Lessons from the recent rise in use of female sterilization in Malawi.

Science.gov (United States)

Jacobstein, Roy

2013-03-01

Although female sterilization is the most widely used modern contraceptive method in the world, most family planning programs in Africa have had difficulty providing it. Malawi, however, despite daunting constraints, has made female sterilization widely and equitably accessible, thereby increasing method choice and helping its citizens better meet their reproductive intentions. Ten percent of currently married Malawian women of reproductive age rely on female sterilization for contraceptive protection, compared with less than 2 percent across Africa, and demand to limit births now exceeds demand to space births. Malawi's female sterilization prevalence surpasses that of some high-resource countries. Key service-delivery factors enabling this achievement include supportive policies, strong public-private partnerships, and mobile services delivered at no cost by dedicated providers. Challenges remain, but Malawi's achievement offers lessons for other countries with low availability of female sterilization and similar resource constraints. © 2013 The Population Council, Inc.

Stroke outcomes in Malawi, a country with high prevalence of HIV: a prospective follow-up study.

Directory of Open Access Journals (Sweden)

Terttu Heikinheimo

Full Text Available BACKGROUND: Stroke contributes significantly to disability and mortality in developing countries yet little is known about the determinants of stroke outcomes in such countries. 12% of Malawian adults have HIV/AIDS. It is not known whether having HIV-infection alters the outcome of stroke. The aim of this study was to document the functional outcome and mortality at 1 year of first-ever acute stroke in Malawi. Also to find out if the baseline variables, including HIV-infection, affect the outcome of stroke. METHODS AND FINDINGS: 147 adult patients with first-ever acute stroke were prospectively followed up for 12 months. Conventional risk factors and HIV-infection were assessed at baseline. Stroke severity was evaluated with modified National Institute of Health Stroke Scale (mNIHSS and functional outcome with modified Rankin scale (mRS. Fifty (34% of patients were HIV-seropositive. 53.4% of patients had a poor outcome (severe disability or death, mRS 4-6 at 1 year. Poor outcome was related to stroke severity and female gender but not to presence of HIV-infection. HIV-seropositive patients were younger and had less often common risk factors for stroke. They suffer more often ischemic stroke than HIV-seronegative patients. CONCLUSIONS: Mild stroke and male gender were associated with favourable outcome. HIV-infection is common in stroke patients in Malawi but does not worsen the outcome of stroke. However, it may be a risk factor for ischemic stroke for young people, who do not have the common stroke risk factors. Our results are significant, because stroke outcome in HIV-seropositive patients has not been studied before in a setting such as ours, with very limited resources and a high prevalence of HIV.

Institutional Challenges to Viable Civil-Military Relations in Malawi

National Research Council Canada - National Science Library

Phiri, Mphatso J

2008-01-01

Malawi is one of the few African countries that has experienced neither a military coup nor a civil war, and has remained peaceful since independence despite being under a dictatorial regime for three decades...

Divorce and Remarriage in Rural Malawi

Directory of Open Access Journals (Sweden)

2003-09-01

Full Text Available The demographic study of nuptiality in African countries is not very developed and often of secondary interest in a discussion of the proximate determinants of fertility. This paper uses unusual marriage history data to examine divorce and remarriage in rural Malawi. Life table probabilities of divorce range from 40 to 65 percent and are among the highest on the continent. An investigation into the determinants of marital instability using proportional hazards models confirms the importance of kinship systems and female empowerment, but the mechanism underlying the high divorce rates in Malawi seems to be more complicated than that. This is, for example, illustrated in the effect of the polygyny variables. Marriage, divorce, and remarriage are further considered as empowering strategies that women deploy throughout their lives.

Kenya-Malawi Health Research Capacity Strengthening Initiative ...

International Development Research Centre (IDRC) Digital Library (Canada)

This grant will support the creation of two task forces in Kenya and Malawi, respectively, to articulate nationally owned and strategies for an effective health research system in each country. The idea is to enhance the capacity of health research institutions to generate new scientific knowledge, and health policymaking ...

Remarkable rates of lightning strike mortality in Malawi.

Science.gov (United States)

Mulder, Monique Borgerhoff; Msalu, Lameck; Caro, Tim; Salerno, Jonathan

2012-01-01

Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area.

Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

Science.gov (United States)

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 2010–2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

Life Skills and Reproductive Health Education Changes Behaviour in Students and Teachers: Evidence from Malawi

Science.gov (United States)

Kalanda, Boniface Francis

2010-01-01

Malawi is one of the countries with a youthful population. Youths are susceptible to various social-economic pressures that put their well being into jeopardy. One of the issues that affect youth is early drop out of school, drug abuse and contracting sexually transmitted diseases including HIV. To address these issues, the Malawi Government…

Creating digital library collections: the experience of Malawi ...

African Journals Online (AJOL)

Activities around the creation of digital library collections in Malawi libraries started after some librarians attended workshops on the subject both within and outside the country. Major challenges to these projects include inadequate technical expertise and equipment, lack of OCR software, inappropriate copyright law, and ...

Extending beyond Policy: Reaching UNAIDS’ Three “90”s in Malawi

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Zengani Chirwa

2018-03-01

Full Text Available Malawi, like other countries with a generalized HIV epidemic, is striving to reach the ambitious targets set by UNAIDS known as the three 90’s for testing, provision of antiretroviral therapy and viral suppression. Assisted by Malawi’s progressive policies on HIV/AIDS, it appears possible that Malawi will attain these targets, but only by employing innovative program approaches to service delivery which help fill policy gaps. This article describes how a dedicated cadre of layperson testers and HIV-positive peers appears to have helped attain increases in HIV and viral load testing and retention in care in four districts in Malawi, and situates these innovations in a policy framework analysis.

Menstruation and School Absenteeism: Evidence from Rural Malawi

Science.gov (United States)

Grant, Monica; Lloyd, Cynthia; Mensch, Barbara

2013-01-01

The provision of toilets and menstrual supplies appears to be a promising strategy to promote adolescent girls' school attendance and performance in less developed countries. In this article, we use the first round of the Malawi Schooling and Adolescent Survey (MSAS) to examine the individual- and school-level factors associated with…

Act local, think global: how the Malawi experience of scaling up antiretroviral treatment has informed global policy

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Anthony D. Harries

2016-09-01

Full Text Available Abstract The scale-up of antiretroviral therapy (ART in Malawi was based on a public health approach adapted to its resource-poor setting, with principles and practices borrowed from the successful tuberculosis control framework. From 2004 to 2015, the number of new patients started on ART increased from about 3000 to over 820,000. Despite being a small country, Malawi has made a significant contribution to the 15 million people globally on ART and has also contributed policy and service delivery innovations that have supported international guidelines and scale up in other countries. The first set of global guidelines for scaling up ART released by the World Health Organization (WHO in 2002 focused on providing clinical guidance. In Malawi, the ART guidelines adopted from the outset a more operational and programmatic approach with recommendations on health systems and services that were needed to deliver HIV treatment to affected populations. Seven years after the start of national scale-up, Malawi launched a new strategy offering all HIV-infected pregnant women lifelong ART regardless of the CD4-cell count, named Option B+. This strategy was subsequently incorporated into a WHO programmatic guide in 2012 and WHO ART guidelines in 2013, and has since then been adopted by the majority of countries worldwide. In conclusion, the Malawi experience of ART scale-up has become a blueprint for a public health response to HIV and has informed international efforts to end the AIDS epidemic by 2030.

Act local, think global: how the Malawi experience of scaling up antiretroviral treatment has informed global policy.

Science.gov (United States)

Harries, Anthony D; Ford, Nathan; Jahn, Andreas; Schouten, Erik J; Libamba, Edwin; Chimbwandira, Frank; Maher, Dermot

2016-09-06

The scale-up of antiretroviral therapy (ART) in Malawi was based on a public health approach adapted to its resource-poor setting, with principles and practices borrowed from the successful tuberculosis control framework. From 2004 to 2015, the number of new patients started on ART increased from about 3000 to over 820,000. Despite being a small country, Malawi has made a significant contribution to the 15 million people globally on ART and has also contributed policy and service delivery innovations that have supported international guidelines and scale up in other countries. The first set of global guidelines for scaling up ART released by the World Health Organization (WHO) in 2002 focused on providing clinical guidance. In Malawi, the ART guidelines adopted from the outset a more operational and programmatic approach with recommendations on health systems and services that were needed to deliver HIV treatment to affected populations. Seven years after the start of national scale-up, Malawi launched a new strategy offering all HIV-infected pregnant women lifelong ART regardless of the CD4-cell count, named Option B+. This strategy was subsequently incorporated into a WHO programmatic guide in 2012 and WHO ART guidelines in 2013, and has since then been adopted by the majority of countries worldwide. In conclusion, the Malawi experience of ART scale-up has become a blueprint for a public health response to HIV and has informed international efforts to end the AIDS epidemic by 2030.

Production of charcoal briquettes from cotton stalk in malawi: methodology for feasibility studies using experiences in Sudan

NARCIS (Netherlands)

Onaji, P.B.; Siemons, R.V.

1993-01-01

The feasibility of charcoal production from cotton stalks in Malawi was studied based on experience from Sudan. The country relies considerably on biomass fuels. Of the total energy consumption in Malawi of 2.376 MTOE in 1989, 92% was met by biomass (fuelwood: 83.6% and charcoal: 8.3% Petroleum

Remote Sensing Analysis of Malawi's Agricultural Inputs Subsidy and Climate Variability Impacts on Productivity

Science.gov (United States)

Galford, G. L.; Fiske, G. J.; Sedano, F.; Michelson, H.

2016-12-01

Agriculture in sub-Saharan Africa is characterized by smallholder production and low yields ( 1 ton ha-1 year-1 since records began in 1961) for staple food crops such as maize (Zea mays). Many years of low-input farming have depleted much of the region's agricultural land of critical soil carbon and nitrogen, further reducing yield potentials. Malawi is a 98,000 km2 subtropical nation with a short rainy season from November to May, with most rainfall occurring between December and mid-April. This short growing season supports the cultivation of one primary crop, maize. In Malawi, many smallholder farmers face annual nutrient deficits as nutrients removed as grain harvest and residues are beyond replenishment levels. As a result, Malawi has had stagnant maize yields averaging 1.2 ton ha-1 year-1 for decades. After multiple years of drought and widespread hunger in the early 2000s, Malawi introduced an agricultural input support program (fertilizer and seed subsidy) in time for the 2006 harvest that was designed to restore soil nutrients, improve maize production, and decrease dependence on food aid. Malawi's subsidy program targets 50-67% of smallholder farmers who cultivate half a hectare or less, yet collectively supply 80% of the country's maize. The country has achieved significant increases in crop yields (now 2 tons/ha/year) and, as our analysis shows, benefited from a new resilience against drought. We utilized Landsat time series to determine cropland extent from 2000-present and identify areas of marginal and/or intermittent production. We found a strong latitudinal gradient of precipitation variability from north to south in CHIRPS data. We used the precipitation variability to normalize trends in a productivity proxy derived from MODIS EVI. After normalization of productivity to precipitation variability, we found significant productivity trends correlated to subsidy distribution. This work was conducted with Google's Earth Engine, a cloud-based platform

The difficulties of conducting maternal death reviews in Malawi

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van den Broek Nynke

2008-09-01

Full Text Available Abstract Background Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. Methods SWOT (strengths, weaknesses, opportunities and threats analysis of the process of maternal death review during a workshop in Malawi. Results Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Conclusion Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.

The difficulties of conducting maternal death reviews in Malawi.

Science.gov (United States)

Kongnyuy, Eugene J; van den Broek, Nynke

2008-09-11

Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. SWOT (strengths, weaknesses, opportunities and threats) analysis of the process of maternal death review during a workshop in Malawi. Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.

Case studies of nurseries in Malawi

DEFF Research Database (Denmark)

Namoto, M.; Likoswe, M.G.

This study of 42 case studies of nurseries was made as part of a major sample survey of 360 nurseries in 6 districts in Malawi. The purpose of the study was to let the small nurseries in the country explain in their own words how they source seed, how and for whom they produce seedlings......, and to explain about their problems and opportunities in the nursery business. The assessment was made within the framework of Improved Seed Supply for Agroforestry in African Countries (ISSAAC), a Danida supported programme implemented in cooperation between Forest & Landscape Denmark and World Agroforestry...

Commentary - Cancer and palliative care | Chan | Malawi Medical ...

African Journals Online (AJOL)

'The rise of cancer in less affluent countries is an impending disaster' Malawi Medical Journal Vol. 20 (4) 2008: pp. 108-108. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v20i4.10978 · AJOL African Journals Online. HOW TO ...

On-the-job training of clinical officers in Malawi | Jiskoot | Malawi ...

African Journals Online (AJOL)

Although Malawi started a Medical College in 1991 to train medical doctors, it continues to face a chronic shortage of medical staff. Malawi Medical Journal Vol. 20 (3) 2008: pp. 74-77. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

HIV and mental illness in Malawi and the neuropsychiatric sequelae of efavirenz.

Science.gov (United States)

Drury, Andrew; Gleadow-Ware, Selena; Gilfillan, Sheila; Ahrens, Jen

2018-03-01

Little is published about mental disorders in Malawi, specifically in relation to Human Immunodeficiency Virus (HIV) and it's treatment. Efavirenz is a medication commonly used as part of triple therapy for HIV treatment. Indeed, in 2013, Malawi introduced 5A with Efavirenz as part of it's 1st line treatment for HIV. There exists some literature documenting known psychiatric side effects of Efavirenz, which include anxiety, mood changes, nightmares, psychosis and suicidal ideation. Little is known about what features are most common in the presentation and what factors in the patient and drug which may make this reaction more likely. The aim of this commentary is to review the association between HIV and psychiatric disorder, and consider the neuropsychiatric side-effects of Efavirenz. An evaluative literature review was completed by means of multiple electronic database search as well as an additional manual search to obtain published works identified through the electronic search. Search terms used were: Efavirenz, Acquired Immunodeficiency Syndrome, Africa, Antiretroviral Therapy, Developing Countries, Malawi, Mental Disorders, Public Health, and Psychiatry. This is an important area of study, as potentially large numbers of individuals with HIV are being placed on Efavirenz as first line treatment, yet 60% may experience some form of neuropsychiatric side effects.

Soil and Terrain Database for Malawi (ver. 1.0) (SOTER_Malawi)

NARCIS (Netherlands)

Kempen, B.

2014-01-01

The Soil and Terrain database for Malawi (version 1.0), at scale 1:1 million, was compiled based on the soil map of Malawi at scale 1:250,000 (compiled by the Land Resources Evaluation Project) that was complemented with soil boundary information from the provisional soil map at scale 1:1 million.

High-Stakes Testing in the Warm Heart of Africa:The Challenges and Successes of the Malawi National Examinations Board

Directory of Open Access Journals (Sweden)

Elias Chakwera

2004-06-01

Full Text Available In the United States, tests are held to high standards of quality. In developing countries such as Malawi, psychometricians must deal with these same high standards as well as several additional pressures such as widespread cheating, test administration difficulties due to challenging landscapes and poor resources, difficulties in reliably scoring performance assessments, and extreme scrutiny from political parties and the popular press. The purposes of this paper are to (a familiarize the measurement community in the US about Malawi’s assessment programs, (b discuss some of the unique challenges inherent in such a program, (c compare testing conditions and test administration formats between Malawi and the US, and (d provide suggestions for improving large-scale testing in countries such as the US and Malawi. By learning how a small country instituted and supports its current testing programs, a broader perspective on resolving current measurement problems throughout the world will emerge.

IWRM and poverty reduction in Malawi: A socio-economic analysis

Science.gov (United States)

Mulwafu, Wapulumuka O.; Msosa, Hendrina K.

Like most other countries in the SADC region, Malawi has swiftly endorsed the United Nations Millennium Development Goals. In the water sector, these principles are reflected in the National Water Policy (2004) and in the Malawi Poverty Reduction Strategy Paper (PRSP) (2002) which emphasize three key aspects. First, the articulation of a vision and policy objectives that address development and management of water for productive purposes, conservation and poverty reduction. Second, the recognition of international and regional conventions and agreements on water resources to which Malawi is a signatory, thereby promoting global partnership for development. Third, the provision of mechanisms for monitoring, assessment and development related to watershed management, conservation and the mitigation of floods and droughts. Both the Malawi Poverty Reduction Strategy Paper and the National Water Policy seek to reduce poverty by increasing access to water for domestic and productive purposes. In particular, the MPRSP will focus on constructing and rehabilitating water facilities, extend water supply capacity, promote community-based management and improve water resources conservation and management. In this paper, we examine the challenges of implementing these goals against the background of various institutional reforms in the water sector. We argue that although Malawi has come up with very clear strategies and guidelines for promoting MDGs, a combination of human and financial resources, bedevil the successful implementation of these ideas. In addition, the strategies do not articulate water as a medium for poverty alleviation in a holistic manner. The paper further demonstrates ways in which the promotion of IWRM can facilitate in reducing poverty.

Malnutrition and Neutropenia in Children Treated for Burkitt Lymphoma in Malawi

NARCIS (Netherlands)

Israëls, Trijn; van de Wetering, Marianne D.; Hesseling, Peter; van Geloven, Nan; Caron, Huib N.; Molyneux, Elizabeth M.

2009-01-01

Background. infection in neutropenic children is a major cause of morbidity and mortality in children treated for cancer. In developing countries, children with cancer are often malnourished at diagnosis. In Blantyre, Malawi, children with Burkitt lymphoma are treated with a local protocol with

Uitdagings vir die Ned Geref Kerk in Suidelike Afrika met Malawi en Zambi� as illustrasiegebiede

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D. Crafford

1990-08-01

Full Text Available Challenges for the Dutch Reformed Church in Southern Africa with Malawi and Zambia as illustration areas What will be the challenges for the Dutch Reformed Church in South Africa if in the coming decades its isolation from Africa could be ended because of political developments in a post-apartheid era? The Dutch Reformed Church planted indigenous churches in many African Countries like Botswana, Malawi, Zimbabwe, Zambia, Mozambique and Namibia. The role of the church in Africa will be determined by its relations with these younger churches. The challenges in the fields of evangelism, church ministry, the youth and in the socioeconomic and political areas are illustrated specifically in the cases of Malawi and Zambia.

Is there a threshold level of maternal education sufficient to reduce child undernutrition? Evidence from Malawi, Tanzania and Zimbabwe.

Science.gov (United States)

Makoka, Donald; Masibo, Peninah Kinya

2015-08-22

Maternal education is strongly associated with young child nutrition outcomes. However, the threshold of the level of maternal education that reduces the level of undernutrition in children is not well established. This paper investigates the level of threshold of maternal education that influences child nutrition outcomes using Demographic and Health Survey data from Malawi (2010), Tanzania (2009-10) and Zimbabwe (2005-06). The total number of children (weighted sample) was 4,563 in Malawi; 4,821 children in Tanzania; and 3,473 children in Zimbabwe Demographic and Health Surveys. Using three measures of child nutritional status: stunting, wasting and underweight, we employ a survey logistic regression to analyse the influence of various levels of maternal education on child nutrition outcomes. In Malawi, 45% of the children were stunted, 42% in Tanzania and 33% in Zimbabwe. There were 12% children underweight in Malawi and Zimbabwe and 16% in Tanzania.The level of wasting was 6% of children in Malawi, 5% in Tanzania and 4% in Zimbabwe. Stunting was significantly (p values educational level in all the three countries. Higher levels of maternal education reduced the odds of child stunting, underweight and wasting in the three countries. The maternal threshold for stunting is more than ten years of schooling. Wasting and underweight have lower threshold levels. These results imply that the free primary education in the three African countries may not be sufficient and policies to keep girls in school beyond primary school hold more promise of addressing child undernutrition.

How are health professionals earning their living in Malawi?

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Maseko Fresier C

2006-08-01

Full Text Available Abstract Background The migration of health professionals from southern Africa to developed nations is negatively affecting the delivery of health care services in the source countries. Oftentimes however, it is the reasons for the out-migration that have been described in the literature. The work and domestic situations of those health professionals continuing to serve in their posts have not been adequately studied. Methods The present study utilized a qualitative data collection and analysis method. This was achieved through focus group discussions and in-depth interviews with health professionals and administrators to determine the challenges they face and the coping systems they resort to and the perceptions towards those coping methods. Results Health professionals identified the following as some of the challenges there faced: inequitable and poor remuneration, overwhelming responsibilities with limited resources, lack of a stimulating work environment, inadequate supervision, poor access to continued professionals training, limited career progression, lack of transparent recruitment and discriminatory remuneration. When asked what kept them still working in Malawi when the pressures to emigrate were there, the following were some of the ways the health professionals mentioned as useful for earning extra income to support their families: working in rural areas where life was perceived to be cheaper, working closer to home village so as to run farms, stealing drugs from health facilities, having more than one job, running small to medium scale businesses. Health professionals would also minimize expenditure by missing meals and walking to work. Conclusion Many health professionals in Malawi experience overly challenging environments. In order to survive some are involved in ethically and legally questionable activities such as receiving "gifts" from patients and pilfering drugs. The efforts by the Malawi government and the international

The composition of demand for newly launched vaccines: results from the pneumococcal and rotavirus vaccine introductions in Ethiopia and Malawi.

Science.gov (United States)

Williams, B Adam; Kidane, Teklay; Chirwa, Geoffrey; Tesfaye, Neghist; Prescott, Marta R; Scotney, Soleine T; Valle, Moussa; Abebe, Sintayehu; Tambuli, Adija; Malewezi, Bridget; Mohammed, Tahir; Kobayashi, Emily; Wootton, Emily; Wong, Renee; Dosani, Rahima; Subramaniam, Hamsa; Joseph, Jessica; Yavuz, Elif; Apple, Aliza; Le Tallec, Yann; Kang'ethe, Alice

2016-06-01

Understanding post-launch demand for new vaccines can help countries maximize the benefits of immunization programmes. In particular, low- and middle-income countries (LMICs) should ensure adequate resource planning with regards to stock consumption and service delivery for new vaccines, whereas global suppliers must produce enough vaccines to meet demand. If a country underestimates the number of children seeking vaccination, a stock-out of commodities will create missed opportunities for saving lives. We describe the post-launch demand for the first dose of pneumococcal conjugate vaccine (PCV1) in Ethiopia and Malawi and the first dose of rotavirus vaccine (Rota1) in Malawi, with focus on the new birth cohort and the 'backlog cohort', comprised of older children who are still eligible for vaccination at the time of launch. PCV1 and Rota1 uptake were compared with the demand for the first dose of pentavalent vaccine (Penta1), a routine immunization that targets the same age group and immunization schedule. In the first year, the total demand for PCV1 was 37% greater than that of Penta1 in Ethiopia and 59% greater in Malawi. In the first 6 months, the demand of Rota1 was only 5.9% greater than Penta1 demand in Malawi. Over the first three post-introduction months, 70.7% of PCV1 demand in Ethiopia and 71.5% of demand in Malawi came from children in the backlog cohort, whereas only 28.0% of Rota1 demand in Malawi was from the backlog cohort. The composition of demand was impacted by time elapsed since vaccine introduction and age restrictions. Evidence suggests that countries' plans should account for the impact of backlog demand, especially in the first 3 months post-introduction. LMICs should request for higher stock volumes when compared with routine needs, plan social mobilization activities to reach the backlog cohort and allocate human resources and cold chain capacity to accommodate high demand following vaccine introduction. © The Author 2016. Published by

Variability of extreme wet events over Malawi

Directory of Open Access Journals (Sweden)

Libanda Brigadier

2017-01-01

Full Text Available Adverse effects of extreme wet events are well documented by several studies around the world. These effects are exacerbated in developing countries like Malawi that have insufficient risk reduction strategies and capacity to cope with extreme wet weather. Ardent monitoring of the variability of extreme wet events over Malawi is therefore imperative. The use of the Expert Team on Climate Change Detection and Indices (ETCCDI has been recommended by many studies as an effective way of quantifying extreme wet events. In this study, ETCCDI indices were used to examine the number of heavy, very heavy, and extremely heavy rainfall days; daily and five-day maximum rainfall; very wet and extremely wet days; annual wet days and simple daily intensity. The Standard Normal Homogeneity Test (SNHT was employed at 5% significance level before any statistical test was done. Trend analysis was done using the nonparametric Mann-Kendall statistical test. All stations were found to be homogeneous apart from Mimosa. Trend results show high temporal and spatial variability with the only significant results being: increase in daily maximum rainfall (Rx1day over Karonga and Bvumbwe, increase in five-day maximum rainfall (Rx5day over Bvumbwe. Mzimba and Chileka recorded a significant decrease in very wet days (R95p while a significant increase was observed over Thyolo. Chileka was the only station which observed a significant trend (decrease in extremely wet rainfall (R99p. Mzimba was the only station that reported a significant trend (decrease in annual wet-day rainfall total (PRCPTOT and Thyolo was the only station that reported a significant trend (increase in simple daily intensity (SDII. Furthermore, the findings of this study revealed that, during wet years, Malawi is characterised by an anomalous convergence of strong south-easterly and north-easterly winds. This convergence is the main rain bringing mechanism to Malawi.

The Causes of Dropout in Rural Primary Schools in Malawi

OpenAIRE

谷口, 京子

2017-01-01

High dropout rates is a critical issue in most of developing countries. Malawi follows this trend of student nonpersistence; in 2013, the primary school dropout rate was approximately 12.2%.This study aims to find the causes of dropout in rural Malawian primary schools. There are two features: data were collected through survival analysis, which has been used to study dropout in developed countries; a multilevel logistic regression was used to classify individual, family, teacher and school f...

Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance

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Makoka Mwai H

2012-03-01

Full Text Available Abstract Background Life-threatening infections present major challenges for health systems in Malawi and the developing world because routine microbiologic culture and sensitivity testing are not performed due to lack of capacity. Use of empirical antimicrobial therapy without regular microbiologic surveillance is unable to provide adequate treatment in the face of emerging antimicrobial resistance. This study was conducted to determine antimicrobial susceptibility patterns in order to inform treatment choices and generate hospital-wide baseline data. Methods Culture and susceptibility testing was performed on various specimens from patients presenting with possible infectious diseases at Kamuzu Central Hospital, Lilongwe, Malawi. Results Between July 2006 and December 2007 3104 specimens from 2458 patients were evaluated, with 60.1% from the adult medical service. Common presentations were sepsis, meningitis, pneumonia and abscess. An etiologic agent was detected in 13% of patients. The most common organisms detected from blood cultures were Staphylococcus aureus, Escherichia coli, Salmonella species and Streptococcus pneumoniae, whereas Streptococcus pneumoniae and Cryptococcus neoformans were most frequently detected from cerebrospinal fluid. Haemophilus influenzae was rarely isolated. Resistance to commonly used antibiotics was observed in up to 80% of the isolates while antibiotics that were not commonly in use maintained susceptibility. Conclusions There is widespread resistance to almost all of the antibiotics that are empirically used in Malawi. Antibiotics that have not been widely introduced in Malawi show better laboratory performance. Choices for empirical therapy in Malawi should be revised accordingly. A microbiologic surveillance system should be established and prudent use of antimicrobials promoted to improve patient care.

Newborn survival in Malawi: a decade of change and future implications.

Science.gov (United States)

Zimba, Evelyn; Kinney, Mary V; Kachale, Fannie; Waltensperger, Karen Z; Blencowe, Hannah; Colbourn, Tim; George, Joby; Mwansambo, Charles; Joshua, Martias; Chanza, Harriet; Nyasulu, Dorothy; Mlava, Grace; Gamache, Nathalie; Kazembe, Abigail; Lawn, Joy E

2012-07-01

Malawi is one of two low-income sub-Saharan African countries on track to meet the Millennium Development Goal (MDG 4) for child survival despite high fertility and HIV and low health worker density. With neonatal deaths becoming an increasing proportion of under-five deaths, addressing newborn survival is critical for achieving MDG 4. We examine change for newborn survival in the decade 2000-10, analysing mortality and coverage indicators whilst considering other contextual factors. We assess national and donor funding, as well as policy and programme change for newborn survival using standard analyses and tools being applied as part of a multi-country analysis. Compared with the 1990s, progress towards MDG 4 and 5 accelerated considerably from 2000 to 2010. Malawi's neonatal mortality rate (NMR) reduced slower than annual reductions in mortality for children 1-59 months and maternal mortality (NMR reduced 3.5% annually). Yet, the NMR reduced at greater pace than the regional and global averages. A significant increase in facility births and other health system changes, including increased human resources, likely contributed to this decline. High level attention for maternal health and associated comprehensive policy change has provided a platform for a small group of technical and programme experts to link in high impact interventions for newborn survival. The initial entry point for newborn care in Malawi was mainly through facility initiatives, such as Kangaroo Mother Care. This transitioned to an integrated and comprehensive approach at community and facility level through the Community-Based Maternal and Newborn Care package, now being implemented in 17 of 28 districts. Addressing quality gaps, especially for care at birth in facilities, and including newborn interventions in child health programmes, will be critical to the future agenda of newborn survival in Malawi.

Archives: Malawi Medical Journal

African Journals Online (AJOL)

Items 1 - 50 of 72 ... Archives: Malawi Medical Journal. Journal Home > Archives: Malawi Medical Journal. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 50 of 72 Items, 1 2 > >> ...

Characterizing the impact of sustained sulfadoxine/pyrimethamine use upon the Plasmodium falciparum population in Malawi

DEFF Research Database (Denmark)

Ravenhall, Matt; Benavente, Ernest Diez; Mipando, Mwapatsa

2016-01-01

BACKGROUND: Malawi experienced prolonged use of sulfadoxine/pyrimethamine (SP) as the front-line anti-malarial drug, with early replacement of chloroquine and delayed introduction of artemisinin-based combination therapy. Extended use of SP, and its continued application in pregnancy is impacting...... the genomic variation of the Plasmodium falciparum population. METHODS: Whole genome sequence data of P. falciparum isolates covering 2 years of transmission within Malawi, alongside global datasets, were used. More than 745,000 SNPs were identified, and differences in allele frequencies between countries...

Road traffic collisions in Malawi: Trends and patterns of mortality on ...

African Journals Online (AJOL)

Background: Worldwide, 90% of injury deaths occur in low- and middle-income countries (LMIC). Road traffic collisions (RTCs) are increasingly common and result in more death and disability in the developing world than in the developed world. We aimed to examine the prehospital case fatality rate from RTCs in Malawi.

Management of Health Information in Malawi: Role of Technology

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Patrick Albert Chikumba

2017-01-01

Full Text Available This paper is an extended version of the conference paper presented at IST Africa Week Conference 2016 and it discusses in detail the existing technology gaps using DHIS2 (District Health Information System 2.0 as an example, and how Geographic Information System (GIS and mobile application, as specific examples of technology, can enhance health management information system (HMIS in Malawi. The paper focuses on management of health information. When organisation information is made available, it is expected that the decision-makers use it objectively making rational decisions. This can be achieved by how the information is organized, integrated and presented probably through technology. Along with the increase in strengthening HMIS, questions of how to support the management of information at various organizational levels arise. Research on technologies in health management in developing countries has been on single technologies. Therefore, in this paper, the interest is on multiple technologies and how they support each other to enhance health information management. It has been observed that when it comes to health information management, HMIS employs a mix of paper-based and technology-based practices. Taking into account the infrastructure in Malawi, as in many developing countries, this is probably the most feasible approach. Hence, discussions of existing technology gaps include both paper-based and technology-based practices and how to better support health information management practices through this mixed use of media. The case study confirms that technology plays a role in strengthening HMIS. However, this should be supported by enhancing a culture of information management. It has been noted that DHIS2 is the main information system but it requires the enhancement through inclusions of other technologies. The DHIS2 alone cannot do everything.

Insights on skilled attendance at birth in Malawi - the findings of a ...

African Journals Online (AJOL)

Increasing the number of women who access skilled attendance at birth is the goal of many developing countries including Malawi. The Skilled Attendance for Everyone (SAFE) international research programme coordinated by the Dugald Baird Centre for research on Women\\'s Health at the University of Aberdeen, ...

Menstruation and School Absenteeism: Evidence from Rural Malawi

OpenAIRE

Grant, Monica J.; Lloyd, Cynthia B.; Mensch, Barbara S.

2013-01-01

The provision of toilets and menstrual supplies has emerged as a promising programmatic strategy to support adolescent girls’ school attendance and performance in less developed countries. We use the first round of the Malawi Schooling and Adolescent Survey (MSAS) to examine the individual- and school-level factors associated with menstruation-related school absenteeism. The MSAS is a school-based longitudinal survey of adolescent students enrolled in coed public primary schools in the southe...

Development and validation of a simple algorithm for initiation of CPAP in neonates with respiratory distress in Malawi

OpenAIRE

Hundalani, Shilpa G; Richards-Kortum, Rebecca; Oden, Maria; Kawaza, Kondwani; Gest, Alfred; Molyneux, Elizabeth

2015-01-01

Background Low-cost bubble continuous positive airway pressure (bCPAP) systems have been shown to improve survival in neonates with respiratory distress, in developing countries including Malawi. District hospitals in Malawi implementing CPAP requested simple and reliable guidelines to enable healthcare workers with basic skills and minimal training to determine when treatment with CPAP is necessary. We developed and validated TRY (T: Tone is good, R: Respiratory Distress and Y=Yes) CPAP, a s...

Combining qualitative and quantitative evidence to determine factors leading to late presentation for antiretroviral therapy in Malawi.

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Fiona R Parrott

Full Text Available Treatment seeking delays among people living with HIV have adverse consequences for outcome. Gender differences in treatment outcomes have been observed in sub-Saharan Africa.To better understand antiretroviral treatment (ART seeking behaviour in HIV-infected adults in rural Malawi.Qualitative interviews with male and female participants in an ART cohort study at a treatment site in rural northern Malawi triangulated with analysis of baseline clinical and demographic data for 365 individuals attending sequentially for ART screening between January 2008 and September 2009.43% of the cohort presented with late stage HIV disease classified as WHO stage 3/4. Respondents reported that women's frequency of testing, health awareness and commitment to children led to earlier ART uptake and that men's commitment to wider social networks of influence, masculine ideals of strength, and success with sexual and marital partners led them to refuse treatment until they were sick. Quantitative analysis of the screening cohort provided supporting evidence for these expressed views. Overall, male gender (adjusted OR 2.3, 95% CI1.3-3.9 and never being married (adjusted OR 4.1, 95% CI1.5-11.5 were risk factors for late presentation, whereas having ≥3 dependent children was associated with earlier presentation (adjusted OR 0.31, 95% CI0.15-0.63, compared to those with no dependent children.Gender-specific barriers and facilitators operate throughout the whole process of seeking care. Further efforts to enrol men into care earlier should focus on the masculine characteristics that they value, and the risks to these of severe health decline. Our results emphasise the value of exploring as well as identifying behavioural correlates of late presentation.

Combining qualitative and quantitative evidence to determine factors leading to late presentation for antiretroviral therapy in Malawi.

Science.gov (United States)

Parrott, Fiona R; Mwafulirwa, Charles; Ngwira, Bagrey; Nkhwazi, Sothini; Floyd, Sian; Houben, Rein M G J; Glynn, Judith R; Crampin, Amelia C; French, Neil

2011-01-01

Treatment seeking delays among people living with HIV have adverse consequences for outcome. Gender differences in treatment outcomes have been observed in sub-Saharan Africa. To better understand antiretroviral treatment (ART) seeking behaviour in HIV-infected adults in rural Malawi. Qualitative interviews with male and female participants in an ART cohort study at a treatment site in rural northern Malawi triangulated with analysis of baseline clinical and demographic data for 365 individuals attending sequentially for ART screening between January 2008 and September 2009. 43% of the cohort presented with late stage HIV disease classified as WHO stage 3/4. Respondents reported that women's frequency of testing, health awareness and commitment to children led to earlier ART uptake and that men's commitment to wider social networks of influence, masculine ideals of strength, and success with sexual and marital partners led them to refuse treatment until they were sick. Quantitative analysis of the screening cohort provided supporting evidence for these expressed views. Overall, male gender (adjusted OR 2.3, 95% CI1.3-3.9) and never being married (adjusted OR 4.1, 95% CI1.5-11.5) were risk factors for late presentation, whereas having ≥3 dependent children was associated with earlier presentation (adjusted OR 0.31, 95% CI0.15-0.63), compared to those with no dependent children. Gender-specific barriers and facilitators operate throughout the whole process of seeking care. Further efforts to enrol men into care earlier should focus on the masculine characteristics that they value, and the risks to these of severe health decline. Our results emphasise the value of exploring as well as identifying behavioural correlates of late presentation.

Understanding job satisfaction amongst mid-level cadres in Malawi: the contribution of organisational justice.

Science.gov (United States)

McAuliffe, Eilish; Manafa, Ogenna; Maseko, Fresier; Bowie, Cameron; White, Emma

2009-05-01

The migration of doctors and nurses from low- to high-income countries has left many countries relying on mid-level cadres as the mainstay of their health delivery system, Malawi being an example. Although an extremely important resource, little attention has been paid to the management and further development of these cadres. In this paper we use the concept of organisational justice - fairness of treatment, procedures and communication on the part of managers - to explore through a questionnaire how mid-level cadres in jobs traditionally done by higher-level cadres self-assessed their level of job satisfaction. All mid-level health workers present on the day of data collection in 34 health facilities in three health districts of Malawi, one district each from the three geographical regions, were invited to participate; 126 agreed. Perceptions of justice correlated strongly with level of job satisfaction, and in particular perceptions of how well they were treated by their managers and the extent to which they were informed about decisions and changes. Pay was not the only important element in job satisfaction; promotion opportunities and satisfaction with current work assignments were also significant. These findings highlight the important role that managers can play in the motivation, career development and performance of mid-level health workers.

