Rashida A Ferrand
Biographic Data
| ID | 1713770 |
|---|---|
| NAME | Rashida A Ferrand |
| GIVEN NAMES | Rashida A |
| FAMILY NAME | Ferrand |
| SIGNATURE | FERRAND R A |
| AFFILIATIONS | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0002-7660-9176 |
| VERIFIED | Yes |
| TOTAL WORKS | 46 |
| TOTAL CITATIONS | 2 |
| AUTHOR COUNT | 46 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2011 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 1 |
Multimorbidity and health-related quality of life after tuberculosis treatment in Zimbabwe
Chronic conditions both drive development of and are consequences of tuberculosis (TB). While there is growing awareness of chronic lung disease, data on other health conditions post-TB are limited. In this cross-sectional study in Zimbabwe, we offered adults with pulmonary TB an integrated health check at or after treatment completion, assessing uptake and yield. Members of the same households were also offered the intervention. Selecting househ…
Barriers to accessing contraceptive services for adolescents in Sub-Saharan Africa
Adolescents in Sub-Saharan Africa (SSA) continue to face significant barriers to accessing contraceptive services, despite global and regional commitments to improve sexual and reproductive health (SRH) outcomes. This scoping review synthesises current evidence on the barriers adolescents encounter when seeking contraceptive services across SSA. Following the Arksey and O'Malley framework and the Joanna Briggs Institute guidelines, a comprehensiv…
Evaluation of the NIH Toolbox Cognition Battery in Adolescents with HIV Infection in Zimbabwe
Electronic assessments of cognition in low-resource settings have the potential to widen access to cognitive appraisal in at-risk populations. We evaluated the performance of the shorter, tablet-based NIH cognition battery (NIH-CB) against the validated paper-based Kaufman Assessment Battery for Children 2nd Edition (KABC-II) in assessment of neurocognitive function in adolescents living with HIV (ALWH). Adolescents aged 11–19 years living with H…
Measuring wealth for health research in rural and urban settings in three African countries
Wealth indices enable socioeconomic status measurement: however, their reliability, validity and data collection and computation efficiency can be improved. This analysis aimed to generate four wealth indices in five geographical settings (rural and urban Gambia, rural and urban South Africa and urban Zimbabwe), to compare and validate these indices and formulate recommendations for wealth measurement in Africa. Population-based cross-sectional d…
I can get all the services I want, without fear of being judged ’
Sexual and reproductive health (SRH) services often do not appeal to youth, leading to limited engagement and poor outcomes. We co-designed a community-based integrated HIV and SRH service with and for youth (16-24 years) in Zimbabwe (CHIEDZA) and investigated its acceptability. Qualitative data from observations of CHIEDZA services ( n = 58), and in-depth interviews with healthcare providers ( n = 51), mobilisers ( n = 23), and clients ( n = 63)…
Understanding the impact of the Covid-19 pandemic and its control measures on women and children
The Coronavirus Disease 2019 (COVID-19) posed significant health policy challenges, particularly for low-income countries, where policymakers faced both direct threats from the virus and social and economic harm owing to lockdown measures. We present a holistic contextualized case study of the direct and indirect impacts on women and children, highlighting disparities across socioeconomic, age, and gender groups. We utilized multiple data sources…
Age- and sex-specific incidence rates and future projections for hip fractures in Zimbabwe
INTRODUCTION: Population ageing in Africa is increasing healthcare demands. Hip fractures require multidisciplinary care and are considered an indicator condition for age-related health services. We aimed to estimate current hip fracture incidence in Zimbabwe, compare rates against other regional estimates and estimate future fracture numbers. METHODS: All hip fracture cases in adults aged ≥40 years, presenting to any hospital in Harare over 2 ye…
Acceptability and effectiveness of a study information video in improving the research consent process for youth
