MSM/W & HIV/STI Care in Senegal

AfWORO has established a research collaboration with the Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation (IRESSEF) in Dakar, Senegal). Within this collaboration, PhD candidate Mrs. Nicole Nkoum (IRESSEF) will receive scientific mentoring from Dr. Elhadji Mbaye (IRESSEF) and Dr. Guillermo Martínez (AfWORO), and will realise her first socio-epidemiological research as principal investigator. The aim of this research is to map and frame the experiences, meanings and values towards psychosocial and sexual health and ill health of men who have sex with men/women (MSM/W) in Dakar, Senegal.

This project received local ethics approval in May 2018. Using a life stories approach, this project has reached out to a group of MSM/W identified using a respondent driven sampling approach with the aid of a local NGO that advocates for the needs of vulnerable populations in Senegal. Participants in this project were invited to voice out their life journey through a legal, social and health system that does not safeguard their sexual rights, including their rights to demand, access and adhere to HIV/STIs prevention and treatment services. This projects aims at translating MSM/W life lessons into a shared knowledge that will inform subsequent training on sexual health and HIV/STI prevention for peer MSM/W, health workers and other policy-makers.

This project is funded by AfWORO and has been conducted in agreement with national regulations for human subjects conduct. In November 2018, AfWORO supported Mrs. Nkoum’s travel to the Faculty of Health Sciences – University of Saragossa (UNIZAR, Spain). During her visit, Mrs. Nkoum received mentorship from Dr. Ángel Gasch, UNIZAR Assistant Professor with expertise in HIV and masculinities research, on the analysis of the project’s data and in the preparation of research dissemination outputs.

Female Genital Modifications in Liberia

The research entitled ‘Health professionals’ perceptions on the health implications of traditional female genital modifications for pregnant women in Liberia’ (PerTradFGMo) is led by Mrs. Christine K. Tarr-Attia (St. Joseph’s Catholic Hospital, Liberia) and Mrs. Grace Hawa Boiwu (Mother Patern School of Health Sciences, Liberia) with the scientific mentoring of Dr. Guillermo Martínez. The aim is to document the implications of tFGMo for pregnant women in Liberia as narrated by the midwives that assist labor/ delivery. Secondary objectives are to i) document how professionals manage the health implications of tFGMo; ii) define how education to professionals in Liberia on the management of implications of tFGMo should be designed, and; iii) explore contextual barriers and opportunities for pregnant women to seek for healthcare when they experience adverse effects of tFGMo. This is a qualitative research that uses a feminist grounded theory approach. This research is entirely funded by AfWORO, and received ethics approval from the University of Liberia-Pacific Institute of Research and Evaluation IRB (Monrovia, Liberia). Seventeen (17) Liberian registered midwives working in Monrovia were invited as key informants. The study started in June 2017 and data collection completed in September 2017. Mrs. Boiwu and Mrs. Tarr-Attia publised the results from this qualitative research as open access in the scientific journal Reproductive Health.

Insights from the midwives participants have been useful for Mrs Boiwu and Mrs Tarr-Attia to propose a comprehensive training programme on the health effects of FGM/C. Their programme proposal has won the 2018 ANESVAD ‘Emprender’ (Entrepreneur) Award. Thanks to this award,  Mrs Boiwu and Mrs Tarr-Attia will have the opportunity to train 60 midwives and 30 traditional circumcisers in rural Liberia. Their project is expected to complete by the end of 2019.

Thanks to ANESVAD ‘Emprender’ Award, in February 2019, three two-day workshops for midwives, nurses and traditional circumcisers were held in Ganta and Monrovia. In total, over 60 health care workers were trained on the health effects of FGM/C. Embracing the possibility to learn, the trainees were eager to acquire knowledge and to reflect on their clinical practice. Following the success of those workshops, the next workshops will be held in August 2019.

Menstrual Health Management in Uganda

Ms. Harriet Namulondo and Ms. Carolyn Namutebi have a long trajectory implementing sexual and reproductive health programs in Uganda. They started working together in the NGO Concern for Children and Women’s Empowerment in 2008. In 2010, they constituted the community based organization Civic Education Network International, which was finally officially registered as the NGO Centre for Transformative Parenting and Research (CTPR). Through their work in all these organizations, Harriet and Carolyn have been dedicated to build the capacity of community members and civil society organizations in the primary prevention of violence against children through interventions assessing familial and school processes associated with poor parenting and teaching practices, poor parental bonding, corporal punishment, and gender-driven differential socialization and sexualization of girls and boys. They have also been engaged in research on labia minora elongation [1] [2] [3], violence against women and children [4], menstrual health management (MHM), and corporal punishment in primary schools.

Of all the topics they have interest in, the lack of education, social support and sanitation for MHM is the one they both have identified asa violation of women’s and girls’ rights that is oftentimes neglected by Ugandan society and cooperation for development agents. In Uganda, many girls drop out from school when they start having their menses because of lack of hygiene means and lack of support from their parents, relatives and male peers. Harriet and Carolyn defend that training and engaging boys and men in MHM is crucial to end discrimination against girls in puberty. Of all the ways they have involved boys and men in MHM, workshops on reusable knitting pads have been the most successful. More research is warranted in that direction. Hence, AfWORO assists Mrs. Namulondo and Mrs. Namutebi in the preparation of an impact evaluation of the MHM component of the CTPR sexual and reproductive health programs, and in the conduct of a qualitative research on men’s perceptions and attitudes towards MHM. The qualitative inquiry will be the core of Harriet’s candidature to accomplish a PhD Health Sciences. Additionally, since the outset of this collaboration, AfWORO has provided support to CTPR in the preparation of grant proposals to competitive calls with the aim to ensure that CTPR MHM programs involving boys and men have continuity and can be rolled out to newer Ugandan districts.

FGMReview: A FGM/C Database

FGMReview is a Knowledge Management Tool that aims at collecting, organising, indexing and making available all the information published on traditional Female Genital Modification (tFGMo) practices. The goal of FGMReview is to help improving and increasing the knowledge on all types of tFGMo by making all grey literature and evidence-based knowledge accessible to researchers, health and social science students, sexual and reproductive health programmes managers, health policy makers, and healthcare providers engaged in the research, project and programme planning, and healthcare and socialcare provision of tFGMo. FGMReview was first launched in 2012. The database is updated on a weekly basis by Dr Guillermo Martínez, President of NGO African Women’s Research Observatory (AfWORO) and is accessible HERE.