Roda Madziva

Background: Missed and zero-dose children remain major barriers to polio eradication in settings affected by insecurity, poverty, weak health systems, and social exclusion. This narrative review synthesized evidence on how gender norms and related social determinants influence childhood polio vaccination in Afghanistan, Nigeria, Pakistan, and Sudan. Afghanistan and Pakistan remain the only countries with endemic wild poliovirus transmission, while northern Nigeria, especially areas affected by insurgency, and war-affected Sudan continue to report substantial numbers of polio zero-dose and under-immunized children, together with occasional reports of circulating vaccine-derived poliovirus. Methods: A comprehensive search of peer-reviewed and institutional literature was conducted in major databases and relevant grey literature sources. Eligible studies examined childhood immunization or polio vaccination among children under five and reported gender-related determinants of vaccination uptake. Findings were synthesized thematically. Results: Forty-one studies were included. Five interconnected domains emerged: women’s empowerment, autonomy, and household decision-making; male involvement, household gender norms, and family power relations; socioeconomic and structural gender-related barriers; education, information access, community perceptions, and health system responsiveness; and war, insurgency and their gendered impact on childhood polio immunization. Across countries, limited maternal autonomy, restricted mobility, dependence on male decision-makers, poverty, conflict, displacement, misinformation, and weak health services reduced access to vaccination. Supportive male engagement, female health workers, trusted community leadership, and culturally responsive outreach facilitated vaccine acceptance. Conclusions: Gender influences childhood polio vaccination through intersecting household, community, structural, and health-system pathways. Family power extends beyond male decision-making, with women’s education and influence within households shaping vaccination decisions. Strengthening women’s agency, constructively engaging men (e.g., through husband schools), and delivering culturally responsive services are essential for reaching missed and zero-dose children and accelerating polio eradication.

The burden of non-communicable diseases (NCDs) has emerged as a critical public health challenge in Zimbabwe, exacerbated by a complex interplay of socioec

This chapter examines the unmet education needs of refugees with disabilities in accessing Technical Vocational Education and Training (TVET). Using research conducted in South Africa, Zimbabwe and Uganda, it focuses on education experiences of refugees in Uganda to highlight the significant lack of provision in policy and practice. This situation is particularly alarming in the context of limited education and training opportunities and low school attendance in primary school despite increasing TVET policy and development interventions. The chapter uses critical capabilities theory and lifelong learning to reinforce the dual need to address the compounded barriers faced by refugees with disabilities in TVET and the need to develop learning pathways and educational transitions that support their life goals. In this narrative, we argue that the refugee policy has inherent structural limitations that limit education transition. We propose practical policy adaptations that promote inclusion and lifelong learning.

Background: Immunisation remains one of the most effective and cost-efficient public health interventions for preventing infectious diseases in children. Despite global progress, Sub-Saharan Africa (SSA) continues to face challenges in achieving equitable immunisation coverage. Gender-related disparities, rooted in sociocultural and structural inequalities, significantly influence the prevalence of zero-dose and under-immunised children in the region. This review critically examines the gender-associated barriers to routine childhood immunisation in SSA to inform more inclusive and equitable health interventions. Methods: A critical literature review was conducted generally following some steps of the PRISMA-P and CRD guidelines. Using the Population–Concept–Context (PCC) framework, studies were selected that examined gender-related barriers to routine immunisation for children under five in Sub-Saharan Africa. Comprehensive searches were performed across PubMed, Google Scholar, and relevant organisational websites, targeting articles published between 2015 and 2025. A total of 3683 articles were retrieved, with 24 studies ultimately meeting the inclusion criteria. Thematic analysis was used to synthesise the findings. Results: Four major themes emerged: (1) women’s empowerment and autonomy, including limited decision-making power, financial control, and the impact of gender-based violence; (2) male involvement and prevailing gender norms, where patriarchal structures and low male engagement negatively influenced vaccine uptake; (3) socioeconomic and structural barriers, such as poverty, geographic inaccessibility, maternal workload, and service availability; and (4) education, awareness, and health system responsiveness. Conclusions: Gender dynamics have a significant impact on childhood immunisation outcomes in Sub-Saharan Africa. Future policies must integrate these insights to improve immunisation equity and reduce preventable child morbidity and mortality across the region.