Management of HIV associated Kaposi's Sarcoma in Malawi ...

African Journals Online (AJOL)

Kaposi's sarcoma is a common malignancy in Malawi and is often managed with single agent vincristine. This article outlines feasible combination chemotherapy for Kaposi's sarcoma in Malawi which should be made more widely available. Malawi Medical Journal Vol. 20 (4) 2008: pp. 129-132.

Some characteristic features of Englishes in Lesotho, Malawi and Swaziland

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Kamwangamalu, Nkonko

2003-12-01

Full Text Available This article discusses the function of the English and the local form it takes in three Southern African countries, namely Lesotho, Malawi and Swaziland. English was introduced in these countries as a result of contacts between the indigenous people and British traders and missionaries during the 19th century. English, which had initially been the language of trade, became the official language in colonial administration. Since then, English has had shifting but always important roles alongside the indigenous languages. As usually happens with languages in contact, there has been a fair amount of mutual influence. In this article, we examine some of the changes in English, concentrating on the usage of non-L1 speakers. Kachru (1982 speaks of this process as ‘indigenisation’: changing the language to suit the communicative needs of non-native users in new, un-English contexts. That explanation is only partly satisfactory. Languages influence one another in sophisticated sociolinguistic ways that require more penetrating analysis. In this article, we are concerned mainly with examining and describing the transfer of syntactic, phonological, lexical and semantic features from indigenous languages into English. From observation, most of the Africanisms that apply in the three countries discussed, particularly in Malawi, could well apply to Zambia and Zimbabwe as well. Finally, we reflect on some future possibilities.

Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa

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Charles Normand

2013-01-01

Full Text Available Background: Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies. Objective: The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Methods: We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave. Results: There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (χ2=140.3, p<0.001. 18.8% of health workers in Tanzania and 26.5% in Malawi indicated that they were actively seeking employment elsewhere, compared to 41.4% in South Africa (χ2=83.5, p<0.001. The country differences were confirmed by multiple regression. The study also confirmed that job satisfaction is statistically related to intention to leave. Conclusions: We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and

Malawi Journal of Science and Technology

African Journals Online (AJOL)

AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES ... The Malawi Journal of Science and Technology (MJST), the research journal of the Faculty of Science, Chancellor College in Malawi is ...

Accommodation services for competitive tourism in Sub-Saharan Africa: Historical evidence from Malawi

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Magombo Alice

2017-12-01

Full Text Available The accommodation services sector is a vital underpinning of the competitiveness of destinations in especially emerging tourism regions of the global economy. Within the environment of Africa building the competitiveness of countries as tourism destinations is inseparable from the challenge of establishing a network of different forms of accommodation at competitive prices and internationally acceptable quality standards. This paper uses a longitudinal approach to analyse the development of the accommodation services sector in one African country - Malawi - which is scaling up its tourism industry. Using historical evidence the objective is to examine the unfolding evolution of accommodation services as a factor in enhancing tourism destination competitiveness. The chequered pathway followed in Malawi to building the country’s network of hotels and small-scale accommodation establishments is traced from the colonial period to post-independence developments. It is argued that in understanding the historical evolution of accommodation services policy re-orientations have been significant drivers of change.

Above- and Belowground Biomass Models for Trees in the Miombo Woodlands of Malawi

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Daud J. Kachamba

2016-02-01

Full Text Available In this study we present general (multiple tree species from several sites above- and belowground biomass models for trees in the miombo woodlands of Malawi. Such models are currently lacking in the country. The modelling was based on 74 trees comprising 33 different species with diameters at breast height (dbh and total tree height (ht ranging from 5.3 to 2 cm and from 3.0 to 25.0 m, respectively. Trees were collected from four silvicultural zones covering a wide range of conditions. We tested different models including dbh, ht and wood specific gravity ( ρ as independent variables. We evaluated model performance using pseudo-R2, root mean square error (RMSE, a covariance matrix for the parameter estimates, mean prediction error (MPE and relative mean prediction error (MPE%. Computation of MPE% was based on leave-one-out cross-validation. Values of pseudo-R2 and MPE% ranged 0.82–0.97 and 0.9%–2.8%, respectively. Model performance indicated that the models can be used over a wide range of geographical and ecological conditions in Malawi.

WP 82 - An overview of women’s work and employment in Malawi

OpenAIRE

Maarten Klaveren; Kea Tijdens; Melanie Hughie Williams; Nuria Ramos Martin

2009-01-01

*Management Summary* This report provides information on Malawi on behalf of the implementation of the DECISIONS FOR LIFE project in that country. The DECISIONS FOR LIFE project aims to raise awareness amongst young female workers about their employment opportunities and career possibilities, family building and the work-family balance. This report is part of the Inventories, to be made by the University of Amsterdam, for all 14 countries involved. It focuses on a gender analysis of work and ...

Health spending, illicit financial flows and tax incentives in Malawi.

Science.gov (United States)

O'Hare, B; Curtis, M

2014-12-01

This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.

Characterization of the solar climate in Malawi using NASA's surface ...

African Journals Online (AJOL)

user

Characterization of the solar climate in Malawi using. NASA's surface meteorology and solar energy. (SSE) model. Senganimalunje, T. C.1 and Tenthani, C. M. 2*. 1Malawi Bureau of Standards, Metrology Services Department, Box 946, Blantyre, Malawi. 2Physics and Biochemical Sciences Department, Malawi Polytechnic, ...

Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

Science.gov (United States)

Zafar, Shamsa; Jean-Baptiste, Rachel; Rahman, Atif; Neilson, James P; van den Broek, Nynke R

2015-01-01

For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective) and psychological morbidities in two different low-income countries. Cross sectional study with assessment of morbidity in early pregnancy (34%), late pregnancy (35%) and the postnatal period (31%) among 3459 women from two rural communities in Pakistan (1727) and Malawi (1732). Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity. One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective). Both infective (Pakistan) and non-infective morbidity (Pakistan and Malawi) was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon (Pakistan 2.6% in Malawi had an Edinburgh Postnatal Depression Score (EPDS) > 9. Complications during a previous pregnancy, infective morbidity (p <0.001), intra or postpartum haemorrhage (p <0.02) were associated with psychological morbidity in both settings. Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

Implementing Free Primary Education Policy in Malawi and Ghana: Equity and Efficiency Analysis

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Inoue, Kazuma; Oketch, Moses

2008-01-01

Malawi and Ghana are among the numerous Sub-Saharan Africa countries that have in recent years introduced Free Primary Education (FPE) policy as a means to realizing the 2015 Education for All and Millennium Development Goals international targets. The introduction of FPE policy is, however, a huge challenge for any national government that has…

Using participatory methods to design an mHealth intervention for a low income country, a case study in Chikwawa, Malawi.

Science.gov (United States)

Laidlaw, Rebecca; Dixon, Diane; Morse, Tracy; Beattie, Tara K; Kumwenda, Save; Mpemberera, Grant

2017-07-05

mHealth holds the potential to educate rural communities in developing countries such as Malawi, on issues which over-burdened and under staffed health centres do not have the facilities to address. Previous research provides support that mHealth could be used as a vehicle for health education campaigns at a community level; however the limited involvement of potential service users in the research process endangers both user engagement and intervention effectiveness. This two stage qualitative study used participatory action research to inform the design and development of an mHealth education intervention. First, secondary analysis of 108 focus groups (representing men, women, leadership, elderly and male and female youth) identified four topics where there was a perceived health education need. Second, 10 subsequent focus groups explored details of this perceived need and the acceptability and feasibility of mHealth implementation in Chikwawa, Malawi. Stage 1 and Stage 2 informed the design of the intervention in terms of target population, intervention content, intervention delivery and the frequency and timing of the intervention. This has led to the design of an SMS intervention targeting adolescents with contraceptive education which they will receive three times per week at 4 pm and will be piloted in the next phase of this research. This study has used participatory methods to identify a need for contraception education in adolescents and inform intervention design. The focus group discussions informed practical considerations for intervention delivery, which has been significantly influenced by the high proportion of users who share mobile devices and the intervention has been designed to allow for message sharing as much as possible.

Health Behaviuor Interventions In Developing Countries

African Journals Online (AJOL)

health promotion interventions specifically focusing on developing countries would ... example from Kenya and Brazil of web-based education on adolescents' ... Master of Public Health, College of Medicine, University of Malawi. Reviewed by: ...

Education, Health, and Labor Force Supply: Broadening Human Capital for National Development in Malawi

Science.gov (United States)

Smith, William C.; Ikoma, Sakiko; Baker, David P.

2016-01-01

Education and health are both capital investments in national development, often viewed as independent factors on a country's labor force supply and productivity. This study uses the 2010-2011 Third Integrated Household Survey in Malawi to propose an Education-enhanced Health Human Capital (EHHC) model where education influences labor force supply…

Understanding the earth systems of Malawi: Ecological sustainability, culture, and place-based education

Science.gov (United States)

Glasson, George E.; Frykholm, Jeffrey A.; Mhango, Ndalapa A.; Phiri, Absalom D.

2006-07-01

The purpose of this 2-year study was to investigate Malawian teacher educators' perspectives and dispositions toward teaching about ecological sustainability issues in Malawi, a developing country in sub-Sahara Africa. This study was embedded in a larger theoretical framework of investigating earth systems science through the understanding of nature-knowledge-culture systems from local, place-based perspectives. Specifically, we were interested in learning more about eco-justice issues that are related to environmental degradation in Malawi and the potential role of inquiry-oriented pedagogies in addressing these issues. In a science methods course, the African educators' views on deforestation and teaching about ecological sustainability were explored within the context of the local environment and culture. Teachers participated in inquiry pedagogies designed to promote the sharing of perspectives related to the connections between culture and ecological degradation. Strategies encouraging dialogue and reflection included role-playing, class discussions, curriculum development activities, teaching experiences with children, and field trips to a nature preserve. Data were analyzed from postcolonial and critical pedagogy of place theoretical perspectives to better understand the hybridization of viewpoints influenced by both Western and indigenous science and the political hegemonies that impact sustainable living in Malawi. Findings suggested that the colonial legacy of Malawi continues to impact the ecological sustainability issue of deforestation. Inquiry-oriented pedagogies and connections to indigenous science were embraced by the Malawian educators as a means to involve children in investigation, decision making, and ownership of critical environmental issues.

Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa.

Science.gov (United States)

Blaauw, Duane; Ditlopo, Prudence; Maseko, Fresier; Chirwa, Maureen; Mwisongo, Aziza; Bidwell, Posy; Thomas, Steve; Normand, Charles

2013-01-24

Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies. The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave. There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (χ2=140.3, pjob satisfaction is statistically related to intention to leave. We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less standardised and more targeted HRH strategies than has been practised to date.

Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa

Science.gov (United States)

Blaauw, Duane; Ditlopo, Prudence; Maseko, Fresier; Chirwa, Maureen; Mwisongo, Aziza; Bidwell, Posy; Thomas, Steve; Normand, Charles

2013-01-01

Background Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies. Objective The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Methods We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave. Results There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (χ2=140.3, pjob satisfaction is statistically related to intention to leave. Conclusions We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less standardised and more targeted HRH strategies than has been practised to date. PMID:23364090

Traditional healers and pulmonary tuberculosis in Malawi

NARCIS (Netherlands)

Brouwer, J. A.; Boeree, M. J.; Kager, P.; Varkevisser, C. M.; Harries, A. D.

1998-01-01

Queen Elizabeth Central Hospital (QECH) and Blantyre district, Malawi. To investigate the use that tuberculosis (TB) patients in Malawi make of traditional healers and traditional medicine. A questionnaire study was carried out on 89 smear-positive pulmonary TB patients admitted to QECH. Seven

What makes staff consider leaving the health service in Malawi?

OpenAIRE

Chimwaza, Wanangwa; Chipeta, Effie; Ngwira, Andrew; Kamwendo, Francis; Taulo, Frank; Bradley, Susan; McAuliffe, Eilish

2014-01-01

Background Malawi faces a severe shortage of health workers, a factor that has contributed greatly to high maternal mortality in the country. Most clinical care is performed by mid-level providers (MLPs). While utilization of these cadres in providing health care is a solution to the current shortages, demotivating factors within the Malawian health system are pushing them into private, non-governmental, and other non-health related positions. This study aims to highlight these demotivating f...

The reproductive biology of an open-water spawning Lake Malawi ...

African Journals Online (AJOL)

The reproductive biology of an open-water spawning Lake Malawi cichlid, Copadichromis chrysonotus. Lance W. Smith. Abstract. Copadichromis chrysonotus is a zooplanktivorous cichlid member of the diverse fish community inhabiting Lake Malawi's rocky, littoral habitat. Like most Lake Malawi cichlids, this species' ...

Comparative analysis of tomato value chain competitiveness in selected areas of Malawi and Mozambique

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Nelson Mango

2015-12-01

Full Text Available This paper discusses tomato value chain performance in Malawi and Mozambique using data collected from a market study commissioned by the International Centre for Tropical Agriculture as part of a regional research on conservation agriculture in maize-based farming systems in Sub-Saharan Africa. The results show that Malawi has a slightly higher competitive advantage in the production of tomato compared to Mozambique. Malawi’s relative competitiveness in tomato is mainly due to slightly higher productivity and the cost advantage in labor (low wages and irrigation costs. The paper proposes policy implications aimed at raising the productivity and trade competitiveness of tomato, as this will ensure the overall productivity of the maize-based smallholder farming systems in the two countries.

Gender, Gays and Gain: The Sexualised Politics of Donor Aid in Malawi Gender, Gays and Gain: Entwicklungshilfe für Malawi und die Rechte Homosexueller

Directory of Open Access Journals (Sweden)

Emmie Chanika

2013-01-01

Full Text Available Many Malawian politicians have exploited religious and cultural discourses, encouraging the discourse of the “God-fearing Malawi nation” while also acknowledging the country as a secular state. This discourse – which most recently underwent further development in the early 1980s when Christians and Muslims, funded by donor money, accelerated their evangelical drives in the context of a one-party Malawi – resonates with a patriarchal, conservative political dispensation. This paper traces the evolution of the “God-fearing nation” discourse in Malawian politics. It posits that the government used the “gay rights issue” as a strategy to disorient human rights activists and donors. Gay rights were de-linked from other civil rights, forcing a binary approach toward gay rights, which were seen by government supporters as “anti-Christian”, “anti-Malawian” concepts. The debate with donors enabled the government to claim “sovereign autonomy” and galvanise the population into an anti-aid mentality (better no aid than aid that supports homosexuality.Für ihren Diskurs der “God-fearing Malawi Nation” bedienten sich viele Politiker Malawis an religiösen und kulturellen Debatten, während sie Malawi gleichzeitig als säkularen Staat anerkannten. Dieser Diskurs wurde in den frühen 1980er Jahren fortentwickelt, als Christen und Muslime im Rahmen des malawischen Einparteiensystems – und unterstützt von externen Geldgebern – ihren Glaubenseifer steigerten. In ihm schwingt die Vorstellung partriarchalischer, konservativer politischer Verhältnisse mit. Der vorliegende Beitrag verfolgt die Entwicklung des Diskurses der “God-fearing Nation” in der malawischen Politik. Die Autoren zeigen auf, wie die Regierung die Frage der Rechte für Homosexuelle zur Desorientierung von Menschenrechtsaktivisten und Gebern einsetzte: Die Rechte Homosexueller wurden von den anderen Bürgerrechten getrennt betrachtet und so konnte zu diesen

Malawi Economic Monitor, November 2017 : Land for Inclusive Development

OpenAIRE

Kandoole, Priscilla; Record, Richard; Deininger, Klaus; Kalemba, Sunganani; Stylianou, Eleni; Chilima, Efrem; Kufeyani, Linly

2017-01-01

The Malawi Economic Monitor (MEM) provides an analysis of economic and structural development issues in Malawi. The aim of the publication is to foster better-informed policy analysis and debate regarding the key challenges that Malawi faces in its endeavor to achieve high rates of stable, inclusive, and sustainable economic growth. Malawi’s economy is primarily based on agriculture and he...

An assessment of the effects of the 2002 food crisis on children's health in Malawi

NARCIS (Netherlands)

R. Hartwig (Renate); M. Grimm (Michael)

2012-01-01

textabstractThe food crisis encountered in 2002 in Malawi was arguably one of the worst in the recent history of the country. The World Food Programme estimated that between 2.1 and 3.2 million people were threatened by starvation. Despite this assumed severity, not much research on the actual

The financial losses from the migration of nurses from Malawi

Directory of Open Access Journals (Sweden)

Muula Adamson S

2006-11-01

Full Text Available Abstract Background The migration of health professionals trained in Africa to developed nations has compromised health systems in the African region. The financial losses from the investment in training due to the migration from the developing nations are hardly known. Methods The cost of training a health professional was estimated by including fees for primary, secondary and tertiary education. Accepted derivation of formula as used in economic analysis was used to estimate the lost investment. Results The total cost of training an enrolled nurse-midwife from primary school through nurse-midwifery training in Malawi was estimated as US$ 9,329.53. For a degree nurse-midwife, the total cost was US$ 31,726.26. For each enrolled nurse-midwife that migrates out of Malawi, the country loses between US$ 71,081.76 and US$ 7.5 million at bank interest rates of 7% and 25% per annum for 30 years respectively. For a degree nurse-midwife, the lost investment ranges from US$ 241,508 to US$ 25.6 million at 7% and 25% interest rate per annum for 30 years respectively. Conclusion Developing countries are losing significant amounts of money through lost investment of health care professionals who emigrate. There is need to quantify the amount of remittances that developing nations get in return from those who migrate.

Public participation in Malawi's environmental impact assessment ...

African Journals Online (AJOL)

Since the adoption of the Environmental Management Act of 1996, Malawi has been using environmental impact assessment (EIA) as a tool for predicting and assessing the impact of development projects on the environment. This study assessed the extent of public participation in Malawi's EIA process. Desktop study of ...

Utilizing NASA Earth Observations to Assess Landslide Characteristics and Devlelop Susceptibility and Exposure Maps in Malawi

Science.gov (United States)

Klug, M.; Cissell, J.; Grossman, M.

2017-12-01

Malawi has become increasingly prone to landslides in the past few decades. This can be attributed to the terrain, types of soil and vegetation, increased human interference, and heavy flooding after long periods of drought. In addition to the floods and droughts, landslides cause extra stress to farmlands, thus exacerbating the current food security crisis in the country. It can be difficult to pinpoint just how many people are affected by landslides in Malawi because landslides often occur in rural areas or are grouped with other disasters, such as floods or earthquakes. This project created a Landslide Susceptibility Map to assess landslide-prone areas in Malawi using variables such as slope, distance to roads, distance to streams, soil type, and precipitation. These variables were derived using imagery from Landsat 8 Operational Land Imager (OLI), Shuttle Radar Topography Mission Version 3 (SRTM-v3), Global Precipitation Measurement (GPM), and Tropical Rainfall Measuring Mission (TRMM) satellites. Furthermore, this project created a Landslide Exposure Map to estimate how much of the local population lives in susceptible areas by intersecting population data with the Landslide Susceptibility Map. Additionally, an assessment of GPM and TRMM precipitation measurements was generated to better understand the reliability of both measurements for landslide monitoring. Finally, this project updated NASA SERVIR's Global Landslide Catalog (GLC) for Malawi by using WorldView data from Google Earth and Landsat 8 OLI. These end products were used by NASA SERVIR and the Regional Centre for Mapping of Resources for Development (RCMRD) for aiding in disaster management throughout Malawi.

All projects related to malawi | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Malawi has high rates of maternal mortality despite concerted efforts to increase the rate of births at health facilities. Topic: MATERNAL AND CHILD ... Malawi has the highest preterm delivery rate in the world. Topic: MATERNAL AND CHILD ...

Improving newborn care practices through home visits: lessons from Malawi, Nepal, Bangladesh, and Uganda

Directory of Open Access Journals (Sweden)

Deborah Sitrin

2015-03-01

Full Text Available Background: Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda. Objective: This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices. Design: Using data from cross-sectional surveys of women with live births at baseline and endline, the Pearson chi-squared test was used to assess changes over time. Generalised linear models were used to assess the relationship between the main independent variable – home visit from a community health worker (CHW during pregnancy (0, 1–2, 3+ – and use of selected practices while controlling for antenatal care, place of delivery, and maternal age and education. Results: There were statistically significant improvements in practices, except applying nothing to the cord in Malawi and early initiation of breastfeeding in Bangladesh. In Malawi, Nepal, and Bangladesh, women who were visited by a CHW three or more times during pregnancy were more likely to report use of selected practices. Women who delivered in a facility were also more likely to report use of selected practices in Malawi, Nepal, and Uganda; association with place of birth was not examined in Bangladesh because only women who delivered outside a facility were asked about these practices. Conclusion: Home visits can play a role in improving practices in different settings. Multiple interactions are needed, so programmes need to investigate the most appropriate and efficient ways to reach families and promote newborn care practices. Meanwhile, programmes must take advantage of

Validation of a Dutch risk score predicting poor outcome in adults with bacterial meningitis in Vietnam and Malawi.

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Ewout S Schut

Full Text Available We have previously developed and validated a prognostic model to predict the risk for unfavorable outcome in Dutch adults with bacterial meningitis. The aim of the current study was to validate this model in adults with bacterial meningitis from two developing countries, Vietnam and Malawi. Demographic and clinical characteristics of Vietnamese (n = 426, Malawian patients (n = 465 differed substantially from those of Dutch patients (n = 696. The Dutch model underestimated the risk of poor outcome in both Malawi and Vietnam. The discrimination of the original model (c-statistic [c] 0.84; 95% confidence interval 0.81 to 0.86 fell considerably when re-estimated in the Vietnam cohort (c = 0.70 or in the Malawian cohort (c = 0.68. Our validation study shows that new prognostic models have to be developed for these countries in a sufficiently large series of unselected patients.

Molecular characterization of rotavirus strains detected during a clinical trial of a human rotavirus vaccine in Blantyre, Malawi

Science.gov (United States)

Nakagomi, Toyoko; Nakagomi, Osamu; Dove, Winifred; Doan, Yen Hai; Witte, Desiree; Ngwira, Bagrey; Todd, Stacy; Steele, A Duncan; Neuzil, Kathleen M; Cunliffe, Nigel A

2014-01-01

The human, G1P[8] rotavirus vaccine (Rotarix) significantly reduced severe rotavirus gastroenteritis episodes in a clinical trial in South Africa and Malawi, but vaccine efficacy was lower in Malawi (49.5%) than reported in South Africa (76.9%) and elsewhere. The aim of this study was to examine the molecular relationships of circulating wild-type rotaviruses detected during the clinical trial in Malawi to RIX4414 (the strain contained in Rotarix) and to common human rotavirus strains. Of 88 rotavirus-positive, diarrhoeal stool specimens, 43 rotaviruses exhibited identifiable RNA migration patterns when examined by polyacrylamide gel electrophoresis. The genes encoding VP7, VP4, VP6 and NSP4 of 5 representative strains possessing genotypes G12P[6], G1P[8], G9P[8], and G8P[4] were sequenced. While their VP7 (G) and VP4 (P) genotype designations were confirmed, the VP6 (I) and NSP4 (E) genotypes were either I1E1 or I2E2, indicating that they were of human rotavirus origin. RNA-RNA hybridization using 21 culture-adapted strains showed that Malawian rotaviruses had a genomic RNA constellation common to either the Wa-like or DS-1 like human rotaviruses. Overall, the Malawi strains appear similar in their genetic make-up to rotaviruses described in countries where vaccine efficacy is greater, suggesting that the lower efficacy in Malawi is unlikely to be explained by the diversity of circulating strains. PMID:22520123

Climate change and developing country interests

DEFF Research Database (Denmark)

Arndt, Channing; Chinowsky, Paul; Fant, Charles

We consider the interplay of climate change impacts, global mitigation policies, and the interests of developing countries to 2050. Focusing on Malawi, Mozambique, and Zambia, we employ a structural approach to biophysical and economic modeling that incorporates climate uncertainty and allows for...

Community Project Funding in Malawi under the Malawi Social ...

African Journals Online (AJOL)

This paper gives an overview of the kind of community development projects that the Malawi Social Action Fund (MASAF) has supported since its inception in July 1996. The MASAF has tended to subscribe to a demand-driven approach in its evaluation of projects, thereby introducing an element of competition in commu ...

Drinking Water Quality Governance: A Comparative Case Study of Brazil, Ecuador, and Malawi.

Science.gov (United States)

Kayser, Georgia L; Amjad, Urooj; Dalcanale, Fernanda; Bartram, Jamie; Bentley, Margaret E

2015-04-01

Human health is greatly affected by inadequate access to sufficient and safe drinking water, especially in low and middle-income countries. Drinking water governance improvements may be one way to better drinking water quality. Over the past decade, many projects and international organizations have been dedicated to water governance; however, water governance in the drinking water sector is understudied and how to improve water governance remains unclear. We analyze drinking water governance challenges in three countries-Brazil, Ecuador, and Malawi-as perceived by government, service providers, and civil society organizations. A mixed methods approach was used: a clustering model was used for country selection and qualitative semi-structured interviews were used with direct observation in data collection. The clustering model integrated political, economic, social and environmental variables that impact water sector performance, to group countries. Brazil, Ecuador and Malawi were selected with the model so as to enhance the generalizability of the results. This comparative case study is important because similar challenges are identified in the drinking water sectors of each country; while, the countries represent diverse socio-economic and political contexts, and the selection process provides generalizability to our results. We find that access to safe water could be improved if certain water governance challenges were addressed: coordination and data sharing between ministries that deal with drinking water services; monitoring and enforcement of water quality laws; and sufficient technical capacity to improve administrative and technical management of water services at the local level. From an analysis of our field research, we also developed a conceptual framework that identifies policy levers that could be used to influence governance of drinking water quality on national and sub-national levels, and the relationships between these levers.

Building Sustainable Partnerships to Strengthen Pediatric Capacity at a Government Hospital in Malawi.

Science.gov (United States)

Eckerle, Michelle; Crouse, Heather L; Chiume, Msandeni; Phiri, Ajib; Kazembe, Peter N; Friesen, Hanny; Mvalo, Tisungane; Rus, Marideth C; Fitzgerald, Elizabeth F; McKenney, Allyson; Hoffman, Irving F; Coe, Megan; Mkandawire, Beatrice M; Schubert, Charles

2017-01-01

To achieve sustained reductions in child mortality in low- and middle-income countries, increased local capacity is necessary. One approach to capacity building is support offered via partnerships with institutions in high-income countries. However, lack of cooperation between institutions can create barriers to successful implementation of programs and may inadvertently weaken the health system they are striving to improve. A coordinated approach is necessary. Three U.S.-based institutions have separately supported various aspects of pediatric care at Kamuzu Central Hospital (KCH), the main government referral hospital in the central region of Malawi, for several years. Within each institution's experience, common themes were recognized, which required attention in order to sustain improvements in care. Each recognized that support of clinical care is a necessary cornerstone before initiating educational or training efforts. In particular, the support of emergency and acute care is paramount in order to decrease in-hospital mortality. Through the combined efforts of Malawian partners and the US-based institutions, the pediatric mortality rate has decreased from >10 to <4% since 2011, yet critical gaps remain. To achieve further improvements, representatives with expertise in pediatric emergency medicine (PEM) from each US-based institution hypothesized that coordinated efforts would be most effective, decrease duplication, improve communication, and ensure that investments in education and training are aligned with local priorities. Together with local stakeholders, the three US-based partners created a multi-institutional partnership, Pediatric Alliance for Child Health Improvement in Malawi at Kamuzu Central Hospital and Environs (PACHIMAKE). Representatives from each institution gathered in Malawi late 2016 and sought input and support from local partners at all levels to prioritize interventions, which could be collectively undertaken by this consortium. Long

Information management in Malawi's prevention of Mother-to-Child ...

African Journals Online (AJOL)

Information Management in Malawi's PMTCT program 306. © 2017 The College of ..... system in Malawi: issues, innovations and results. Oxf Univ Press ... Role of Information and Knowledge Managers: Managers Perspectives. In Barcelona ...

The ‘community’ in community case management of childhood illnesses in Malawi

Directory of Open Access Journals (Sweden)

Wanga Z. Zembe-Mkabile

2016-01-01

Full Text Available Background: Malawi has achieved a remarkable feat in reducing its under-5 mortality in time to meet its MDG 4 target despite high levels of poverty, low female literacy rates, recurrent economic crises, a severe shortage of human resources for health, and poor health infrastructure. The country's community-based delivery platform (largely headed by Health Surveillance Assistants, or HSAs has been well established since the 1960s, although their tasks and responsibilities have evolved from surveillance to health promotion and prevention, and more recently to include curative services. However, the role of and the form that community involvement takes in community-based service delivery in Malawi is unclear. Design: A qualitative rapid appraisal approach was utilised to explore the role of community involvement in the HSA programme in Malawi to better understand how the various community providers intersect to support the delivery of integrated community case management by HSAs. Twelve focus group discussions and 10 individual interviews were conducted with HSAs, HSA supervisors, mothers, members of village health committees (VHCs, senior Ministry of Health officials, district health teams, and implementing partners. Results: Our findings reveal that HSAs are often deployed to areas outside of their village of residence as communities are not involved in selecting their own HSAs in Malawi. Despite this lack of involvement in selection, the high acceptance of the HSAs by community members and community accountability structures such as VHCs provide the programme with legitimacy and credibility. Conclusions: This study provides insight into how community involvement plays out in the context of a government-managed professionalised community service delivery platform. It points to the need for further research to look at the impact of removing the role of HSA selection and deployment from the community and placing it at the central level.

Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

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Shamsa Zafar

Full Text Available For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective and psychological morbidities in two different low-income countries.Cross sectional study with assessment of morbidity in early pregnancy (34%, late pregnancy (35% and the postnatal period (31% among 3459 women from two rural communities in Pakistan (1727 and Malawi (1732. Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity.One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective. Both infective (Pakistan and non-infective morbidity (Pakistan and Malawi was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon ( 9. Complications during a previous pregnancy, infective morbidity (p <0.001, intra or postpartum haemorrhage (p <0.02 were associated with psychological morbidity in both settings.Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

Determinants of adolescent fertility in Malawi | Palamuleni | Gender ...

African Journals Online (AJOL)

High adolescent fertility is recognized as a global challenge given its adverse consequences. As such understanding the factors that influence adolescent fertility is critical to addressing this challenge. This study aims at examining the causes of adolescent fertility in Malawi using the 2010 Malawi Demographic and Health ...

Establishing a children's orthopaedic hospital for Malawi: A review ...

African Journals Online (AJOL)

ordinate the MNCP since 2007. At present the program has a total of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has overseen the full or partial training of 5 orthopaedic surgeons and 82 orthopaedic clinical officers in Malawi.

Malawi Medical Journal - Vol 26, No 3 (2014)

African Journals Online (AJOL)

Presentation of Primary Open Angle Glaucoma (POAG) at Lions Sight First Eye Hospital in Blantyre, Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. PC Kayange, HB Nkume, A Feyi-Waboso, K Kalua, G Msukwa, M Schwering Schulze, 60-62 ...

Anaemia in pregnancy in Malawi - A Review | Munasinghe | Malawi ...

African Journals Online (AJOL)

No Abstract. Malawi Medical Journal Vol. 18 (4) 2006: pp. 160-175. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v18i4.10920 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

Responding to Crop Failure: Understanding Farmers’ Coping Strategies in Southern Malawi

Directory of Open Access Journals (Sweden)

Jeanne Y. Coulibaly

2015-02-01

Full Text Available Malawi is a country in southern Africa facing high climate variability and many agricultural challenges. This paper examines farmers’ coping strategies for crop failure and the determinants of their choices using household level data from rural southern Malawi. The results highlight that farmers are not responding directly to climate variability, but to crop failure, which is influenced by climate stress, as well as other constraints, such as poor soil fertility and lack of agricultural inputs and technologies. The coping strategies adopted by households are mostly ex-post measures, including engaging in casual labor, small businesses and the sale of forest products. The main determinants of the adoption of these coping options are education, gender of the head of household, soil fertility and frequency of crop failure. This study concludes by recommending, among other things, that policies for the more efficient communication of climate change threats should emphasize the risk of crop failure. Furthermore, initiatives to assist households to better cope with climate change should take into consideration the local context of decision-making which is shaped by multiple stressors.

Molecular characterization of rotavirus strains detected during a clinical trial of a human rotavirus vaccine in Blantyre, Malawi.

Science.gov (United States)

Nakagomi, Toyoko; Nakagomi, Osamu; Dove, Winifred; Doan, Yen Hai; Witte, Desiree; Ngwira, Bagrey; Todd, Stacy; Duncan Steele, A; Neuzil, Kathleen M; Cunliffe, Nigel A

2012-04-27

The human, G1P[8] rotavirus vaccine (Rotarix™) significantly reduced severe rotavirus gastroenteritis episodes in a clinical trial in South Africa and Malawi, but vaccine efficacy was lower in Malawi (49.5%) than reported in South Africa (76.9%) and elsewhere. The aim of this study was to examine the molecular relationships of circulating wild-type rotaviruses detected during the clinical trial in Malawi to RIX4414 (the strain contained in Rotarix™) and to common human rotavirus strains. Of 88 rotavirus-positive, diarrhoeal stool specimens, 43 rotaviruses exhibited identifiable RNA migration patterns when examined by polyacrylamide gel electrophoresis. The genes encoding VP7, VP4, VP6 and NSP4 of 5 representative strains possessing genotypes G12P[6], G1P[8], G9P[8], and G8P[4] were sequenced. While their VP7 (G) and VP4 (P) genotype designations were confirmed, the VP6 (I) and NSP4 (E) genotypes were either I1E1 or I2E2, indicating that they were of human rotavirus origin. RNA-RNA hybridization using 21 culture-adapted strains showed that Malawian rotaviruses had a genomic RNA constellation common to either the Wa-like or the DS-1 like human rotaviruses. Overall, the Malawi strains appear similar in their genetic make-up to rotaviruses described in countries where vaccine efficacy is greater, suggesting that the lower efficacy in Malawi is unlikely to be explained by the diversity of circulating strains. Copyright © 2011 Elsevier Ltd. All rights reserved.

Language loss and language decay of Malawi's indigenous ...

African Journals Online (AJOL)

This article focuses on the decay of almost all of Malawi's indigenous languages with the exception of ciCewa. The languages facing loss and decay have been suppressed, neglected and not developed, particularly since Malawi attained her independence in 1964. This is a crucial matter in issues of national unity, group ...

Identifying Potential Recommendation Domains for Conservation Agriculture in Ethiopia, Kenya, and Malawi

Science.gov (United States)

Tesfaye, Kindie; Jaleta, Moti; Jena, Pradyot; Mutenje, Munyaradzi

2015-02-01

Conservation agriculture (CA) is being promoted as an option for reducing soil degradation, conserving water, enhancing crop productivity, and maintaining yield stability. However, CA is a knowledge- and technology-intensive practice, and may not be feasible or may not perform better than conventional agriculture under all conditions and farming systems. Using high resolution (≈1 km2) biophysical and socioeconomic geospatial data, this study identified potential recommendation domains (RDs) for CA in Ethiopia, Kenya, and Malawi. The biophysical variables used were soil texture, surface slope, and rainfall while the socioeconomic variables were market access and human and livestock population densities. Based on feasibility and comparative performance of CA over conventional agriculture, the biophysical and socioeconomic factors were first used to classify cultivated areas into three biophysical and three socioeconomic potential domains, respectively. Combinations of biophysical and socioeconomic domains were then used to develop potential RDs for CA based on adoption potential within the cultivated areas. About 39, 12, and 5 % of the cultivated areas showed high biophysical and socioeconomic potential while 50, 39, and 21 % of the cultivated areas showed high biophysical and medium socioeconomic potential for CA in Malawi, Kenya, and Ethiopia, respectively. The results indicate considerable acreages of land with high CA adoption potential in the mixed crop-livestock systems of the studied countries. However, there are large differences among countries depending on biophysical and socio-economic conditions. The information generated in this study could be used for targeting CA and prioritizing CA-related agricultural research and investment priorities in the three countries.

IDRC in Malawi

International Development Research Centre (IDRC) Digital Library (Canada)

As 85% of Malawi's popu- lation are agricultural smallholders, IDRC has focused much of its support on farming systems. Early efforts improved crop production and processing methods. For example, researchers developed a low-cost wooden tool to shell groundnuts, saving farmers time and money. Hand pump designs ...

New attitudes key to progress in Malawi, Cameroon | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-11-08

Nov 8, 2011 ... New attitudes key to progress in Malawi, Cameroon ... in Malawi — good laws protecting women's rights — but they are not working. Why? ... Colonial rule — first by the Germans and later the French and British — brought in a ...

Treadle pump irrigation in Malawi: adoption, gender and benefits

NARCIS (Netherlands)

Kamwamba-Mtethiwa, J.; Namara, R.; Fraiture, de C.M.S.; Mangisoni, J.; Owusu, E.

