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Healthcare Providers' Perceptions of the Sexual and Reproductive Health Needs (Including Family Planning) of Elderly Women from Selected Sites in Botswana

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World Journal of AIDS 2012年第3期2卷 143-158页

作者： njoku ola ama Enock Ngome Department of Population Studies University of Botswana Gaborone Botswana Department of Statistics University of Botswana Gaborone Botswana

Much of the sexual and reproductive health services and service delivery including family planning target women of child bearing ages (15 - 49 years) and sometimes men. Hardly are there programmes/interventions that specifically target the needs of the elderly women (50 years and above), yet this group has serious sexual and reproductive health needs as many of them are still sexually active. This cross-sectional study obtained the views of a stratified random sample of 169 healthcare providers (doctors, nurses and pharmacists) from four selected sites, Gaborone, Selibe Phikwe, Barolong and Kweneng East health districts in Botswana on how the healthcare system in the selected sites is meeting the SRH/FP needs of the elderly women. The study found out that while overwhelming majority of the healthcare providers feltthat the healthcare system has no programme that specifically target the SRH/FP needs of this significant others and their SRH/FP needs are not being met ,less than 15% indicated that Pap smear screening as well as screening of cervical cancer were on-going. Although there are SRH/FP services available in the healthcare system, the elderly women are minimally accessing these services. Only condom, combined oral contraceptives, progestogen-only pills, treatment of STIs, screening for HIV/AIDS and screening for cervical cancer are accessed and information is also limited to these services. Reasons given by the healthcare providers for the non-accessibility of these services were cultural diversity (80%), people's sexual behavior and perceptions about sex (79%), lack of knowledge about the desired SRH/FP services (76%), religion (73%) and gender issues (62%). The study, advocates as part of policy options to mitigate the obstacles to accessing SRH/FP services, the expansion of counseling programmes, screening and treatment for breast cancer, public awareness campaigns, production and circulation of appropriate educational materials, effective training of heal

关键词： Healthcare Providers Elderly Women Sexual and Reproductive Health Services Family Planning

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Menopausal Perceptions and Experiences of Older Women from Selected Sites in Botswana

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Advances in Sexual Medicine 2013年第3期3卷 47-59页

作者： njoku ola ama Enock Ngome Department of Population Studies University of Botswana Gaborone Botswana Department of Statistics University of Botswana Gaborone Botswana

Objective: To assess the menopausal perceptions and experiences of older women from selected sites in Botswana. Design: This study used snowball sampling to recruit 444 older women in four health districts of Botswana. Trained research assistants administered a structured questionnaire to determine respondents’ menopausal symptoms, perceptions and knowledge of menopause and sexual experiences. Multiple logistic regression procedures were used to evaluate the association of socio-demographic characteristics with knowledge of menopause and factor analysis was used to cluster menopausal symptoms. Results: Participants had low levels of knowledge and awareness of menopause. The three most common changes identified were weakening of bones (78%), changes in sex drive (69.6%), and difficulty working (56.2%). The majority of respondents perceived menopause as freedom from menstrual cycles (85%) and cost saving (65%). Employment status was significantly associated with knowledge of menopause. The mean age at menopause was 48.9 years. With an average life expectancy of 54.5 years, there remains about 6 years of postmenopausal life. Recommendation: Public health care systems in and beyond Botswana should mobilize resources and take measures to improve older women’s awareness and knowledge about menopause-related changes through educational training and guidance to maintain active, healthy lives.

关键词： Older Women Menopause Knowledge Perceptions Logistic Regression Factor Analysis

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TB/HIV Coinfection and Other Medical Co-Morbidity in Older Adults (50 - 64 Years) in Botswana: Evidence from 2013 Botswana AIDS Impact Survey (BAIS IV)

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Advances in Sexual Medicine 2019年第3期9卷 40-51页

作者： njoku ola ama Helen Aforji ama Francis Nathan Okurut Department of Statistics University of Botswana Gaborone Botswana Department of Educational Management University of Botswana Gaborone Botswana Department of Economics University of Botswana Gaborone Botswana

Background: Many older adults (50 - 64 years) in Botswana with HIV do not know they are infected with TB. Some with TB disease are unaware of their HIV status, yet HIV/TB coinfection is high. The study aims to determine the prevalence of TB among older adults with HIV, their HIV/AIDS knowledge and vulnerability to hypertension, diabetes and asthma using the 2013 BAIS IV data. Material and Methods: The BAIS IV study, from which the data for this article is derived, used a stratified two-stage probability sampling design. The first stage was the selection of 297 Enumeration Areas (EAs) as Primary Sampling Units and second stage was selection of households (5,415) in the EAs. The study targeted all usual members of the selected households aged 6 weeks and above for the Biomarker or testing for HIV and those aged 10 - 64 years old for the behavioral questionnaire. Results: The study shows that the older adults (50 - 64 years) with TB have a low level of education and HIV prevalence is very high (44% for age 50 - 54, 40.6% for age 55 - 59 and 68.4% for age 60 - 64 years). The rate of HIV/TB coinfection, 21.9%, is high and prevalence of TB among the older adults is 8.6% (13%, males and 5.3%, females) while only 0.8% are currently on treatment. Only 67.2% know that if a pregnant mother is infected with HIV, there is a way of preventing transmission of the virus to the child. Age, level of education, marital status and employment status significantly (p Conclusion: The study concludes that lower education seems to be an obstacle to accessing TB treatment. Therefore, older adults’ awareness and knowledge of the symptoms of both diseases (TB and HIV), mode of infection and treatment need to adequately improve through increased education to overcome health challenges when infected with asthma, diabetes and high blood pressure/hypertension.

关键词： TB HIV/AIDS Older Adults TB/HIV Coinfection Logistic Regression

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A Multivariate Test for Three-Factor Interaction in 3-Way Contingency Table under the Multiplicative Model

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Open Journal of Statistics 2014年第8期4卷 586-596页

作者： njoku O. ama Department of Statistics University of Botswana Gaborone Botswana

Two test statistics that have been commonly used in analysing interactions in contingency table are the Pearson’s Chi-square statistic, χ2, and likelihood ratio test statistic, G2. Both test statistics, in tables with sufficiently large sample size, have an asymptotic chi-square distribution with degrees of freedom (df) equal to the number of free parameters in the saturated model. For example under the hypothesis of independence of the row and column conditioned on the layer in an I × J × K contingency table, the df is K(I –1)(J– 1). These test statistics, in large sized tables, will have less power since they have large degrees of freedom. This paper proposes a product effect model, which combines the advantages of the multiplicative models over the additive, for analysing the interaction between the row and column of the 3-way table conditioned on the layer. The derived statistics is shown to be asymptotically chi-square with a small degree of freedom, K?– 1, for the I × J × K contingency table. The performance of the developed statistic is compared with the Pearson’s chi-square statistic and the likelihood ratio statistic test using an illustrative example. The results show that the product effect test can detect interaction even when some of the main effects are not significant and can perform better than the other competitors having smaller degree of freedom in large sized tables.

关键词： Contingency Tables Product Effect Models Interaction

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