INTRODUCTION: Obtaining informed consent for research includes the use of information sheets, which are often long and may be difficult for participants to understand. We conducted a trial to investigate whether consent procedures using a study information video coupled with electronic consent were non-inferior to standard consent procedures using participant information sheets (PIS) among youth aged 18-24 years in Zimbabwe. METHODS: The trial wa…
Integrating point-of-care screening for curable sexually transmitted infections with HIV, syphilis and hepatitis B screening in antenatal care services in Zimbabwe
Introduction Sexually transmitted infections (STIs) in pregnancy are associated with adverse birth outcomes. We investigated the uptake and yield of point-of-care screening for Chlamydia trachomatis , Neisseria gonorrhoeae and Trichomonas vaginalis , integrated with HIV, syphilis and hepatitis B virus (HBV) screening in antenatal care (ANC) in Zimbabwe, and conducted a mixed-methods process evaluation of the strategy. Methods A prospective interv…
Infectious diseases burden and antibiotic prescribing patterns among primary care patients in Harare, Zimbabwe – a cross-sectional analysis
Low- and middle-income countries (LMIC) continue to experience a high burden of infectious diseases and disparities in access to and use of antimicrobials, yet data on antibiotic prescribing in outpatient settings, where the majority of global prescriptions occur, remain scarce. The objective of this study is to provide data on diagnoses and antibiotic prescriptions among primary care patients in Harare, Zimbabwe. We conducted a retrospective stu…
Barriers to and facilitators of linkage to care following hypertension and diabetes screening among health workers in Zimbabwe
The benefits of screening for any condition are only realised if individuals who screen positive link to care services. We investigated linkage to hypertension and diabetes care by healthcare workers accessing a comprehensive health check service. We also explored facilitators and barriers to linkage to care. Between July 2020 and June 2022, a health check with referral and follow-up was offered to healthcare workers (clients) in Zimbabwe. We aim…
Integrated health checks as a person-centred approach to systematic screening of household tuberculosis contacts
Globally, tuberculosis incidence and mortality is driven by syndemic interactions of tuberculosis with other chronic conditions including HIV, diabetes and undernutrition in a deleterious social and structural context, often characterised by poverty. Systematic screening for tuberculosis among household contacts is a core element of the WHO tuberculosis strategy but is hampered in high-tuberculosis incidence settings by health system constraints …
Multimorbidity and health system priorities in Zimbabwe
Multimorbidity, increasingly recognised as a global health challenge, has recently emerged on the health agendas of many countries experiencing rapid epidemiological change, including in Africa. Yet with its conceptual origins in the global North, its meaning and possible utility in African contexts remains abstract. This study drew together policymakers, public health practitioners, academics, health informaticians, health professionals, and peo…
Evaluation of a novel point-of-care lateral flow assay screening for Neisseria gonorrhoeae infection among pregnant women in Zimbabwe
Affordable, easy-to-use and rapid diagnostics may support a move away from syndromic management for sexually transmitted infections (STIs) in resource-constrained settings. A lateral flow assay for Neisseria gonorrhoeae (NG-LFA) has shown high sensitivity and specificity (>90%) in symptomatic individuals. We investigated the performance and acceptability of this assay as a screening tool for NG among pregnant women. This evaluation was embedded w…
Challenges to fracture service availability and readiness provided by allopathic and traditional health providers
Background: Populations in Africa are ageing, hence the number of age-related fragility fractures, including hip fractures, is rising. Hip fractures are an indicator condition for older adult health provision, as they require a multifaceted pathway of care. To enable health service planning, detailed national-level understanding of current fracture service provision is needed. Methods: The WHO Service Availability & Readiness Assessment survey wa…
Hospital referral patterns amongst older adults in Zimbabwe