2012-01-01

As part of their irrigation strategy, the government and non-governmental organizations (NGOs) in Malawi are actively promoting the use of treadle pumps in smallholder irrigation. The positive impact of treadle pumps on food security and poverty reduction in Malawi and elsewhere in sub-Saharan

Exchange rate policy and devaluation in Malawi:

OpenAIRE

Pauw, Karl; Dorosh, Paul A.; Mazunda, John

2013-01-01

This study demonstrates why devaluation was ultimately necessary in Malawi and also what its eventual impact might be in terms of prices, income distribution, and domestic production. Our approach is to use a computable general equilibrium (CGE) model to evaluate the economywide impacts of foreign exchange shortages in Malawi under two alternative exchange rate regimes. The foreign exchange shortages are modeled by simulating the effect of actual shocks, including tobacco price declines and r...

When will community management conserve biodiversity? Evidence from Malawi

Directory of Open Access Journals (Sweden)

Joy E. Hecht

2008-12-01

Full Text Available Both development practitioners and conservation organizations are focused on community ownership and management of natural resources as a way to create incentives for the conservation of biodiversity. This has led to the implementation of a number of large community-based conservation projects in sub-Saharan Africa, in countries including Namibia, Zimbabwe, Malawi, Zambia, and Rwanda. While the concept is logical, and valuation studies may suggest that conservation is more valuable than other uses of the resources in some areas, there has been little detailed analysis of the financial costs and benefits to the communities, to determine whether they would actually have an incentive to conserve if they had more extensive legal rights to the resources. This paper assesses the conditions under which this approach may be viable, based on a valuation study of the resources of Mount Mulanje in southern Malawi.Les spécialistes du développement et les organisations de conservation s’intéressent à la propriété et à la gestion communautaire des ressources naturelles comme moyen de créer des mesures d’incitation en faveur de la conservation de la biodiversité. Cette approche a conduit à la mise en œuvre d’un certain nombre de grands projets de conservation communautaires en Afrique subsaharienne, notamment en Namibie, au Zimbabwe, au Malawi, en Zambie et au Rwanda. Même si cette approche est logique et si les études d’évaluation semblent suggérer que, dans certaines régions, la conservation est plus utile que l’exploitation des ressources, il existe peu d’analyses détaillées sur les coûts et les avantages financiers que cela engendrerait pour les communautés, analyses qui permettraient de déterminer si le développement des droits légaux des communautés sur ces ressources les inciterait à les conserver. Ce rapport évalue les conditions de viabilité de cette approche sur la base d’une étude d’évaluation des

Village health volunteers: key issues facing agencies in Malawi ...

African Journals Online (AJOL)

The participants discussed recruitment, training, rewards, retention, and roles of village health volunteers. This paper presents background data on village health volunteers in Malawi and elsewhere and reviews the key issues facing health care providers in working with village health volunteers. A copy of the workshop ...

The research, policy and practice interface: reflections on using applied social research to promote equity in health in Malawi.

Science.gov (United States)

Theobald, Sally; Nhlema-Simwaka, Bertha

2008-09-01

The case for research to promote equity in health in resource poor contexts such as Malawi is compelling. In Malawi, nearly half of all the people with tuberculosis cannot afford to access free tuberculosis services. In this scenario, there is a clear need to understand the multiple barriers poor women and men face in accessing services and pilot interventions to address these in a way that engages policy makers, practitioners and communities. This paper provides a critical reflection on our experience as applied social researchers working at the REACH (Research for Equity and Community Health) Trust in Malawi. Our work largely uses qualitative research methodologies as a tool for applied social research to explore the equity dimensions of health services in the country. We argue that a key strength of qualitative research methods and analysis is the ability to bring the perceptions and experiences of marginalised groups to policy makers and practitioners. The focus of this paper is two-fold. The first focus lies in synthesising the opportunities and challenges we have encountered in promoting the use of applied social research, and in particular qualitative research methods, on TB and HIV in Malawi. The second focus is on documenting and reflecting on our experiences of using applied social research to promote gender equity in TB/HIV policy and practice in Malawi. In this paper, we reflect on the strategic frameworks we have used in the Malawian context to try and bring the voices of poor women and men to policy makers and practitioners and hence intensify the research to policy and practice interface.

Book Reviews Journalism Practice in Malawi: History, Progress, and ...

African Journals Online (AJOL)

zeleza

Management of the Newspaper Industry in Malawi. ... The new media is the focus of Chapter Three titled Online Journalism in Malawi: Emergence, ... The chapter tackles a number of areas of national development and the beauty ... commodity, including market forces or regulations, which sometimes can restrict new market.

The Resistable Rise of Surgical Sepsis in Malawi | Lavy | Malawi ...

African Journals Online (AJOL)

The Resistable Rise of Surgical Sepsis in Malawi. C Lavy, C Schmidt, E Kalau, J Phuka. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

Nursing in Malawi: nursing theory in the movement to professionalize nursing.

Science.gov (United States)

Bultemeier, Kaye I

2012-04-01

Nursing in Malawi has been predominately a technical trade and only recently has begun the transition to a profession with autonomy and advanced degree preparation. Nursing theories provide a framework for the evolution of nursing to an independent profession. Theories provide a means for the articulation of the nursing role to other members of the healthcare team including consumers. Healthcare and human needs are basic and the guidance provided by nursing theories, including Nightingale's, gives language and structure to the education of nurses as the profession moves into advanced practice in a developing country.

Use of electricity and malaria occurrence: Is there a link? The case of Malawi

International Nuclear Information System (INIS)

Tasciotti, Luca

2017-01-01

Sub-Saharan countries are facing a number of similar challenges, including their need to increase electricity access for both urban and rural dwellers and to limit the cases of malaria related morbidity and mortality. This study explores the link between using electricity, for either lighting or cooking purposes, and the occurrence of malaria cases using country-representative household level data for Malawi. The descriptive statistics and the econometric results highlight the fact that those household members living in ‘electrified’ households are more likely to experience malaria. The interpretations behind those results can be diverse; as evidence suggests, malaria vectors are attracted by electric lights and outdoor lighting available after the sunset may change people habits and increases their exposure to those vectors. This study aims at raising the attention to a nexus which has very rarely been studied theoretically and even less empirically, despite the fact that electricity projects are now in the agenda of several Sub-Saharan countries and that malaria still continue to constitute a major threat for an incredible high number of people, most of all children and pregnant women. - Highlights: • This study examines an unintended impact related to the electrification in Malawi. • The study looks if dwellers with electricity are more likely of having malaria. • ‘Vector density’ and ‘exposure’ channels explain the electricity/malaria nexus. • Results point out that electrified dwellers have higher chance of getting malaria.

Cost-effectiveness analysis and mortality impact estimation of scaling-up pregnancy test kits in Madagascar, Ethiopia and Malawi.

Science.gov (United States)

Kolesar, Robert J; Audibert, Martine; Comfort, Alison B

2017-07-01

Cost-effective, innovative approaches are needed to accelerate progress towards ending preventable infant, child and maternal mortality. To inform policy decisions, we conducted a cost-effectiveness analysis of adding urine pregnancy test kits to the maternal and reproductive services package offered at the community level in Madagascar, Ethiopia and Malawi. We used a decision tree model to compare the intervention with the status quo for each country. We also completed single factor sensitivity analyses and Monte Carlo simulations with 10 000 iterations to generate the probability distribution of the estimates and uncertainty limits. Among a hypothetical cohort of 100 000 women of reproductive age, we estimate that over a 1-year period, the intervention would save 26, 35 and 48 lives in Madagascar, Ethiopia, and Malawi, respectively. The Incremental Cost Effectiveness Ratio (ICER) for the cost per life saved varies by country: $2311 [95% Uncertainty Interval (UI): $1699; $3454] in Madagascar; $2969 [UI: $2260; $5041] in Ethiopia and $1228 [UI: $918; $1777] in Malawi. This equates to an average cost per Disability Adjusted Life Year (DALY) averted of $36.28, $47.95 and $21.92, respectively. Based on WHO criteria and a comparison with other maternal, newborn, and child health interventions, we conclude that the addition of urine pregnancy tests to an existing community health worker maternal and reproductive services package is highly cost-effective in all three countries. To optimize uptake of family planning and antenatal care services and, in turn, accelerate the reduction of mortality and DALYs, decision makers and program planners should consider adding urine pregnancy tests to the community-level package of services. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The guardians' perspective on paediatric cancer treatment in Malawi and factors affecting adherence.

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Israëls, Trijn; Chirambo, Chawanangwa; Caron, Huib; de Kraker, Jan; Molyneux, Elizabeth; Reis, Ria

2008-11-01

Abandonment of paediatric cancer treatment is a common problem in developing countries. Little is known about the guardians' perspective on cancer treatment in these countries, especially the factors that affect adherence. Following a pilot study enquiring into the possible causes of abandonment, a problem analysis diagram was drawn which helped to develop the questionnaires. Semi-structured interviews (n = 83) and focus group discussions (n = 8) were held with the guardians of 25 Burkitt lymphoma patients and 7 Wilms tumour patients at different phases of therapy in Malawi. Parents in Malawi are very motivated to continue treatment if they think that it will cure their child. Financial costs are important concerns. Not all tasks at home are assumed by other household members. The diagnosis of cancer was unknown before being told about it in hospital and caused fear of recurrence and death. Guardians are reluctant to ask the health personnel questions. They worry that taking frequent blood samples will weaken their child. The side effects of the chemotherapy are seen as a proof of efficacy. It is important to appreciate the guardians' concerns when offering treatment that requires their sustained commitment. It is necessary to provide not only medical treatment, but also travel allowances and adequate nutritional support during long hospital stays to impoverished families. Information should be given proactively. (c) 2008 Wiley-Liss, Inc.

Spatial analysis and mapping of malaria risk in Malawi using point-referenced prevalence of infection data

Directory of Open Access Journals (Sweden)

Kazembe Lawrence N

2006-09-01

Full Text Available Abstract Background Current malaria control initiatives aim at reducing malaria burden by half by the year 2010. Effective control requires evidence-based utilisation of resources. Characterizing spatial patterns of risk, through maps, is an important tool to guide control programmes. To this end an analysis was carried out to predict and map malaria risk in Malawi using empirical data with the aim of identifying areas where greatest effort should be focussed. Methods Point-referenced prevalence of infection data for children aged 1–10 years were collected from published and grey literature and geo-referenced. The model-based geostatistical methods were applied to analyze and predict malaria risk in areas where data were not observed. Topographical and climatic covariates were added in the model for risk assessment and improved prediction. A Bayesian approach was used for model fitting and prediction. Results Bivariate models showed a significant association of malaria risk with elevation, annual maximum temperature, rainfall and potential evapotranspiration (PET. However in the prediction model, the spatial distribution of malaria risk was associated with elevation, and marginally with maximum temperature and PET. The resulting map broadly agreed with expert opinion about the variation of risk in the country, and further showed marked variation even at local level. High risk areas were in the low-lying lake shore regions, while low risk was along the highlands in the country. Conclusion The map provided an initial description of the geographic variation of malaria risk in Malawi, and might help in the choice and design of interventions, which is crucial for reducing the burden of malaria in Malawi.

Job satisfaction and retention of health-care providers in Afghanistan and Malawi.

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Fogarty, Linda; Kim, Young Mi; Juon, Hee-Soon; Tappis, Hannah; Noh, Jin Won; Zainullah, Partamin; Rozario, Aleisha

2014-02-17

This study describes job satisfaction and intention to stay on the job among primary health-care providers in countries with distinctly different human resources crises, Afghanistan and Malawi. Using a cross-sectional design, we enrolled 87 health-care providers in 32 primary health-care facilities in Afghanistan and 360 providers in 10 regional hospitals in Malawi. The study questionnaire was used to assess job satisfaction, intention to stay on the job and five features of the workplace environment: resources, performance recognition, financial compensation, training opportunities and safety. Descriptive analyses, exploratory factor analyses for scale development, bivariate correlation analyses and bivariate and multiple linear regression analyses were conducted. The multivariate model for Afghanistan, with demographic, background and work environment variables, explained 23.9% of variance in job satisfaction (F(9,73) = 5.08; P job satisfaction. The multivariate model for intention to stay for Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P job satisfaction (F(8,332) = 4.19; P job are highly dependent on the local context. Although health-care workers in both Afghanistan and Malawi reported satisfaction with their jobs, the predictors of satisfaction, and the extent to which those predictors explained variations in job satisfaction and intention to stay on the job, differed substantially. These findings demonstrate the need for more detailed comparative human resources for health-care research, particularly regarding the relative importance of different determinants of job satisfaction and intention to stay in different contexts and the effectiveness of interventions designed to improve health-care worker performance and retention.

Malawi's Mental Health Service

African Journals Online (AJOL)

ual, the child running off into the bush, the adoles- cent who almost unnoticed begins to lose concentration and fail at his studies. ... Malawi Medical Journal. .... topic. In this way the specialist service comes out to the district, rather than all those ...

On-the-job training of clinical officers in Malawi | Jiskoot | Malawi ...

African Journals Online (AJOL)

Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 3 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

Family medicine training and practice in Malawi: History, progress ...

African Journals Online (AJOL)

Family medicine training and practice in Malawi: History, progress, and the anticipated role of the family physician in the Malawian health system. ... The idea of formal family medicine training and practice in Malawi started as early as 2001 but did not come to fruition until 2011, with the start of the undergraduate clerkship in ...

The effect of increased primary schooling on adult women's HIV status in Malawi and Uganda: Universal Primary Education as a natural experiment.

Science.gov (United States)

Behrman, Julia Andrea

2015-02-01

This paper explores the causal relationship between primary schooling and adult HIV status in Malawi and Uganda, two East African countries with some of the highest HIV infection rates in the world. Using data from the 2010 Malawi Demographic Health Survey and the 2011 Uganda AIDS Indicator Survey, the paper takes advantage of a natural experiment, the implementation of Universal Primary Education policies in the mid 1990s. An instrumented regression discontinuity approach is used to model the relationship between increased primary schooling and adult women's HIV status. Results indicate that a one-year increase in schooling decreases the probability of an adult woman testing positive for HIV by 0.06 (p primary schooling positively affects women's literacy and spousal schooling attainment in Malawi and age of marriage and current household wealth in Uganda. However primary schooling has no effect on recent (adult) sexual behavior. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

Establishing a children's orthopaedic hospital for Malawi: A review ...

African Journals Online (AJOL)

other providers in Lilongwe, the capital of Malawi located in the central region. BCIH is situated in Blantyre in the southern region of Malawi. Therefore it is not unexpected that there is likely to be a natural bias towards treatment of southern patients. This bias was noted at 5-years with 48% of operatively treated case hailing ...

Better processing and marketing of healthy fish products in Malawi

International Development Research Centre (IDRC) Digital Library (Canada)

In Malawi, fish provide 70% of the animal protein in people's diets: small fish, in particular, are a vital source of calcium, vi- tamin A, iron, and zinc. ... es in Malawi coincide with seasonal rains and high humidity, which interfere with drying and ...

Malawi: a christian theological

African Journals Online (AJOL)

groups of people: smallholder farmers, female-headed households, estate workers ... poverty in Malawi and these are: low agricultural production, low income, low education .... A agreed to pay tax for anyone who worked for two months and also ..... efficient, environmentally sustainable and socially equitable land tenure.

Dynamics of Community Participation, Student Achievement and School Management: The Case of Primary Schools in a Rural Area of Malawi

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Taniguchi, Kyoko; Hirakawa, Yukiko

2016-01-01

School management in many sub-Saharan African countries has been enhanced through community participation in an attempt to improve education quality. This study uses field research in a rural district of Malawi to assess how community and parent participation differs between schools, the intentions of communities and parents when carrying out…

HIV Testing and Antiretroviral Therapy in Government and Mission Hospitals in Malawi: 2002-2007

OpenAIRE

Kamoto, K; Makombe, SD; Nkhata, A; Jahn, A; Moses, P; Schouten, EJ; Harries, AD

2008-01-01

: HIV testing and antiretroviral therapy (ART) has scaled up tremendously in Malawi in the last 5 years. We analyzed trends of HIV testing uptake in the course of ART scale-up in 25 government and mission hospitals, which were selected because they do not receive support from non-governmental organizations. Data on numbers of clients HIV tested and on cumulative ART registrations were collected from annual country-wide situational analyses and from quarterly ART supervisory visits from 2002 t...

Environmental risk factors for oesophageal cancer in Malawi: A case ...

African Journals Online (AJOL)

Methods A hospital-based case-control study of the association between environmental risk factors and oesophageal cancer was conducted at Kamuzu Central Hospital in Lilongwe, Malawi and Queen Elizabeth Central Hospital in Blantyre, Malawi. Ninety-six persons with squamous cell carcinoma and 180 controls were ...

Establishing a children's orthopaedic hospital for Malawi: A review ...

African Journals Online (AJOL)

At present the program has a total of 29 clinics, which .... Thus a total of 1154 paediatric orthopaedic operations were known to have taken place in Malawi during the 10th year of operational services with 53% of cases being performed at BCIH. ... regional hip replacement course, 1 regional knee replacement course for ...

Lessons from Neno, Malawi

African Journals Online (AJOL)

The NCD screening models were integrated into existing platforms, utilising regular mass screening events in the ... feasible to introduce NCD screening into a public system, but screening may have ... been advocated.10 However, limited data exist in Malawi on ..... system of drugs and equipment forecasting, procurement,.

Estimating the costs of implementing the rotavirus vaccine in the national immunisation programme: the case of Malawi

DEFF Research Database (Denmark)

Madsen, Lizell Bustamante; Ustrup, Marte; Hansen, Karsten S.

2014-01-01

in the national immunisation programme of a low-income country. Furthermore, the aim was to examine the relative contribution of different components to the total cost. methods Following the World Health Organization guidelines, we estimated the resource use and costs associated with rotavirus vaccine...... implementation, using Malawi as a case. The cost analysis was undertaken from a governmental perspective. All costs were calculated for a 5-years period (2012–2016) and discounted at 5%. The value of key input parameters was varied in a sensitivity analysis. results The total cost of rotavirus vaccine...... purchase, while 17% was attributed to system costs, with personnel, transportation and cold chain as the main cost components. conclusion The total cost of rotavirus vaccine implementation in Malawi is high compared with the governmental health budget of US$ 26 per capita per year. This highlights the need...

1. A Qualitative Study of Medical Student Socialization in Malawi's ...

African Journals Online (AJOL)

students at the University of Malawi's College of Medicine.i. Malawi is both culturally ... influences of the structural adjustment programs mandated ... For five decades, social scientists have examined the moral ... studied the impact of medical training outside the global ... Wanted to help people. 42% .... political issues.15,16.

Moving malaria in pregnancy programs from neglect to priority: experience from Malawi, Senegal, and Zambia

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Roman, Elaine; Wallon, Michelle; Brieger, William; Dickerson, Aimee; Rawlins, Barbara; Agarwal, Koki

2014-01-01

Background: Pregnant women and infants are particularly vulnerable to malaria. National malaria in pregnancy (MIP) programs in Malawi, Senegal, and Zambia were reviewed to identify promising strategies that have helped these countries achieve relatively high coverage of MIP interventions as well as ongoing challenges that have inhibited further progress. Methods: We used a systematic case study methodology to assess health system strengths and challenges in the 3 countries, including desk reviews of available reports and literature and key informant interviews with national stakeholders. Data were collected between 2009 and 2011 and analyzed across 8 MIP health systems components: (1) integration of programs and services, (2) policy, (3) commodities, (4) quality assurance, (5) capacity building, (6) community involvement, (7) monitoring and evaluation, and (8) financing. Within each program area, we ranked degree of scale up across 4 stages and synthesized the findings in a MIP table of analysis to reveal common themes related to better practices, remaining bottlenecks, and opportunities to accelerate MIP coverage, strengthen MIP programs, and improve results. Findings: Each of the 3 countries has malaria policies in place that reflect current MIP guidance from the World Health Organization. The 3 countries successfully integrated MIP interventions into a platform of antenatal care services, but coordination at the national level was disjointed. All 3 countries recognized the importance of having a MIP focal person to ensure collaboration and planning at the national level, but only Malawi had appointed one. Commodity stockouts were frequent due to problems at all levels of the logistics system, from quantification to distribution. Lack of support for quality assurance and weak monitoring and evaluation mechanisms across all 3 countries affected optimal coverage. Conclusions: MIP programs should address all 8 interconnected MIP health systems areas holistically, in

the Malawi National NCDI Povert

African Journals Online (AJOL)

elderly, or urban populations.2 Furthermore, the interventions aimed around NCDIs ... disability-adjusted life years (DALYs) in Malawi are from the big 4 categories ... chronic NCDs, as well as health promotion, are currently being scaled up ...

The artisanal fishery of Metangula, Lake Malawi/Niassa, East Africa ...

African Journals Online (AJOL)

Malawi indicates that the fish populations at Metangula are not yet as impacted as they are on the populous and accessible Malawi coast. Some constraints on the fishery include the lack of management and financial support, poor gear and infrastructure, and the lack of access to markets. African Journal of Aquatic Science

Parental Divorce and Children's Schooling in Rural Malawi.

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Chae, Sophia

2016-12-01

A growing body of literature has examined the impact of different types of family structures on children's schooling in sub-Saharan Africa. These studies have investigated how living arrangements, gender of the household head, parental death, and paternal migration are related to schooling. Although many sub-Saharan African countries have high divorce rates, very few studies have explored the impact of parental divorce on children's schooling. The present study uses three waves of data from the Malawi Longitudinal Study of Families and Health (MLSFH) to investigate the effect of parental divorce on children's schooling and the possible mechanisms driving this relationship. Unlike prior studies, this study uses child-level fixed-effects models to control for selection into divorce. Results show that parental divorce is associated with lower grade attainment and a larger schooling gap, defined as the number of years a child is behind in school (among children currently attending school). Although no association exists between parental divorce and current school attendance, girls affected by divorce are significantly less likely to be attending school. Differences in economic resources, maternal coresidence, or maternal psychological well-being do not explain the relationship between parental divorce and children's schooling.

Country Presentation Uganda

International Nuclear Information System (INIS)

Oriada, R.; Byakagaba, A.; Kiza, M.; Magembe, M.

2010-01-01

Like Many African countries, Uganda is not Immune to the problem of illicit trafficking of Nuclear and Radioactive materials. This has been worsened by the porosity of the Ugandan Borders. There is control on the few Entry points and much of the border line does not have adequate control on what enters and leaves the country. Uganda is also used as a transit route with the neighboring countries like Sudan, Democratic Republic of Congo, Kenya,Tanzania.

Health spending, illicit financial flows and tax incentives in Malawi ...

African Journals Online (AJOL)

Health spending, illicit financial flows and tax incentives in Malawi. B O'Hare, M Curtis. Abstract. This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax ...

Current Status and Management of Hand Pump Equipped Water Facilities in Blantyre Rural District, Malawi : Case Study of Kapeni and Lundu Traditional Authorities

OpenAIRE

Njalam'mano, John Bright Joseph

2007-01-01

Although the access to adequate safe drinking water is taken for granted in developed countries and urban settlements in some developing countries at the end of 2002 it was estimated that globally, some 1.1 billion people still rely on unsafe drinking water sources particularly in the developing regions of India and Africa. Malawi is one of the developing countries located in the arid-semiarid Sub-Saharan African region with only 62% of its people having access to safe drinking water. Borehol...

Global tobacco control and economic norms: an analysis of normative commitments in Kenya, Malawi and Zambia.

Science.gov (United States)

Lencucha, Raphael; Reddy, Srikanth K; Labonte, Ronald; Drope, Jeffrey; Magati, Peter; Goma, Fastone; Zulu, Richard; Makoka, Donald

2018-04-01

Tobacco control norms have gained momentum over the past decade. To date 43 of 47 Sub-Saharan African countries are party to the Framework Convention on Tobacco Control (FCTC). The near universal adoption of the FCTC illustrates the increasing strength of these norms, although the level of commitment to implement the provisions varies widely. However, tobacco control is enmeshed in a web of international norms that has bearing on how governments implement and strengthen tobacco control measures. Given that economic arguments in favor of tobacco production remain a prominent barrier to tobacco control efforts, there is a continued need to examine how economic sectors frame and mobilize their policy commitments to tobacco production. This study explores the proposition that divergence of international norms fosters policy divergence within governments. This study was conducted in three African countries: Kenya, Malawi, and Zambia. These countries represent a continuum of tobacco control policy, whereby Kenya is one of the most advanced countries in Africa in this respect, whereas Malawi is one of the few countries that is not a party to the FCTC and has implemented few measures. We conducted 55 key informant interviews (Zambia = 23; Kenya = 17; Malawi = 15). Data analysis involved deductive coding of interview transcripts and notes to identify reference to international norms (i.e. commitments, agreements, institutions), coupled with an inductive analysis that sought to interpret the meaning participants ascribe to these norms. Our analysis suggests that commitments to tobacco control have yet to penetrate non-health sectors, who perceive tobacco control as largely in conflict with international economic norms. The reasons for this perceived conflict seems to include: (1) an entrenched and narrow conceptualization of economic development norms, (2) the power of economic interests to shape policy discourses, and (3) a structural divide between sectors in

Achieving the sustainable development goals: a case study of the complexity of water quality health risks in Malawi.

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Holm, Rochelle; Wandschneider, Philip; Felsot, Allan; Msilimba, Golden

2016-07-15

Suppose 35 % of the households with children under 5 years of age in a low-income suburban neighborhood in a developing country have diarrhea where improved water sources are available. Clearly, something is amiss-but what? In addition to focusing on the need to examine water quality among water sources that meet the 'improved' category when assessing health risk, the relative importance of the range of transmission routes for diarrhea is unknown. In Malawi, relevant baseline data affecting human health are simply not available, and acquiring data is hampered by a lack of local analytical capacity for characterizing drinking water quality. The objective of this work is to develop a risk communication program with partnership among established regional development professionals for effectively meeting the sustainable development goals. A field study was conducted in the city of Mzuzu, Malawi, to study water quality (total coliform and Escherichia coli) and human dimensions leading to development of a public health risk communication strategy in a peri-urban area. A structured household questionnaire was administered to adult residents of 51 households, encompassing 284 individuals, who were using the 30 monitored shallow wells. The water quality data and human dimension questionnaire results were used to develop a household risk presentation. Sixty-seven percent and 50 % of well water and household drinking water samples, respectively, exceeded the WHO health guideline of zero detections of E. coli. Technology transfer was advanced by providing knowledge through household risk debriefing/education, establishing a water quality laboratory at the local university, and providing training to local technicians. Communicating the science of water quality and health risks in developing countries requires sample collection and analysis by knowledgeable personnel trained in the sciences, compiling baseline data, and, ultimately, an effective risk presentation back to

Changing times? Gender roles and relationships in maternal, newborn and child health in Malawi.

Science.gov (United States)

Manda-Taylor, Lucinda; Mwale, Daniel; Phiri, Tamara; Walsh, Aisling; Matthews, Anne; Brugha, Ruairi; Mwapasa, Victor; Byrne, Elaine

2017-09-25

For years, Malawi remained at the bottom of league tables on maternal, neonatal and child health. Although maternal mortality ratios have reduced and significant progress has been made in reducing neonatal morality, many challenges in achieving universal access to maternal, newborn and child health care still exist in Malawi. In Malawi, there is still minimal, though increasing, male involvement in ANC/PMTCT/MNCH services, but little understanding of why this is the case. The aim of this paper is to explore the role and involvement of men in MNCH services, as part of the broader understanding of those community system factors. This paper draws on the qualitative data collected in two districts in Malawi to explore the role and involvement of men across the MNCH continuum of care, with a focus on understanding the community systems barriers and enablers to male involvement. A total of 85 IDIs and 20 FGDs were conducted from August 2014 to January 2015. Semi-structure interview guides were used to guide the discussion and a thematic analysis approach was used for data analysis. Policy changes and community and health care provider initiatives stimulated men to get involved in the health of their female partners and children. The informal bylaws, the health care provider strategies and NGO initiatives created an enabling environment to support ANC and delivery service utilisation in Malawi. However, traditional gender roles in the home and the male 'unfriendly' health facility environments still present challenges to male involvement. Traditional notions of men as decision makers and socio-cultural views on maternal health present challenges to male involvement in MNCH programs. Health care provider initiatives need to be sensitive and mindful of gender roles and relations by, for example, creating gender inclusive programs and spaces that aim at reducing perceptions of barriers to male involvement in MNCH services so that programs and spaces that are aimed at

Physical attractiveness and women's HIV risk in rural Malawi.

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Frye, Margaret; Chae, Sophia

2017-01-01

Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country's severe AIDS epidemic. We use interviewers' ratings of respondents' attractiveness, along with HIV test results and women's assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15-35. Results show that women who are rated by interviewers as 'much less' or 'less' attractive than other women their age are 9% more likely to test positive for HIV. We also find that attractiveness is associated with women's own assessments of their HIV risk: Among women who tested negative, those perceived as 'much less' or 'less' attractive than average report themselves to be at greater risk of HIV infection. These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings.

Analysis of Effectiveness of Modern Information and Communication Technologies on Maize Marketing Efficiency in Selected Markets of Malawi

OpenAIRE

Tione, S. E.; Katengeza, Samson P.; Mangisoni, Julius H.

2013-01-01

Developing countries have been promoting initiatives that aim at reducing information asymmetry among market players especially smallholder farmers. Using co-integration error correction models, the study assessed effectiveness of modern Information and Communication Technologies (ICT) based market interventions in improving maize market efficiency in Malawi. Considering that efficient markets are integrated markets when price difference is only a factor of transaction costs, Threshold Autore...

Schistosomiasis in Lake Malawi villages

DEFF Research Database (Denmark)

Madsen, Henry; Bloch, Paul; Makaula, Peter

2011-01-01

Historically, open shorelines of Lake Malawi were free from schistosome, Schistosoma haematobium, transmission, but this changed in the mid-1980s, possibly as a result of over-fishing reducing density of molluscivore fishes. Very little information is available on schistosome infections among...

Modeling rain-fed maize vulnerability to droughts using the standardized precipitation index from satellite estimated rainfall—Southern Malawi case study

Science.gov (United States)

Funk, Christopher C.; Verdin, James; Adams Chavula,; Gregory J. Husak,; Harikishan Jayanthi,; Tamuka Magadzire,

2013-01-01

During 1990s, disaster risk reduction emerged as a novel, proactive approach to managing risks from natural hazards. The World Bank, USAID, and other international donor agencies began making efforts to mainstream disaster risk reduction in countries whose population and economies were heavily dependent on rain-fed agriculture. This approach has more significance in light of the increasing climatic hazard patterns and the climate scenarios projected for different hazard prone countries in the world. The Famine Early Warning System Network (FEWS NET) has been monitoring the food security issues in the sub-Saharan Africa, Asia and in Haiti. FEWS NET monitors the rainfall and moisture availability conditions with the help of NOAA RFE2 data for deriving food security status in Africa. This paper highlights the efforts in using satellite estimated rainfall inputs to develop drought vulnerability models in the drought prone areas in Malawi. The satellite RFE2 based SPI corresponding to the critical tasseling and silking phases (in the months of January, February, and March) were statistically regressed with drought-induced yield losses at the district level. The analysis has shown that the drought conditions in February and early March lead to most damage to maize yields in this region. The district-wise vulnerabilities to drought were upscaled to obtain a regional maize vulnerability model for southern Malawi. The results would help in establishing an early monitoring mechanism for drought impact assessment, give the decision makers additional time to assess seasonal outcomes, and identify potential food-related hazards in Malawi.

Risk factors for fetal anaemia in a malarious area of Malawi

NARCIS (Netherlands)

Brabin, B. J.; Kalanda, B. F.; Verhoeff, F. H.; Chimsuku, L. H.; Broadhead, R. L.

2004-01-01

The prevalence of infants born with low cord haemoglobin (fetal anaemia) is high in areas where malaria and iron deficiency anaemia in pregnancy are common. The objective of the present study was to determine risk factors for fetal anaemia in an area of high malaria transmission in southern Malawi.

Socio-economic inequity in HIV testing in Malawi

Directory of Open Access Journals (Sweden)

Sung Wook Kim

2016-10-01

Full Text Available Background: Human immunodeficiency virus (HIV is a significant contributor to Malawi's burden of disease. Despite a number of studies describing socio-economic differences in HIV prevalence, there is a paucity of evidence on socio-economic inequity in HIV testing in Malawi. Objective: To assess horizontal inequity (HI in HIV testing in Malawi. Design: Data from the Demographic and Health Surveys (DHSs 2004 and 2010 in Malawi are used for the analysis. The sample size for DHS 2004 was 14,571 (women =11,362 and men=3,209, and for DHS 2010 it was 29,830 (women=22,716 and men=7,114. The concentration index is used to quantify the amount of socio-economic-related inequality in HIV testing. The inequality is a primary method in this study. Corrected need, a further adjustment of the standard decomposition index, was calculated. Standard HI was compared with corrected need-adjusted inequity. Variables used to measure health need include symptoms of sexually transmitted infections. Non-need variables include wealth, education, literacy and marital status. Results: Between 2004 and 2010, the proportion of the population ever tested for HIV increased from 15 to 75% among women and from 16 to 54% among men. The need for HIV testing among men was concentrated among the relatively wealthy in 2004, but the need was more equitably distributed in 2010. Standard HI was 0.152 in 2004 and 0.008 in 2010 among women, and 0.186 in 2004 and 0.04 in 2010 among men. Rural–urban inequity also fell in this period, but HIV testing remained pro-rich among rural men (HI 0.041. The main social contributors to inequity in HIV testing were wealth in 2004 and education in 2010. Conclusions: Inequity in HIV testing in Malawi decreased between 2004 and 2010. This may be due to the increased support to HIV testing by global donors over this period.

Online virtual patients - A driver for change in medical and healthcare professional education in developing countries?

Science.gov (United States)

Dewhurst, David; Borgstein, Eric; Grant, Mary E; Begg, Michael

2009-08-01

The development of online virtual patients has proved to be an effective vehicle for pedagogical and technological skills transfer and capacity building for medical and healthcare educators in Malawi. A project between the University of Edinburgh and the University of Malawi has delivered more than 20 collaboratively developed, virtual patients, contextualised for in-country medical and healthcare education and, more significantly, a cadre of healthcare professionals skilled in developing digital resources and integrating these into their emerging curricula. The process of engaging with new approaches to teaching and delivering personalised, context sensitive content via a game-informed, technology-supported process has contributed to the ability of healthcare educators in Malawi to drive pedagogical change, meet the substantial challenges of delivering new curricula, cope with increasing student numbers and promote teacher professional development. This initial phase of the project has laid the foundation for a broader second phase that focuses on promoting curriculum change, developing educational infrastructure and in-country capacity to create, and integrate digital resources into education and training across multi-professional groups and across educational levels.

Trade Balance and the J-Curve Phenomenon in Malawi

OpenAIRE

Mataya, Charles S.; Veeman, Michele M.

1997-01-01

The effects of successive currency devaluations, since the 1980s, on Malawi's trade balance are analysed. The major hypothesis tested is that currency devaluation leads to an improvement in trade balance through changes in the real exchange rate. This hypothesis is not supported by the data for Malawi. Although there is evidence of a lagged adjustment yielding an improvement in the trade balance three years after devaluation, the magnitude of this improvement is insufficient to overcome the i...

Barriers to using eHealth data for clinical performance feedback in Malawi: A case study.

Science.gov (United States)

Landis-Lewis, Zach; Manjomo, Ronald; Gadabu, Oliver J; Kam, Matthew; Simwaka, Bertha N; Zickmund, Susan L; Chimbwandira, Frank; Douglas, Gerald P; Jacobson, Rebecca S

2015-10-01

Sub-optimal performance of healthcare providers in low-income countries is a critical and persistent global problem. The use of electronic health information technology (eHealth) in these settings is creating large-scale opportunities to automate performance measurement and provision of feedback to individual healthcare providers, to support clinical learning and behavior change. An electronic medical record system (EMR) deployed in 66 antiretroviral therapy clinics in Malawi collects data that supervisors use to provide quarterly, clinic-level performance feedback. Understanding barriers to provision of eHealth-based performance feedback for individual healthcare providers in this setting could present a relatively low-cost opportunity to significantly improve the quality of care. The aims of this study were to identify and describe barriers to using EMR data for individualized audit and feedback for healthcare providers in Malawi and to consider how to design technology to overcome these barriers. We conducted a qualitative study using interviews, observations, and informant feedback in eight public hospitals in Malawi where an EMR system is used. We interviewed 32 healthcare providers and conducted seven hours of observation of system use. We identified four key barriers to the use of EMR data for clinical performance feedback: provider rotations, disruptions to care processes, user acceptance of eHealth, and performance indicator lifespan. Each of these factors varied across sites and affected the quality of EMR data that could be used for the purpose of generating performance feedback for individual healthcare providers. Using routinely collected eHealth data to generate individualized performance feedback shows potential at large-scale for improving clinical performance in low-resource settings. However, technology used for this purpose must accommodate ongoing changes in barriers to eHealth data use. Understanding the clinical setting as a complex adaptive

Formalization of Informal Waste Pickers’ Cooperatives in Blantyre, Malawi: A Feasibility Assessment

Directory of Open Access Journals (Sweden)

Cidrick Kasinja

2018-04-01

Full Text Available Poor road networks, inadequate financial resources and low levels of political will mean that many developing countries, especially their unplanned settlements, struggle with solid waste management. Recently, Informal Waste Pickers (IWPs have been incorporated into waste management cooperatives by formalizing their operations as a strategy to improve the quality and efficiency of waste management in such areas. This study was conducted in Zingwangwa, an unplanned settlement in Blantyre, Malawi, to understand whether the formalization of IWPs into cooperatives could be effective and/or accepted as a way of managing Municipal Solid Waste in unplanned urban settlements in Malawi. Thirty-four IWPs in Zingwangwa were identified and interviewed using a structured questionnaire; personnel from the Blantyre City Council and middlemen were interviewed as key informants. We determined that IWPs experience challenges in all dimensions of their lives: low material prices with exploitative price fluctuations, negative public perception and a lack of transportation are a few of their struggles. Furthermore, a fear of decreased income, conflicts during proceeds sharing, free riding behaviors and an attachment to their independence mean that IWPs are unlikely to form a cooperative on their own though some would be willing to join if a third party initiated the formalization process.

