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Browsing Journals by Author "Mwandali, Bupe K."

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    Availability, Range and Utilization of Sexual and Reproductive Health (SRH) Services for Adolescents at Kinondoni Municipality, Dar es Salaam—Tanzania
    (Open Journal of Nursing, 2020-03-27) Mwandali, Bupe K.; Mwakanyamale, Adela A.
    It is estimated 1.2 billion of world’s population are adolescents aged 10 - 19 years; 80% live in developing countries. Adolescents in developing countries especially Sub-Saharan Africa (SSA) face high burden of sexual and reproductive health problems. Sixteen million girls aged 15 to 19 years give birth every year of which 95% occur in low- and middle-income countries. Twenty five percent of unsafe abortions are in 15 - 19 years in Sub-Saharan Africa. Contraceptive use is low as approximately 10% of adolescents are current users. These problems can be averted if different ranges of Sexual and Reproductive Health Services for adolescent (SRHSA) are available and utilized by adolescents. In Tanzania, there is limited information addressing the availability, types and utilization pattern of sexual and re- productive health services by adolescents. This study investigates the availability, range and utilization of sexual and reproductive health services for adolescents (ASRHS) at Kinondoni Municipality, Tanzania. Method: A cross-sectional study was carried out in April to May 2013. A checklist was used to collect information on the availability and range of services offered at selected health facilities. In depth interviews conducted with incharges of Reproductive and Child Health (RCH) clinics to explore barriers for provision Of Sexual and Reproductive Health Services (SRHS) for adolescents. Adolescents were questioned using a questionnaire on utilization of SRHS and perceived barriers. Descriptive statistics were used to summarize quantitative data and content analysis for qualitative data. Results: On availability and range of adolescents’ sexual and reproductive health services, a total of 25 health facilities were surveyed. Forty four percent of the surveyed facilities did not have the adolescent sexual and reproductive health services (ASRHS). The Adolescents Sexual and Reproductive Health (ASRH) services offered differed greatly between facilities. On utilization of adolescents’ sexual and reproductive health services in total, 204 adolescents from the community were involved in this study. A third of adolescents reported to have ever used ASRH. The adolescents perceived barriers for underutilization of the services were fear of being seen at the clinics (23.3%), lack of money (18.3%), lack of privacy & confidentiality (14.2%) and unfriendly health care providers. Three barriers were perceived by health care providers in the provision of ASRHS: integration of SRHS, lack of training in relation to adolescents SRHS and attitudes of health care providers towards young people. Conclusion: About half of the health facilities did not have the SRH-services to adolescent (44%) and different ranges of services were not offered at the facilities as it was shown in the records. The results from this study show services were underu- tilized by adolescents. Training, attitudes of health care providers towards young people, & cost influenced ASRHS provision and utilization. Strategies to increase training in ASRHS for health providers including communication skills and scaling ASRH services to all primary care facilities may help to improve availability and access of services to adolescents. Keywords Adolescent, Sexual Health, Reproductive Health, Utilization, Barriers to ASRH Services, Kinondoni Municipality and Tanzania
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    Perceived Gender Inequality and Psychological Well-being in Women Aged 18 to 25 Years: An Integrative Review Design
    (Journal of Community Medicine and Public Health Reports, 2023-07-06) Mwandali, Bupe K.
    Purpose: To determine how perceived gender inequality in women between 18 to 25 years affects their psychological well-being. Methods: An integrative review design was conducted, guided by Whittemore and Kanfl's (2005) five steps. Published peer-review articles were searched from CINAHL, PubMed, Google Scholar, and other sources. Four papers were included in the review, organized and summarized in the table. The documents' quality was evaluated using Johns Hopkins, and all pieces were at level III (B). Results: Higher prevalence of gender inequality was perceived among Black women more than White women from different settings, with a higher percentage in service provision (91.3 %). All articles showed direct connections between psychological effects and gendered racism. One study reported that 73 % of participants suffered from stress. Approximately all participants used disengagement as a coping mechanism, which in turn increased the psychological effects due to poor social support. Conclusions: The magnitude of gender inequality was higher among African American women with poor coping and support systems, which increased the psychological distress among participants. The government and stakeholders should develop strategies that focus on integrating social systems and policies to support the reduction of gendered racism. The intersectionality framework was highly suggested in research and practice. Keywords: Gendered inequality, women aged 18-25 years, emerging adults, African American Women, psychological well-being.