Over the coming decades Africa is projected to undergo a significant demographic shift towards an older population. Healthcare provision for older adults is made more complex by age-related multimorbidity and frailty, which contribute to older adults more frequently requiring intensive, hospital-based treatment than those in younger age groups. We investigate age and sex-stratified, diagnosis-specific hospital referral patterns in Harare, Zimbabw…
How and why do young people engage in STI screening, treatment, and partner notification? A qualitative positive deviance study in Zimbabwe
Young people have a high burden of sexually transmitted infections (STIs) but low uptake of and high attrition from services. We adopted a positive deviance approach to explore uptake of STI screening, treatment, and partner notification within a sexual and reproductive health service. We conducted in-depth interviews with young people (aged 16-24 years) who accepted screening, treatment, and partner notification slips ( n = 15), and healthcare p…
Insights into tuberculosis burden in Karachi, Pakistan
Pakistan is one of the five highest tuberculosis burden countries globally. We estimated prevalence of adult bacteriologically confirmed pulmonary tuberculosis and annual risk of Mycobacterium tuberculosis (M . tuberculosis) infection in children aged 2–4 years in Karachi, Pakistan. The survey design enabled exploration of tuberculosis burden by whether the population had previously been exposed to widespread tuberculosis active case-finding (ACF…
Higher loss of livelihood and impoverishment in households affected by tuberculosis compared to non-tuberculosis affected households in Zimbabwe
Tuberculosis (TB) disproportionally affects poor people, leading to income and non-income losses. Measures of socioeconomic impact of TB, e.g. impoverishment and patient costs are inadequate to capture non-income losses. We applied impoverishment and a multidimensional measure on TB and non-TB affected households in Zimbabwe. We conducted a cross-sectional study in 270 households: 90 non-TB; 90 drug-susceptible TB (DS-TB), 90 drug-resistant TB (D…
Interdisciplinary perspectives on multimorbidity in Africa
Multimorbidity is an emerging challenge for health systems globally. It is commonly defined as the co-occurrence of two or more chronic conditions in one person, but its meaning remains a lively area of academic debate, and the utility of the concept beyond high-income settings is uncertain. This article presents the findings from an interdisciplinary research initiative that drew together 60 academic and applied partners working in 10 African co…
Person-centered and youth-oriented interventions to improve TB Care for adolescents and young adults
Introduction Globally adolescents and young adults (AYA) with tuberculosis (TB) face unique challenges. Until recently they have received little attention and few tailored interventions exist. To improve TB outcomes in this population, there is a need to implement tailored interventions. However, limited research has been conducted about how to meet the needs of AYA with tuberculosis. In this paper we present the findings of a qualitative study t…
Evaluation of a comprehensive health check offered to frontline health workers in Zimbabwe
Health workers are essential for a functioning healthcare system, and their own health is often not addressed. During the COVID-19 pandemic health workers were at high risk of SARS-CoV-2 infection whilst coping with increased healthcare demand. Here we report the development, implementation, and uptake of an integrated health check combining SARS-CoV-2 testing with screening for other communicable and non-communicable diseases for health workers …
Clinical characteristics and outcomes of patients admitted with Covid-19 at a public-sector hospital over the first two waves of Sars-CoV-2 infection in Harare, Zimbabwe
Background We investigated the clinical profile, complications, and outcomes of inpatients with COVID-19 at Parirenyatwa Hospital, Harare, across the first two waves of SARS-CoV-2 infection, and factors associated with mortality. Methods We conducted a prospective cohort study on all patients admitted to the COVID-19 unit. Data were extracted from medical records and negative binomial regression with robust standard errors was used to assess the …
Prevalence of chronic conditions and multimorbidity among healthcare workers in Zimbabwe
