Microcredit, Its Promise And Mirage For Fostering Development And Rolling Back HIV Among Ugandan Youths 13-35 years; A Casuistic Qualitative Analysis Of Reports 2015-2019

Background: Microcredit or Micro finance services are precursors and catalysts for many other social services and development goals. This has policy, programming and planning implications in many areas including services for Young Persons, eradicating HIV and Key Population-led Programmatic Interventions and increasing household level living standards. The aim of the report is twofold: explore the categories that made Microcredit a catalyst for quality life practices; how Key Populations (KP) can use Microcredit to engage in quality life improving practices.

Methods: Community immersion, literature review and key informant interviews were used to generate the report between December 2015-February 2019 in 15 Ugandan Town Councils. 230 respondent aged 17-34 years were eligible out of 330. Eligibility was based on age; 5-7 months grace period after first loan withdrawal; small interest on loans ranging 0.002-0.009%; membership to more than one group or social collateral; did not have to deposit money in bank as collateral; plans set aside to ensure food sustenance; number of months in business between 6 months and 3 years; had plans for long term investments; and requested first/kick-starter loan equal to or below Ugx. 2,000,000.00. 

  

Results:  All 230 reported self employment for past two years, flexibility to innovate, engage in self care and saved for food. Out of two thirty (230), one hundred seven (107) with median age 29    (IQR17-34) tested for HIV at least five times in 2018. 

A disaggregation of respondents: 101 Straight females; 90 Straight males; 22 Transgender; 7 Lesbians; 20 Gay male. All respondents were below 35 years. 53 with median age 25( IQR 17-34) were living with HIV among whom 7 are Transgender; 5 were Gay males. 

Microcredit supports participation in quality life practices, it is a motivator to demand SRHR/RMNCAH/HIV Services, it galvanizes communities into forming, maintaining collateral viable groups and links businesses that follow market demands because their businesses were linked into food consumption (72) operated a food kiosk- and a side grocery); telephone kiosks operation (25); attire and shoes (22); movie kiosk (8) artisanry (12); brick-making (32); carpentry (9); Boda-riders (7); event planning and hosting (23); stationery (27); grocery shops (20); and commitment to nurture goodwill and credibility e.g. return the money.  

Conclusions and Recommendations: Microcredit supports engagement in quality life improving practices most especially for young women and people. People explore their potential to develop financially, it increases interpersonal and intrapersonal skills. Businesses that are market-linked provide possibilities for increased Household income base. Further study into how young people can use the funds to save for pensions and insurance is called for.

The Link Between Violence Against Women and Children And Quality of RMNCAH Outcomes In 8 African Countries

Background: Effective and quality RMNCAH outcomes are linked to reduced risk to violence. This study explored negative stereotypes of hegemonic masculinity and the social structures linked to it. An exploration of 8 Sub-Saharan African countries found 3 country-specific definitive social structures impacting the stereotypes, i.e., Enabling; Restrictive; and Hindering structures.

Methods: A meta-analysis of data from 2015-2019 of relationship between violence against women and children, is reflected in: Trauma Informed Care (TIC); comprehensive RMNCAH strategies such as IMNI, A/PNC, KMC, perinatal death review, and/or integrated maternal and perinatal death surveillance and response (MPDSR) processes; enforcement of legal gender equality; religious and traditional support for respect and dignity of women; uptake of gender-specific prevention services; Domestic Violence (DV) reports and HIV Prevention. 170 articles and reports were identified but 80 met inclusion criteria.

Results: Stereotypes of hegemonic masculinity exist in all 8 countries studied. Politics, religion and tradition influence risk reduction, e.g., enforcement of legal gender equality, political commitment and accountable judiciary ensure women can report abuses. Male dominance beliefs; traditions e.g. precarious toxic masculinity, indifference to expectant mother health by males, stigmatization of frequent clinic visits; and gender of breadwinner are linked to violence-related risks. Compared to all 8 countries, Rwanda, Ethiopia and Kenya have a hindering structure promoting significant risk reduction with institutions fostering increased rule of law, political commitment to RMNCAH outcomes, enforcement and risk-reduction consciousness. Uganda and Tanzania have a restrictive structure characterised with legal loopholes, irregular enforcement and ambivalent political commitment to address acts of violence against women and children. In Senegal, South Africa and Nigeria political, religious and traditional factors blatantly backing traditional negative stereotypes of hegemonic masculinity foster violence enabling structures entrenching repressive acts and hate crimes against women and children. In all countries however, Delivery room reception; level of Health Information Management skills; HIV criminalization; affinity and sensitivity to quality health by all people; stigma around attending clinics by males; negotiating for safer sex by women which is circumscribed as a threat to male dominance, subvert or support optimal RMNCAH goals.

Conclusions: Justice dispensation, economic autonomy, religion and traditional backing contribute effectively to risk-reduction. Contexts hindering violence prevail where state-led commitment thrives and these have far reaching benefits e.g., more people benefit from RMNCAH outcomes. Effective and quality RMNCAH programming in the countries studied will be effective if it is designed to address hegemonic masculinity practices too. Mortality implementation audits need to be disaggregated to reflect causes of and contributing factors to deaths.