Contraceptive Implant Discontinuation in Huambo and Luanda, Angola: A Qualitative Exploration of Motives.

Introduction The Government of Angola is engaged in ongoing efforts to increase access to contraceptives, in particular contraceptive implants (CIs). Discontinuation of CIs, however, has been identified as being a challenge to this work, hindering the improvement of contraceptive prevalence, and in turn, maternal and child health. The objective of this study was to understand motives for contraceptive implant discontinuation in Luanda and Huambo, Angola. Methods We conducted 45 in-depth interviews and six focus groups amongst former and current contraceptive implant clients and family planning nurses in eight clinics across the provinces of Huambo and Luanda. Data collectors transcribed and translated key information from Portuguese into English. We used a combined deductive/inductive approach to code and analyze data. Results Participants described adverse side effects, desire for pregnancy, partner dissatisfaction, quality of care, alternative or lack of information, and religion as motives for discontinuation. Adverse side effects, including prolonged bleeding, amenorrhea, and headaches were most commonly cited by both clients and providers. Discussion Motives for discontinuation reflect existing findings from other studies in similar settings, in particular the influence of adverse side effects and desire for pregnancy as motivating factors. We contextualize these findings in the Angolan setting to tease out the relationship between cultural norms of ideal family size and the perceived role of women in regards to fertility and child-bearing. We suggest that programs enter into dialog with communities to address these concerns, rather than working exclusively on improving service delivery and quality.

Depresión en personas con VIH en dos municipios de Angola / Depression affecting HIV people in two municipalities of Angola

Introducción: la depresión constituye un evento frecuente en las personas con VIH, de ahí que su estudio haya cobrado interés, entre los profesionales encargados de la atención a este segmento de la población. Objetivo: estimar la frecuencia de la depresión y su relación con factores sociodemográficos en personas con VIH/sida. Métodos: estudio descriptivo de corte transversal en 100 personas con VIH residentes en los municipios de Huambo y Bailundo, provincia de Huambo-Angola atendidas entre enero y mayo de 2012 y que cumplían con los criterios de inclusión. El estado depresivo se evaluó con el Inventario de Depresión de Beck y se aplicó una entrevista con preguntas cerradas. Resultados: hubo predominio del sexo femenino y la mayor parte de la población estudiada tenía bajo nivel de instrucción. Los síntomas depresivos de varias intensidades estuvieron presentes en 33 pacientes (33 por ciento) de ambos sexos. Conclusiones: en la población estudiada la frecuencia de depresión fue relativamente baja con predominio de mujeres, personas jóvenes, con apoyo social y no asociada al empleo, al estado civil, ni a la escolaridad. Se recomienda el incremento de estudios en este contexto sociocultural considerando el impacto de la epidemia del VIH en esa parte del continente africano(AU)

Introduction: depression is a common event in HIV people, hence the study of this condition arouses growing interest of the professionals in charge of this population segment. Objective: to estimate the frequency of depression and its relationship with sociodemographic factors in HIV people. Methods: cross-sectional descriptive study of 100 HIV people who live in Huambo and Bailundo municipalities in Huambo-Angola province and treated in the period of January through May 2012, who met the inclusion criteria. The depressive condition was evaluated with the Beck Depression Inventory and a closed question interview. Results: females prevailed and most of this population section had low schooling. Various depressive symptoms were present in 33 patients (33 percent) of both sexes. Conclusions: in the studied population, the frequency of depression was relatively low and predominant in women, young people, with social support, and it was not related to employment, civil status or schooling. Therefore, it is recommended to carry out more studies in this socio-cultural context, considering the severe impact of HIV epidemics on that part of the African continent(AU)

Problemas teóricos, metodológicos e instrumentales para el estudio de la calidad de vida en personas con VIH en Angola / Theoretical, methodological and instrumental problems for the study of quality of life in HIV persons in Angola

El estudio de la calidad de vida es uno de los problemas que merecen especial atención en la actualidad en las ciencias de la salud ante el desarrollo científico, tecnológico y la transición epidemiológica. Su investigación requiere de un abordaje multidisciplinario e intersectorial. El VIH es un problema que afecta la calidad de vida de la población angoleña. Los problemas teóricos, metodológicos e instrumentales de la investigación sobre la calidad de vida en personas con VIH, así como sus principales tendencias, se discuten mediante un enfoque deductivo. Uno de los problemas de este constructo es la falta de consenso entorno a su definición conceptual, desde diferentes disciplinas, base de las falencias metodológicas que han dado paso a la proliferación de instrumentos genéricos y específicos para el estudio de la calidad de vida relacionada con la salud y la enfermedad. Así, se arriba al estado actual y perspectiva de su estudio en la población angolana. Se proponen alternativas para una investigación multidisciplinaria sobre la calidad de vida en personas con VIH, punto de partida para la elaboración de estrategias para su mejoramiento

The study of the quality of life is one of the problems deserving special attention in the health sciences at present due to the scientific and technological development and to the epidemiological transition. The research on this topic requires multidisciplinary and intersectoral approach. HIV is a problem having an impact on the quality of life of the Angolan population. This article discussed with deductive approach the theoretical, methodological and instrumental problems in research as well as the main tendencies in the research of the quality of life in HIV persons. One of the difficulties in this construct is the lack of consensus around its conceptual definition by different disciplines, which leads to the proliferation of generic and specific instruments to study the quality of life associated to health and disease. This is the present state and perspective of the quality of life study in the Angolan population. Some alternatives are submitted in order to conduct a multidisciplinary research study on the quality of life of HIV persons, the starting point to draw adequate strategies for its improvement

Acidentes ocupacionais com material biológico entre profissionais de enfermagem em um hospital de Angola / Occupational accidents with biological material among nursing workers in a hospital in Angola

Trata-se de um estudo descritivo exploratório com abordagem de análise quantitativa, cujo objetivo foi caracterizar os acidentes ocupacionais com material biológico potencialmente contaminado, ocorridos com trabalhadores de enfermagem de um hospital geral público localizado no interior de Angola, no período de julho de 2002 a julho de 2003, visando contribuir para criação de bases à implementação de políticas de prevenção de acidentes ocupacionais entre os trabalhadores da saúde. Coletaram-se os dados mediante entrevistas face a face, com base em roteiro aplicado por cinco sujeitos previamente treinados, após cumpridos todos os pressupostos éticos. Participaram do estudo 278 trabalhadores de enfermagem, de um total de 378, cujos resultados permitiram concluir que a população estudada é heterogênea, com idade variando de 22 a 66 anos, com maior concentração dos sujeitos nas faixas etárias de 22 a 30 anos (30,93%) e de 31 a 40 anos de idade (24,82%). A maioria é casada, com escolaridade de nível médio (59,00%). A incidência de acidentes nesta população foi elevada, uma vez que, dos 278 trabalhadores participantes do estudo, 93,88% sofreram um total de 1.477 acidentes diversos, com uma freqüência de 1 a 56 acidentes por sujeito. No presente estudo cada trabalhador descreveu até 4 acidentes no máximo, perfazendo um total de 376 acidentes descritos, sendo o sangue e seus derivados o material biológico mais citado (78,46%). Do total dos acidentes, 47,10% ocorreram por contato, seguidos dos acidentes percutâneos (45,20%), tendo a maioria (61,44%), acontecido no período da manhã, resultante da administração de medicamentos....