The burden of non-communicable diseases (NCDs) in southern Africa is expanding and is superimposed on high HIV prevalence. Healthcare workers are a scarce resource; yet are vital to health systems. There are very limited studies on the burden of chronic conditions among healthcare workers in Africa, and none exploring multimorbidity (≥2 chronic conditions). We describe the epidemiology of infectious (HIV) and non-communicable chronic conditions, …
Differentiated care for youth in Zimbabwe
Youth living with HIV are at higher risk than adults of disengaging from HIV care. Differentiated models of care such as community delivery of antiretroviral therapy (ART) may improve treatment outcomes. We investigated outcomes across the HIV cascade among youth accessing HIV services in a community-based setting. This study was nested in a cluster-randomised controlled trial (CHIEDZA: Clinicaltrials.gov, Registration Number: NCT03719521) conduc…
The role of community health workers in improving HIV treatment outcomes in children
Reliance on community health workers (CHWs) for HIV care continues to increase, particularly in resource-limited settings. CHWs can improve HIV service use and adherence to treatment, but effectiveness of these programmes relies on providing an enabling work environment for CHWs, including reasonable workload, supportive supervision and adequate training and supplies. Although criteria for effective CHW programmes have been identified, these have…
Perception of Risk of Vertically Acquired HIV Infection and Acceptability of Provider-Initiated Testing and Counseling Among Adolescents in Zimbabwe
Objectives. We investigated attitudes toward provider-initiated HIV testing and counseling (PITC) in the suburbs of Harare, Zimbabwe, where late presentation after mother-to-child HIV transmission (MTCT) is a major cause of adolescent mortality. Methods. Adolescents (10–18 years) attending 2 primary clinics were offered PITC. Participants completed a questionnaire investigating acceptability of PITC, and in-depth interviews with 41 adolescents an…
Perception of Risk of Vertically Acquired HIV Infection and Acceptability of Provider-Initiated Testing and Counseling Among Adolescents in Zimbabwe
Objectives. We investigated attitudes toward provider-initiated HIV testing and counseling (PITC) in the suburbs of Harare, Zimbabwe, where late presentation after mother-to-child HIV transmission (MTCT) is a major cause of adolescent mortality. Methods. Adolescents (10–18 years) attending 2 primary clinics were offered PITC. Participants completed a questionnaire investigating acceptability of PITC, and in-depth interviews with 41 adolescents an…
Burden of HIV among primary school children and feasibility of primary school-linked HIV testing in Harare, Zimbabwe
Population-based surveys in Southern Africa suggest a substantial burden of undiagnosed HIV-infected long-term survivors of mother-to-child transmission. We conducted an HIV prevalence survey of primary school pupils in Harare, Zimbabwe, and evaluated school-linked HIV counselling and testing (HCT) for pupils, their families and schoolteachers. Population-weighted cluster sampling was used to select six primary schools. Randomly selected class-gr…
Perinatally acquired HIV infection in adolescents from sub-Saharan Africa
Factors associated with self-reported adherence among adolescents on antiretroviral therapy in Zimbabwe
Nonadherence to medication is the key obstacle to human immunodeficiency virus (HIV) treatment success. The group at highest risk of nonadherence is adolescents, but relatively little is known about risk factors for and protective factors against poor adherence in this age group. We undertook a cross-sectional study of 262 HIV-infected adolescents aged 10-19 years on antiretroviral therapy at two clinics in Harare, Zimbabwe, to investigate person…
TestMeEast
Late diagnosis occurs in almost half of those diagnosed in the UK (HIV Prevention England, 2013. Retrieved June 22, 2014, from HIV Prevention England: http://www.hivpreventionengland.org.uk/Campaigns-Current/National-HIV-Testing-Week ). Testing occurs mainly in sexual health and antenatal clinics despite recommendations to test more broadly [Ellis, S., & Curtis, H. (2012). HIV diagnoses and missed opportunities. Results of the British HIV associa…
“It is not possible to go inside and have a discussion”
