Translating lessons to reinforce national stillbirth response; multi-stakeholder perspectives regarding priorities and opportunities to deliver quality evidence-based interventions within a limited-resource context in Uganda.

BACKGROUND: There is noted increase in attention towards implementation of evidence-based interventions in response to the stillbirth burden in low- and middle-income countries including Uganda. Recent results reporting some of the strategies adopted have tended to focus much attention towards their overall effect on the stillbirth burden. More is needed regarding stakeholder reflections on priorities and opportunities for delivering quality services within a limited resource setting like Uganda. This paper bridges this knowledge gap. METHODS: Data collection occurred between March and June 2019 at the national level. Qualitative interviews were analysed using a thematic analysis technique. RESULTS: Identified priorities included; a focus on supportive functions such as the referral system, attention to the demand side component of maternal health services, and improvements in the support supervision particularly focusing on empowering subnational level actors. The need to strengthen the learning for better implementation of strategies which are compatible with context was also reported. A comprehensive and favourable policy environment with the potential to direct implementation of strategies, harnessing the private sector contribution as well as the role of national level champions and patient advocates to amplify national stillbirth reduction efforts for continued visibility and impact were recommended. CONCLUSION: Great potential exists within the current strategies to address the national stillbirth burden. However, priorities such as improving the supportive functions of MCH service delivery and attention to the demand side need to be pursued more for better service delivery with opportunities including a favourable policy environment primed to better serve the current strategies. This calls for dedicated efforts targeted at addressing gaps within the existing priorities and opportunities for better delivery of national strategies to address the stillbirth burden in Uganda.

The juxtaposition of invalidation and "inviting in": a qualitative study of bisexual identity in South Africa.

Understanding one's sexual orientation plays a significant role in contributing to one's sexual identity and developing a coherent sense of self. Misconceptions and prevailing prejudices make it difficult for bisexual individuals to navigate their sexual identities in many societies. Disclosure of one's identity is accompanied by certain risks depending on how the information is received. However, disclosing one's identity can also be positive, especially as it assists in fostering relationships. This article derives from a descriptive study involving 14 semi-structured interviews with young adults aged 18-24 who identified as bisexual. Data were subjected to a reflexive thematic analysis. Themes of invalidation, belongingness and reclaiming through 'inviting in' were identified. By processing the feelings of invalidation regarding their bisexual identities which were placed upon them by their respective cultural groups, and society in general, participants were able to develop a sense of agency and reclaim their power. Findings highlight the need for further research on bisexuality, particularly in South Africa, and the need to understand how bisexual identity development occurs in interaction with other sexual and gender identities.

The lived experience of South African men having a premature baby.

Background: Much has been written about fathers, fatherhood and premature babies. However, in the South African context, studies about the experiences of fathers having a premature baby are lacking. Aim: This study aimed to explore how South African fathers (n = 10) experience having a premature baby using a descriptive phenomenological approach. Setting: This research study was conducted online using various social media platforms such as WhatsApp, Google Meet and through telephonic conversations. Methods: A descriptive phenomenological approach that allowed for the distillation and elucidation of common core experiences among fathers who had a premature baby. Results: The findings demonstrated that the participants experienced intense fears regarding the survival and well-being of their children. They reported experiencing financial difficulties related to hospital bills and experienced being alienated by hospital institutions. Despite these reported barriers, these fathers were adamant in their resolve to support their children and partners during this challenging time. Conclusion: The experiences of fathers were riddled with fear, uncertainty, ambiguity and alienation, which placed them in very precarious situations when trying to navigate their role in a more sensitive and enlightened way. Having a premature infant calls into question the systems that men are positioned within as these systems to a large extent shape these events and how they are experienced. Contribution: This study is original as no other published studies seem to exist in South Africa that speaks to fathers' lived experiences of having a premature baby.