Malawi | IDRC - International Development Research Centre

International Development Research Centre (IDRC) Digital Library (Canada)

Our support has aided the fight against poverty and malnutrition in Malawi. ... find ways to address degraded soils, food insecurity, and child malnutrition. ... explore urban-rural interdependence and the impact of climate change on food supply ...

Physical attractiveness and women's HIV risk in rural Malawi

Directory of Open Access Journals (Sweden)

Margaret Frye

2017-08-01

Full Text Available Background: Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. Objective: We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country's severe AIDS epidemic. Methods: We use interviewers' ratings of respondents' attractiveness, along with HIV test results and women's assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15‒35. Results: Results show that women who are rated by interviewers as 'much less' or 'less' attractive than other women their age are 9Š more likely to test positive for HIV. We also find that attractiveness is associated with women's own assessments of their HIV risk: Among women who tested negative, those perceived as 'much less' or 'less' attractive than average report themselves to be at greater risk of HIV infection. Conclusions: These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. Contribution: This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings.

Wastewood as a source of woodfuel: The case of Malawi and its relevance to sub-Saharan Africa

International Nuclear Information System (INIS)

Teplitz Sembitzky, W.

1991-01-01

Land clearing and forest sector residues, notably the wastewood generated on large timber plantations, can provide a sizeable and hitherto neglected source of woodfuel. This article highlights experience in Malawi where wastewood from pine plantations is converted into charcoal that is sold to residential, industrial and agro-industrial users. Similar initiatives proposed in other countries of sub-Saharan Africa indicate that comprehensive utilization of wastewood resources could help to reduce regional and local imbalances. (author). 19 refs

Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

Directory of Open Access Journals (Sweden)

Victoria K Fort

2011-03-01

Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

Socially disempowered women as the key to addressing change in Malawi: how do they do it?

Science.gov (United States)

Macintyre, Linda M; Rankin, Sally; Pinderhughes, Howard; Waters, Catherine M; Schell, Ellen; Fiedler, Rachel

2013-01-01

Malawi women are in the ironic juxtaposition of being socially disempowered while, at the same time, thought to hold the key to shaping an effective community response to the HIV crisis. Based on this juxtaposition, a descriptive, qualitative study was conducted in Malawi and the United States where 26 participants from nongovernmental organizations (NGOs) and community-based organizations (CBOs) discussed the roles of Malawi women. Interviews were audiotaped, transcribed, and analyzed. We identified an improvement in women's economic status as the strongest factor in reducing gender inequities. Through providing stipends for rural Malawi women, one NGO created unintended changes in gender roles.

Bat records from Malawi (Mammalia, Chiroptera)

NARCIS (Netherlands)

Bergmans, Wim; Jachmann, Hugo

1983-01-01

Five species of bats are recorded from Kasungu National Park, Malawi: Eidolon helvum (Kerr, 1792); Epomophorus anurus Heuglin, 1864; Epomophorus minor Dobson, 1880; Epomops dobsonii (Bocage, 1889); and Scotoecus hindei Thomas, 1901. Some other Malawian records of these species, based on literature

Malawi - Infrastructure Development and Power Sector Reform

Data.gov (United States)

Millennium Challenge Corporation — Social Impact was contracted by MCC to develop and conduct an evaluation of the Malawi Compact. Specifically, SI has been tasked to “assess the program design and...

What makes staff consider leaving the health service in Malawi?

Science.gov (United States)

Chimwaza, Wanangwa; Chipeta, Effie; Ngwira, Andrew; Kamwendo, Francis; Taulo, Frank; Bradley, Susan; McAuliffe, Eilish

2014-03-19

Malawi faces a severe shortage of health workers, a factor that has contributed greatly to high maternal mortality in the country. Most clinical care is performed by mid-level providers (MLPs). While utilization of these cadres in providing health care is a solution to the current shortages, demotivating factors within the Malawian health system are pushing them into private, non-governmental, and other non-health related positions. This study aims to highlight these demotivating factors by exploring the critical aspects that influence MLPs' intention to leave their jobs. This descriptive qualitative study formed part of the larger Health Systems Strengthening for Equity (HSSE) study. Data presented in this paper were collected in Malawi using the Critical Incident Analysis tool. Participants were asked to narrate an incident that had happened during the past three months which had made them seriously consider leaving their job. Data were subjected to thematic analysis using NVivo 8 software. Of the 84 respondents who participated in a Critical Incident Analysis interview, 58 respondents (69%) indicated they had experienced a demotivating incident in the previous three months that had made them seriously consider leaving their job. The most commonly cited critical factors were being treated unfairly or with disrespect, lack of recognition of their efforts, delays and inconsistencies in salary payments, lack of transparent processes and criteria for upgrading or promotion, and death of patients. Staff motivation and an enabling environment are crucial factors for retaining MLPs in the Malawian health system. This study revealed key 'tipping points' that drive staff to seriously consider leaving their jobs. Many of the factors underlying these critical incidents can be addressed by improved management practices and the introduction of fair and transparent policies. Managers need to be trained and equipped with effective managerial skills and staff should have access

The Epidemiology of District Surgery in Malawi: a Two Year Study of ...

African Journals Online (AJOL)

Background: The true surgical requirement of a rural African population is also not precisely known. Methods: Data gathered over a 2-year period from 1993 to 1995 on surgical and anaesthetic activities in 18 District Hospitals in Malawi are presented. Results: Theatre records showed that 45,032 operations were carried out ...

Young Women's Political Participation in Malawi | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

IDRC's Democratic Governance, Women's Rights and Gender Equality initiative is ... They continue to be underrepresented in positions of power. ... social, economic, cultural and political situation of rural women in Malawi affects the political ...

Making a difference in adult-child relationships: evidence from an adult-child communication intervention in Botswana, Malawi, and Mozambique.

Science.gov (United States)

Schwandt, Hilary M; Underwood, Carol

2013-12-01

Girls are vulnerable to HIV in part because the social systems in which they live have failed to protect them. This study evaluates a program aimed at strengthening adult-child relationships to reduce girls' vulnerability to HIV in Botswana, Malawi, and Mozambique. In addition to an extensive process evaluation, a cross-sectional post-intervention survey was conducted in the three countries. The total sample size was 1418 adolescent girls (ages 11-18). Bivariate and multilevel, multivariate analyses were conducted to assess the association between adult program exposure and adult-child relationship improvement. In Botswana, Malawi, and Mozambique, girls whose mothers and fathers participated in the program, as compared to those whose parents did not participate in the program, were significantly more likely to report that their relationships with their parents had improved. Research has shown the important role that adults can play in the mitigation of youth risk taking behavior. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. All rights reserved.

Sources of Social Capital for Malawi People Living With HIV

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Sally H. Rankin

2016-11-01

Full Text Available With one of the highest rates of poverty and HIV in the world, Malawi faith-based organizations (FBOs, non-governmental organizations (NGOs, and community-based organizations (CBOs are expected to provide tangible and emotional support to people living with HIV (PLWH. Using Lin’s social capital theoretical approach, we examine the perspective of PLWH regarding the adequacy of support responses. Forty-six rural Malawi HIV+ adults provided interviews that were recorded digitally, translated, and transcribed by Malawi research assistants. Atlas.ti was used to organize the data and to aid in the analytic process. Participants expressed disappointment in the lack of resources that could be accessed through the FBOs although their expectations may have been unrealistic. Outcomes from accessing and mobilizing the FBO network were negative in terms of stigmatization by FBO leaders and members, whereas outcomes related to CBOs and NGOs were generally positive in terms of empowerment through HIV information and attendance at support groups.

Parental Divorce and Children’s Schooling in Rural Malawi

Science.gov (United States)

Chae, Sophia

2016-01-01

A growing body of literature has examined the impact of different types of family structures on children’s schooling in sub-Saharan Africa. These studies have investigated how living arrangements, gender of the household head, parental death, and paternal migration are related to schooling. Although many sub-Saharan African countries have high divorce rates, very few studies have explored the impact of parental divorce on children’s schooling. The present study uses three waves of data from the Malawi Longitudinal Study of Families and Health (MLSFH) to investigate the effect of parental divorce on children’s schooling and the possible mechanisms driving this relationship. Unlike prior studies, this study uses child-level fixed-effects models to control for selection into divorce. Results show that parental divorce is associated with lower grade attainment and a larger schooling gap, defined as the number of years a child is behind in school (among children currently attending school). Although no association exists between parental divorce and current school attendance, girls affected by divorce are significantly less likely to be attending school. Differences in economic resources, maternal coresidence, or maternal psychological well-being do not explain the relationship between parental divorce and children’s schooling. PMID:27822897

ROLE OF GRASSROOTS ENVIRONMENTAL LITERACY: The case of water security at Bwaila Secondary School in Malawi

Science.gov (United States)

Chasukwa Mwalwenje, Yvonne; Chasukwa, Steria

2015-04-01

Malawi is popularly known as the Warm Heart of Africa. Malawi has a total land area of 45,747 sq. miles. Of the total area, 80 % is covered by fresh water from Lake Malawi and other rivers. The country boasts that it holds large amounts of fresh water and has the third largest lake in Africa. Ironically, the number of households with reliable water access is low (Water Aid, 2014, UNDP, Human Development Report 2008). Regardless of signs of economic development, water security still remains a challenge in the Warm Heart of Africa. The problem with access to water prompted the Government of Malawi to introduce a National Water Policy in 1994 with the vision of 'Water and Sanitation for All'. Since then, other water access interventions have impacted on the ability to manage water sustainably. Over the past few years, more inclusive and diversified interventions have been put in place to reverse the situation. For instance, the government of Malawi has taken action to increase the number of water tanks in schools (UNICEF 2005). Several stakeholders' support the government in their role provides policy direction and coordinate management of the water sector. The outlined National Water and Sanitation Policy strategies includes promoting water conservation and catchment protection; incorporating local governments and communities in planning, development and management of water supplies and sanitation services; rehabilitating the existing infrastructure; creating an enabling environment for public-private partnerships in water supply and sanitation activities; undertaking rehabilitation and reduction of unaccounted-for-water of existing urban, peri-urban, as a priority; promoting economic incentives and opportunities to encourage the participation of small-scale water and sanitation service providers; and promoting water recycling and re-use. Despite of all these interventions, Malawi still continues to face significant challenges with issues of access and quality of

Stoves or sugar? Willingness to adopt improved cookstoves in Malawi

International Nuclear Information System (INIS)

Jagger, Pamela; Jumbe, Charles

2016-01-01

Malawi has set a target of adoption of two million improved cookstoves (ICS) by 2020. Meeting this objective requires knowledge about determinants of adoption, particularly in rural areas where the cost of traditional cooking technologies and fuels are non-monetary, and where people have limited capacity to purchase an ICS. We conducted a discrete choice experiment with 383 households in rural Malawi asking them if they would chose a locally made ICS or a package of sugar and salt of roughly equal value. Six months later, we assessed adoption and stove use patterns. Sixty-six percent of households chose the ICS. We find that having a larger share of crop residues in household fuel supply, awareness of the environmental impacts of woodfuel reliance, time the primary cook devotes to collecting fuelwood, and peer effects at the village-level increase the odds of choosing the ICS. Having a large labor supply for fuelwood collection and experience with a non-traditional cooking technology decreased the odds of choosing the ICS. In a rapid assessment six months after stoves were distributed, we found 80% of households were still using the ICS, but not exclusively. Our findings suggest considerable potential for wide-scale adoption of low cost ICS in Malawi. - Highlights: •There is demand for locally produced improved cookstoves in rural Malawi. •Environmental awareness, labor availability, and peer effects influence adoption. •Sustained and exclusive use of improved cookstoves requires training and follow-up.

Evaluating a streamlined clinical tool and educational outreach intervention for health care workers in Malawi: the PALM PLUS case study

OpenAIRE

Sodhi, Sumeet; Banda, Hastings; Kathyola, Damson; Burciul, Barry; Thompson, Sandy; Joshua, Martias; Bateman, Eric; Fairall, Lara; Martiniuk, Alexandra; Cornick, Ruth; Faris, Gill; Draper, Beverley; Mondiwa, Martha; Katengeza, Egnat; Sanudi, Lifah

2011-01-01

Abstract Background Nearly 3 million people in resource-poor countries receive antiretrovirals for the treatment of HIV/AIDS, yet millions more require treatment. Key barriers to treatment scale up are shortages of trained health care workers, and challenges integrating HIV/AIDS care with primary care. The research PALM PLUS (Practical Approach to Lung Health and HIV/AIDS in Malawi) is an intervention designed to simplify and integrate existing Malawian national guidelines into a single, simp...

Lake Malawi cichlid evolution along a benthic/limnetic axis.

Science.gov (United States)

Hulsey, C D; Roberts, R J; Loh, Y-H E; Rupp, M F; Streelman, J T

2013-07-01

Divergence along a benthic to limnetic habitat axis is ubiquitous in aquatic systems. However, this type of habitat divergence has largely been examined in low diversity, high latitude lake systems. In this study, we examined the importance of benthic and limnetic divergence within the incredibly species-rich radiation of Lake Malawi cichlid fishes. Using novel phylogenetic reconstructions, we provided a series of hypotheses regarding the evolutionary relationships among 24 benthic and limnetic species that suggests divergence along this axis has occurred multiple times within Lake Malawi cichlids. Because pectoral fin morphology is often associated with divergence along this habitat axis in other fish groups, we investigated divergence in pectoral fin muscles in these benthic and limnetic cichlid species. We showed that the eight pectoral fin muscles and fin area generally tended to evolve in a tightly correlated manner in the Lake Malawi cichlids. Additionally, we found that larger pectoral fin muscles are strongly associated with the independent evolution of the benthic feeding habit across this group of fish. Evolutionary specialization along a benthic/limnetic axis has occurred multiple times within this tropical lake radiation and has produced repeated convergent matching between exploitation of water column habitats and locomotory morphology.

First Responders and Prehospital Care for Road Traffic Injuries in Malawi.

Science.gov (United States)

Chokotho, Linda; Mulwafu, Wakisa; Singini, Isaac; Njalale, Yasin; Maliwichi-Senganimalunje, Limbika; Jacobsen, Kathryn H

2017-02-01

Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi. In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes. All governmental and nongovernmental first response organizations identified by key informants were contacted, and a checklist was used to identify the services they offer. Access to professional prehospital care in Malawi is almost nonexistent, aside from a few city fire departments and private ambulance services. Rapid transportation to a hospital is usually the primary goal of roadside care because of limited first aid knowledge and a lack of access to basic safety equipment. The key informants recommended: expanding community-based first aid training; emphasizing umunthu (shared humanity) to inspire bystander involvement in roadside care; empowering local leaders to coordinate on-site responses; improving emergency communication systems; equipping traffic police with road safety gear; and expanding access to ambulance services. Prehospital care in Malawi would be improved by the creation of a formal network of community leaders, police, commercial drivers, and other lay volunteers who are trained in basic first aid and are equipped to respond to crash sites to provide roadside care to trauma patients and prepare them for safe transport to hospitals. Chokotho L , Mulwafu W , Singini I , Njalale Y , Maliwichi-Senganimalunje L , Jacobsen KH . First responders and prehospital care for road traffic injuries in Malawi. Prehosp Disaster Med. 2017;32(1):14-19.

Magnetic Resonance Imaging in Malawi: Contributions to Clinical ...

African Journals Online (AJOL)

Magnetic Resonance Imaging in Malawi: Contributions to Clinical Care, Medical Education and Biomedical Research. MJ Potchen, S Kampondeni, GL Birbeck, CA Hammond, A Gonani, KS Phiri, KB Seydel, TE Taylor ...

Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi

Directory of Open Access Journals (Sweden)

Melanie Y. Hami

2014-10-01

Vroue se vermeende vatbaarheid en benutting van servikale kanker dienste in Malawi  Agtergrond: Malawi verskaf gratis servikale kanker siftings dienste by sommige openbare gesondheids instansies. Min vrouens maak gebruik van die kanker siftings dienste in Malawi en baie vrouens word steeds gediagnoseer met servikale kanker tydens die laat onopereerbare fases van die toestand. Doelwitte: Die doel van die studie was was om te bepaal of Malawiese vrouens wat 42 en ouer is se waargenome vatbaarheid vir servikale kanker hulle beïnvleod om beskikbare gratis servikale siftingsdienste te gebruik. ’n Kwantitatiwe, deursnee beskrywende navorsingsontwerp was gekies. Metode: Gestruktureerde onderhoude is met 381 vrouens gevoer wat drie gesondheidsdiensentrums in die Blantyre Distrik van Malawi besoek het. Resultate: ’n Statistiese beduidende verhouding het bestaan tussen vrouens se voornemens om vir servikale kanker getoets te word en hulle kennis oor servikale kanker (X² = 8.9; df = 1; p = 0.003 en dat hulle al gehoor het van MPV infeksies (X² = 4.2; df = 1; p = 0.041 op die 5% vlak van beduidenis. Servikale kanker siftingsdienste is gratis beskikbaar in openbare gesondheidsdiensinrigtings in Malawi. Desnieteenstaande was daar ’n lae waargenome risiko van servikale kanker onder vrouens wat 42 jaar oud en ouer was en dit het bygedra tot die beperkte benutting van siftingsdienste, wat verduidelik waarom 80% van servikale kankergevalle in Malawi gedurende die laat onopereerbare fases gediagnoseer is. Gevolgtrekkings: Malawiese vrouens was onbewus van hulle vatbaarheid vir servikale kanker en het inligting benodig oor servikale kanker siftingsdienste. Malawi se vrouens wat 42 jaar oud en ouer is, moet ingelig word aangaande die voordele van servikale sifting en die belangrikheid van effektiewe behandeling indien ’n vroë diagnose gemaak is. Vrouens van 42 of ouer benut selde voorgeboorte, nageboorte gesonde baba, of gesinsbeplanningsklinieke waar voorliging

Prevalence and risk factors for trachoma in central and southern Malawi.

Directory of Open Access Journals (Sweden)

Khumbo Kalua

Full Text Available BACKGROUND: Trachoma, one of the neglected tropical diseases is suspected to be endemic in Malawi. OBJECTIVES: To determine the prevalence of trachoma and associated risk factors in central and southern Malawi. METHODOLOGY/PRINCIPAL FINDINGS: A population based survey conducted in randomly selected clusters in Chikwawa district (population 438,895, southern Malawi and Mchinji district (population 456,558, central Malawi. Children aged 1-9 years and adults aged 15 and above were assessed for clinical signs of trachoma. In total, 1010 households in Chikwawa and 1016 households in Mchinji districts were enumerated within 108 clusters (54 clusters in each district. A total of 6,792 persons were examined for ocular signs of trachoma. The prevalence of trachomatous inflammation, follicular (TF among children aged 1-9 years was 13.6% (CI 11.6-15.6 in Chikwawa and 21.7% (CI 19.5-23.9 in Mchinji districts respectively. The prevalence of trachoma trichiasis (TT in women and men aged 15 years and above was 0.6% (CI 0.2-0.9 in Chikwawa and 0.3% (CI 0.04-0.6 in Mchinji respectively. The presence of a dirty face was significantly associated with trachoma follicular (TF in both Chikwawa and Mchinji districts (P10%, and warrants the trachoma SAFE control strategy to be undertaken in Chikwawa and Mchinji districts.

Through the back door: nurse migration to the UK from Malawi and Nepal, a policy critique.

Science.gov (United States)

Adhikari, Radha; Grigulis, Astrida

2014-03-01

The UK National Health Service has a long history of recruiting overseas nurses to meet nursing shortages in the UK. However, recruitment patterns regularly fluctuate in response to political and economic changes. Typically, the UK government gives little consideration of how these unstable recruitment practices affect overseas nurses. In this article, we present findings from two independent research studies from Malawi and Nepal, which aimed to examine how overseas nurses encountered and overcame the challenges linked to recent recruitment and migration restrictions. We show how current UK immigration policy has had a negative impact on overseas nurses' lives. It has led them to explore alternative entry routes into the UK, affecting both the quality of their working lives and their future decisions about whether to stay or return to their home country. We conclude that the shifting forces of nursing workforce demand and supply, leading to abrupt policy changes, have significant implications on overseas nurses' lives, and can leave nurses 'trapped' in the UK. We make recommendations for UK policy-makers to work with key stakeholders in nurse-sending countries to minimize the negative consequences of unstable nurse recruitment, and we highlight the benefits of promoting circular migration.

Immigrant-Host Community Relations in Malawi's Community Based ...

African Journals Online (AJOL)

government sponsored settlement schemes in Zimbabwe, for example, are viewed as ... diversity of community development projects and state provided public ..... Development Project in Malawi: case studies of beneficiary groups in Machinga ...

Job satisfaction and retention of health-care providers in Afghanistan and Malawi

Science.gov (United States)

2014-01-01

Background This study describes job satisfaction and intention to stay on the job among primary health-care providers in countries with distinctly different human resources crises, Afghanistan and Malawi. Methods Using a cross-sectional design, we enrolled 87 health-care providers in 32 primary health-care facilities in Afghanistan and 360 providers in 10 regional hospitals in Malawi. The study questionnaire was used to assess job satisfaction, intention to stay on the job and five features of the workplace environment: resources, performance recognition, financial compensation, training opportunities and safety. Descriptive analyses, exploratory factor analyses for scale development, bivariate correlation analyses and bivariate and multiple linear regression analyses were conducted. Results The multivariate model for Afghanistan, with demographic, background and work environment variables, explained 23.9% of variance in job satisfaction (F(9,73) = 5.08; P job satisfaction. The multivariate model for intention to stay for Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P job satisfaction (F(8,332) = 4.19; P job satisfaction and intention to stay on the job, differed substantially. These findings demonstrate the need for more detailed comparative human resources for health-care research, particularly regarding the relative importance of different determinants of job satisfaction and intention to stay in different contexts and the effectiveness of interventions designed to improve health-care worker performance and retention. PMID:24533615

Late Pleistocene temperature history of Southeast Africa: A TEX(86) temperature record from Lake Malawi

NARCIS (Netherlands)

Woltering, M.; Johnson, T.C.; Werne, J.P.; Schouten, S.; Sinninghe Damsté, J.S.

2011-01-01

We present a TEX86-derived surface water temperaturerecord for LakeMalawi that provides the first continuous continental record of temperature variability in the continental tropics spanning the past ∼ 74 kyr with millennial-scale resolution. Average temperature during Marine Isotope Stage (MIS) 5A

A case study of Blantyre City, Malawi

African Journals Online (AJOL)

user

African Journal of Environmental Science and Technology Vol. 6(2), pp. 94-103 ... that national authorities in Malawi need to spearhead public policies that will effectively regulate the operations of .... private sector combined with the commercialisation of ..... International Institute for Geo- Information Sciences and Earth.

Associations between maternal experiences of intimate partner violence and child nutrition and mortality: findings from Demographic and Health Surveys in Egypt, Honduras, Kenya, Malawi and Rwanda.

Science.gov (United States)

Rico, Emily; Fenn, Bridget; Abramsky, Tanya; Watts, Charlotte

2011-04-01

If effective interventions are to be used to address child mortality and malnutrition, then it is important that we understand the different pathways operating within the framework of child health. More attention needs to be given to understanding the contribution of social influences such as intimate partner violence (IPV). To investigate the relationship between maternal exposure to IPV and child mortality and malnutrition using data from five developing countries. Population data from Egypt, Honduras, Kenya, Malawi and Rwanda were analysed. Logistic regression analysis was used to generate odds ratios of the associations between several categories of maternal exposure to IPV since the age of 15 and three child outcomes: under-2-year-old (U2) mortality and moderate and severe stunting (Honduras) to 46.2% (Kenya). For child stunting, prevalence ranged from 25.4% (Egypt) to 58.0% (Malawi) and for U2 mortality from 3.6% (Honduras) to 15.2% (Rwanda). In Kenya, maternal exposure to IPV was associated with higher U2 mortality (adjusted odds ratio (OR)=1.42, 95% CI 1.18 to 1.71) and child stunting (adjusted OR=1.36, 95% CI 1.16 to 1.61). In Malawi and Honduras, marginal associations were observed between IPV and severe stunting and U2 mortality, respectively, with strength of associations varying by type of violence. The relationship between IPV and U2 mortality and stunting in Kenya, Honduras and Malawi suggests that, in these countries, IPV plays a role in child malnutrition and mortality. This contributes to a growing body of evidence that broader public health benefits may be incurred if efforts to address IPV are incorporated into a wider range of maternal and child health programmes; however, the authors highlight the need for more research that can establish temporality, use data collected on the basis of the study's objectives, and further explore the causal framework of this relationship using more advanced statistical analysis.

Untreated surgical conditions in Malawi: A randomised cross ...

African Journals Online (AJOL)

This was a multistage random cluster sampling national survey. Households ... sample size was estimated to be 1497 households from a pilot study that was ..... with fracture management by skeletal traction; a qualitative study from. Malawi.

The use and management of water in the Likangala Irrigation Scheme Complex in Southern Malawi

Science.gov (United States)

Mulwafu, Wapulumuka O.; Nkhoma, Bryson G.

This paper examines the uses and management of water for agriculture in Lake Chilwa catchment area in Zomba district of Southern Malawi. It focuses on the Likangala Rice Irrigation Scheme Complex situated along the Likangala River. The scheme is one of the largest government-run schemes. Established in the late 1960s by the government to meet the growing demand for rice, the scheme contributes greatly to the agricultural industry of the country. Besides, the scheme was established to ensure maximum utilization of Malawi's largest wetland, which, due to its hydromorphic soils and the littoral floodplains, does not favour the production of traditional upland seasonal crops such as maize. The scheme's overdependence on water from the Likangala River has attracted a considerable degree of academic interest in the use and management of the river to ensure that there is equity and efficiency for both productive and domestic users. The paper focuses on four main issues: the historical development of the scheme, the distribution of water to farmers, social relations, and the overall contribution of the scheme towards the social and economic development of the area and the country in general. The paper contends that the growing population of the basin and the increase in the number of formal and informal smallholder farmers, contributes greatly to the growth of competition and conflicts over water, which tends to undermine the economic potential of the scheme. Furthermore, the paper provides clearest indication of the need for a realistic and informed water management policy and strategy to solve the growing problem of social inequity without necessarily compromising the production of rice in the scheme.

Using social and behavior change communication to increase HIV testing and condom use: the Malawi BRIDGE Project.

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Kaufman, Michelle R; Rimal, Rajiv N; Carrasco, Maria; Fajobi, OlaOluwa; Soko, Anthony; Limaye, Rupali; Mkandawire, Glory

2014-01-01

While overall HIV prevalence in Malawi has decreased, it is still high in the southern region of the country. Behavioral prevention activities are crucial to continue the reduction in HIV prevalence. Behavior change is influenced by many factors. Previous work indicates knowledge about HIV transmission, self-efficacy to protect oneself from exposure, and accurate risk perception of one's susceptibility all impact sexual behavior. The current study looks at the effects of a behavior change communication program in Malawi called the BRIDGE II Project on psychosocial and behavioral variables. The program sought to address barriers to individual action and confront societal norms related to sexual risk behavior through a mix of community-based activities and mass media messages delivered through local radio stations. Using cohort data (n = 594), we examined the effect of BRIDGE exposure on three variables that affect HIV behaviors: knowledge, self-efficacy, and risk perception, as well as two behavioral outcomes: HIV testing and condom use at last sex. Data were collected at baseline and for a midterm evaluation. Regression analyses showed exposure to BRIDGE was significantly associated with knowledge level (β = 0.20, p use at last sex (OR = 1.26, p increased.

Marriage as a risk factor for HIV: learning from the experiences of HIV-infected women in Malawi.

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Mkandawire-Valhmu, Lucy; Wendland, Claire; Stevens, Patricia E; Kako, Peninnah M; Dressel, Anne; Kibicho, Jennifer

2013-01-01

The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.

FIFA 11 for Health Programme: Implementation in Five Countries in Sub-Saharan Africa

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Fuller, Colin W.; Junge, Astrid; Amaning, Jacob; Kaijage, Rogasian R.; Kaputa, John; Magwende, George; Pambo, Prince; Dvorak, Jiri

2015-01-01

Objective: To assess the effectiveness of the FIFA 11 for Health programme in increasing children's knowledge about communicable and non-communicable diseases in five countries of Sub-Saharan Africa. Method: A prospective five-cohort study was implemented in schools in Ghana (17), Malawi (12), Namibia (11), Tanzania (18) and Zambia (11). The…

Characteristics and critical success factors for implementing problem-based learning in a human resource-constrained country.

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Giva, Karen R N; Duma, Sinegugu E

2015-08-31

Problem-based learning (PBL) was introduced in Malawi in 2002 in order to improve the nursing education system and respond to the acute nursing human resources shortage. However, its implementation has been very slow throughout the country. The objectives of the study were to explore and describe the goals that were identified by the college to facilitate the implementation of PBL, the resources of the organisation that facilitated the implementation of PBL, the factors related to sources of students that facilitated the implementation of PBL, and the influence of the external system of the organisation on facilitating the implementation of PBL, and to identify critical success factors that could guide the implementation of PBL in nursing education in Malawi. This is an ethnographic, exploratory and descriptive qualitative case study. Purposive sampling was employed to select the nursing college, participants and documents for review.Three data collection methods, including semi-structured interviews, participant observation and document reviews, were used to collect data. The four steps of thematic analysis were used to analyse data from all three sources. Four themes and related subthemes emerged from the triangulated data sources. The first three themes and their subthemes are related to the characteristics related to successful implementation of PBL in a human resource-constrained nursing college, whilst the last theme is related to critical success factors that contribute to successful implementation of PBL in a human resource-constrained country like Malawi. This article shows that implementation of PBL is possible in a human resource-constrained country if there is political commitment and support.

Leveling the Playing Field: Giving Girls An Equal Chance for Basic Education--Three Countries' Efforts. EDI Learning Resources Series.

Science.gov (United States)

Stromquist, Nelly; Murphy, Paud

This booklet examines the efforts of Pakistan, Bangladesh and Malawi to increase the enrollment of girls in their schools. Each country has severe problems of access to education for girls; the gender gap in the gross enrollment rate at the primary school level is at least 10 percentage points in each country. What is noteworthy about these three…

Malaria research in Malawi from 1984 to 2016: a literature review and bibliometric analysis.

Science.gov (United States)

Mwendera, Chikondi A; de Jager, Christiaan; Longwe, Herbert; Hongoro, Charles; Mutero, Clifford M; Phiri, Kamija S

2017-06-12

Malaria research can play a vital role in addressing the malaria burden in Malawi. An organized approach in addressing malaria in Malawi started in 1984 by the establishment of the first National Malaria Control Programme and research was recognized to be significant. This study aimed to assess the type and amount of malaria research conducted in Malawi from 1984 to 2016 and its related source of funding. A systematic literature search was conducted in the Medline/PubMed database for Malawian publications and approved malaria studies from two Ethical Committees were examined. Bibliometric analysis was utilized to capture the affiliations of first and senior/last authors, funding acknowledgements, while titles, abstracts and accessed full text were examined for research type. A total of 483 publications and 165 approved studies were analysed. Clinical and basic research in the fields of malaria in pregnancy 105 (21.5%), severe malaria 97 (20.1%) and vector and/or agent dynamics 69 (14.3%) dominated in the publications while morbidity 33 (20%), severe malaria 28 (17%) and Health Policy and Systems Research 24 (14.5%) dominated in the approved studies. In the publications, 146 (30%) first authors and 100 (21%) senior authors, and 88 (53.3%) principal investigators in approved studies were affiliated to Malawian-based institutions. Most researchers were affiliated to the Malawi-Liverpool Wellcome Trust, College of Medicine, Blantyre Malaria Project, Ministry of Health, and Malaria Alert Centre. The major malaria research funders were the National Institute for Health/USA, Wellcome Trust and the US Agency for International Development. Only three (2.5%) out of 118 journals publishing research on malaria in Malawi were from Africa and the Malaria Journal, with 76 (15.7%) publications, published most of the research from Malawi, followed by the American Journal of Tropical Medicine and Hygiene with 57 (11.8%) in comparison to only 13 (2.7%) published in the local Malawi

Rural nutrition interventions with indigenous plant foods - a case study of vitamin A deficiency in Malawi

Directory of Open Access Journals (Sweden)

Babu S.C.

2000-01-01

Full Text Available Identification, propagation, and introduction of a nutritionally rich, indigenous plant species in the existing cropping system are presented in this paper as a method of rural nutrition intervention. A case study of Moringa (Moringa oleifera Lam., Moringaceae, which is a common tree in Malawi and one of the richest sources of vitamin A and vitamin C compared to the commonly consumed vegetables is presented to address the problem of vitamin A deficiency. After a brief review of the prevalence of vitamin A deficiency and the efforts to reduce its incidence in Malawi, Moringa is suggested as a potential solution to the problem. A framework for designing nutrition intervention with Moringa is described for actual implementation. It is argued that attempts to identify, document, and encourage the utilization of nutrient-rich indigenous plants could be cost-effective, and a sustainable method of improving the nutritional status of local populations.

Pentecostalism, gerontocratic rule and democratization in Malawi : the changing position of the young in political culture

NARCIS (Netherlands)

Dijk, van R.A.; Haynes, J.

1999-01-01

This chapter explores the relationship between the father-metaphor, gerontocratic power, democratization and religion in the context of changing political culture in Malawi. It argues that democratization in Malawi signalled a change in the nature of the dominant gerontocratic power relations

Baseline axle load survey in Malawi - 2014

CSIR Research Space (South Africa)

Roux, M

2015-07-01

Full Text Available of 50.4%. The average overloaded mass on the 1 356 overloaded vehicles was 4 264 kg, representing an average degree of overloading of 26.1%. Weigh data from 4 of the 5 permanent weighbridges in Malawi were also analysed to compare the extent and degree...

A matching decomposition of the rural–urban difference in malnutrition in Malawi

Science.gov (United States)

2014-01-01

Background Child malnutrition remains widespread in many developing countries. Malnutrition during infancy may substantially increase vulnerability to infection and disease, and the risk of premature death. Malnutrition in children may also lead to permanent effects and to their having diminished health capital later in life as adults. These negative consequences of child malnutrition entail that the reduction of child malnutrition is vital for the social-economic development of countries. Urban children generally have better nutritional status than rural children. Malawi is no exception in this regard. The objective of this paper is to explore how much of the rural-urban nutrition gap in Malawi is explained and how much is unexplained by differences in characteristics. Method Using data from the 2006 multiple indicator cluster survey (MICS), the paper used the Nopo decomposition method to decompose the rural-urban malnutrition gap. This nonparametric method takes into account the fact that the supports of the distributions of characteristics between the two areas can be different. Results The results show that 90% and 89% of the stunting and underweight gaps respectively would be eliminated if there were no urban children with combinations of characteristics which positively influence child nutrition that remain entirely unmatched by rural children. Further to that, 4% and 6% of the stunting and underweight gaps respectively would disappear if there were no rural children with combinations of characteristics which negatively affect child nutrition that remain entirely unmatched by urban children. Conclusions These findings suggest that the characteristics which negatively affect child nutrition in rural areas play a small role in the gap, and that most of the gap is largely due to the favourable characteristics such as better parental education and better household economic status among others that urban children have. The findings imply that in order to reduce

A matching decomposition of the rural-urban difference in malnutrition in Malawi.

Science.gov (United States)

Mussa, Richard

2014-01-01

Child malnutrition remains widespread in many developing countries. Malnutrition during infancy may substantially increase vulnerability to infection and disease, and the risk of premature death. Malnutrition in children may also lead to permanent effects and to their having diminished health capital later in life as adults. These negative consequences of child malnutrition entail that the reduction of child malnutrition is vital for the social-economic development of countries. Urban children generally have better nutritional status than rural children. Malawi is no exception in this regard. The objective of this paper is to explore how much of the rural-urban nutrition gap in Malawi is explained and how much is unexplained by differences in characteristics. Using data from the 2006 multiple indicator cluster survey (MICS), the paper used the Nopo decomposition method to decompose the rural-urban malnutrition gap. This nonparametric method takes into account the fact that the supports of the distributions of characteristics between the two areas can be different. The results show that 90% and 89% of the stunting and underweight gaps respectively would be eliminated if there were no urban children with combinations of characteristics which positively influence child nutrition that remain entirely unmatched by rural children. Further to that, 4% and 6% of the stunting and underweight gaps respectively would disappear if there were no rural children with combinations of characteristics which negatively affect child nutrition that remain entirely unmatched by urban children. These findings suggest that the characteristics which negatively affect child nutrition in rural areas play a small role in the gap, and that most of the gap is largely due to the favourable characteristics such as better parental education and better household economic status among others that urban children have. The findings imply that in order to reduce the malnutrition gap policy

Nurturing professional social work in Malawi | Kakowa | African ...