Caregivers mediate children's access to HIV care and their adherence to treatment. Support for caregivers may improve health outcomes in children, but fear of HIV stigma and discrimination can affect both uptake and delivery of support services. Within a trial evaluating community-based support for caregivers of newly HIV diagnosed children in Harare, Zimbabwe, we conducted a longitudinal qualitative study to explore how stigma affected delivery …
Familial silence surrounding HIV and non-disclosure of HIV status to older children and adolescents
Increasing numbers of children with HIV are surviving to adolescence and beyond, many of whom are orphaned. Disclosure of childrens' and adolescents' HIV status has been shown to improve adherence and retention in HIV treatment programmes. We investigated caregiving arrangements and intra-familial experience of HIV and its relationship to HIV disclosure to older children and adolescents. Children aged 6-15 years, newly diagnosed with HIV infectio…
The role of community health workers in improving HIV treatment outcomes in children
Reliance on community health workers (CHWs) for HIV care continues to increase, particularly in resource-limited settings. CHWs can improve HIV service use and adherence to treatment, but effectiveness of these programmes relies on providing an enabling work environment for CHWs, including reasonable workload, supportive supervision and adequate training and supplies. Although criteria for effective CHW programmes have been identified, these have…
Lockdown measures in response to Covid-19 in nine sub-Saharan African countries
Lockdown measures have been introduced worldwide to contain the transmission of COVID-19. However, the term ‘lockdown’ is not well-defined. Indeed, WHO’s reference to ‘so-called lockdown measures’ indicates the absence of a clear and universally accepted definition of the term ‘lockdown’. We propose a definition of ‘lockdown’ based on a two-by-two matrix that categorises different communicable disease measures based on whether they are compulsory…
Antibiotic stories
BACKGROUND: As concerns about the prevalence of infections that are resistant to available antibiotics increase, attention has turned toward the use of these medicines both within and outside of formal healthcare settings. Much of what is known about use beyond formal settings is informed by survey-based research. Few studies to date have used comparative, mixed-methods approaches to render visible patterns of use within and between settings as w…
Adolescents’ and caregivers’ perceptions of caregiver-provided testing and HIV self-testing using oral mucosal transudate tests in Zimbabwe
Uptake of HIV testing remains lower among children and adolescents compared to adults. This study explored adolescents' perceptions of HIV self-testing (HIVST) and caregivers' perceptions of testing their children using an oral mucosal transudate (OMT) rapid HIV test (caregiver-provided testing). We conducted 31 interviews with adolescents aged 16-18 years and caregivers of children aged 2-15 years who received an OMT test. Participants described…
I was trying to get there, but I couldn’t’
Increasing facility-based delivery rates is pivotal to reach Sustainable Development Goals to improve skilled attendance at birth and reduce maternal and neonatal mortality in low- and middle-income countries (LMICs). The translation of global health initiatives into national policy and programmes has increased facility-based deliveries in LMICs, but little is known about the impact of such policies on social norms from the perspective of women w…
Coverage and effectiveness of conditional cash transfer for people with drug resistant tuberculosis in Zimbabwe
The End TB strategy recommends social protection to mitigate socio-economic impacts of tuberculosis. Zimbabwe started implementing a conditional cash transfer (CCT) programme for people on drug resistant tuberculosis (DR-TB) treatment in 2013. We aimed to determine the proportion of people receiving CCT and effectiveness of CCT in improving treatment outcomes, explore their experiences with registering for CCT and understand the impact of CCT fro…
Principles for delivery of youth lay counsellor programs
There is accumulating evidence that lay counsellors can effectively provide structured, evidence-based counselling interventions to improve mental health outcomes [1–4]. Lay counsellors help alleviate overburdened health systems that have limited numbers of mental health professionals through ‘task-shifting,’ a process of referring straightforward, or common mental health illness to lay workers who have received counselling training [...]
