In each of these strategies, girls and young women with disabilities are the target group, with other stakeholders brought together to support them.
As soon as the Federation of Rhodesia and Nyasaland was formed in 1953, disgruntled white settler politicians in the new polity pushed for the reconfiguration of its borders. Driven by decolonisation struggles across Africa and a surge of anti-colonial nationalism in Nyasaland in particular, these debates were particularly vibrant among the political establishment in Southern Rhodesia, the Federation's dominant constituent. The question of Southern Rhodesia's relationship to the Federation became divisive in right-wing circles as African decolonisation unfolded. However, as the pattern of imperial retreat solidified, the right wing abandoned interest in a reconstructed Federation and unified around a “Southern Rhodesia First” mantra. The “centrist” ruling party, entangled by the Federation's extant scaffolding, was forced to eventually embrace a partition plan which closely resembled the ideas traditionally espoused by the opposition. The process of this ideological realignment had important ramifications for Southern Rhodesian politics. In particular, it facilitated the reunification of the right wing and the embrace of unilateralism that manifested most dramatically in Southern Rhodesia's Unilateral Declaration of Independence in 1965.
Different political projects and ideological positions are founded upon distinct accounts of the past, each with their own emphases, silences, and omissions. The case of Zimbabwe illustrates this connection between power and history. Whereas the myths of colonial historiography provided legitimization frameworks for settler colonialism, “patriotic history” became a key element of the legitimation strategy implemented by the post-independence regime. Pinto analyses how history and historiography were incorporated into narratives of power legitimization in both pre- and post-independence Zimbabwe and how, in the late 90s, history and historiography became critical sites of political polarization and contestation.
Interactions between people and wild animals often result in negative impacts, and different views on the management of such interactions can lead to conflicts. Both intentional and unintentional negative human–wildlife interactions are increasing problems in many places where people share space with wild animals. Here we focus on negative interactions between people and Nile crocodiles Crocodylus niloticus in and around Lake Kariba in Zimbabwe. In the study area, crocodile attacks on people occur frequently, leading to people being injured or killed, which in turn prompts retaliatory actions against crocodiles. However, despite the negative impact of such interactions on both people and crocodiles, little is known about the spatio-temporal patterns of crocodile attacks or environmental conditions under which attacks occur. We collected information about crocodile attacks on people that occurred during 2000–2020, including the date, time, season and location of attacks, the age of victims and the activities they were carrying out when attacks occurred, and water conditions during attacks. We analysed these data to discern patterns and trends of crocodile attacks on people. Attacks occurred in clear as well as turbid water, and nearly half of all reported attacks were at night or in the early morning. The locations with the highest number of recorded attacks were Nyanyana and Charara lakeside, and the fewest attacks occurred at Andora harbour. Most victims were 26–40 years old, and most were attacked in the dry-hot season, while they were fishing. Our findings can be used to design area-specific mitigation strategies to reduce negative human–crocodile interactions.
Countries in Southern Africa face many social, development, economic, trade, education, health, diplomatic, defense, security, and political challenges. These countries also have a history of colonialism, liberatory struggle, and independence. Although the language of business and schooling is English for most of the countries, there are still huge chunks of the population that are illiterate and functionally illiterate. People also speak one or more indigenous languages. The majority of the countries in this region have high levels of unemployment and poverty. Ensuring that psychological assessments are appropriate and fair in these contexts is a huge challenge. When this challenge occurs in a poorly resourced setting against the background of social inequality, practitioners need to be highly resourceful, as well as culturally sensitive and ethically aware. This chapter discusses the historical development of psychological assessment in South Africa, Zambia, Botswana, and Zimbabwe demonstrating how the social and contextual factors interacted with assessment.
Politicized homophobia has become a dominant theme in the study of regime preservation tactics in southern Africa. However, a consensus on the potency of this tool has prevented researchers from fully exploring the conditions of its general success and occasional failure. Frossard de Saugy fills this gap with a thorough examination of the strategies of politicized homophobia deployed by the Robert Mugabe regime, their connection to hegemonic masculinity, the liberation war, and land questions, and the conditions which led them to lose their potency and ultimately fail to save Mugabe from mounting domestic challenges.