African Journals Online (AJOL)

Further to this, there is no regulating or coordinating body for social work ... A regulating body of social work in Malawi would enhance development of the ... A reflexive approach where curriculum and practice would inform each other is ...

Countdown to 2015 country case studies: what can analysis of national health financing contribute to understanding MDG 4 and 5 progress?

Science.gov (United States)

Mann, Carlyn; Ng, Courtney; Akseer, Nadia; Bhutta, Zulfiqar A; Borghi, Josephine; Colbourn, Tim; Hernández-Peña, Patricia; Huicho, Luis; Malik, Muhammad Ashar; Martinez-Alvarez, Melisa; Munthali, Spy; Salehi, Ahmad Shah; Tadesse, Mekonnen; Yassin, Mohammed; Berman, Peter

2016-09-12

Countdown to 2015 (Countdown) supported countries to produce case studies that examine how and why progress was made toward the Millennium Development Goals (MDGs) 4 and 5. Analysing how health-financing data explains improvements in RMNCH outcomes was one of the components to the case studies. This paper presents a descriptive analysis on health financing from six Countdown case studies (Afghanistan, Ethiopia, Malawi, Pakistan, Peru, and Tanzania), supplemented by additional data from global databases and country reports on macroeconomic, health financing, demographic, and RMNCH outcome data as needed. It also examines the effect of other contextual factors presented in the case studies to help interpret health-financing data. Dramatic increases in health funding occurred since 2000, where the MDG agenda encouraged countries and donors to invest more resources on health. Most low-income countries relied on external support to increase health spending, with an average 20-64 % of total health spending from 2000 onwards. Middle-income countries relied more on government and household spending. RMNCH funding also increased since 2000, with an average increase of 119 % (2005-2010) for RMNH expenditures (2005-2010) and 165 % for CH expenditures (2005-2011). Progress was made, especially achieving MDG 4, even with low per capita spending; ranging from US$16 to US$44 per child under 5 years among low-income countries. Improvements in distal factors were noted during the time frame of the analysis, including rapid economic growth in Ethiopia, Peru, and Tanzania and improvements in female literacy as documented in Malawi, which are also likely to have contributed to MDG progress and achievements. Increases in health and RMNCH funding accompanied improvements in outcomes, though low-income countries are still very reliant on external financing, and out-of-pocket comprising a growing share of funds in middle-income settings. Enhancements in tracking RMNCH expenditures

Improving high quality, equitable maternal health services in Malawi ...

International Development Research Centre (IDRC) Digital Library (Canada)

Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.

Malawi Medical Journal - Vol 26, No 2 (2014)

African Journals Online (AJOL)

Assessment of laboratory test utilization for HIV/AIDS care in urban ART clinics of Lilongwe, Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. S Palchaudhuri, H Tweya, M Hosseinipour, 42-44 ...

A medical career in Malawi – personal reflections

African Journals Online (AJOL)

After spending 30 of the last 40 years working in Malawi's health service, I am ... the infection in women attending the antenatal clinic, for example, rising from 0% .... possible exception of North Korea, that attempts to move forward on its own.

Cholera Epidemic Control | Zachariah | Malawi Medical Journal

African Journals Online (AJOL)

Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 13, No 1 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Cholera Epidemic Control. R Zachariah. Full Text: EMAIL FREE ...

Is quality of care a key predictor of perinatal health care utilization and patient satisfaction in Malawi?

Science.gov (United States)

Creanga, Andreea A; Gullo, Sara; Kuhlmann, Anne K Sebert; Msiska, Thumbiko W; Galavotti, Christine

2017-05-22

services received. Quality of care is a key predictor of perinatal health service utilization and complete patient satisfaction with such services in Malawi. The current heightened attention toward perinatal health services and outcomes should be coupled with efforts to improve the actual quality of care offered to women in this country.

Basement and alluvial aquifers of Malawi: An overview of ...

African Journals Online (AJOL)

Elizabeth B Mapoma

2014-02-17

Feb 17, 2014 ... Malawi as regards water resources use and degradation ...... action plan for integrated water resource development and management that establishes rules and procedures to implement joint management of water resources.

Deforestation in Mwanza District, Malawi, from 1981 to 1992 as determined from Landsat MSS imagery

Science.gov (United States)

Andrew T. Hudak; Carol A. Wessman

2000-01-01

Malawi is critically short of fuelwood, the primary energy source for its poverty-stricken populace. Deforestation from 1981 to 1992 in Mwanza District in southern Malawi was assessed using Normalized Difference Vegetation Index (NDVI) values calculated from multitemporal Landsat Multispectral Scanner (MSS) images. A control site, where vegetation change was assumed to...

76 FR 55419 - Report on Countries That Are Candidates for Millennium Challenge Account Eligibility in Fiscal...

Science.gov (United States)

2011-09-07

... programs that advance the progress of such countries to achieve lasting economic growth and poverty [[Page...) investments in its people; and (b) considering the opportunity to reduce poverty and generate economic growth...; Ghana, Guinea, Haiti, Honduras, India, Kenya, Kyrgyz Republic, Lao PDR, Lesotho, Liberia, Malawi, Mali...

A social autopsy of neonatal mortality suggests needed improvements in maternal and neonatal interventions in Balaka and Salima districts of Malawi

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Alain K. Koffi

2015-06-01

Full Text Available Background The Every Newborn Action Plan calls for reducing the neonatal mortality rates to fewer than 10 deaths per 1000 live births in all countries by 2035. The current study aims to increase our understanding of the social and modifiable factors that can be addressed or reinforced to improve and accelerate the decline in neonatal mortality in Malawi. Methods The data come from the 2013 Verbal and Social Autopsy (VASA study that collected data in order to describe the biological causes and the social determinants of deaths of children under 5 years of age in Balaka and Salima districts of Malawi. This paper analyses the social autopsy data of the neonatal deaths and presents results of a review of the coverage of key interventions along the continuum of normal maternal and newborn care and the description of breakdowns in the care provided for neonatal illnesses within the Pathway to Survival framework. Results A total of 320 neonatal deaths were confirmed from the VASA survey. While one antenatal care (ANC visit was high at 94%, the recommended four ANC visits was much lower at 41% and just 17% of the mothers had their urines tested during the pregnancy. 173 (54% mothers of the deceased newborns had at least one labor/delivery complication that began at home. The caregivers of 65% (n = 75 of the 180 newborns that were born at home or born and left a health facility alive perceived them to be severely ill at the onset of their illness, yet only 44% (n = 80 attempted and 36% (n = 65could reach the first health provider after an average of 91 minutes travel time. Distance, lack of transport and cost emerged as the most important constraints to formal care–seeking during delivery and during the newborn fatal illness. Conclusions This study suggests that maternal and neonatal health organizations and the local government of Malawi should increase the demand for key maternal and child health interventions, including the recommended 4

The Malawi National Tuberculosis Programme: an equity analysis

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Chimzizi Rhehab

2007-12-01

Full Text Available Abstract Background Until 2005, the Malawi National Tuberculosis Control Programme had been implemented as a vertical programme. Working within the Sector Wide Approach (SWAp provides a new environment and new opportunities for monitoring the equity performance of the programme. This paper synthesizes what is known on equity and TB in Malawi and highlights areas for further action and advocacy. Methods A synthesis of a wide range of published and unpublished reports and studies using a variety of methodological approaches was undertaken and complemented by additional analysis of routine data on access to TB services. The analysis and recommendations were developed, through consultation with key stakeholders in Malawi and a review of the international literature. Results The lack of a prevalence survey severely limits the epidemiological knowledge base on TB and vulnerability. TB cases have increased rapidly from 5,334 in 1985 to 28,000 in 2006. This increase has been attributed to HIV/AIDS; 77% of TB patients are HIV positive. The age/gender breakdown of TB notification cases mirrors the HIV epidemic with higher rates amongst younger women and older men. The WHO estimates that only 48% of TB cases are detected in Malawi. The complexity of TB diagnosis requires repeated visits, long queues, and delays in sending results. This reduces poor women and men's ability to access and adhere to services. The costs of seeking TB care are high for poor women and men – up to 240% of monthly income as compared to 126% of monthly income for the non-poor. The TB Control Programme has attempted to increase access to TB services for vulnerable groups through community outreach activities, decentralising DOT and linking with HIV services. Conclusion The Programme of Work which is being delivered through the SWAp is a good opportunity to enhance equity and pro-poor health services. The major challenge is to increase case detection, especially amongst the poor

Identifying urban infrastructure multi-hazard risk in developing country contexts

Science.gov (United States)

Taylor, Faith; Malamud, Bruce; Millington, James

2017-04-01

This work presents a method to coarsely zone urban areas into different infrastructure typologies, from which physical vulnerability to a range of natural hazards and multi-hazard interactions can be estimated, particularly for developing country contexts where access to data can be a challenge. This work builds upon techniques developed for urban micrometeorology for classifying 12 urban typologies (Stewart and Oke, 2011) using Landsat 8 30 m × 30 m remote sensing imagery (Betchel et al., 2015). For each of these 12 urban typologies, we develop general rules about the presence, type and level of service of 10 broad categories of infrastructure (including buildings, roads, electricity and water), which we refer to as 'urban textures'. We have developed and applied this technique to five urban areas varying in size and structure across Africa: Nairobi (Kenya); Karonga (Malawi); Mzuzu (Malawi); Ibadan (Nigeria) and Cape Town (South Africa). For each urban area, a training dataset of 10 samples of each of the 12 urban texture classes is digitised using Google Earth imagery. A random forest classification is performed using SAGA GIS, resulting in a map of different urban typologies for each city. Based on >1200 georeferenced field photographs and expert interviews for Karonga (Malawi) and Nairobi (Kenya), generally applicable rules about the presence, type and level of service of 12 infrastructure types (the 'urban texture') are developed for each urban typology. For each urban texture, we are broadly reviewing how each infrastructure might be physically impacted by 21 different natural hazards and hazard interactions. This can aid local stakeholders such as emergency responders and urban planners to systematically identify how the infrastructure in different parts of an urban area might be affected differently during a natural disaster event.

Malawi Medical Journal - Vol 25, No 2 (2013)

African Journals Online (AJOL)

Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital, Blantyre-Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. NL Kalata, L Kamange, AS Muula, 50-52 ...

Bearing the Cost: An Examination of the Gendered Impacts of Water Policy Reform in Malawi

Science.gov (United States)

Marra, Simona

2008-01-01

Water insecurity is one of the most pressing issues currently faced by Malawi. The consequences of these issues are borne significantly by women, who are most directly involved with water provision and use, particularly at the household level. Since the mid-1990s, Malawi has undertaken a process of water policy reform. Reflective of international…

Eliminating child labour in Malawi: a British American Tobacco corporate responsibility project to sidestep tobacco labour exploitation.

Science.gov (United States)

Otañez, M G; Muggli, M E; Hurt, R D; Glantz, S A

2006-06-01

To examine British American Tobacco and other tobacco industry support of the Eliminating Child Labour in Tobacco Growing Foundation. Analyses of internal tobacco industry documents and ethnographic data. British American Tobacco co-founded the Eliminating Child Labour in Tobacco Growing Foundation (ECLT) in October 2000 and launched its pilot project in Malawi. ECLT's initial projects were budgeted at US2.3 million dollars over four years. Labour unions and leaf dealers, through ECLT funds, have undertook modest efforts such as building schools, planting trees, and constructing shallow wells to address the use of child labour in tobacco farming. In stark contrast, the tobacco companies receive nearly US40 million dollars over four years in economic benefit through the use of unpaid child labour in Malawi during the same time. BAT's efforts to combat child labour in Malawi through ECLT was developed to support the company's "corporate social responsibility agenda" rather than accepting responsibility for taking meaningful steps to eradicate child labour in the Malawi tobacco sector. In Malawi, transnational tobacco companies are using child labour projects to enhance corporate reputations and distract public attention from how they profit from low wages and cheap tobacco.

Country Presentation Congo

International Nuclear Information System (INIS)

Mwata, P.K.; SAKI, A.; KAZADI, J.

2010-01-01

Illicit trafficking of radioactive minerals, precious metals and nuclear materials is generally expanded practice in some parts of the Democratic Republic of Congo. The phenomenon took place early in 1990 and amplified from 1998. The main causes of this practice are political instability that led to general poverty among population and the lack of legal framework governing the exploitation of minerals. Nuclear Illicit trafficking in Congo concerns radioactive mineral sand precious metals in eastern and southern parts of the country. The unfavorable political environment that took place in Congo in the 1990s resulted in local manpower and mine workers immigrating to neighboring countries. A great fraction of these new jobless started exploiting abandoned mines residues searching for Cu, Co and Au for survival. First cases of illicit exploitation of uranium minerals were reported very soon after rock sliding that occurred in 2004 on Shinkolobwe site in Katanga region. This uncontrolled mineral exploitation got worse when several mining companies were licensed by GECAMINES company to explore, exploit, purchase minerals from individuals and export raw materials and concentrates.

Violence against nurses in the southern region of Malawi

African Journals Online (AJOL)

Chimwemwe Kwanjo Banda

reporting to managers, telling their friends, crying, retaliating, or ignoring the incident. Most ... Conclusions: Workplace violence against nurses exists in Malawi and it affects nurses ... safety, well-being or health” (WHO, 2010, p. 1).

Sleeping sickness surveys: game reserve adjacent villages in Malawi

African Journals Online (AJOL)

Sleeping sickness surveys: game reserve adjacent villages in Malawi. ... Sera from 160 game ranger volunteers and from 82 suspected cases_of Rhodesian sleeping sickness were tested by use of ELISA, ... AJOL African Journals Online.

A Study of Journalists' Conditions of Service in Malawi

African Journals Online (AJOL)

zeleza

establish journalists' salaries and benefits in Malawi; to determine if these salaries .... Agency reporter from the districts of Zomba, Dedza and Nkhata Bay, which were .... responsibilities of employers and employees and copyright ownership of ...

Research on human immunodeficiency virus (HIV) in Malawi: the ...

African Journals Online (AJOL)

Research on human immunodeficiency virus (HIV) in Malawi: the Johns Hopkins University- Ministry of Health (JHU-MOH) project. TE Taha, JK Canner, AM Wangel, JD Chiphangwi, NG Liomba, PG Miotti, GA Dallabetta, AJ Saah ...

Malawi Medical Journal - Vol 30, No 1 (2018)

African Journals Online (AJOL)

Perceptions of a mobile health intervention for Community Case Management in Malawi: Opportunities and challenges for Health Surveillance Assistants in a ... Relationship between tumour size and response to neoadjuvant chemotherapy among breast cancer patients in a tertiary center in Nigeria · EMAIL FREE FULL ...

Magnetic Resonance Imaging in Malawi: Contributions to Clinical ...

African Journals Online (AJOL)

Advanced medical imaging technologies are generally unavailable in low income, tropical settings despite the reality that neurologic disorders are disproportionately common in such environments. Through a series of donations as well as extramural research funding support, an MRI facility opened in Blantyre, Malawi in ...

Distribution of haematological and chemical pathology values among infants in Malawi and Uganda

Science.gov (United States)

Kumwenda, Newton I.; Khonje, Tiwonge; Mipando, Linda; Nkanaunena, Kondwani; Katundu, Pauline; Lubega, Irene; Elbireer, Ali; Bolton, Steve; Bagenda, Danstan; Mubiru, Michael; Fowler, Mary Glenn; Taha, Taha E.

2013-01-01

Background Data on paediatric reference laboratory values are limited for sub-Saharan Africa. Objective To describe the distribution of haematological and chemical pathology values among healthy infants from Malawi and Uganda. Methods A cross-sectional study was conducted among healthy infants, 0–6 months old, born to HIV-uninfected mothers recruited from two settings in Blantyre, Malawi and Kampala, Uganda. Chemical pathology and haematology parameters were determined using standard methods on blood samples. Descriptive analyses by age-group were performed based on 2004 Division of AIDS Toxicity Table age categories. Mean values and interquartile ranges were compared by site and age-group. Results A total of 541 infants were included altogether, 294 from Malawi and 247 from Uganda. Overall, the mean laboratory values were comparable between the two sites. Mean alkaline phosphatase levels were lower among infants aged ≤21 days while aspartate aminotransferase, creatinine, total bilirubin and gamma-glutamyl transferase were higher in those aged 0–7 days than in older infants. Mean haematocrit, haemoglobin and neutrophil counts were higher in the younger age-groups (<35 days) and overall were lower than US norms. Red and white blood cell counts tended to decrease after birth but increased after ~2 months of age. Mean basophil counts were higher in Malawi than in Uganda in infants aged 0–1 and 2–7 days; mean counts for eosinophils (for age groups 8–21 or older) and platelets (for all age groups) were higher in Ugandan than in Malawian infants. Absolute lymphocyte counts increased with infant age. Conclusion The chemical pathology and haematological values in healthy infants born to HIV-uninfected mothers were comparable in Malawi and Uganda and can serve as useful reference values in these settings. PMID:23164296

National poverty reduction strategies and HIV/AIDS governance in Malawi: a preliminary study of shared health governance.

Science.gov (United States)

Wachira, Catherine; Ruger, Jennifer Prah

2011-06-01

The public health and development communities understand clearly the need to integrate anti-poverty efforts with HIV/AIDS programs. This article reports findings about the impact of the Poverty Reduction Strategy Paper (PRSP) process on Malawi's National HIV/AIDS Strategic Framework (NSF). In this article we ask, how does the PRSP process support NSF accountability, participation, access to information, funding, resource planning and allocation, monitoring, and evaluation? In 2007, we developed and conducted a survey of Malawian government ministries, United Nations agencies, members of the Country Coordination Mechanism, the Malawi National AIDS Commission (NAC), and NAC grantees (N = 125, 90% response rate), seeking survey respondents' retrospective perceptions of NSF resource levels, participation, inclusion, and governance before, during, and after Malawi's PRSP process (2000-2004). We also assessed principle health sector and economic indicators and budget allocations for HIV/AIDS. These indicators are part of a new conceptual framework called shared health governance (SHG), which seeks congruence among the values and goals of different groups and actors to reflect a common purpose. Under this framework, global health policy should encompass: (i) consensus among global, national, and sub-national actors on goals and measurable outcomes; (ii) mutual collective accountability; and (iii) enhancement of individual and group health agency. Indicators to assess these elements included: (i) goal alignment; (ii) adequate resource levels; (iii) agreement on key outcomes and indicators for evaluating those outcomes; (iv) meaningful inclusion and participation of groups and institutions; (v) special efforts to ensure participation of vulnerable groups; and (vi) effectiveness and efficiency measures. Results suggest that the PRSP process supported accountability for NSF resources. However, the process may have marginalized key stakeholders, potentially undercutting the

Determinants Of Vaccination Coverage In Malawi: Evidence From ...

African Journals Online (AJOL)

also shown that birth order of the child, residence (rural/ urban) and mother's education are major determinants of the immunization status of the child. Introduction. Vaccination has been practised in Malawi since the arrival of the missionaries and colonial administrators. While these vaccinations were taking place, ...

All projects related to malawi | Page 3 | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

Topic: CLIMATE CHANGE, ADAPTATION TO CHANGE, NATURAL DISASTERS, DISASTER PREPAREDNESS, DISASTER MANAGEMENT. Region: Kenya, Malawi, Sudan, Tanzania, Uganda, South Africa, Zambia, Zimbabwe, South of Sahara. Program: Climate Change. Total Funding: CA$ 1,398,500.00. Strengthening ...

Prevention and treatment of childhood malnutrition in rural Malawi ...

African Journals Online (AJOL)

in rural Malawi: Lungwena nutrition studies ... a community based nutritional intervention for malnourished children in rural .... and height gain were similar in the two groups. .... A-M, Ashorn P. Socio-economic support for good health in rural.

Childhood disability in Malawi: a population based assessment using the key informant method.

Science.gov (United States)

Tataryn, Myroslava; Polack, Sarah; Chokotho, Linda; Mulwafu, Wakisa; Kayange, Petros; Banks, Lena Morgon; Noe, Christiane; Lavy, Chris; Kuper, Hannah

2017-11-28

Epidemiological data on childhood disability are lacking in Low and Middle Income countries (LMICs) such as Malawi, hampering effective service planning and advocacy. The Key Informant Method (KIM) is an innovative, cost-effective method for generating population data on the prevalence and causes of impairment in children. The aim of this study was to use the Key Informant Method to estimate the prevalence of moderate/severe, hearing, vision and physical impairments, intellectual impairments and epilepsy in children in two districts in Malawi and to estimate the associated need for rehabilitation and other services. Five hundred key informants (KIs) were trained to identify children in their communities who may have the impairment types included in this study. Identified children were invited to attend a screening camp where they underwent assessment by medical professionals for moderate/severe hearing, vision and physical impairments, intellectual impairments and epilepsy. Approximately 15,000 children were identified by KIs as potentially having an impairment of whom 7220 (48%) attended a screening camp. The estimated prevalence of impairments/epilepsy was 17.3/1000 children (95% CI: 16.9-17.7). Physical impairment (39%) was the commonest impairment type followed by hearing impairment (27%), intellectual impairment (26%), epilepsy (22%) and vision impairment (4%). Approximately 2100 children per million population could benefit from physiotherapy and occupational therapy and 300 per million are in need of a wheelchair. An estimated 1800 children per million population have hearing impairment caused by conditions that could be prevented or treated through basic primary ear care. Corneal opacity was the leading cause of vision impairment. Only 50% of children with suspected epilepsy were receiving medication. The majority (73%) of children were attending school, but attendance varied by impairment type and was lowest among children with multiple impairments (38

Challenges for modelling spatio-temporal variations of malaria risk in Malawi

Science.gov (United States)

Lowe, R.; Chirombo, J.; Tompkins, A. M.

2012-04-01

Malaria is the leading cause of morbidity and mortality in Malawi with more than 6 million episodes reported each year. Malaria poses a huge economic burden to Malawi in terms of the direct cost of treating malaria patients and also indirect costs resulting from workdays lost in agriculture and industry and absenteeism from school. Malawi implements malaria control activities within the Roll Back Malaria framework, with the objective to provide those most at risk (i.e. children under five years, pregnant woman and individuals with suppressed immune systems) access to personal and community protective measures. However, at present there is no mechanism by which to target the most 'at risk' populations ahead of an impending epidemic. Malaria transmission is influenced by variations in meteorological conditions, which impact the biology of the mosquito and the availability of breeding sites, but also socio-economic conditions such as levels of urbanisation, poverty and education, which influence human vulnerability and vector habitat. The many potential drivers of malaria, both extrinsic, such as climate, and intrinsic, such as population immunity are often difficult to disentangle. This presents a challenge for modelling of malaria risk in space and time. Using an age-stratified spatio-temporal dataset of malaria cases at the district level from July 2004 - June 2011, we use a spatio-temporal modelling framework to model variations in malaria risk in Malawi. Climatic and topographic variations are accounted for using an interpolation method to relate gridded products to administrative districts. District level data is tested in the model to account for confounding factors, including the proportion of the population living in urban areas; residing in traditional housing; with no toilet facilities; who do not attend school, etc, the number of health facilities per population and yearly estimates of insecticide-treated mosquito net distribution. In order to account for

Scaling-up antiretroviral therapy in Malawi.

Science.gov (United States)

Jahn, Andreas; Harries, Anthony D; Schouten, Erik J; Libamba, Edwin; Ford, Nathan; Maher, Dermot; Chimbwandira, Frank

2016-10-01

In Malawi, health-system constraints meant that only a fraction of people infected with human immunodeficiency virus (HIV) and in immediate need of antiretroviral treatment (ART) received treatment. In 2004, the Malawian Ministry of Health launched plans to scale-up ART nationwide, adhering to the principle of equity to ensure fair geographical access to therapy. A public health approach was used with standardized training and treatment and regular supervision and monitoring of the programme. Before the scale-up, an estimated 930 000 people in Malawi were HIV-infected, with 170 000 in immediate need of ART. About 3000 patients were on ART in nine clinics. By December 2015, cumulatively 872 567 patients had been started on ART from 716 clinics, following national treatment protocols and using the standard monitoring system. Strong national leadership allowed the ministry of health to implement a uniform system for scaling-up ART and provided benchmarks for implementation on the ground. New systems of training staff and accrediting health facilities enabled task-sharing and decentralization to peripheral health centres and a standardized approach to starting and monitoring ART. A system of quarterly supervision and monitoring, into which operational research was embedded, ensured stocks of drug supplies at facilities and adherence to national treatment guidelines.

Malawi Medical Journal - Vol 10, No 1 (1994)

African Journals Online (AJOL)

Research on human immunodeficiency virus (HIV) in Malawi: the Johns Hopkins University- Ministry of Health (JHU-MOH) project · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. TE Taha, JK Canner, AM Wangel, JD Chiphangwi, NG Liomba, PG Miotti, GA Dallabetta ...

Malawi Medical Journal - Vol 14, No 2 (2002)

African Journals Online (AJOL)

Changes in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. R Zachariah, AD Harries, MP Spielmann, V Arendt, D Nchingula, ...

Centralization and Experimentation in the Implementation of a National Monitoring and Evaluation System: The Experience of Malawi.

Science.gov (United States)

Useem, Michael; Chipande, Graham

1991-01-01

To identify general principles of implementing a system of evaluation, the experience of Malawi in building a national system for agriculture is described. Applying principles of both centralization and decentralization and principles of trial and error has helped translate theories of evaluation into practice in Malawi. (SLD)

Genetic sex determination in Astatotilapia calliptera, a prototype species for the Lake Malawi cichlid radiation

Science.gov (United States)

Peterson, Erin N.; Cline, Maggie E.; Moore, Emily C.; Roberts, Natalie B.; Roberts, Reade B.

2017-06-01

East African cichlids display extensive variation in sex determination systems. The species Astatotilapia calliptera is one of the few cichlids that reside both in Lake Malawi and in surrounding waterways. A. calliptera is of interest in evolutionary studies as a putative immediate outgroup species for the Lake Malawi species flock and possibly as a prototype ancestor-like species for the radiation. Here, we use linkage mapping to test association of sex in A. calliptera with loci that have been previously associated with genetic sex determination in East African cichlid species. We identify a male heterogametic XY system segregating at linkage group (LG) 7 in an A. calliptera line that originated from Lake Malawi, at a locus previously shown to act as an XY sex determination system in multiple species of Lake Malawi cichlids. Significant association of genetic markers and sex produce a broad genetic interval of approximately 26 megabases (Mb) using the Nile tilapia genome to orient markers; however, we note that the marker with the strongest association with sex is near a gene that acts as a master sex determiner in other fish species. We demonstrate that alleles of the marker are perfectly associated with sex in Metriaclima mbenjii, a species from the rock-dwelling clade of Lake Malawi. While we do not rule out the possibility of other sex determination loci in A. calliptera, this study provides a foundation for fine mapping of the cichlid sex determination gene on LG7 and evolutionary context regarding the origin and persistence of the LG7 XY across diverse, rapidly evolving lineages.

Development and validation of a simple algorithm for initiation of CPAP in neonates with respiratory distress in Malawi.

Science.gov (United States)

Hundalani, Shilpa G; Richards-Kortum, Rebecca; Oden, Maria; Kawaza, Kondwani; Gest, Alfred; Molyneux, Elizabeth

2015-07-01

Low-cost bubble continuous positive airway pressure (bCPAP) systems have been shown to improve survival in neonates with respiratory distress, in developing countries including Malawi. District hospitals in Malawi implementing CPAP requested simple and reliable guidelines to enable healthcare workers with basic skills and minimal training to determine when treatment with CPAP is necessary. We developed and validated TRY (T: Tone is good, R: Respiratory Distress and Y=Yes) CPAP, a simple algorithm to identify neonates with respiratory distress who would benefit from CPAP. To validate the TRY CPAP algorithm for neonates with respiratory distress in a low-resource setting. We constructed an algorithm using a combination of vital signs, tone and birth weight to determine the need for CPAP in neonates with respiratory distress. Neonates admitted to the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi, were assessed in a prospective, cross-sectional study. Nurses and paediatricians-in-training assessed neonates to determine whether they required CPAP using the TRY CPAP algorithm. To establish the accuracy of the TRY CPAP algorithm in evaluating the need for CPAP, their assessment was compared with the decision of a neonatologist blinded to the TRY CPAP algorithm findings. 325 neonates were evaluated over a 2-month period; 13% were deemed to require CPAP by the neonatologist. The inter-rater reliability with the algorithm was 0.90 for nurses and 0.97 for paediatricians-in-training using the neonatologist's assessment as the reference standard. The TRY CPAP algorithm has the potential to be a simple and reliable tool to assist nurses and clinicians in identifying neonates who require treatment with CPAP in low-resource settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Malawi faith communities responding to HIV/AIDS: preliminary ...

African Journals Online (AJOL)

This paper reports on the preliminary findings (year one) of a four-year intervention and participatory-action research (PAR) project in Malawi. Project goals are to enhance the response capacity and effectiveness of faith community (FC) leaders to the problem of HIV/AIDS. Ethnographic interviews with FC leaders were ...

Rural Fuel-wood and Poles Research Project in Malawi: a general account

Energy Technology Data Exchange (ETDEWEB)

Nkaonja, R S.W.

1981-01-01

The Rural Fuel-wood and Poles Research Project was initiated to provide information about afforestation in the dry silvicultural zones. Plantation forestry in Malawi has concentrated on production of timber, poles, and pulpwood. It is estimated that 90% of Malawi's population of 5.5 million live in rural communities, and that the purely domestic wood requirement is 4.05 cubic m per family (of five) annually. In addition, wood is required for agricultural purposes such as tobacco curing. The remaining indigenous forest cannot meet the demand. There is an urgent need for plantations. Rather than simply planting trees, the aim is to make local communities self-sufficient in forest products. In view of the shortage of land, great emphasis is placed on trying species which have many end-uses-- e.g., poles, fuel-wood, mulch, fodder, and shade--and those which can be grown together with farm crops, a concept known as ''agroforestry.'' Over 20 ha of trials were established at locations in the three regions of the country. Acacia albida allows maize and other farm crops to grow under it, provides good shade and fodder, and--as legume--enriches the soil with nitrogen. Eucalypts were included because most produce straight poles for construction, are drought-hardy, and are rated higher than Gmelina arborea in calorific value, durability, and strength. Another tree favored for its multiple uses is Leucaena leucocephala (Hawaiian giant), but it appears that there is considerable mixture of varieties in the seeds. With the exception of one trial at Bwanje, trials have not included farm crops, but the agroforestry element will be a very important consideration in future trials.

SIMPLE MEASURES ARE AS EFFECTIVE AS INVASIVE TECHNIQUES IN THE DIAGNOSIS OF PULMONARY TUBERCULOSIS IN MALAWI

Science.gov (United States)

Bell, David J; Dacombe, Russell; Graham, Stephen M; Hicks, Alexander; Cohen, Danielle; Chikaonda, Tarsizio; French, Neil; Molyneux, Malcolm E; Zijlstra, Ed E; Squire, S Bertel; Gordon, Stephen B

2010-01-01

Setting Detection of smear-positive pulmonary tuberculosis (PTB) cases is vital for tuberculosis control. Methods to augment sputum collection are available but their additional benefit is uncertain in resource-limited settings. Objective To compare the diagnostic yields using five methods to obtain sputum from adults diagnosed with smear-negative PTB in Malawi. Design Self-expectorated sputum was collected under supervision for microscopy and mycobacterial culture in the study laboratory. Confirmed smear-negative patients, provided physiotherapy-assisted sputum and induced sputum followed, the next morning, by gastric washing and bronchoalveolar-lavage samples. Results 150 patients, diagnosed with smear-negative PTB by the hospital service, were screened. 39 (26%) were smear-positive from supervised self-expectorated sputum examined in the study laboratory. The remaining 111 confirmed smear-negative patients were enrolled; 89% were HIV positive. Seven additional smear-positive cases were diagnosed using the augmented sputum collection techniques. No differences were observed in the numbers of cases detected using the different methods. 44 (95.6%) of the 46 smear-positive cases could be detected from self-expectorated and physiotherapy-assisted samples Conclusions For countries like Malawi, the best use of limited resources to detect smear-positive PTB cases would be to improve the quality of self-expectorated sputum collection and microscopy. The additional diagnostic yield using bronchoalveolar-lavage after induced sputum is limited. PMID:19105886

A platform to integrate climate information and rural telemedicine in Malawi

Science.gov (United States)

Lowe, R.; Chadza, T.; Chirombo, J.; Fonda, C.; Muyepa, A.; Nkoloma, M.; Pietrosemoli, E.; Radicella, S. M.; Tompkins, A. M.; Zennaro, M.

2012-04-01

It is commonly accepted that climate plays a role in the transmission of many infectious diseases, particularly those transmitted by mosquitoes such as malaria, which is one of the most important causes of mortality and morbidity in developing countries. Due to time lags involved in the climate-disease transmission system, lagged observed climate variables could provide some predictive lead for forecasting disease epidemics. This lead time could be extended by using forecasts of the climate in disease prediction models. This project aims to implement a platform for the dissemination of climate-driven disease risk forecasts, using a telemedicine approach. A pilot project has been established in Malawi, where a 162 km wireless link has been installed, spanning from Blantyre City to remote health facilities in the district of Mangochi in the Southern region, bordering Lake Malawi. This long Wi-Fi technology allows rural health facilities to upload real-time disease cases as they occur to an online health information system (DHIS2); a national medical database repository administered by the Ministry of Health. This technology provides a real-time data logging system for disease incidence monitoring and facilitates the flow of information between local and national levels. This platform allows statistical and dynamical disease prediction models to be rapidly updated with real-time climate and epidemiological information. This permits health authorities to target timely interventions ahead of an imminent increase in malaria incidence. By integrating meteorological and health information systems in a statistical-dynamical prediction model, we show that a long-distance Wi-Fi link is a practical and inexpensive means to enable the rapid analysis of real-time information in order to target disease prevention and control measures and mobilise resources at the local level.

Bedside paediatric HIV testing in Malawi: Impact on testing rates

African Journals Online (AJOL)

2017-05-25

May 25, 2017 ... Malawi Integrated Guidelines on 'Clinical Management of ... referred by nursing staff to attend the HIV counsellor's ... Implementation of a bedside testing service at Queen Elizabeth Central Hospital significantly increased HIV ...

Making products available among community health workers: Evidence for improving community health supply chains from Ethiopia, Malawi, and Rwanda.

Science.gov (United States)

Chandani, Yasmin; Andersson, Sarah; Heaton, Alexis; Noel, Megan; Shieshia, Mildred; Mwirotsi, Amanda; Krudwig, Kirstin; Nsona, Humphreys; Felling, Barbara

2014-12-01

A UNICEF review of the challenges to scaling up integrated community case management (iCCM) found that drug shortages were a common bottleneck. In many settings, little thought has gone into the design of supply chains to the community level and limited evidence exists for how to address these unique challenges. SC4CCM's purpose was to conduct intervention research to identify proven, simple, affordable solutions that address the unique supply chain challenges faced by CHWs and to demonstrate that supply chain constraints at the community level can be overcome. SC4CCM selected three countries to implement supply chain innovations and developed a theory of change (TOC) framework for the learning phase, which identified the main drivers of product availability and was used for baseline assessments, design, implementation and evaluation of interventions in Ethiopia, Malawi, and Rwanda. Interventions were developed in each country and tested over 12-24 months. Mixed-method follow up assessments were conducted in each country in 2012-2013. The Supply Chain for Community Case Management (SC4CCM) Project then simplified the TOC into a Community Health Supply Chain (CHSC) framework to enable cross country analysis. The findings from interventions in the three countries suggest that the greatest supply chain benefits are realized when all three CHSC framework elements (data flow, product flow, and effective people) are in place and working together. The synergistic effect of these three elements on supply chain performance was most effectively demonstrated by results from the Enhanced Management and Quality Collaborative interventions in Malawi and Rwanda, respectively, which were characterized by lower mean stockout rates and higher in stock rates on day of visit, when compared to other interventions. Many conditions are necessary to ensure continuous product availability at the community level, however a supply chain works best when three key elements (product flow, data

Making products available among community health workers: Evidence for improving community health supply chains from Ethiopia, Malawi, and Rwanda

Science.gov (United States)

Chandani, Yasmin; Andersson, Sarah; Heaton, Alexis; Noel, Megan; Shieshia, Mildred; Mwirotsi, Amanda; Krudwig, Kirstin; Nsona, Humphreys; Felling, Barbara

2014-01-01

Background A UNICEF review of the challenges to scaling up integrated community case management (iCCM) found that drug shortages were a common bottleneck. In many settings, little thought has gone into the design of supply chains to the community level and limited evidence exists for how to address these unique challenges. SC4CCM’s purpose was to conduct intervention research to identify proven, simple, affordable solutions that address the unique supply chain challenges faced by CHWs and to demonstrate that supply chain constraints at the community level can be overcome. Methods SC4CCM selected three countries to implement supply chain innovations and developed a theory of change (TOC) framework for the learning phase, which identified the main drivers of product availability and was used for baseline assessments, design, implementation and evaluation of interventions in Ethiopia, Malawi, and Rwanda. Interventions were developed in each country and tested over 12–24 months. Mixed–method follow up assessments were conducted in each country in 2012–2013. The Supply Chain for Community Case Management (SC4CCM) Project then simplified the TOC into a Community Health Supply Chain (CHSC) framework to enable cross country analysis Results The findings from interventions in the three countries suggest that the greatest supply chain benefits are realized when all three CHSC framework elements (data flow, product flow, and effective people) are in place and working together. The synergistic effect of these three elements on supply chain performance was most effectively demonstrated by results from the Enhanced Management and Quality Collaborative interventions in Malawi and Rwanda, respectively, which were characterized by lower mean stockout rates and higher in stock rates on day of visit, when compared to other interventions. Conclusions Many conditions are necessary to ensure continuous product availability at the community level, however a supply chain works

HIV Stigma and Nurse Job Satisfaction in Five African Countries

OpenAIRE

Greeff, Minrie; Chirwa, Maureen L; Kohi, Thecla W; Naidoo, Joanne R; Makoae, Lucy N; Dlamini, Priscilla S; Kaszubski, Christopher; Cuca, Yvette P; Uys, Leana R; Holzermer, William L

2009-01-01

This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The Personal Satisfaction subscale was the highest in this sa...