Improving Experiences of the Menopause for Women in Zimbabwe and South Africa
Women in sub-Saharan Africa report multiple impacts of menopause on daily life and have requested further information to support themselves. This study co-produced contextually relevant resources—booklets and poster—about menopause with women in Zimbabwe and South Africa. The study was conducted in four stages: interviews with women about the menopause; the development of prototype information resources; workshops with women to discuss country-sp…
Interrupted Access to and Use of Family Planning Among Youth in a Community‐Based Service in Zimbabwe During the First Year of the Covid‐19 Pandemic
The COVID‐19 pandemic has had serious impacts on economic, social, and health systems, and fragile public health systems have become overburdened in many countries, exacerbating existing service delivery challenges. This study describes the impact of the COVID‐19 pandemic on family planning services within a community‐based integrated HIV and sexual and reproductive health intervention for youth aged 16–24 years being trialled in Zimbabwe (CHIEDZ…
Antibiotics and the Biopolitics of Sex Work in Zimbabwe
The advent of antibiotics transformed the global public health landscape, dramatically improving health outcomes. Drawing on historical and ethnographic research on sex work in Zimbabwe, we examine the role of antibiotics in the management of sexually transmitted infections among sex workers, from punitive colonial approaches to "empowerment"-based discourses. We illustrate how programs for sex workers, while valued by these women, are narrow, ex…
Are concepts of adolescence from the Global North appropriate for Africa? A debate
Adolescence is widely defined as a distinct phase in the life-course during which an individual completes their biological development and transitions from childhood to adulthood. This article presents a debate, conducted in 2018 at a scientific symposium in Mwanza, Tanzania, of the appropriateness of this for Africa, and by extension whether health interventions and global health policy that are shaped by such concepts can be universally applica…
Addressing sociodemographic disparities in Covid-19 vaccine uptake among youth in Zimbabwe
INTRODUCTION: COVID-19 vaccine acceptance research has mostly originated from high-income countries and reasons why youth may not get vaccinated may differ in low-income settings. Understanding vaccination coverage across different population groups and the sociocultural influences in healthcare delivery is important to inform targeted vaccination campaigns. METHODS: A population-based survey was conducted in 24 communities across three provinces…
Exploring Covid-19 vaccine uptake among healthcare workers in Zimbabwe
With COVID-19 no longer categorized as a public health emergency of international concern, vaccination strategies and priority groups for vaccination have evolved. Africa Centres for Diseases Prevention and Control proposed the ‘100-100-70%’ strategy which aims to vaccinate all healthcare workers, all vulnerable groups, and 70% of the general population. Understanding whether healthcare workers were reached during previous vaccination campaigns a…
Insights into tuberculosis burden in Karachi, Pakistan
Pakistan is one of the five highest tuberculosis burden countries globally. We estimated prevalence of adult bacteriologically confirmed pulmonary tuberculosis and annual risk of Mycobacterium tuberculosis (M . tuberculosis) infection in children aged 2–4 years in Karachi, Pakistan. The survey design enabled exploration of tuberculosis burden by whether the population had previously been exposed to widespread tuberculosis active case-finding (ACF…
Higher loss of livelihood and impoverishment in households affected by tuberculosis compared to non-tuberculosis affected households in Zimbabwe
Tuberculosis (TB) disproportionally affects poor people, leading to income and non-income losses. Measures of socioeconomic impact of TB, e.g. impoverishment and patient costs are inadequate to capture non-income losses. We applied impoverishment and a multidimensional measure on TB and non-TB affected households in Zimbabwe. We conducted a cross-sectional study in 270 households: 90 non-TB; 90 drug-susceptible TB (DS-TB), 90 drug-resistant TB (D…
Interdisciplinary perspectives on multimorbidity in Africa
Multimorbidity is an emerging challenge for health systems globally. It is commonly defined as the co-occurrence of two or more chronic conditions in one person, but its meaning remains a lively area of academic debate, and the utility of the concept beyond high-income settings is uncertain. This article presents the findings from an interdisciplinary research initiative that drew together 60 academic and applied partners working in 10 African co…
Person-centered and youth-oriented interventions to improve TB Care for adolescents and young adults
Introduction Globally adolescents and young adults (AYA) with tuberculosis (TB) face unique challenges. Until recently they have received little attention and few tailored interventions exist. To improve TB outcomes in this population, there is a need to implement tailored interventions. However, limited research has been conducted about how to meet the needs of AYA with tuberculosis. In this paper we present the findings of a qualitative study t…
Evaluation of a comprehensive health check offered to frontline health workers in Zimbabwe
Health workers are essential for a functioning healthcare system, and their own health is often not addressed. During the COVID-19 pandemic health workers were at high risk of SARS-CoV-2 infection whilst coping with increased healthcare demand. Here we report the development, implementation, and uptake of an integrated health check combining SARS-CoV-2 testing with screening for other communicable and non-communicable diseases for health workers …
Medicine (36 works) · Environmental health (20 works) · Population (19 works) · Family medicine (17 works) · Adolescent Sexual and Reproductive Health (15 works) · HIV/AIDS Research and Interventions (13 works) · Health care (12 works) · Nursing (12 works) · Global Maternal and Child Health (11 works) · Internal Medicine (9 works)