Community resistance to a peer education programme in Zimbabwe

BMC Health Services Research

Simon Gregson⁵  Morten Skovdal⁴  Constance Nyamukapa⁵  Mercy Nhamo²  Zivai Mupambireyi²  Kerry Scott¹  Catherine Campbell³ 

[1]Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

[2]Biomedical Research and Training Institute, Harare, Zimbabwe

[3]Department of Social Psychology, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK

[4]Department of Public Health, University of Copenhagen, Copenhagen, Denmark

[5]School of Public Health, Imperial College, London, UK

关键词: Commercial sex work;    Community mobilisation;    Africa;    Programme evaluation;    HIV/AIDS intervention;   

Others  :  1091517
DOI  :  10.1186/s12913-014-0574-5

 received in 2014-04-04, accepted in 2014-11-03,  发布年份 2014

【 摘 要 】

Background

This paper presents community perceptions of a state-of-the-art peer education programme in Manicaland, Zimbabwe. While the intervention succeeded in increasing HIV knowledge among men and condom acceptability among women, and reduced HIV incidence and rates of unprotected sex among men who attended education events, it did not succeed in reducing population-level HIV incidence. To understand the possible reasons for this disappointing result, we conducted a qualitative study of local perspectives of the intervention.

Methods

Eight focus group discussions and 11 interviews with 81 community members and local project staff were conducted. Transcripts were interrogated and analysed thematically.

Results

We identified three factors that may have contributed to the programme’s disappointing outcomes: (1) difficulties of implementing all elements of the programme, particularly the proposed income generation component in the wider context of economic strain; (2) a moralistic approach to commercial sex work by programme staff; and (3) limitations in the programme’s ability to engage with social realities facing community members.

Conclusions

We conclude that externally-imposed programmes that present new information without adequately engaging with local realities and constraints on action can be met by resistance to change.

【 授权许可】

   
2014 Campbell et al.; licensee BioMed Central Ltd.

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