RCCbc RURAL RESEARCH STORIES
Submitted by Kelsey Furk
During the summer of 2018, UBC Medicine and Dietetics undergraduates worked with a local grassroots development group, Pamoja Community Organization, to conduct research about family planning, and gender-based violence knowledge and services in a rural subsistence farming and fishing community near Kisumu, Kenya. The work was supported by a $4,825 Rural Global Health Partnership Initiative Grant through the Rural Coordination Centre of BC.
With guidance from Pamoja staff, who identified research needs and provided logistical support, four UBC students conducted five focus group discussions with 42 young women (aged 18-24) and 10 interviews with health care service providers and Pamoja program officers. Interviews focused on understanding the women’s knowledge of reproductive health, gender-based violence, access and barriers to family planning options, and post-violence care services. The UBC Behavioural Research Ethics Board approved the project.
Women interviewed in focus groups were part of the DREAMS initiative (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe), a comprehensive program with a goal to reduce HIV infection among adolescent girls and young women (10-24) by 40 per cent in two years in regions with high HIV rates. This work – funded by US PEPFAR and delivered by Pamoja – also includes: weekly ‘safe space’ support and education meetings with mentors, post-violence care services, HIV education, testing and pre-exposure prophylaxis, education on contraceptive method mix, cash transfers, educational and employment supports, and community mobilization and norms change.
Focus group and key informant interview transcripts were translated in Kenya and the students are currently working on analyzing the data. Initial impressions from the focus groups are that young women in the program reported being familiar with a range of family planning options and had generally good experiences with health care providers, but reported that community members and husbands were often wary of family planning. Young women expressed concerns about side effects, and the ability to change long term methods without prohibitive cost. Most young women were not familiar with options for emergency contraception, and options for abortion were reported as limited, and often unsafe. Young women reported that unplanned pregnancies were often associated with stigma, and may result in limiting education, early marriage, or suicide. Young women indicated that gender-based violence was common, usually perpetrated by familiar people, and that there was often stigma, repercussions, lack of confidentiality, and economic hardship associated with reporting and fleeing violence.
Students are currently coding and interpreting data and summarizing the key findings. They will be working with Pamoja to identify opportunities for program improvement based on the project findings this winter. One student from the team will be travelling to the Western Student and Medical Research Forum to present initial findings in late January 2019.
The UBC Global Health Initiative has a long standing relationship with Pamoja Community Organization and facilitated the connections that enabled this research project