The Parallel Economy in Malawi: Size, Effect on Tax Revenue and Policy Options

OpenAIRE

Chiumya, Chiza

2007-01-01

This study looks at the dynamics of the Parallel Economy. I estimate the size of the Parallel Economy in Malawi and its relationship with Tax Revenues. The Parallel Economy in Malawi was 12.3%, 23.1% and 17.3% of GDP in the 1970s, 1980s, and 1990s respectively. Income Taxes were a major driver of the Parallel Economy as compared to Import and Consumption Taxes. An increase in Tax Revenue led to an increase in the Parallel Economy and a decrease in tax Revenue led to a decrease in the Parallel...

Moving up the sanitation ladder with the help of microfinance in urban Malawi

OpenAIRE

Chunga, R; Jenkins, MW; Ensink, J; Brown, J

2017-01-01

We carried out a stated preference survey in Malawi to examine whether access to microfinance for sanitation would significantly increase the proportion of households upgrading to improved pit latrines or alternative improved sanitation technologies (urine diverting dry toilet, fossa alterna, pour flush). We presented a range of sanitation options at local market prices, initially without and then with a real microfinance option, to 1,300 households sampled across 27 low-income urban settleme...

Zika virus infection in Asian island countries in Indian Ocean：Present situation

Institute of Scientific and Technical Information of China (English)

Somsri Wiwanitkit; Viroj Wiwanitkit

2016-01-01

Zika virus infection is the present global problem. The infection is widely seen in tropical Latin and South American countries and results in several problems in that area. In addition, the previous big outbreak in many island countries in Pacific region brings attention to the further expansion of the infection worldwide. The specific situation of the infection in island countries is very interesting. Here, the current situation (in 2016) of Zika virus infection in Asian island countries in Indian Ocean is summarized and presented. Although there is still no current problem in the Asian island countries in Indian Ocean, the appearance of infection in the sea resorts of countries lining Indian Ocean is a big concern. Due to the high volume of traveler to sea resorts, emergence of the new disease in Asian island countries in Indian Ocean can be expected.

Scaling up agroforestry farming systems: Lessons from the Malawi ...

African Journals Online (AJOL)

The study examined the factors affecting agroforestry technology upscaling and identified gaps in scaling up approaches of agroforestry technologies. One hundred and sixty-four farmers in Malawi Agroforestry Extension (MAFE) project districts of Mzimba, Ntcheu and Mangochi were interviewed. Logistic model was used in ...

The economic burden of chronic non-communicable diseases in rural Malawi: an observational study.

Science.gov (United States)

Wang, Qun; Brenner, Stephan; Kalmus, Olivier; Banda, Hastings Thomas; De Allegri, Manuela

2016-09-01

Evidence from population-based studies on the economic burden imposed by chronic non-communicable diseases (CNCDs) is still sparse in Sub-Saharan Africa. Our study aimed to fill this existing gap in knowledge by estimating both the household direct, indirect, and total costs incurred due to CNCDs and the economic burden households bear as a result of these costs in Malawi. The study used data from the first round of a longitudinal household health survey conducted in 2012 in three rural districts in Malawi. A cost-of-illness method was applied to estimate the economic burden of CNCDs. Indicators of catastrophic spending and impoverishment were used to estimate the economic burden imposed by CNCDs on households. A total 475 out of 5643 interviewed individuals reported suffering from CNCDs. Mean total costs of all reported CNCDs were 1,040.82 MWK, of which 56.8 % was contributed by direct costs. Individuals affected by chronic cardiovascular conditions and chronic neuropsychiatric conditions bore the highest levels of direct, indirect, and total costs. Using a threshold of 10 % of household non-food expenditure, 21.3 % of all households with at least one household member reporting a CNCD and seeking care for such a condition incurred catastrophic spending due to CNCDs. The poorest households were more likely to incur catastrophic spending due to CNCDs. An additional 1.7 % of households reporting a CNCD fell under the international poverty line once considering direct costs due to CNCDs. Our study showed that the economic burden of CNCDs is high, causes catastrophic spending, and aggravates poverty in rural Malawi, a country where in principle basic care for CNCDs should be offered free of charge at point of use through the provision of an Essential Health Package (EHP). Our findings further indicated that particularly high direct, indirect, and total costs were linked to specific diagnoses, although costs were high even for conditions targeted by the EHP. Our

Impacts of environmental degradation and climate change on electricity generation in Malawi

Energy Technology Data Exchange (ETDEWEB)

Kaunda, Chiyembekezo S. [Department of Energy and Process Engineering – WaterPower Laboratory, Norway University of Science and Technology, Trondheim NO-7491 (Norway); Mtalo, Felix [Department of Water Resources Engineering, University of Dar es Salaam, P.O. Box 35031, Dar es Salaam (Tanzania, United Republic of)

2013-07-01

Hydropower is an important energy source in Malawi because it provides almost all of the country’s electricity generation capacity. This paper has reviewed the impacts of environmental degradation and climate change on hydropower generation in Malawi. Energy scenario and other issues that contribute towards the current state of environment have been discussed. All of Malawi’s hydropower stations are run-of-river schemes cascaded along the Shire River with an installed capacity of nearly 280 MW. The generation is impacted negatively by floods, siltation, droughts and aquatic weeds infestation. The way how these challenges are being exacerbated by the poor state of the environment, especially within the Shire River basin in particular is also discussed in the paper. Measures taken by the national electricity utility company on how to manage the impacts are discussed as well. The paper concludes that hydropower generation system in a highly environmental degraded area is difficult to manage both technically and economically. In the case of Malawi, diversifying to other energy sources of generating electricity is considered to be a viable option. Some mitigation measures concerning environment degradation and climate change challenges have been suggested in the paper.

HIV and mental illness in Malawi and the neuropsychiatric sequelae ...

African Journals Online (AJOL)

ZMH) is the only government- run tertiary psychiatric referral hospital in Malawi. ... use, multiple sex partners and intravenous drug use,12,13 ... SPECIAL COMMUNICATION ... for psychiatric referral in subjects who have been informed about a ...

Countdown to 2015 country case studies: what can analysis of national health financing contribute to understanding MDG 4 and 5 progress?

Directory of Open Access Journals (Sweden)

Carlyn Mann

2016-09-01

Full Text Available Abstract Background Countdown to 2015 (Countdown supported countries to produce case studies that examine how and why progress was made toward the Millennium Development Goals (MDGs 4 and 5. Analysing how health-financing data explains improvements in RMNCH outcomes was one of the components to the case studies. Methods This paper presents a descriptive analysis on health financing from six Countdown case studies (Afghanistan, Ethiopia, Malawi, Pakistan, Peru, and Tanzania, supplemented by additional data from global databases and country reports on macroeconomic, health financing, demographic, and RMNCH outcome data as needed. It also examines the effect of other contextual factors presented in the case studies to help interpret health-financing data. Results Dramatic increases in health funding occurred since 2000, where the MDG agenda encouraged countries and donors to invest more resources on health. Most low-income countries relied on external support to increase health spending, with an average 20–64 % of total health spending from 2000 onwards. Middle-income countries relied more on government and household spending. RMNCH funding also increased since 2000, with an average increase of 119 % (2005–2010 for RMNH expenditures (2005–2010 and 165 % for CH expenditures (2005–2011. Progress was made, especially achieving MDG 4, even with low per capita spending; ranging from US$16 to US$44 per child under 5 years among low-income countries. Improvements in distal factors were noted during the time frame of the analysis, including rapid economic growth in Ethiopia, Peru, and Tanzania and improvements in female literacy as documented in Malawi, which are also likely to have contributed to MDG progress and achievements. Conclusions Increases in health and RMNCH funding accompanied improvements in outcomes, though low-income countries are still very reliant on external financing, and out-of-pocket comprising a growing share of funds in

Commentary - Cancer and palliative care | Chan | Malawi Medical ...

African Journals Online (AJOL)

Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

Interview with two palliative care nurses | Crutchlow | Malawi ...

African Journals Online (AJOL)

Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

HIV/AIDS and time allocation in rural Malawi

Directory of Open Access Journals (Sweden)

Simona Bignami-Van Assche

2011-05-01

Full Text Available AIDS morbidity and mortality are expected to have a large impact on households' labor supply in rural Malawi since they reduce the time that adults can spend on production for subsistence and on income generating activities. However, the data demands for estimating this impact are high, limiting the amount of empirical evidence. In this paper, we utilize a unique combination of quantitative and qualitative data, including biomarkers for HIV, collected by the Malawi Diffusion and Ideational Change Project, to analyze the impact of AIDS-related morbidity and mortality on time allocation decisions for rural Malawians. We evaluate both the direct effect of HIV/AIDS on the time allocation of affected individuals as well as its indirect effect on the time allocation of surviving household members. We find that the latter is the most important effect of AIDS-related morbidity and mortality, especially on women's time. Specifically, AIDS induces diversification of income sources, with women reallocating their time from work-intensive (typically farming and heavy chores to cash-generating tasks (such as casual labor.

Malawi : tous les projets | Page 3 | CRDI - Centre de recherches ...

International Development Research Centre (IDRC) Digital Library (Canada)

Sujet: URBAN HOUSING, HOUSING NEEDS, HOUSING CONDITIONS, LOW COST HOUSING, HOUSING POLICY, HOUSING PROGRAMMES, ENVIRONMENTAL HEALTH. Région: North of Sahara, South of Sahara, Malawi, Senegal, Tunisia, Uganda. Programme: Alimentation, environnement et santé. Financement total ...

Mother-tongue education in primary schools in Malawi: From policy ...

African Journals Online (AJOL)

Mother-tongue education in primary schools in Malawi: From policy to ... The policy remains fragmented, and suffers from a lack of appropriate planning and ... to bring about social change in terms of linguistic balance and social justice.

The performance of exchange rate regimes in three SADC countries: An overview

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Bernard N. Iyke

2014-08-01

Full Text Available This paper provides an overview of the real exchange rate and economic growth dynamics in three low-income Southern African countries, namely: the Democratic Republic of Congo (DRC, Malawi and Mozambique. Specifically, the paper investigates the nature of exchange rate regimes and the impact that they have on economic growth, as well as the movement of real exchange rates and real GDP from 1970—2010 in these countries. The paper identifies the following trends: Fixed exchange regimes were pursued from the 1960s until the late 1980s and early 1990s in these countries, which were growth-repressing; the countries pursued floating and managed-floating regimes from the 1990s to date, resulting in moderate-to-rapid economic growth. We conclude that liberalised exchange rates, which lead to undervalued currencies in these Southern African countries, were growth-enhancing.

Maternal biomass smoke exposure and birth weight in Malawi ...

African Journals Online (AJOL)

We, therefore, investigated effects of exposure to biomass fuels on reduced birth weight in the Malawian population. Methods: We conducted a cross-sectional analysis using secondary data from the 2010 Malawi Demographic Health Survey with a total of 9124 respondents. Information on exposure to biomass fuels, ...

Are one-stop centres an appropriate model to deliver services to sexually abused children in urban Malawi?

Science.gov (United States)

Mulambia, Yabwile; Miller, Aaron J; MacDonald, Geraldine; Kennedy, Neil

2018-04-30

The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as 'Chikwanekwanes' - 'everything under one roof') to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country's first Chikwanekwane in the large, urban city of Blantyre. One hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services. All 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi.

Oesophageal cancer and Kaposi's Sarcoma in Malawi: a ...

African Journals Online (AJOL)

Given that oesophageal cancer (OC) is common in Malawi and its outcome is so dismal, would it be pragmatic to promptly mitigate the effects of smoking, alcohol and aflatoxins rather than seek a higher degree of local evidence for their role in OC? We retrospectively analysed a total of 13,217 OC and. Kaposi's sarcoma ...

Improving the efficiency of use of small amounts of nitrogen and phosphorus fertilizer on smallholders maize in Central Malawi

NARCIS (Netherlands)

Kamanga, B.C.G.; Waddington, S.R.; Almekinders, C.J.M.; Giller, K.E.

2014-01-01

Mineral fertiliser is a scarce input for smallholder maize farmers in Malawi. A recent provision of small amounts of subsidised fertilisers by government programmes to farmers throughout Malawi has increased fertiliser access and raised maize production, but fertiliser management and yield responses

Evaluating a streamlined clinical tool and educational outreach intervention for health care workers in Malawi: the PALM PLUS case study

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Martiniuk Alexandra

2011-11-01

Full Text Available Abstract Background Nearly 3 million people in resource-poor countries receive antiretrovirals for the treatment of HIV/AIDS, yet millions more require treatment. Key barriers to treatment scale up are shortages of trained health care workers, and challenges integrating HIV/AIDS care with primary care. The research PALM PLUS (Practical Approach to Lung Health and HIV/AIDS in Malawi is an intervention designed to simplify and integrate existing Malawian national guidelines into a single, simple, user-friendly guideline for mid-level health care workers. Training utilizes a peer-to-peer educational outreach approach. Research is being undertaken to evaluate this intervention to generate evidence that will guide future decision-making for consideration of roll out in Malawi. The research consists of a cluster randomized trial in 30 public health centres in Zomba District that measures the effect of the intervention on staff satisfaction and retention, quality of patient care, and costs through quantitative, qualitative and health economics methods. Results and outcomes In the first phase of qualitative inquiry respondents from intervention sites demonstrated in-depth knowledge of PALM PLUS compared to those from control sites. Participants in intervention sites felt that the PALM PLUS tool empowered them to provide better health services to patients. Interim staff retention data shows that there were, on average, 3 to 4 staff departing from the control and intervention sites per month. Additional qualitative, quantitative and economic analyses are planned. The partnership Dignitas International and the Knowledge Translation Unit at the University of Cape Town Lung Institute have led the adaptation and development of the PALM PLUS intervention, using experience gained through the implementation of the South African precursor, PALSA PLUS. The Malawian partners, REACH Trust and the Research Unit at the Ministry of Health, have led the qualitative and

Evaluating a streamlined clinical tool and educational outreach intervention for health care workers in Malawi: the PALM PLUS case study.

Science.gov (United States)

Sodhi, Sumeet; Banda, Hastings; Kathyola, Damson; Burciul, Barry; Thompson, Sandy; Joshua, Martias; Bateman, Eric; Fairall, Lara; Martiniuk, Alexandra; Cornick, Ruth; Faris, Gill; Draper, Beverley; Mondiwa, Martha; Katengeza, Egnat; Sanudi, Lifah; Zwarenstein, Merrick; Schull, Michael J

2011-11-08

Nearly 3 million people in resource-poor countries receive antiretrovirals for the treatment of HIV/AIDS, yet millions more require treatment. Key barriers to treatment scale up are shortages of trained health care workers, and challenges integrating HIV/AIDS care with primary care. PALM PLUS (Practical Approach to Lung Health and HIV/AIDS in Malawi) is an intervention designed to simplify and integrate existing Malawian national guidelines into a single, simple, user-friendly guideline for mid-level health care workers. Training utilizes a peer-to-peer educational outreach approach. Research is being undertaken to evaluate this intervention to generate evidence that will guide future decision-making for consideration of roll out in Malawi. The research consists of a cluster randomized trial in 30 public health centres in Zomba District that measures the effect of the intervention on staff satisfaction and retention, quality of patient care, and costs through quantitative, qualitative and health economics methods. In the first phase of qualitative inquiry respondents from intervention sites demonstrated in-depth knowledge of PALM PLUS compared to those from control sites. Participants in intervention sites felt that the PALM PLUS tool empowered them to provide better health services to patients. Interim staff retention data shows that there were, on average, 3 to 4 staff departing from the control and intervention sites per month. Additional qualitative, quantitative and economic analyses are planned. Dignitas International and the Knowledge Translation Unit at the University of Cape Town Lung Institute have led the adaptation and development of the PALM PLUS intervention, using experience gained through the implementation of the South African precursor, PALSA PLUS. The Malawian partners, REACH Trust and the Research Unit at the Ministry of Health, have led the qualitative and economic evaluations. Dignitas and Ministry of Health have facilitated interaction with

Organic sedimentation in modern lacustrine systems: A case study from Lake Malawi, East Africa

Science.gov (United States)

Ellis, Geoffrey S.; Barry J. Katz,; Christopher A. Scholz,; Peter K. Swart,

2015-01-01

This study examines the relationship between depositional environment and sedimentary organic geochemistry in Lake Malawi, East Africa, and evaluates the relative significance of the various processes that control sedimentary organic matter (OM) in lacustrine systems. Total organic carbon (TOC) concentrations in recent sediments from Lake Malawi range from 0.01 to 8.80 wt% and average 2.83 wt% for surface sediments and 2.35 wt% for shallow core sediments. Hydrogen index (HI) values as determined by Rock-Eval pyrolysis range from 0 to 756 mg HC g−1 TOC and average 205 mg HC g−1 TOC for surface sediments and 228 mg HC g−1 TOC for shallow core samples. On average, variations in primary productivity throughout the lake may account for ~33% of the TOC content in Lake Malawi sediments (as much as 1 wt% TOC), and have little or no impact on sedimentary HI values. Similarly, ~33% to 66% of the variation in TOC content in Lake Malawi sediments appears to be controlled by anoxic preservation of OM (~1–2 wt% TOC), although some component of the water depth–TOC relationship may be due to physical sediment transport processes. Furthermore, anoxic preservation has a minimal effect on HI values in Lake Malawi sediments. Dilution of OM by inorganic sediment may account for ~16% of variability in TOC content in Lake Malawi sediments (~0.5 wt% TOC). The effect of inputs of terrestrial sediment on the organic character of surface sediments in these lakes is highly variable, and appears to be more closely related to the local depositional environment than the regional flux of terrestrial OM. Total nitrogen and TOC content in surface sediments collected throughout the lake are found to be highly correlated (r2 = 0.95), indicating a well-homogenized source of OM to the lake bottom. The recurring suspension and deposition of terrestrial sediment may account for significant amounts of OM deposited in offshore regions of the lake. This process effectively separates denser

Motivation of health surveillance assistants in Malawi: A qualitative ...

African Journals Online (AJOL)

Background: Motivation of health workers is a critical component of performance and is shaped by multiple factors. This study explored factors that influence motivation of health surveillance assistants (HSAs) in Malawi, with the aim of identifying interventions that can be applied to enhance motivation and performance of ...

The HIV/AIDS pandemic in Malawi: cultural and gender perspectives

African Journals Online (AJOL)

first step towards behaviour change lies in whether or not people accept that the illness they ... account the issues of culture and gender. The problem I ..... transmission, see J.C. Chakanza, "HIV/AIDS and Culture in Malawi," The. Lamp, 43 ...

Better processing and marketing of healthy fish products in Malawi

International Development Research Centre (IDRC) Digital Library (Canada)

: small fish, in particular, are a vital source of calcium, vi- tamin A, iron, and zinc. Once caught, most fish are sun-dried, smoked, parboiled, or pan roasted. However, peak fish catches in Malawi coincide with seasonal rains and high humidity,.

Bringing People Back into Protected Forests in Developing Countries: Insights from Co-Management in Malawi

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Leo Zulu

2013-05-01

Full Text Available This study examines struggles to bring people back into protected forests to enhance sustainable forest management and livelihoods using insights emerging from a co-management project in Malawi. It uses mixed social science methods and a process-based conceptualization of co-management to analyze experiences, and theory of reciprocal altruism to explain major findings of continuing local forest-user commitment to co-management despite six years of conservation burdens largely for minimal financial benefits. It argues that overemphasis on cash incentives as the motivation for “self-interested” users to participate in co-management overlooks locally significant non-cash motivations, inflates local expectations, and creates perverse incentives that undermine socio-ecological goals. Some non-cash incentives outweighed cash-driven ones. Findings support broadening of incentives mechanisms, including via nested cross-scale institutional arrangements for holistic management that integrates adjacent forests into forest-reserve co-management. Strengthened institutions, improving community/government and intra-community trust, improved village forests easing pressure on the reserve, measures minimizing elite capture, and impetus from an external threat, enhanced forest condition. Generous forest rights and appropriate community licensing and benefit-sharing systems also helped. Bureaucratic/donor inefficiencies, wood-extraction challenges, poor forest-based enterprise development, and low resource value undermined performance. Insights on forest-management planning, fair cost-sharing, targeting the poor, and need for social learning are highlighted.

Physical trauma experience among school children in periurban Blantyre, Malawi

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Muula Adamson S

2009-07-01

Full Text Available Abstract Background Physical trauma is an important cause of childhood morbidity and mortality in Africa. There are however, few community-based reports on the subject on the continent. The present study was conducted to explore school children's experience of physical trauma in a disadvantaged periurban area of Blantyre, in Malawi. Methods A cross sectional questionnaire study was carried out among school children in Ndirande-Blantyre, Malawi in 2004. Data were obtained to describe the following aspects of trauma experience: being a victim or observer of motor vehicular accidents involving pedestrians; history of falls from heights; and knowledge about road safety. Sex differences were determined for some of the variables in order to gain insights as to whether there is a difference in trauma experience between boys and girls. Results A total of 217 school children, 99 (45.6% boys and 118 (54.4% girls participated in the study. Eight of them reported to have ever been hit by a motor vehicle, 87 (40.1% had witnessed a road accident where a pedestrian had been hit and 83 (38.2% had witnessed a pedestrian they knew having been hit by a motor vehicle. Of those that reported to have ever been hit by motor vehicle, 2 (25% reported that they had been hospitalized as a result of injury. With regard to falling from heights, 86 reported to have ever fallen from tree, 44 of these (51.2% were injured from the fall and 14 (16.3% were hospitalized as a result of injury sustained from the fall. Girls were more likely to fall from trees and getting injured as compared to males (p = 0.04 for both situations. Just under half (41.9% of the study participants were able to report the correct procedure of crossing the road despite the fact that the majority (80% reported having been taught road safety at home or school. Conclusion Many school children in Blantyre, Malawi have been exposed to trauma either involving themselves or someone they observed. Prevention

Emergence of Double- and Triple-Gene Reassortant G1P[8] Rotaviruses Possessing a DS-1-Like Backbone after Rotavirus Vaccine Introduction in Malawi.

Science.gov (United States)

Jere, Khuzwayo C; Chaguza, Chrispin; Bar-Zeev, Naor; Lowe, Jenna; Peno, Chikondi; Kumwenda, Benjamin; Nakagomi, Osamu; Tate, Jacqueline E; Parashar, Umesh D; Heyderman, Robert S; French, Neil; Cunliffe, Nigel A; Iturriza-Gomara, Miren

2018-02-01

To combat the high burden of rotavirus gastroenteritis, multiple African countries have introduced rotavirus vaccines into their childhood immunization programs. Malawi incorporated a G1P[8] rotavirus vaccine (Rotarix) into its immunization schedule in 2012. Utilizing a surveillance platform of hospitalized rotavirus gastroenteritis cases, we examined the phylodynamics of G1P[8] rotavirus strains that circulated in Malawi before (1998 to 2012) and after (2013 to 2014) vaccine introduction. Analysis of whole genomes obtained through next-generation sequencing revealed that all randomly selected prevaccine G1P[8] strains sequenced ( n = 32) possessed a Wa-like genetic constellation, whereas postvaccine G1P[8] strains ( n = 18) had a DS-1-like constellation. Phylodynamic analyses indicated that postvaccine G1P[8] strains emerged through reassortment events between human Wa- and DS-1-like rotaviruses that circulated in Malawi from the 1990s and hence were classified as atypical DS-1-like reassortants. The time to the most recent common ancestor for G1P[8] strains was from 1981 to 1994; their evolutionary rates ranged from 9.7 × 10 -4 to 4.1 × 10 -3 nucleotide substitutions/site/year. Three distinct G1P[8] lineages chronologically replaced each other between 1998 and 2014. Genetic drift was the likely driver for lineage turnover in 2005, whereas replacement in 2013 was due to reassortment. Amino acid substitution within the outer glycoprotein VP7 of G1P[8] strains had no impact on the structural conformation of the antigenic regions, suggesting that it is unlikely that they would affect recognition by vaccine-induced neutralizing antibodies. While the emergence of DS-1-like G1P[8] rotavirus reassortants in Malawi was therefore likely due to natural genotype variation, vaccine effectiveness against such strains needs careful evaluation. IMPORTANCE The error-prone RNA-dependent RNA polymerase and the segmented RNA genome predispose rotaviruses to genetic mutation and

A framework to explore micronutrient deficiency in maternal and child health in Malawi, Southern Africa.

Science.gov (United States)

Dickinson, Natalie; Gulliver, John; MacPherson, Gordon; Atkinson, John; Rankin, Jean; Cummings, Maria; Nisbet, Zoe; Hursthouse, Andrew; Taylor, Avril; Robertson, Chris; Burghardt, Wolfgang

2009-12-21

Global food insecurity is associated with micronutrient deficiencies and it has been suggested that 4.5 billion people world-wide are affected by deficiencies in iron, vitamin A and iodine. Zinc has also been identified to be of increasing concern. The most vulnerable are young children and women of childbearing age. A pilot study has been carried out in Southern Malawi, to attempt to link the geochemical and agricultural basis of micronutrient supply through spatial variability to maternal health and associated cultural and social aspects of nutrition. The aim is to establish the opportunity for concerted action to deliver step change improvements in the nutrition of developing countries. Field work undertaken in August 2007 and July/August 2008 involved the collection of blood, soil and crop samples, and questionnaires from ~100 pregnant women. Complex permissions and authorisation protocols were identified and found to be as much part of the cultural and social context of the work as the complexity of the interdisciplinary project. These issues are catalogued and discussed. A preliminary spatial evaluation is presented linking soil quality and food production to nutritional health. It also considers behavioural and cultural attitudes of women and children in two regions of southern Malawi, (the Shire Valley and Shire Highlands plateau). Differences in agricultural practice and widely varying soil quality (e.g. pH organic matter, C/N and metal content) were observed for both regions and full chemical analysis of soil and food is underway. Early assessment of blood data suggests major differences in health and nutritional status between the two regions. Differences in food availability and type and observations of life style are being evaluated through questionnaire analysis. The particular emphasis of the study is on the interdisciplinary opportunities and the barriers to progress in development support in subsistence communities. Engaging at the community level

A framework to explore micronutrient deficiency in maternal and child health in Malawi, Southern Africa

Directory of Open Access Journals (Sweden)

Nisbet Zoe

2009-12-01

Full Text Available Abstract Background Global food insecurity is associated with micronutrient deficiencies and it has been suggested that 4.5 billion people world-wide are affected by deficiencies in iron, vitamin A and iodine. Zinc has also been identified to be of increasing concern. The most vulnerable are young children and women of childbearing age. A pilot study has been carried out in Southern Malawi, to attempt to link the geochemical and agricultural basis of micronutrient supply through spatial variability to maternal health and associated cultural and social aspects of nutrition. The aim is to establish the opportunity for concerted action to deliver step change improvements in the nutrition of developing countries. Results Field work undertaken in August 2007 and July/August 2008 involved the collection of blood, soil and crop samples, and questionnaires from ~100 pregnant women. Complex permissions and authorisation protocols were identified and found to be as much part of the cultural and social context of the work as the complexity of the interdisciplinary project. These issues are catalogued and discussed. A preliminary spatial evaluation is presented linking soil quality and food production to nutritional health. It also considers behavioural and cultural attitudes of women and children in two regions of southern Malawi, (the Shire Valley and Shire Highlands plateau. Differences in agricultural practice and widely varying soil quality (e.g. pH organic matter, C/N and metal content were observed for both regions and full chemical analysis of soil and food is underway. Early assessment of blood data suggests major differences in health and nutritional status between the two regions. Differences in food availability and type and observations of life style are being evaluated through questionnaire analysis. Conclusion The particular emphasis of the study is on the interdisciplinary opportunities and the barriers to progress in development support in

Analysis of Effectiveness of Modern Information and Communication Technologies on Maize Marketing Efficiency in Lilongwe and Dedza Districts and Selected Markets of Malawi

OpenAIRE

Tione, Sarah Ephridah

2011-01-01

Government of Malawi has been promoting initiatives like Malawi Agriculture Commodity Exchange (MACE) that aim at reducing information asymmetry among market players especially smallholder farmers. Using co-integration error correction models, the study assessed effectiveness of modern ICT based market interventions on improving maize marketing efficiency in Malawi. Considering that efficient markets are integrated markets when price difference is only a factor of transaction costs, TAR model...

Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi

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Melanie Y. Hami

2014-10-01

Full Text Available Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services. Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi. Results: A statistically-significant association existed between women’s intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003 and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041 at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages. Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi’s women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women

Research On Human Immunodeficiency Virus (HIV) In Malawi: The ...

African Journals Online (AJOL)

The Johns Hopkins University- Ministry of Health OHU-MOH) Project ... HIV infection among low ... in Africa were infected with the virus; these women gave ... information and medical, repro(l1K;Y~ ;~d pregnancy ... white blood cell differentials were done with a ... Malawi are at increased risk during the postnatal period.

Molecular characterisation of Musa L. cultivars cultivated in Malawi ...

African Journals Online (AJOL)

enoh

2012-03-01

Mar 1, 2012 ... five plants (individuals) growing next to each other were collected representing each ... and Ecology Research Unit, DNA laboratory in Zomba, Malawi for analysis. ..... diversity in this case would be due to self pollination and inbreeding .... including the long-term evolutionary history of the species. (shifts in ...

Iodine status in the Nordic countries - past and present.

Science.gov (United States)

Nyström, Helena Filipsson; Brantsæter, Anne Lise; Erlund, Iris; Gunnarsdottir, Ingibjörg; Hulthén, Lena; Laurberg, Peter; Mattisson, Irene; Rasmussen, Lone Banke; Virtanen, Suvi; Meltzer, Helle Margrete

2016-01-01

Adequate iodine nutrition is dependent on ground water content, seafood, and, as many countries use iodized cow fodder, dairy products. In most countries, salt fortification programs are needed to assure adequate iodine intake. The objectives are threefold: 1) to describe the past and present iodine situation in the Nordic countries, 2) to identify important gaps of knowledge, and 3) to highlight differences among the Nordic countries' iodine biomonitoring and fortification policies. Historical data are compared with the current situation. The Nordic countries' strategies to achieve recommended intake and urine iodine levels and their respective success rates are evaluated. In the past, the iodine situation ranged from excellent in Iceland to widespread goiter and cretinism in large areas of Sweden. The situation was less severe in Norway and Finland. According to a 1960 World Health Organization (WHO) report, there were then no observations of iodine deficiency in Denmark. In Sweden and Finland, the fortification of table salt was introduced 50-75 years ago, and in Norway and Finland, the fortification of cow fodder starting in the 1950s helped improve the population's iodine status due to the high intake of milk. In Denmark, iodine has been added to household salt and salt in bread for the past 15 years. The Nordic countries differ with regard to regulations and degree of governmental involvement. There are indications that pregnant and lactating women, the two most vulnerable groups, are mildly deficient in iodine in several of the Nordic countries. The Nordic countries employ different strategies to attain adequate iodine nutrition. The situation is not optimal and is in need of re-evaluation. Iodine researchers, Nordic national food administrations, and Nordic governmental institutions would benefit from collaboration to attain a broader approach and guarantee good iodine health for all.

SMALLHOLDER FARMERS’ WILLINGNESS TO INCORPORATE BIOFUEL CROPS INTO CROPPING SYSTEMS IN MALAWI

Directory of Open Access Journals (Sweden)

Beston Bille Maonga

2015-01-01

Full Text Available Using cross-sectional data, this study analysed the critical and significant socioeconomic factors with high likelihood to determine smallholder farmers’ decision and willingness to adopt jatropha into cropping systems in Malawi. Employing desk study and multi-stage random sampling technique a sample of 592 households was drawn from across the country for analysis. A probit model was used for the analysis of determinants of jatropha adoption by smallholder farmers. Empirical findings show that education, access to loan, bicycle ownership and farmers’ expectation of raising socioeconomic status are major significant factors that would positively determine probability of smallholder farmers’ willingness to adopt jatropha as a biofuel crop on the farm. Furthermore, keeping of ruminant herds of livestock, long distance to market and fears of market unavailability have been revealed to have significant negative influence on farmers’ decision and willingness to adopt jatropha. Policy implications for sustainable crop diversification drive are drawn and discussed.

Religion, condom use acceptability and use within marriage among rural women in Malawi.

Science.gov (United States)

Muula, Adamson S; Thomas, James C; Pettifor, Audrey E; Strauss, Ronald P; Suchindran, Chirayath M; Meshnick, Steve R

2011-01-01

Correct and consistent condom use within an HIV-discordant partnership could prevent sexual transmission of human immunodeficiency virus (HIV). Data on ever-married women from rural Malawi were obtained from the Malawi Diffusion and Ideational Change Project (MDICP) of 2006. We assessed the strength of association between religion and acceptability of condom use within marriage in general and also when one of the partners is suspected or known to be HIV infected. A total of 1,664 ever-married women participated in the MDICP 2006. Of these, 66.7% believed condom use was acceptable within marriage when one partner suspects or knows that the other was HIV infected; 38.2% believed condoms were acceptable within marriage generally. Only 13.8% reported ever having used condoms within the current or most recent marriage. Multivariate analysis found no difference in acceptability of condoms within marriage between Christians and Muslims, or between Catholics and all but one of the individual denominations assessed. Christian women in rural Malawi were no more or no less likely to accept condom use than Muslim women; there was also no difference in attitude toward condom use within marriage among Malawian women.

Country Presentation. Central African Republic

International Nuclear Information System (INIS)

Paulin Poussoumandji-Ouinga, P.

2010-01-01

No incident related to the illicit trafficking of nuclear and other radioactive materials has been yet reported in the country. However, rumors relating to the orphaned sources exist due to buried radioactive waste and former radiotherapy activities. Illicit trafficking of nuclear materials and radioactive materials is a new threat for the law enforcement agents.This is contributed by absence of dedicated equipment for radiation detection either at the border or within the country, lack of awareness of agents in charge of enforcement control, porosity of the border, absence of a protocol for exchanging information between Customs, intelligence and Police Service

Cholera outbreak in districts around Lake Chilwa, Malawi: Lessons ...

African Journals Online (AJOL)

Cholera is endemic in Malawi with seasonal outbreaks during the wet season. People living around Lake Chilwa rely on the lake for their water supply. From May 2009 to May 2010, a cholera outbreak occurred in fishing communities around Lake Chilwa. This paper describes the outbreak response and lessons learned for ...

Factors associated with delayed Antenatal Care attendance in Malawi

African Journals Online (AJOL)

SITWALA COMPUTERS

1. Centre for Bioethics in Eastern and Southern Africa (CEBESA),. University of ... researchers found three main barriers to care, namely: (a) ... Malawi: (a) lack of interaction with health workers, (b) .... ah, this time we don't have schedules but we are planning ... three topics of six food groups, three topics maybe of birth.

Exploring the ethical basis of animal treatment in Malawi

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City councils in Malawi have often considered shooting animals, especially .... believed that a hyena's tail makes people fall into a deep slumber and facilitates the .... Observing such animals performing acts akin to human beings helps us to love ... of indirect duties a human being who kills a dog belonging to someone or.

Assessment of Malawi's success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation.