It is widely recognised that education plays a critical role in achieving gender equality, yet refugee girls face significant challenges in accessing education globally. This study, grounded on feminist theory, explores girls’ gendered barriers to education in Zimbabwe’s Tongogara Refugee Camp. Through focus group discussions and face-to-face interviews with 124 girls and boys, 45 parents/ guardians, and 30 key informants (Ministry officials, teachers, camp officials, and NGO workers), the study examines how gender intersects with the vulnerabilities of displacement to create a complex web of challenges. These include the prioritisation of boys’ education, increased domestic burdens on girls, limited access to menstrual hygiene products, and heightened protection risks. The study underscores the remarkable resilience of refugee girls to persevere in their education despite facing significant challenges. The findings emphasise the need for gender-transformative interventions that address the root causes of educational inequality and empower refugee girls to access quality education. The study proposes a model of gendered barriers to education. It recommends that policymakers, practitioners, and humanitarian actors promote educational equity and empowerment for refugee girls in Zimbabwe and beyond. This research contributes to a nuanced understanding of the intersection of gender, displacement, and education, with implications for humanitarian interventions and educational policy in refugee settings.

This paper draws on research with a group of Zimbabwean orphaned young people. It explores their experiences of migrating to South Africa during the COVID‐19 period when official borders were closed. It draws attention to the complexities of south–south migration in the era of COVID‐19 in a way that situates the orphaned child migrants as having contradictory, fluid identities that are simultaneously victimised, agentic and infinitely more complex than the dominant binary representation of adult/child.

HIV and AIDS continue to be major public health concerns globally. Despite significant progress in addressing their impact on the general population and achieving epidemic control, there is a need to improve HIV testing, particularly among men who have sex with men (MSM). This study applied deep and machine learning algorithms such as recurrent neural networks (RNNs), the bagging classifier, gradient boosting classifier, support vector machines, and Naïve Bayes classifier to predict HIV status among MSM using the dataset from the Zimbabwe Ministry of Health and Child Care. RNNs performed better than the bagging classifier, gradient boosting classifier, support vector machines, and Gaussian Naïve Bayes classifier in predicting HIV status. RNNs recorded a high prediction accuracy of 0.98 as compared to the Gaussian Naïve Bayes classifier (0.84), bagging classifier (0.91), support vector machine (0.91), and gradient boosting classifier (0.91). In addition, RNNs achieved a high precision of 0.98 for predicting both HIV-positive and -negative cases, a recall of 1.00 for HIV-negative cases and 0.94 for HIV-positive cases, and an F1-score of 0.99 for HIV-negative cases and 0.96 for positive cases. HIV status prediction models can significantly improve early HIV screening and assist healthcare professionals in effectively providing healthcare services to the MSM community. The results show that integrating HIV status prediction models into clinical software systems can complement indicator condition-guided HIV testing strategies and identify individuals that may require healthcare services, particularly for hard-to-reach vulnerable populations like MSM. Future studies are necessary to optimize machine learning models further to integrate them into primary care. The significance of this manuscript is that it presents results from a study population where very little information is available in Zimbabwe due to the criminalization of MSM activities in the country. For this reason, MSM tends to be a hidden sector of the population, frequently harassed and arrested. In almost all communities in Zimbabwe, MSM issues have remained taboo, and stigma exists in all sectors of society.

In this article, the authors discuss the problem of high prevalences of active syphilis amongst key populations (KPs) in Zimbabwe, in combination with low testing rates, partly because of a difficult legal and social environment for these populations. The article highlights the need to develop strategies to address the high prevalence of syphilis amongst KPs. The authors discuss requirements for addressing deficits in existing clinical services, predominantly primary care settings, in providing primary healthcare, including sexually transmitted infection (STI) management, to Zimbabwe's KP communities and utility of point-of-care testing and self-testing and other innovations to improve testing uptake.