Science.gov (United States)

Doherty, Tanya; Zembe, Wanga; Ngandu, Nobubelo; Kinney, Mary; Manda, Samuel; Besada, Donela; Jackson, Debra; Daniels, Karen; Rohde, Sarah; van Damme, Wim; Kerber, Kate; Daviaud, Emmanuelle; Rudan, Igor; Muniz, Maria; Oliphant, Nicholas P; Zamasiya, Texas; Rohde, Jon; Sanders, David

2015-12-01

Malawi is estimated to have achieved its Millennium Development Goal (MDG) 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies. We performed a retrospective evaluation of the Catalytic Initiative (CI) programme of support (2007-2013). We developed estimates of child mortality using four population household surveys undertaken between 2000 and 2010. We recalculated coverage indicators for high impact child health interventions and documented child health programmes and policies. The Lives Saved Tool (LiST) was used to estimate child lives saved in 2013. The mortality rate in children under 5 years decreased rapidly in the 10 CI districts from 219 deaths per 1000 live births (95% confidence interval (CI) 189 to 249) in the period 1991-1995 to 119 deaths (95% CI 105 to 132) in the period 2006-2010. Coverage for all indicators except vitamin A supplementation increased in the 10 CI districts across the time period 2000 to 2013. The LiST analysis estimates that there were 10 800 child deaths averted in the 10 CI districts in 2013, primarily attributable to the introduction of the pneumococcal vaccine (24%) and increased household coverage of insecticide-treated bednets (19%). These improvements have taken place within a context of investment in child health policies and scale up of integrated community case management of childhood illnesses. Malawi provides a strong example for countries in sub-Saharan Africa of how high impact child health interventions implemented within a decentralised health system with an established community-based delivery platform, can lead to significant reductions in child mortality.

How much do patients in Blantyre, Malawi know about antibiotics ...

African Journals Online (AJOL)

Introduction This qualitative and quantitative exploratory study was conducted to assess patients'/customers' knowledge, beliefs and practices about antibiotics and other prescription only medication (POM) in 10 community pharmacies in Blantyre, Malawi. Method 5 out of 10 pharmacies were selected by simple random ...

The Politics, Development and Problems of Small Irrigation Dams in Malawi: Experiences from Mzuzu ADD

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Bryson Gwiyani Nkhoma

2011-10-01

Full Text Available The paper examines the progress made regarding the development of small irrigation dams in Malawi with the view of establishing their significance in improving rural livelihoods in the country. The paper adopts a political economy theory and a qualitative research approach. Evidence from Mzuzu Agricultural Development Division (ADD, where small reservoirs acquire specific relevance, shows that despite the efforts made, the development of small dams is making little progress. The paper highlights that problems of top-down planning, high investment costs, negligence of national and local interests, over-dependency on donors, and conflicts over the use of dams – which made large-scale dams unpopular in the 1990s – continue to affect the development of small irrigation dams in Malawi. The paper argues that small irrigation dams should not be simplistically seen as a panacea to the problems of large-scale irrigation dams. Like any other projects, small dams are historically and socially constructed through interests of different actors in the local settings, and can only succeed if actors, especially those from formal institutions, develop adaptive learning towards apparent conflicting relations that develop among them in the process of implementation. In the case of Mzuzu ADD, it was the failure of the government to develop this adaptive learning to the contestations and conflicts among these actors that undermined successful implementation of small irrigation dams. The paper recommends the need to consider local circumstances, politics, interests, rights and institutions when investing in small irrigation dams.

Palliative care; what do you really mean? | Mackriell | Malawi ...

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Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

Palliative care in Salima district | Finch | Malawi Medical Journal

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Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

Determinants of vaccination coverage in Malawi: Evidence from the ...

African Journals Online (AJOL)

has been decreasing: it was 67% in 1992, then 55%, 54% and 51% in 1996, 2000 and 2004, respectively. The review has also shown that birth order of the child, residence (rural/ urban) and mother's education are major determinants of the immunization status of the child. Malawi Medical Journal Biology Vol. 19 (2) 2007: ...

Avifauna of Vwaza Marsh Wildlife Reserve, Malawi | Engel | Journal ...

African Journals Online (AJOL)

Despite having a well-documented avifauna, some areas of Malawi, such as Vwaza Marsh Wildlife Reserve (986 km²), are still poorly known ornithologically. We spent 12 days in October 2009, before the wet season, and two days in November 2009, after the first rains, documenting the birds of Vwaza. We found six new ...

Case Report: Ward Round - A football injury? | Freeman | Malawi ...

African Journals Online (AJOL)

Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 1 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

Village registers for vital registration in rural Malawi.

Science.gov (United States)

Singogo, E; Kanike, E; van Lettow, M; Cataldo, F; Zachariah, R; Bissell, K; Harries, A D

2013-08-01

Paper-based village registers were introduced 5 years ago in Malawi as a tool to measure vital statistics of births and deaths at the population level. However, usage, completeness and accuracy of their content have never been formally evaluated. In Traditional Authority Mwambo, Zomba district, Malawi, we assessed 280 of the 325 village registers with respect to (i) characteristics of village headmen who used village registers, (ii) use and content of village registers, and (iii) whether village registers provided accurate information on births and deaths. All village headpersons used registers. There were 185 (66%) registers that were regarded as 95% completed, and according to the registers, there were 115 840 people living in the villages in the catchment area. In 2011, there were 1753 births recorded in village registers, while 6397 births were recorded in health centre registers in the same catchment area. For the same year, 199 deaths were recorded in village registers, giving crude death rates per 100 000 population of 189 for males and 153 for females. These could not be compared with death rates in health centre registers due to poor and inconsistent recording in these registers, but they were compared with death rates obtained from the 2010 Malawi Demographic Health Survey that reported 880 and 840 per 100 000 for males and females, respectively. In conclusion, this study shows that village registers are a potential source for vital statistics. However, considerable inputs are needed to improve accuracy of births and deaths, and there are no functional systems for the collation and analysis of data at the traditional authority level. Innovative ways to address these challenges are discussed, including the use of solar-powered electronic village registers and mobile phones, connected with each other and the health facilities and the District Commissioner's office through the cellular network and wireless coverage. © 2013 John Wiley & Sons Ltd.

Geographic variation in sexual behavior can explain geospatial heterogeneity in the severity of the HIV epidemic in Malawi.

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Palk, Laurence; Blower, Sally

2018-02-09

of the HIV epidemic in Malawi and, potentially, in other countries in sub-Saharan Africa.

HIV/AIDS messages in Malawi and their implications for effective ...

African Journals Online (AJOL)

We consider the role of institutional and personal actors involved in Malawi's recently instated and decentralised behaviour-change intervention strategy, as well as the form and function of interpersonal social networks that mediate this information. The research reveals that the organisational capacity of actors and the ...

Where Did it Go Wrong? Marriage and Divorce in Malawi

NARCIS (Netherlands)

L. Cherchye (Laurens); B. de Rock (Bram); S. Walther (Selma); F. Vermeulen (Frederic)

2016-01-01

textabstractDo individuals divorce for economic reasons? Can we measure the attractiveness of new matches in the marriage market? We answer these questions using a structural model of the household and a rich panel dataset from Malawi. We propose a model of the household with consumption, production

Water demand management in Malawi: problems and prospects for its promotion

Science.gov (United States)

Mulwafu, W.; Chipeta, C.; Chavula, G.; Ferguson, A.; Nkhoma, B. G.; Chilima, G.

This paper discusses the status of water demand management (WDM) in Malawi. Findings from the study indicate that, while WDM is highly advocated in the urban and peri-urban areas, very few aspects of WDM are practiced in the rural areas. The water pricing structure that the supplying institutions established serves as a disincentive for water wastages in the urban areas. Both private firms and individuals use various measures to conserve water as a way of minimizing water consumption. The motives for water conservation range from profit maximization to inadequate financial resources to meet the costs of water respectively. In the rural areas where water is supplied at no cost, the people tend to pay less attention to water conservation. In cases where water providers attempted to institute factors of cost sharing, the rural inhabitants tended to be reluctant to contribute. This is so because people view water as a social good that should be supplied to them free of charge. The paper demonstrates that although some aspects of WDM are being practiced in the country, the existing conditions on the ground militate against its increased expansion as a strategy for promoting an efficient and equitable use of existing water resources. A large section of the population still lack access to potable water and the Malawi government is committed to the provision of basic water services. Yet WDM will become even more critical in future because of the growing competition for water resources, particularly due to the growing population and the increasing economic activities such as farming, industrialization and urbanization. The paper argues that despite the promising benefits that WDM has, its promotion must necessarily be infused with ideas of water supply, considering that the largest population still lacks access to potable water. Coupled with this will be the need for a proper policy framework that promotes public awareness for people to start appreciating the economic value

Non-use of Formal Health Services in Malawi: Perceptions from Non ...

African Journals Online (AJOL)

for those who were non-users of health services due to poor attitudes of health workers, they ..... services (especially mother and child services) free of charge to the .... Ngozo C: Malawi: vaccination foiled by divine intervention. Africaonline: the ...

Case Report: Ward Round - A football injury? | Freeman | Malawi ...

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No Abstract Malawi Medical Journal Vol. 20 (1) 2008 pp. 23. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v20i1.10952 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

Criteria for clinical audit of women friendly care and providers' perception in Malawi

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van den Broek Nynke

2008-07-01

Full Text Available Abstract Background There are two dimensions of quality of maternity care, namely quality of health outcomes and quality as perceived by clients. The feasibility of using clinical audit to assess and improve the quality of maternity care as perceived by women was studied in Malawi. Objective We sought to (a establish standards for women friendly care and (b explore attitudinal barriers which could impede the proper implementation of clinical audit. Methods We used evidence from Malawi national guidelines and World Health Organisation manuals to establish local standards for women friendly care in three districts. We equally conducted a survey of health care providers to explore their attitudes towards criterion based audit. Results The standards addressed different aspects of care given to women in maternity units, namely (i reception, (ii attitudes towards women, (iii respect for culture, (iv respect for women, (v waiting time, (vi enabling environment, (vii provision of information, (viii individualised care, (ix provision of skilled attendance at birth and emergency obstetric care, (x confidentiality, and (xi proper management of patient information. The health providers in Malawi generally held a favourable attitude towards clinical audit: 100.0% (54/54 agreed that criterion based audit will improve the quality of care and 92.6% believed that clinical audit is a good educational tool. However, there are concerns that criterion based audit would create a feeling of blame among providers (35.2%, and that manager would use clinical audit to identify and punish providers who fail to meet standards (27.8%. Conclusion Developing standards of maternity care that are acceptable to, and valued by, women requires consideration of both the research evidence and cultural values. Clinical audit is acceptable to health professionals in Malawi although there are concerns about its negative implications to the providers.

Parenting children with intellectual disabilities in Malawi: the impact that reaches beyond coping?

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Masulani-Mwale, C; Mathanga, D; Silungwe, D; Kauye, F; Gladstone, M

2016-11-01

Rates of disability are high in resource poor settings with 85% of children with disabilities living in these settings. Long-term caregiving for disabled children is associated with fatigue, financial difficulties, parenting distress and other psychological issues. While such parents of children have repeatedly highlighted their feelings of discrimination, stigma and exclusion, leading to mental health issues, there is little research from the developing world addressing these issues. This study aims to explore psychological experiences of parents caring for children with intellectual disabilities; understand their mechanisms of coping and their psychosocial needs in Malawi. This study used a qualitative phenomenological design. We purposively sampled parents who had children diagnosed with intellectual disability from two clinics in two cities in Malawi. Between January 2015 and March 2015, we conducted 10 focus group discussions and four in-depth interviews. All ethical study procedures were carefully followed. All interviews were tape-recorded, transcribed and translated from vernacular to English. Thematic approach of data analysis was adopted to understand the data. Caring for intellectually disabled children comes with a number of challenges. Parents have limited access to services for their children let alone for their own psychological issues; they experience stigma and discrimination, have mental health issues resulting from the caring role, have suicidal ideas and in some cases have even been coerced by neighbours to kill their disabled child. To manage these issues, most parents cope through their spirituality. Apart from suicide and filicide, the findings of this study are similar to those performed in other countries. It is recommended that parents' psychological issues be managed concurrently when providing services for their children. There is also a need to develop psychosocial training interventions to address the needs of the parents of these

Sex work and the construction of intimacies: meanings and work pragmatics in rural Malawi.

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Tavory, Iddo; Poulin, Michelle

2012-05-01

This article focuses on Malawian sex workers' understandings of exchange and intimacy, showing how multiple historically emergent categories and specific work pragmatics produce specific patterns of relational meanings. As we show, sex workers make sense of their relationships with clients through two categories. The first is sex work; the second is the chibwenzi , an intimate premarital relational category that emerged from pre-colonial transformations in courtship practices. These categories, in turn, are also shaped differently in different work settings. We use narratives from in-depth interviews with 45 sex workers and bar managers in southern Malawi to describe how the everyday pragmatics of two forms of sex work-performed by "bargirls" and "freelancers"-foster distinct understandings of relationships between them and men they have sex with. Bargirls, who work and live in bars, blurred the boundaries between "regulars" and chibwenzi; freelancers, who are not tethered to a specific work environment, often subverted the meanings of the chibwenzi , presenting these relationships as both intimate and emotionally distant. Through this comparison, we thus refine an approach to the study of the intimacy-exchange nexus, and use it to capture the complexities of gender relations in post-colonial Malawi.

Promoting universal financial protection: contracting faith-based health facilities to expand access--lessons learned from Malawi.

Science.gov (United States)

Chirwa, Maureen L; Kazanga, Isabel; Faedo, Giulia; Thomas, Stephen

2013-08-19

Public-private collaborations are increasingly being utilized to universalize health care. In Malawi, the Ministry of Health contracts selected health facilities owned by the main faith-based provider, the Christian Health Association of Malawi (CHAM), to deliver care at no fee to the most vulnerable and underserved populations in the country through Service Level Agreements (SLAs). This study examined the features of SLAs and their effectiveness in expanding universal coverage. The study involved a policy analysis focusing on key stakeholders around SLAs as well as a case study approach to analyse how design and implementation of SLAs affect efficiency, equity and sustainability of services delivered by SLAs. The study employed both qualitative and quantitative research methods to address the research questions and was conducted in five CHAM health facilities: Mulanje Mission, Holy Family, and Mtengowanthenga Hospitals, and Mabiri and Nkope Health Centres. National and district level decision makers were interviewed while providers and clients associated with the health facilities were surveyed on their experiences. A total of 155 clients from an expected 175 were recruited in the study. The study findings revealed key aspects of how SLAs were operating, the extent to which their objectives were being attained and why. In general, the findings demonstrated that SLAs had the potential to improve health and universal health care coverage, particularly for the vulnerable and underserved populations. However, the findings show that the performance of SLAs in Malawi were affected by various factors including lack of clear guidelines, non-revised prices, late payment of bills, lack of transparency, poor communication, inadequate human and material resources, and lack of systems to monitor performance of SLAs, amongst others. There was strong consensus and shared interest between the government and CHAM regarding SLAs. It was clear that free services provided by SLAs had

Reproductive decisions of couples living with HIV in Malawi: What ...

African Journals Online (AJOL)

policies and guidelines on HIV, AIDS and sexual and reproductive health in Malawi for ... reflect the social cultural experiences of couples living with HIV. In addition, there is ... then, treatment is available free of charge in the public hospital facilities. ... started implementing an integrated antiretroviral / PMTCT programme ...

Measuring Institutions: Indicators of Political and Property Rights in Malawi

Science.gov (United States)

Fedderke, Johannes; Garlick, Julia

2012-01-01

This paper constructs a new set of institutional indicators for Malawi. We develop indicators of political rights, of freehold, traditional (communitarian) and intellectual property rights, based on the Malawian legislative framework. In exploring the association between our rights measures and a range of indicators of socio-economic development,…

A macro-econometric diagnosis of the Keynesian propositions of the money demand function in Malawi: An error-correction approach

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Ken Chamuva Shawa

2012-06-01

Full Text Available The institution of sound monetary policies largely depends on a good understanding of the money demand function. While there have been studies to understand the behaviour of the money demand function in general, critical analyses solely devoted to testing Keynesian propositions, particularly in developing countries, are rare. Using data from 1970 to 2005, the study employs the Augmented Dickey-Fuller (ADF procedure to test for non-stationarity and the Johansen procedure to test for a long-run equilibrium relationship among economic fundamentals. Due to non-stationarity of variables an error-correction mechanism is used to characterise the money demand function in Malawi. Although the income elasticity of money demand bears the expected positive sign, contrary to Keynes’ contentions, the study finds a stable demand function and an inelastic interest rate elasticity of money demand. The level of financial development and exchange rates are also found significant in influencing money demand in Malawi. Vital policy implications can be drawn from the results. First, monetary policy should be undertaken bearing in mind the stability of the money demand function and the less than proportionate response of money demand to interest rate changes. Second, policies to improve the functioning of the financial sector are indispensable. Nonetheless, such policies should be supported by prudent exchange rate management to check currency substitution.

Burden of physical, psychological and social ill-health during and after pregnancy among women in India, Pakistan, Kenya and Malawi.

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McCauley, Mary; Madaj, Barbara; White, Sarah A; Dickinson, Fiona; Bar-Zev, Sarah; Aminu, Mamuda; Godia, Pamela; Mittal, Pratima; Zafar, Shamsa; van den Broek, Nynke

2018-01-01

For every woman who dies during pregnancy and childbirth, many more suffer ill-health, the burden of which is highest in low-resource settings. We sought to assess the extent and types of maternal morbidity. Descriptive observational cross-sectional study at primary-level and secondary-level healthcare facilities in India, Pakistan, Kenya and Malawi to assess physical, psychological and social morbidity during and after pregnancy. Sociodemographic factors, education, socioeconomic status (SES), quality of life, satisfaction with health, reported symptoms, clinical examination and laboratory investigations were assessed. Relationships between morbidity and maternal characteristics were investigated using multivariable logistic regression analysis. 11 454 women were assessed in India (2099), Malawi (2923), Kenya (3145), and Pakistan (3287). Almost 3 out of 4 women had ≥1 symptoms (73.5%), abnormalities on clinical examination (71.3%) or laboratory investigation (73.5%). In total, 36% of women had infectious morbidity of which 9.0% had an identified infectious disease (HIV, malaria, syphilis, chest infection or tuberculosis) and an additional 32.5% had signs of early infection. HIV-positive status was highest in Malawi (14.5%) as was malaria (10.4%). Overall, 47.9% of women were anaemic, 11.5% had other medical or obstetric conditions, 25.1% reported psychological morbidity and 36.6% reported social morbidity (domestic violence and/or substance misuse). Infectious morbidity was highest in Malawi (56.5%) and Kenya (40.4%), psychological and social morbidity was highest in Pakistan (47.3%, 60.2%). Maternal morbidity was not limited to a core at-risk group; only 1.2% had all four morbidities. The likelihood of medical or obstetric, psychological or social morbidity decreased with increased education; adjusted OR (95% CI) for each additional level of education ranged from 0.79 (0.75 to 0.83) for psychological morbidity to 0.91 (0.87 to 0.95) for infectious morbidity

Surviving life as a woman: a critical ethnography of violence in the lives of female domestic workers in Malawi.

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Mkandawire-Valhmu, Lucy; Rodriguez, Rachel; Ammar, Nawal; Nemoto, Keiko

2009-09-01

A common form of employment for low-income third world women is domestic work. The power dynamics in this type of employer-employee relationship may place women at risk for abuse. Our aim in conducting this qualitative inquiry was to describe the experiences of violence in the lives of young female domestic workers in Malawi, a small country in South East Africa. Forty-eight women participated in focus group and individual interviews. "Surviving" was the main theme identified, with women employing creative ways of surviving the challenges they met at various points in their lives. This study provides information that health care professionals could use in assisting women through the process of surviving.

malawi : tous les projets | Page 2 | CRDI - Centre de recherches ...

International Development Research Centre (IDRC) Digital Library (Canada)

Sujet: HEALTH PERSONNEL, COOPERATION BETWEEN ORGANIZATIONS, TRAINING METHODS, TRAINING PROGRAMMES. Région: South of Sahara, Malawi, South Africa. Programme: Santé des mères et des enfants. Financement total : CA$ 307,640.00. Délégation des tâches en Afrique de l'Est : soins de la vue.

Life history traits of Bathyclarias nyasensis (Siluroidei) in Lake Malawi

African Journals Online (AJOL)

Life history traits, including age, growth, reproduction and diet of Bathyclarias nyasensis from Lake Malawi were studied between December 1996 and November 1998. Owing to reabsorp tion of pectoral spines with increasing fish size, and the relatively low number of spines that could be aged reliably, only otoliths were ...

Presentation of radioecology in the Scandinavian countries

International Nuclear Information System (INIS)

Agnedal, P.O.

1980-01-01

One of the working groups dealt with the activity of the committee and in its report it is said that three types for the joint Scandinavian work could be identified: 1. - Projects. 2. - Conferences and training-courses. 3. - Publications and information. Among projects 'Intercalibration' regarding sampling techniques and analytical methods. Transport models, consequences of large accidents, were mentioned and in other groups the same type of projects was given. Another working group dealt with international cooperation in the field of radioecology and in its report it was said that it is important to present the work performed in the Scandinavian countries

Health Selection, Migration, and HIV Infection in Malawi.

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Anglewicz, Philip; VanLandingham, Mark; Manda-Taylor, Lucinda; Kohler, Hans-Peter

2018-04-27

Despite its importance in studies of migrant health, selectivity of migrants-also known as migration health selection-has seldom been examined in sub-Saharan Africa (SSA). This neglect is problematic because several features of the context in which migration occurs in SSA-very high levels of HIV, in particular-differ from contextual features in regions that have been studied more thoroughly. To address this important gap, we use longitudinal panel data from Malawi to examine whether migrants differ from nonmigrants in pre-migration health, assessed via SF-12 measures of mental and physical health. In addition to overall health selection, we focus on three more-specific factors that may affect the relationship between migration and health: (1) whether migration health selection differs by destination (rural-rural, rural-town, and rural-urban), (2) whether HIV infection moderates the relationship between migration and health, and (3) whether circular migrants differ in pre-migration health status. We find evidence of the healthy migrant phenomenon in Malawi, where physically healthier individuals are more likely to move. This relationship varies by migration destination, with healthier rural migrants moving to urban and other rural areas. We also find interactions between HIV-infected status and health: HIV-infected women moving to cities are physically healthier than their nonmigrant counterparts.

Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model.

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Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume

2013-05-28

To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. A cross-sectional survey. Malawi The study used a sample of 6395 women aged 15-49 years from the 2010 Malawi Health and Demographic Surveys. Individual HIV status: positive or not. Findings from the Pearson χ(2) and χ(2) Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15-24) never married or in union and living in rural areas. In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25-49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30-49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment.

Evidence for Strong Controls from Preexisting Structures on Border Fault Development and Basin Evolution in the Malawi Rift from 3D Lacustrine Refraction Data

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Accardo, N. J.; Shillington, D. J.; Gaherty, J. B.; Scholz, C. A.; Ebinger, C.; Nyblade, A.; McCartney, T.; Chindandali, P. R. N.; Kamihanda, G.; Ferdinand-Wambura, R.

2017-12-01

A long-standing debate surrounds controls on the development and ultimately abandonment of basin bounding border faults. The Malawi Rift in the the Western Branch of the East African Rift System presents an ideal location to investigate normal fault development. The rift is composed of a series of half graben basins bound by large border faults, which cross several terranes and pre-existing features. To delineate rift basin structure, we undertook 3D first arrival tomography across the North and Central basins of the Malawi Rift based on seismic refraction data acquired in Lake Malawi. The resulting 3D velocity model allows for the first-ever mapping of 3D basin structure in the Western Branch of the EAR. We estimate fault displacement profiles along the two border faults and find that each accommodated 7.2 km of throw. Previous modeling studies suggest that given the significant lengths (>140 km) and throws of these faults, they may be nearing their maximum dimensions or may have already been abandoned. While both faults accommodate similar throws, their lengths differ by 40 km, likely due to the influence of both preexisting basement fabric and large-scale preexisting structures crossing the rift. Over 4 km of sediment exists where the border faults overlap in the accommodation zone indicating that these faults likely established their lengths early. Portions of both basins contain packages of sediment with anomalously fast velocities (> 4 km/s), which we interpret to represent sediment packages from prior rifting episodes. In the Central Basin, this preexisting sediment traces along the inferred offshore continuation of the Karoo-aged Ruhuhu Basin that intersects Lake Malawi at the junction between the North and Central basins. This feature may have influenced the length of the border fault bounding the Central Basin. In the North Basin, the preexisting sediment is thicker ( 4 km) and likely represents the offshore continuation of a series of preexisting rift

The impact of training non-physician clinicians in Malawi on maternal and perinatal mortality: a cluster randomised controlled evaluation of the enhancing training and appropriate technologies for mothers and babies in Africa (ETATMBA project

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Ellard David

2012-10-01

Full Text Available Abstract Background Maternal mortality in much of sub-Saharan Africa is very high whereas there has been a steady decline in over the past 60 years in Europe. Perinatal mortality is 12 times higher than maternal mortality accounting for about 7 million neonatal deaths; many of these in sub-Saharan countries. Many of these deaths are preventable. Countries, like Malawi, do not have the resources nor highly trained medical specialists using complex technologies within their healthcare system. Much of the burden falls on healthcare staff other than doctors including non-physician clinicians (NPCs such as clinical officers, midwives and community health-workers. The aim of this trial is to evaluate a project which is training NPCs as advanced leaders by providing them with skills and knowledge in advanced neonatal and obstetric care. Training that will hopefully be cascaded to their colleagues (other NPCs, midwives, nurses. Methods/design This is a cluster randomised controlled trial with the unit of randomisation being the 14 districts of central and northern Malawi (one large district was divided into two giving an overall total of 15. Eight districts will be randomly allocated the intervention. Within these eight districts 50 NPCs will be selected and will be enrolled on the training programme (the intervention. Primary outcome will be maternal and perinatal (defined as until discharge from health facility mortality. Data will be harvested from all facilities in both intervention and control districts for the lifetime of the project (3–4 years and comparisons made. In addition a process evaluation using both quantitative and qualitative (e.g. interviews will be undertaken to evaluate the intervention implementation. Discussion Education and training of NPCs is a key to improving healthcare for mothers and babies in countries like Malawi. Some of the challenges faced are discussed as are the potential limitations. It is hoped that the findings

Exploring the ethical basis of animal treatment in Malawi | Kayange ...

African Journals Online (AJOL)

The paper argues that the maltreatment/cruelty and destruction of animals common in Malawi is rooted in an African form of utilitarian ethics and a biased conception of animals that is promoted by Umunthu/Ubuntu ethical discourse. It explores the possibility of developing or discovering a moral ground for animal ethics ...

Immunisation of smallholder dairy cattle against anaplasmosis and babesiosis in Malawi

DEFF Research Database (Denmark)

Tjørnehøj, Kirsten; Lawrence, J. A.; Kafuwa, P. T.

1997-01-01

A field study was conducted in the Southern Region of Malawi to evaluate the possible benefits of immunisation of improved dairy cattle against Anaplasma marginale, Babesia bigemina and Babesia bovis. Friesian crossbred heifers were immunised when they were being reared on Government farms. They ...

A cost function analysis of child health services in four districts in Malawi.

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Johns, Benjamin; Munthali, Spy; Walker, Damian G; Masanjala, Winford; Bishai, David

2013-05-10

Recent analyses show that donor funding for child health is increasing, but little information is available on actual costs to deliver child health care services. Understanding how unit costs scale with service volume in Malawi can help planners allocate budgets as health services expand. Data on facility level inputs and outputs were collected at 24 health centres in four districts of Malawi visiting a random sample of government and a convenience sample of Christian Health Association of Malawi (CHAM) health centres. In the cost function, total outputs, quality, facility ownership, average salaries and case mix are used to predict total cost. Regression analysis identifies marginal cost as the coefficient relating cost to service volume intensity. The marginal cost per patient seen for all health centres surveyed was US$ 0.82 per additional patient visit. Average cost was US$ 7.16 (95% CI: 5.24 to 9.08) at government facilities and US$ 10.36 (95% CI: 4.92 to 15.80) at CHAM facilities per child seen for any service. The first-line anti-malarial drug accounted for over 30% of costs, on average, at government health centres. Donors directly financed 40% and 21% of costs at government and CHAM health centres, respectively. The regression models indicate higher total costs are associated with a greater number of outpatient visits but that many health centres are not providing services at optimal volume given their inputs. They also indicate that CHAM facilities have higher costs than government facilities for similar levels of utilization. We conclude by discussing ways in which efficiency may be improved at health centres. The first option, increasing the total number of patients seen, appears difficult given existing high levels of child utilization; increasing the volume of adult patients may help spread fixed and semi-fixed costs. A second option, improving the quality of services, also presents difficulties but could also usefully improve performance.

The rise and fall of tuberculosis in Malawi: associations with HIV infection and antiretroviral therapy.

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Kanyerere, Henry; Harries, Anthony D; Tayler-Smith, Katie; Jahn, Andreas; Zachariah, Rony; Chimbwandira, Frank M; Mpunga, James

2016-01-01

Since 1985, Malawi has experienced a dual epidemic of HIV and tuberculosis (TB) which has been moderated recently by the advent of antiretroviral therapy (ART). The aim of this study was to describe the association over several decades between HIV/AIDS, the scale-up of ART and TB case notifications. Aggregate data were extracted from annual reports of the National TB Control Programme, the Ministry of Health HIV Department and the National Statistics Office. ART coverage was calculated using the total HIV population as denominator (derived from UNAIDS Spectrum software). In 1970, there were no HIV-infected persons but numbers had increased to a maximum of 1.18 million by 2014. HIV prevalence reached a maximum of 10.8% in 2000, thereafter decreasing to 7.5% by 2014. Numbers alive on ART increased from 2586 in 2003 to 536 527 (coverage 45.3%) by 2014. In 1985, there were 5286 TB cases which reached a maximum of 28 234 in 2003 and then decreased to 17 723 by 2014 (37% decline from 2003). There were increases in all types of new TB between 1998-2003 which then declined by 30% for extrapulmonary TB, by 37% for new smear-positive PTB and by 50% for smear-negative PTB. Previously treated TB cases reached a maximum of 3443 in 2003 and then declined by 42% by 2014. The rise and fall of TB in Malawi between 1985 and 2014 was strongly associated with HIV infection and ART scale-up; this has implications for ending the TB epidemic in high HIV-TB burden countries. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Uptake and outcomes of a prevention-of mother-to-child transmission (PMTCT program in Zomba district, Malawi

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Gawa Lucy

2011-06-01

Full Text Available Abstract Background HIV prevalence among pregnant women in Malawi is 12.6%, and mother-to-child transmission is a major route of transmission. As PMTCT services have expanded in Malawi in recent years, we sought to determine uptake of services, HIV-relevant infant feeding practices and mother-child health outcomes. Methods A matched-cohort study of HIV-infected and HIV-uninfected mothers and their infants at 18-20 months post-partum in Zomba District, Malawi. 360 HIV-infected and 360 HIV-uninfected mothers were identified through registers. 387 mother-child pairs were included in the study. Results 10% of HIV-infected mothers were on HAART before delivery, 27% by 18-20 months post-partum. sd-NVP was taken by 75% of HIV-infected mothers not on HAART, and given to 66% of infants. 18% of HIV-infected mothers followed all current recommended PMTCT options. HIV-infected mothers breastfed fewer months than HIV-uninfected mothers (12 vs.18, respectively; p p Conclusion This study shows low PMTCT program efficiency and effectiveness under routine program conditions in Malawi. HIV-free infant survival may have been influenced by key factors, including underuse of HAART, underuse of sd-NVP, and suboptimal infant feeding practices. Maternal mortality among HIV-infected women demands attention; improved maternal survival is a means to improve infant survival.

Post-neonatal mortality, morbidity, and developmental outcome after ultrasound-dated preterm birth in rural Malawi: a community-based cohort study.

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Gladstone, Melissa; White, Sarah; Kafulafula, George; Neilson, James P; van den Broek, Nynke

2011-11-01

Preterm birth is considered to be associated with an estimated 27% of neonatal deaths, the majority in resource-poor countries where rates of prematurity are high. There is no information on medium term outcomes after accurately determined preterm birth in such settings. This community-based stratified cohort study conducted between May-December 2006 in Southern Malawi followed up 840 post-neonatal infants born to mothers who had received antenatal antibiotic prophylaxis/placebo in an attempt to reduce rates of preterm birth (APPLe trial ISRCTN84023116). Gestational age at delivery was based on ultrasound measurement of fetal bi-parietal diameter in early-mid pregnancy. 247 infants born before 37 wk gestation and 593 term infants were assessed at 12, 18, or 24 months. We assessed survival (death), morbidity (reported by carer, admissions, out-patient attendance), growth (weight and height), and development (Ten Question Questionnaire [TQQ] and Malawi Developmental Assessment Tool [MDAT]). Preterm infants were at significantly greater risk of death (hazard ratio 1.79, 95% CI 1.09-2.95). Surviving preterm infants were more likely to be underweight (weight-for-age z score; prates of developmental delay on the MDAT at 18 months (p = 0.009), with gestational age at delivery (p = 0.01) increasing this likelihood. Morbidity-visits to a health centre (93%) and admissions to hospital (22%)-was similar for both groups. During the first 2 years of life, infants who are born preterm in resource poor countries, continue to be at a disadvantage in terms of mortality, growth, and development. In addition to interventions in the immediate neonatal period, a refocus on early childhood is needed to improve outcomes for infants born preterm in low-income settings.

The quality of care of diabetic patients in rural Malawi: A case of ...

African Journals Online (AJOL)

Diabetes mellitus is a global public health problem. In Malawi ... Information Education and Communication messages ... health education, foot care and screening for signs of neuropathy .... knowledge about the recommended diabetes diet.

Integrating interannual climate variability forecasts into weather-indexed crop insurance. The case of Malawi, Kenya and Tanzania

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Vicarelli, M.; Giannini, A.; Osgood, D.

2009-12-01

In this study we explore the potential for re-insurance schemes built on regional climatic forecasts. We focus on micro-insurance contracts indexed on precipitation in 9 villages in Kenya, Tanzania (Eastern Africa) and Malawi (Southern Africa), and analyze the precipitation patterns and payouts resulting from El Niño Southern Oscillation (ENSO). The inability to manage future climate risk represents a “poverty trap” for several African regions. Weather shocks can potentially destabilize not only household, but also entire countries. Governments in drought-prone countries, donors and relief agencies are becoming aware of the importance to develop an ex-ante risk management framework for weather risk. Joint efforts to develop innovative mechanisms to spread and pool risk such as microinsurance and microcredit are currently being designed in several developing countries. While ENSO is an important component in modulating the rainfall regime in tropical Africa, the micro-insurance experiments currently under development to address drought risk among smallholder farmers in this region do not take into account ENSO monitoring or forecasting yet. ENSO forecasts could be integrated in the contracts and reinsurance schemes could be designed at the continental scale taking advantage of the different impact of ENSO on different regions. ENSO is associated to a bipolar precipitation pattern in Southern and Eastern Africa. La Niña years (i.e. Cold ENSO Episodes) are characterized by dry climate in Eastern Africa and wet climate in Southern Africa. During El Niño (or Warm Episode) the precipitation dipole is inverted, and Eastern Africa experiences increased probability for above normal rainfall (Halpert and Ropelewski, 1992, Journal of Climate). Our study represents the first exercise in trying to include ENSO forecasts in micro weather index insurance contract design. We analyzed the contracts payouts with respect to climate variability. In particular (i) we simulated

Intergenerational transfers in the era of HIV/AIDS: Evidence from rural Malawi.

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Kohler, Iliana V; Kohler, Hans-Peter; Anglewicz, Philip; Behrman, Jere R

2012-12-13

Intergenerational transfer patterns in sub-Saharan Africa are poorly understood, despite the alleged importance of support networks to ameliorate the complex implications of the HIV/AIDS epidemic for families. There is a considerable need for research on intergenerational support networks and transfers to better understand the mechanisms through which extended families cope with the HIV/AIDS epidemic and potentially alleviate some of its consequences in sub-Saharan Africa, and to comprehend how transfers respond-or not-to perceptions about own and other family members' health. Using the 2008 round of the Malawi Longitudinal Study of Families and Health (MLSFH), we estimate the age patterns and the multiple directions of financial and non-financial transfer flows in rural Malawi-from prime-aged respondents to their elderly parents and adult children age 15 and up. We also estimate the social, demographic and economic correlates of financial and non-financial transfers of financial intergenerational transfers in this context. Our findings are that: (1) intergenerational financial and non-financial transfers are widespread and a key characteristic of family relationships in rural Malawi; (2) downward and upward transfers are importantly constrained and determined by the availability of transfer partners (parents or adult children); (3) financial net transfers are strongly age-patterned and the middle generations are net-providers of transfers; (4) non-financial transfers are based on mutual assistance rather than reallocation of resources; and (5) intergenerational transfers are generally not related to health status, including HIV positive status.

A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

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Brathwaite, Rachel; Addo, Juliet; Smeeth, Liam; Lock, Karen

2015-01-01

To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

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Rachel Brathwaite

Full Text Available To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries.Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions.26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries.Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website.Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%. Rwanda had the highest prevalence of women smokers (12.6% and Ghana had the lowest (0.2%. Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents.Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

Country Presentation Angola

International Nuclear Information System (INIS)

Cardoso, L.; Ferreira, Edson; Goma, A.

2010-01-01

The Republic of Angola joined the IAEA in September 1999. Since then, the country started by designing, promoting and developing its programme on nuclear and technology through the Unit for Nuclear Science and Technology created by the Ministry of Science and Technology.The Angolan Atomic Law was approved on June 28 and published on September 05, 2007.Radioactive Waste Every person who is licensed to generate, keep or manage radioactive waste shall be responsible for the safe management of radioactive waste generated by the practice or source for which he/she is authorized. No person shall transport any radioactive material, radioactive substance or radiation generator on any vessel or boat within the territorial waters or the exclusive economic zone of Angola; on any aircraft within the airspace of Angola; or any means of land transport without authorization from the Regulatory Authority of Atomic Energy

Refractive errors, visual impairment, and the use of low-vision devices in albinism in Malawi.

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Schulze Schwering, M; Kumar, N; Bohrmann, D; Msukwa, G; Kalua, K; Kayange, P; Spitzer, M S

2015-04-01

This study focuses on the refractive implications of albinism in Malawi, which is mostly associated with the burden of visual impairment. The main goal was to describe the refractive errors and to analyze whether patients with albinism in Malawi, Sub-Saharan Africa, benefit from refraction. Age, sex, refractive data, uncorrected and best-corrected visual acuity (UCVA, BCVA), colour vision, contrast sensitivity, and the prescription of sunglasses and low vision devices were collected for a group of 120 albino individuals with oculocutaneous albinism (OCA). Refractive errors were evaluated objectively and subjectively by retinoscopy, and followed by cycloplegic refraction to reconfirm the results. Best-corrected visual acuity (BCVA) was also assessed binocularly. One hundred and twenty albino subjects were examined, ranging in age from 4 to 25 years (median 12 years), 71 (59 %) boys and 49 (41 %) girls. All exhibited horizontal pendular nystagmus. Mean visual acuity improved from 0.98 (0.33) logMAR to 0.77 (0.15) logMAR after refraction (p < 0.001). The best improvement of VA was achieved in patients with mild to moderate myopia. Patients with albinism who were hyperopic more than +1.5 D hardly improved from refraction. With the rule (WTR) astigmatism was more present (37.5 %) than against the rule (ATR) astigmatism (3.8 %). Patients with astigmatism less than 1.5 D improved in 15/32 of cases (47 %) by 2 lines or more. Patients with astigmatism equal to or more than 1.5 D in any axis improved in 26/54 of cases (48 %) by 2 lines or more. Refraction improves visual acuity of children with oculocutaneous albinism in a Sub-Saharan African population in Malawi. The mean improvement was 2 logMAR units.

Using mobile clinics to deliver HIV testing and other basic health services in rural Malawi.

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Lindgren, T G; Deutsch, K; Schell, E; Bvumbwe, A; Hart, K B; Laviwa, J; Rankin, S H

2011-01-01

The majority of Malawians are impoverished and primarily dependant on subsistence farming, with 85% of the population living in a rural area. The country is highly affected by HIV and under-resourced rural health centers struggle to meet the government's goal of expanding HIV testing, antiretroviral treatment, and other basic services. This report describes the work of two four-wheel drive mobile clinics launched in 2008 to fill an identified service gap in the remote areas of Mulanje District, Malawi. The program was developed by an international non-governmental organization, Global AIDS Interfaith Alliance (GAIA), and the Mulanje District Health Office, with funding from the Elizabeth Taylor HIV/AIDS Foundation. The clinics provide: (1) rapid HIV testing and treatment referral; (2) diagnosis and treatment of malaria; (3) sputum collection for TB screening; (4) diagnosis and treatment of sexually transmitted and opportunistic infections; and (5) pre-natal care. The clinic vehicles provide medical supplies and personnel (a clinical officer, nurse, and nurse aide) to set up clinics in community buildings such as churches or schools. In such a project, the implementation process and schedule can be affected by medication, supply chain and infrastructural issues, as well as governmental and non-governmental requirements. Timelines should be sufficiently flexible to accommodate unexpected delays. Once established, service scheduling should be flexible and responsive; for instance, malaria treatment rather than HIV testing was most urgently needed in the season when these services were launched. Assessing the impact of healthcare delivery in Malawi is challenging. Although mobile clinic and the government Health Management Information System (HMIS) data were matched, inconsistent variables and gaps in data made direct comparisons difficult. Data collection was compromised by the competing demand of high patient volume; however, rather than reducing the burden on

Health spending, illicit financial flows and tax incentives in Malawi

African Journals Online (AJOL)

financing of health care services and a weak health system. Malawi is one of the ... and two-thirds of adults, who need antiretroviral treatment for HIV are ... health service delivery”4. There are two ... estimated the cost for the provision of minimal services .... However, the key issue is to differentiate between tax incentives that.

Erasmus, Syphilis and the abuse of stigma | Whitty | Malawi Medical ...

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Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 13, No 1 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

Ward Round - a boy with multiple joint swellings | Tickell | Malawi ...

African Journals Online (AJOL)

Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 3 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

The experience of HIV reactive patients in rural Malawi - Part I

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Y Sliep

2001-09-01

Full Text Available Malawi has a population of 9 million people with AIDS the leading cause of death in the 20 - 40 age group. The HIV positive prevalence rate, estimated at 23% in urban areas and 8% in rural areas, is one of the highest in the world (AIDSEC, 1994:1. Evaluation of counselling practices showed poor results with counsellors feeling ineffective and inadequate. Patients are mostly tested on medical indication but patients who do not see the benefit of knowing their HIV status increasingly refuse testing. The counselling practise as it is known in the Western world is a foreign concept for patients living in rural Malawi. The high stigma of AIDS complicates support of the patients. The goal of the research study was to describe a model of counselling that would meet the needs of an AIDS patient in rural community in Malawi. A qualitative research design that was explorative, descriptive and contextually specific to rural Malawi was used for the study. In order to describe a counselling model it was important to understand the illness experience of HIV reactive patients. The patients are seen in group context congruent with the African culture and therefore the experience of the primary care giver of AIDS patients is explored as the other major factor in the phenomenon examined. One phase of the research is described in this article namely exploring and describing the experience of the HIV reactive patient in rural Malawi. Results show that patients are in an advanced stage of AIDS when they are diagnosed and complain of weakness and an inability to do work, including an inability to do their daily chores. This causes a feeling of desperateness that is worsened by the perception that support systems are inadequate. Support systems are mostly identified as parents, partners and siblings to assist mainly with the physical care and financial support. Despite the fact that the family is very important to patients there is a reluctance to acknowledge their

HIV stigma and nurse job satisfaction in five African countries.

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Chirwa, Maureen L; Greeff, Minrie; Kohi, Thecla W; Naidoo, Joanne R; Makoae, Lucy N; Dlamini, Priscilla S; Kaszubski, Christopher; Cuca, Yvette P; Uys, Leana R; Holzemer, William L

2009-01-01

This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The Personal Satisfaction subscale was the highest in this sample, as in the other 2. Job satisfaction scores differed significantly among the 5 countries, and these differences were consistent across all subscales. A hierarchical regression showed that mental and physical health, marital status, education level, urban/rural setting, and perceived HIV stigma had significant influence on job satisfaction. Perceived HIV stigma was the strongest predictor of job dissatisfaction. These results provide new areas for intervention strategies that might enhance the work environment for nurses in these countries.

What influences where they seek care? Caregivers' preferences for under-five child healthcare services in urban slums of Malawi: A discrete choice experiment.

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Lungu, Edgar Arnold; Guda Obse, Amarech; Darker, Catherine; Biesma, Regien

2018-01-01

Access to and utilisation of quality healthcare promotes positive child health outcomes. However, to be optimally utilised, the healthcare system needs to be responsive to the expectations of the population it serves. Health systems in many sub-Saharan African countries, including Malawi, have historically focused on promoting access to health services by the rural poor. However, in the context of increasing urbanisation and consequent proliferation of urban slums, promoting health of children under five years of age in these settings is a public health imperative. We conducted a discrete choice experiment to determine the relative importance of health facility factors in seeking healthcare for childhood illnesses in urban slums of Malawi. Caregivers of children under five years of age were presented with choice cards that depicted two hypothetical health facilities using six health facility attributes: availability of medicines and supplies, thoroughness of physical examination of the child, attitude of health workers, cost, distance, and waiting time. Caregivers were asked to indicate the health facility they would prefer to use. A mixed logit model was used to estimate the relative importance of and willingness to pay (WTP) for health facility attributes. Attributes with greatest influence on choice were: availability of medicines and supplies (β = 0.842, ppay 1.8 and 2.4 times more for medicine availability over thorough examination and positive attitude of health workers respectively. Therefore, strengthening health service delivery system through investment in sustained availability of essential medicines and supplies, sufficient and competent health workforce with positive attitude and clinical discipline to undertake thorough examination, and reductions in waiting times have the potential to improve child healthcare utilization in the urban slums.

THE TEACHING OF GEO SCIENCE IN MALAWI SECONDARY SCHOOLS: The case of the Solar System and beyond

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Chasukwa Mwalwenje, Yvonne; Chasukwa, Fidel

2016-04-01

Malawi secondary school curriculum has been offering Geo sciences Education since the dawn of independence from the British rule in 1964. Qualified primary and secondary school teachers are responsible for the teaching of Geo sciences. The assumption is that trained teachers are more likely to produce successful students thus making geoscience a successful subject. To make the subject more relevant and captivating to stakeholders, the government revised Geo science curriculum and incorporated other topics. Among additional topic was the solar system that was covered in great detail in secondary school. The solar system is a Geo science concept taught in Geography curriculum from primary school for 8 years and in secondary school for 4 years. Despite the solar system being one of the traditional topics in Malawi school curriculum and Government's effort to revise the curriculum in the interest of learners and improving the pass rate, number of students conversant with the topic has been failing sharply over the years. The disparity between the input in terms of effort to improve familiarity with solar system among learners and the outcomes is of great concern and worth hard investigation to inform education policy and curriculum revision decisions. Based on empirical data collected through qualitative research design, the paper establishes that regardless of imploring such interventions, there are still indicators that students continue to fail in solar system related subjects. Malawi National Examination report (2015) reveals that Geography at Malawi School Certificate Examinations pass rate has been going down ranging from 69.49 to 60.78 per cent from 2009 to 2014. The report advances that lack of instruction materials across the schools have contributed to deteriorating knowledge in solar system education. For instance, the school may have no simple models such as globes that clarify the shape of the earth better. As such, the teacher may improvise by getting an

Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysis.

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Barden-O'Fallon, Janine

2017-05-08

Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. Results show that FBOs are less likely to offer FP services than other managing authorities (p faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). Results from this analysis indicate that there is room for improvement in the availability of FP services by FBOs in these countries. Quality of counseling should be improved by all managing authorities in the three countries, as indicated by low overall

Malawi | CRDI - Centre de recherches pour le développement ...

International Development Research Centre (IDRC) Digital Library (Canada)

Étant donné que la population du Malawi est composée à 85 % de petits exploitants agricoles, nous avons axé notre aide sur les systèmes d'exploitation agricole, nous concentrant d'abord sur l'amélioration des méthodes de production végétale et de transformation.

Ward Round - a boy with multiple joint swellings | Tickell | Malawi ...

African Journals Online (AJOL)

Ward Round - a boy with multiple joint swellings. D Tickell. Abstract. No Abstract Malawi Medical Journal Vol. 20 (3) 2008: pp. 99-100. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v20i3.10968 · AJOL African Journals Online.

The burden of selected chronic non-communicable diseases and their risk factors in Malawi: nationwide STEPS survey.

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Kelias P Msyamboza

Full Text Available Chronic non-communicable diseases (NCDs are becoming significant causes of morbidity and mortality, particularly in sub-Saharan African countries, although local, high-quality data to inform evidence-based policies are lacking.To determine the magnitude of NCDs and their risk factors in Malawi.Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based, nationwide cross-sectional survey was conducted between July and September 2009 on participants aged 25-64 years. Socio-demographic and behaviour risk factors were collected in Step 1. Physical anthropometric measurements and blood pressure were documented in Step 2. Blood cholesterol and fasting blood glucose were measured in Step 3.A total of 5,206 adults (67% females were surveyed. Tobacco smoking, alcohol drinking and raised blood pressure (BP were more frequent in males than females, 25% vs 3%, 30% vs 4% and 37% vs 29%. Overweight, physical inactivity and raised cholesterol were more common in females than males, 28% vs 16%, 13% vs 6% and 11% vs 6%. Tobacco smoking was more common in rural than urban areas 11% vs 7%, and overweight and physical inactivity more common in urban than rural areas 39% vs 22% and 24% vs 9%, all with p<0.05. Overall (both sexes prevalence of tobacco smoking, alcohol consumption, overweight and physical inactivity was 14%, 17%, 22%, 10% and prevalence of raised BP, fasting blood sugar and cholesterol was 33%, 6% and 9% respectively. These data could be useful in the formulation and advocacy of NCD policy and action plan in Malawi.

Is the Urban Child Health Advantage Declining in Malawi?: Evidence from Demographic and Health Surveys and Multiple Indicator Cluster Surveys.

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Lungu, Edgar Arnold; Biesma, Regien; Chirwa, Maureen; Darker, Catherine

2018-06-01

In many developing countries including Malawi, health indicators are on average better in urban than in rural areas. This phenomenon has largely prompted Governments to prioritize rural areas in programs to improve access to health services. However, considerable evidence has emerged that some population groups in urban areas may be facing worse health than rural areas and that the urban advantage may be waning in some contexts. We used a descriptive study undertaking a comparative analysis of 13 child health indicators between urban and rural areas using seven data points provided by nationally representative population based surveys-the Malawi Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Rate differences between urban and rural values for selected child health indicators were calculated to denote whether urban-rural differentials showed a trend of declining urban advantage in Malawi. The results show that all forms of child mortality have significantly declined between 1992 and 2015/2016 reflecting successes in child health interventions. Rural-urban comparisons, using rate differences, largely indicate a picture of the narrowing gap between urban and rural areas albeit the extent and pattern vary among child health indicators. Of the 13 child health indicators, eight (neonatal mortality, infant mortality, under-five mortality rates, stunting rate, proportion of children treated for diarrhea and fever, proportion of children sleeping under insecticide-treated nets, and children fully immunized at 12 months) show clear patterns of a declining urban advantage particularly up to 2014. However, U-5MR shows reversal to a significant urban advantage in 2015/2016, and slight increases in urban advantage are noted for infant mortality rate, underweight, full childhood immunization, and stunting rate in 2015/2016. Our findings suggest the need to rethink the policy viewpoint of a disadvantaged rural and much better-off urban in child health

present

African Journals Online (AJOL)

as medium of instruction enhances concept formation, especially in science subjects as ... The study, on which this paper is based, was conducted to evaluate Malawi's ... corrected in the wake of information flowing from the evaluation phase (Kaplan .... concerning the background information and suggested activities (Thodi,.

Why Rural Community Day Secondary Schools Students' Performance in Physical Science Examinations Is Poor in Lilongwe Rural West Education District in Malawi

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Mlangeni, Angstone Noel J. Thembachako; Chiotha, Sosten Staphael

2015-01-01

A study was conducted to investigate factors that affect students' poor performance in physical science examinations at Malawi School Certificate of Education and Junior Certificate of Education levels in Community day secondary schools (CDSS) in Lilongwe Rural West Education District in Malawi. Students' performance was collected from schools'…

Early childhood development: the role of community based childcare centres in Malawi.

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Munthali, Alister C; Mvula, Peter M; Silo, Lois

2014-01-01

Somatic changes including growth and development of the brain of a human being occur very early in life. Programmes that enhance early childhood development (ECD) therefore should be part of the national agenda. Cognizant of this fact, the Malawi Government together with development partners facilitated the establishment of community-based child care centres (CBCCs) which are owned and managed by community members. This study was aimed at understanding how CBCCs operated and their core functions. Using information from databases kept by the District Social Welfare Officers from all the 28 districts in Malawi, coupled with snowballing, all functioning CBCCs were enumerated. A questionnaire was administered to the head of the CBCC or a care giver. Highly trained Research Assistants also carried our observations of the structures around the centres and the activities that actually happened. Data was analysed using a Statistical Package for Social Sciences. Communities provide structures, support for care givers, food, utensils, labour and play materials for the children in CBCCs. The first ECD centre was established in 1966 but the real surge in establishing these happened towards the end of the 1990s and by 2007 there were 5,665 CBCCs in Malawi caring for 407,468 children aged between 3 and 5 years. CBCCs were established to provide pre-primary school learning, and in some cases provide special care to orphans and other vulnerable. Despite the fact that most CBCC premises and structures fell short of the standards laid down by the CBCC profile, the activities and services provided were mostly to the book. Children were provided with nutritious foods and subjected to play that stimulated their cognitive and mental development. Despite the fact that some members of the community do not realize the value of the CBCCs, the existence of these institutions is an opportunity for the community to take care of their children communally, a task that has become imperative as a

Institutional Challenges to Viable Civil-Military Relations in Malawi

Science.gov (United States)

2008-03-01

teacher who was responsible for discipline and physical education and was the most feared teacher at every institution. In short, Banda successfully...of guidance is particularly evident in the higher education program of the armed forces. The Malawi Defense Force, in 2007, established a Centre for...has lost respect, due to what he termed childish and irresponsible, with opposition MPs and their leaders who use abusive language while transacting

Moral transgression, disease and holistic health in the Livingstonia Mission in late nineteenth and early twenttieth-century Malawi

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Hokkanen, Markku

2009-06-01

Full Text Available This article examines ideas of morality and health, and connections between moral transgression and disease in both Scottish missionary and Central African thought in the context of the Livingstonia Mission of the Presbyterian Free Church of Scotland in Malawi during the late nineteenth and early twentieth centuries.2 By concentrating on debates, conflicts and co-operation between missionaries and Africans over the key issues of beer drinking and sexual morality, this article explores the emergence of a new ‘moral hygiene’ among African Christian communities in Northern Malawi.

Este artículo analiza las ideas sobre moralidad y salud, así como las relaciones entre transgresión moral y enfermedad, tanto en el pensamiento misionero escocés como en el pensamiento del África central, en el contexto de la Misión de Livingstonia de la Iglesia Libre Presbiteriana de Escocia en Malawi entre finales del siglo XIX y principios del XX. Centrándose en las conversaciones, los conflictos y la colaboración entre los misioneros y los africanos sobre cuestiones clave como el consumo de cerveza y la moralidad sexual, este artículo estudia la aparición de una nueva «higiene moral» entre las comunidades cristianas africanas en Malawi del norte.

Moral maps and medical imaginaries: clinical tourism at Malawi's College of Medicine.

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Wendland, Claire L

2012-01-01

At an understaffed and underresourced urban African training hospital, Malawian medical students learn to be doctors while foreign medical students, visiting Malawi as clinical tourists on short-term electives, learn about “global health.” Scientific ideas circulate fast there; clinical tourists circulate readily from outside to Malawi but not the reverse; medical technologies circulate slowly, erratically, and sometimes not at all. Medicine's uneven globalization is on full display. I extend scholarship on moral imaginations and medical imaginaries to propose that students map these wards variously as places in which—or from which—they seek a better medicine. Clinical tourists, enacting their own moral maps, also become representatives of medicine “out there”: points on the maps of others. Ethnographic data show that for Malawians, clinical tourists are colleagues, foils against whom they construct ideas about a superior and distinctly Malawian medicine and visions of possible alternative futures for themselves.

Mathematical Modeling to Assess the Drivers of the Recent Emergence of Typhoid Fever in Blantyre, Malawi.

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Pitzer, Virginia E; Feasey, Nicholas A; Msefula, Chisomo; Mallewa, Jane; Kennedy, Neil; Dube, Queen; Denis, Brigitte; Gordon, Melita A; Heyderman, Robert S

2015-11-01

Multiyear epidemics of Salmonella enterica serovar Typhi have been reported from countries across eastern and southern Africa in recent years. In Blantyre, Malawi, a dramatic increase in typhoid fever cases has recently occurred, and may be linked to the emergence of the H58 haplotype. Strains belonging to the H58 haplotype often exhibit multidrug resistance and may have a fitness advantage relative to other Salmonella Typhi strains. To explore hypotheses for the increased number of typhoid fever cases in Blantyre, we fit a mathematical model to culture-confirmed cases of Salmonella enterica infections at Queen Elizabeth Central Hospital, Blantyre. We explored 4 hypotheses: (1) an increase in the basic reproductive number (R0) in response to increasing population density; (2) a decrease in the incidence of cross-immunizing infection with Salmonella Enteritidis; (3) an increase in the duration of infectiousness due to failure to respond to first-line antibiotics; and (4) an increase in the transmission rate following the emergence of the H58 haplotype. Increasing population density or decreasing cross-immunity could not fully explain the observed pattern of typhoid emergence in Blantyre, whereas models allowing for an increase in the duration of infectiousness and/or the transmission rate of typhoid following the emergence of the H58 haplotype provided a good fit to the data. Our results suggest that an increase in the transmissibility of typhoid due to the emergence of drug resistance associated with the H58 haplotype may help to explain recent outbreaks of typhoid in Malawi and similar settings in Africa. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

Modelling the Contributions of Malaria, HIV, Malnutrition and Rainfall to the Decline in Paediatric Invasive Non-typhoidal Salmonella Disease in Malawi.

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Feasey, Nicholas A; Everett, Dean; Faragher, E Brian; Roca-Feltrer, Arantxa; Kang'ombe, Arthur; Denis, Brigitte; Kerac, Marko; Molyneux, Elizabeth; Molyneux, Malcolm; Jahn, Andreas; Gordon, Melita A; Heyderman, Robert S

2015-01-01

Nontyphoidal Salmonellae (NTS) are responsible for a huge burden of bloodstream infection in Sub-Saharan African children. Recent reports of a decline in invasive NTS (iNTS) disease from Kenya and The Gambia have emphasised an association with malaria control. Following a similar decline in iNTS disease in Malawi, we have used 9 years of continuous longitudinal data to model the interrelationships between iNTS disease, malaria, HIV and malnutrition. Trends in monthly numbers of childhood iNTS disease presenting at Queen's Hospital, Blantyre, Malawi from 2002 to 2010 were reviewed in the context of longitudinal monthly data describing malaria slide-positivity among paediatric febrile admissions, paediatric HIV prevalence, nutritional rehabilitation unit admissions and monthly rainfall over the same 9 years, using structural equation models (SEM). Analysis of 3,105 iNTS episodes identified from 49,093 blood cultures, showed an 11.8% annual decline in iNTS (p malnutrition on the prevalence of iNTS disease. When these data were smoothed to eliminate seasonal cyclic changes, these associations remained strong and there were additional significant effects of HIV prevalence. These data suggest that the overall decline in iNTS disease observed in Malawi is attributable to multiple public health interventions leading to reductions in malaria, HIV and acute malnutrition. Understanding the impacts of public health programmes on iNTS disease is essential to plan and evaluate interventions.

Development, reliability and validity of the Chichewa WHOQOL-BREF in adults in lilongwe, Malawi

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Colbourn Tim

2012-07-01

Full Text Available Abstract Background Quality of life measurement is a useful addition to measurement of health outcomes in evaluation of the benefits of many health and welfare interventions. The WHOQOL-BREF measures quality of life from a broad multi-dimensional perspective but was not used in Malawi. The objective of this study was to translate the WHOQOL-BREF questionnaire into the main local language of Malawi: Chichewa; and to validate it quantitatively with respect to internal consistency, domain structure, and discriminant validity for this context. Methods WHO-mandated guidelines were followed for translation, adaptation, pre-testing (focus groups, piloting (patient interviews and data coding. Analyses using descriptive statistics, correlation and regression were undertaken to investigate the validity of the WHOQOL-BREF in the ways described above. Additional regression analyses examined the impact of socio-demographic variables on the domain scores. Results 309 respondents completed the questionnaire (with >98% response rates for all questions except Q21 (sex life. 259 were sick with a variety of health problems, and 50 were considered healthy. All domains showed adequate internal consistency (Cronbach’s alpha > =0.7 with all item scores also most highly correlated with the scores of their assigned domain. All domain scores varied by health problem, and more depressed respondents had significantly lower scores in all domains than those less depressed. Domain scores and their associations with socio-demographic variables are presented and discussed. Conclusion This study demonstrates that the new Chichewa WHOQOL-BREF questionnaire is acceptable and comprehensible to respondents in Malawi. The questionnaire also passed a number of tests of the validity of its psychometric properties. In the pilot population we found that older age was associated with lower Physical domain scores. Conversely, higher levels of educational attainment were found to be

Economic Efficiency, Allen / Uzama and Morishima Elasticities of Smallholder Agriculture In Dedza District, Malawi

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Assa MAGANGA

2013-06-01

Full Text Available This paper is an attempt to measure the economic efficiency of Dedza smallholder Irish potato (Solanum tuberosum farmers in Malawi using a translog cost frontier, inefficiency effect model and input Elasticities from Seeming Unrelated Regression Model for asystem of cost share equations for labour, fertilizer, seed and land. A sample of 200 farmers has been considered from Dedza district in Malawi. Results indicate that the mean economic efficiency of Irish potato production in Dedza District is 0.61 with scores ranging between 0.12 and 0.94. The economic efficiency differences are significantly explained by non-farm employment, education, credit access, farm experience, degree of specialization, household size and frequency of weeding. The highest input substitution existed between labour and fertilizer, followed by seedfertilizer.

Forestry policy and woodfuel markets in Malawi

International Nuclear Information System (INIS)

Dewees, P.A.

1995-01-01

Forestry and energy policies in Malawi place the blame for the country's high rate of deforestation on the demand for woodfuel. The government has been involved in a range of questionable supply-side initiatives, as well as in a number of interventions in woodfuel markets, with the objective of slowing rates of deforestation. It seeks to encourage farmers to grow woodfuel to meet market demands, and has provided subsidies to do so. The Forest Department has kept prices for firewood from its plantations low, both in order to discourage the market for wood from free resources and because of concerns about the impact of high producer prices on the urban poor. In doing so, the government is less able to rely on the market to provide producers with the incentive to plant trees to meet market demands. In any event, the market accounts for a relatively small proportion of total woodfuel demand. Policies do not distinguish between rural household demands and the specific market demands which are having the greatest impact on deforestation: woodfuel for urban markets, for tobacco curring, and for small industries. These, coupled with the expansion of the estate sector, have had a far greater impact on woodland clearance than rural, subsistence woodfuel demands. Rural household energy demands need to be addressed from a much broader perspective which considers the household's larger needs for tree based products or outputs: income, food, fibre, fodder, soil fertility, as well as for fuel. (author). 24 refs, 3 figs, 2 tabs

An Analysis of HIV Risky Behaviors of College Students in Malawi: A ...

African Journals Online (AJOL)

zeleza

Professor, Department of Agricultural Communication, Education & .... In Malawi, sex and condom use is seen largely as the responsibility of the male, ... largely successful (Kaiser Family Foundation, 2008). ... x To assess perceived awareness of HIV & AIDS, condom usage and role of religion on self- ... Literature Review.

What factors drive fishery yields in the Lower Shire River, Malawi ...

African Journals Online (AJOL)

The Shire River drains from Lake Malawi to the Lower Zambezi River. Annual flow is dependent mainly on lake level, partially controlled by the operation of a barrage at Liwonde to regulate flows for hydroelectricity generation in the escarpment reaches of the river. Downstream of the escarpment, the floodplains of the ...

Post-neonatal infant mortality in Malawi: the importance of maternal health

NARCIS (Netherlands)

Verhoeff, Francine H.; le Cessie, Saskia; Kalanda, Boniface F.; Kazembe, Peter N.; Broadhead, Robin L.; Brabin, Bernard J.

2004-01-01

In a cohort study of mothers and their infants, information was collected from women attending the antenatal services of two hospitals in a rural area of Malawi and 561 of their babies were enrolled in a follow-up study. There were 128 with a low birthweight (LBW, <2500 g), 138 with fetal anaemia

Ward Round - Late Presentation of Acute Compartment Syndrome in ...

African Journals Online (AJOL)

following the course of ibuprofen mentioned. Twelve days after admission he started to complain of increasing pain and tightness in his left thigh. Sensation and motor function. Ward Round - Late Presentation of Acute. Compartment Syndrome in the Thigh. University of Malawi, College of Medicine, Department of Surgery,.

Impact of Extended Combination Antiretroviral Therapy on the Decline of HIV Prevalence in Pregnant Women in Malawi.

Science.gov (United States)

Liotta, Giuseppe; Chimbwandira, Frank; Wouters, Kristien; Nielsen-Saines, Karin; Jere, Haswell; Mancinelli, Sandro; Ceffa, Susanna; Erba, Fulvio; Palombi, Leonardo; Marazzi, Maria Cristina

2016-01-01

Combination antiretroviral therapy has been shown to reduce HIV transmission and incident infections. In recent years, Malawi has significantly increased the number of individuals on combination antiretroviral drugs through more inclusive treatment policies. Using a retrospective observational cohort design, records with HIV test results were reviewed for pregnant women attending a referral hospital in Malawi over a 5-year period, with viral load measurements recorded. HIV prevalence over time was determined, and results correlated with population viral load. A total of 11 052 women were included in this analysis, with 440 (4.1%) HIV infections identified. HIV prevalence rates in pregnant women in Malawi halved from 6.4% to 3.0% over 5 years. Mean viral loads of adult patients decreased from 120 000 copies/mL to less than 20 000 copies/mL. Results suggest that community viral load has an effect on HIV incidence rates in the population, which in turn correlates with reduced HIV prevalence rates in pregnant women. © The Author(s) 2015.

Moral competence among nurses in Malawi: A concept analysis approach.

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Maluwa, Veronica Mary; Gwaza, Elizabeth; Sakala, Betty; Kapito, Esnath; Mwale, Ruth; Haruzivishe, Clara; Chirwa, Ellen

2018-01-01

Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Analysis of moral competence concept was done using Walker and Avant's strategy of concept analysis. Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi.

Capturing Complexities of Relationship-Level Family Planning Trajectories in Malawi.

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Furnas, Hannah E

2016-09-01

In a transitioning fertility climate, preferences and decisions surrounding family planning are constantly in flux. Malawi provides an ideal case study of family planning complexities as fertility preferences are flexible, the relationship context is unstable, and childbearing begins early. I use intensive longitudinal data from Tsogolo la Thanzi-a research project in Malawi that follows young adults in romantic partnerships through the course of their relationship. I examine two questions: (1) What are the typical patterns of family planning as young adults transition through a relationship? (2) How are family planning trajectories related to individual and relationship-level characteristics? I use sequence analysis to order family planning across time and to contextualize it within each relationship. I generate and cluster the family planning trajectories and find six distinct groups of young adults who engage in family planning in similar ways. I find that family planning is complex, dynamic, and unique to each relationship. I argue that (a) family planning research should use the relationship as the unit of analysis and (b) family planning behaviors and preferences should be sequenced over time for a better understanding of key concepts, such as unmet need. © 2016 The Population Council, Inc.

Awareness and perceived fairness of Option B+ in Malawi: A population-level perspective

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Yeatman, Sara; Trinitapoli, Jenny

2017-03-08

Policies for rationing antiretroviral therapy (ART) have been subject to on-going ethical debates. Introduced in Malawi in 2011, Option B+ prioritized HIV-positive pregnant women for lifelong ART regardless of the underlying state of their immune system, shifting the logic of allocation away from medical eligibility. Despite the rapid expansion of this policy, we know little about how it has been understood and interpreted by the people it affects. We assessed awareness and perceived fairness of the prioritization system for ART among a population-based sample of young women (n = 1440) and their partners (n = 574) in southern Malawi. We use a card-sort technique to elicit understandings of who gets ART under Option B+ and who should be prioritized, and we compare perceptions to actual ART policy using sequence analysis and optimal matching. We then use ordered logistic regression to identify the factors associated with policy awareness. In 2015, only 30.7% of women and 21.1% of male partners understood how ART was being distributed. There was widespread confusion around whether otherwise healthy HIV-positive pregnant women could access ART under Option B + . Nonetheless, more young adults thought that the fairest policy should prioritize such women than believed the actual policy did. Women who were older, more educated or had recently engaged with the health system through antenatal care or ART had more accurate understandings of Option B + . Among men, policy awareness was lower, and was patterned only by education. Although most respondents were unaware that Option B+ afforded ART access to healthy-pregnant women, Malawians support the prioritization of pregnant women. Countries adopting Option B+ or other new ART policies such as universal test-and-treat should communicate the policies and their rationales to the public - such transparency would be more consistent with a fair and ethical process and could additionally serve to clarify confusion and

Transition and Tertiary Education: A Case Study of Mzuzu University, Malawi

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Zozie, Paxton Andrew; Kayira, Peter Benwell

2012-01-01

This article reviews the role of guidance and counselling in Malawi in reducing dropout and easing the transition of students to tertiary education, as well as in helping them during their time in tertiary education. It begins by identifying key success factors in guidance and counselling services for learners in both developed and developing…

Iodine status in the Nordic countries – past and present

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Helena Filipsson Nyström

2016-06-01

Full Text Available Background: Adequate iodine nutrition is dependent on ground water content, seafood, and, as many countries use iodized cow fodder, dairy products. In most countries, salt fortification programs are needed to assure adequate iodine intake. Objectives: The objectives are threefold: 1 to describe the past and present iodine situation in the Nordic countries, 2 to identify important gaps of knowledge, and 3 to highlight differences among the Nordic countries’ iodine biomonitoring and fortification policies. Design: Historical data are compared with the current situation. The Nordic countries’ strategies to achieve recommended intake and urine iodine levels and their respective success rates are evaluated. Results: In the past, the iodine situation ranged from excellent in Iceland to widespread goiter and cretinism in large areas of Sweden. The situation was less severe in Norway and Finland. According to a 1960 World Health Organization (WHO report, there were then no observations of iodine deficiency in Denmark. In Sweden and Finland, the fortification of table salt was introduced 50–75 years ago, and in Norway and Finland, the fortification of cow fodder starting in the 1950s helped improve the population's iodine status due to the high intake of milk. In Denmark, iodine has been added to household salt and salt in bread for the past 15 years. The Nordic countries differ with regard to regulations and degree of governmental involvement. There are indications that pregnant and lactating women, the two most vulnerable groups, are mildly deficient in iodine in several of the Nordic countries. Conclusion: The Nordic countries employ different strategies to attain adequate iodine nutrition. The situation is not optimal and is in need of re-evaluation. Iodine researchers, Nordic national food administrations, and Nordic governmental institutions would benefit from collaboration to attain a broader approach and guarantee good iodine health for all.

Iodine status in the Nordic countries – past and present

Science.gov (United States)

Nyström, Helena Filipsson; Brantsæter, Anne Lise; Erlund, Iris; Gunnarsdottir, Ingibjörg; Hulthén, Lena; Laurberg, Peter; Mattisson, Irene; Rasmussen, Lone Banke; Virtanen, Suvi; Meltzer, Helle Margrete

2016-01-01

Background Adequate iodine nutrition is dependent on ground water content, seafood, and, as many countries use iodized cow fodder, dairy products. In most countries, salt fortification programs are needed to assure adequate iodine intake. Objectives The objectives are threefold: 1) to describe the past and present iodine situation in the Nordic countries, 2) to identify important gaps of knowledge, and 3) to highlight differences among the Nordic countries’ iodine biomonitoring and fortification policies. Design Historical data are compared with the current situation. The Nordic countries’ strategies to achieve recommended intake and urine iodine levels and their respective success rates are evaluated. Results In the past, the iodine situation ranged from excellent in Iceland to widespread goiter and cretinism in large areas of Sweden. The situation was less severe in Norway and Finland. According to a 1960 World Health Organization (WHO) report, there were then no observations of iodine deficiency in Denmark. In Sweden and Finland, the fortification of table salt was introduced 50–75 years ago, and in Norway and Finland, the fortification of cow fodder starting in the 1950s helped improve the population's iodine status due to the high intake of milk. In Denmark, iodine has been added to household salt and salt in bread for the past 15 years. The Nordic countries differ with regard to regulations and degree of governmental involvement. There are indications that pregnant and lactating women, the two most vulnerable groups, are mildly deficient in iodine in several of the Nordic countries. Conclusion The Nordic countries employ different strategies to attain adequate iodine nutrition. The situation is not optimal and is in need of re-evaluation. Iodine researchers, Nordic national food administrations, and Nordic governmental institutions would benefit from collaboration to attain a broader approach and guarantee good iodine health for all. PMID:27283870

Prevalence and correlates of cigarette smoking among adolescents in Malawi: results from the Global Youth Tobacco Survey 2005.

Science.gov (United States)

Muula, A S; Siziya, S; Rudatsikira, E

2008-07-01

The majority of adults who smoke cigarettes initiated the habit when they were adolescents or young adults. While rates of smoking and associated factors are known among 13-15 year olds in Malawi, correlates of cigarette smoking among adolescents in a national representative sample in Malawi have not been studied. We, therefore, carried out this study to estimate the prevalence of current smoking and determine its correlates in a nationally representative sample of in-school adolescents in Malawi. An analysis of the Malawi Global Youth Tobacco Survey (GYTS) 2005 was conducted. Using logistic regression analysis, we estimated the association between current cigarette smoking and potential explanatory variables. Overall, 2.5% of adolescents (3.2% among males, and 1.8% among females) were current cigarette smokers. Smoking among parents was 9.6% with no significant difference between males and females (10.3% versus 10.1%). Stronger associations with smoking were observed for friends smoking status (AOR=3.07, 95%CI 2.99, 3.16), receiving pocket money (AOR=3.06, 95%CI 2.98, 3.14), and perception that smoking increases body weight (AOR=2.98, 95%CI 2.81, 3.16). Students who thought that cigarette smoking is harmful to health were 56% (AOR=0.44, 95%CI 0.43, 0.45) less likely to smoke than students who thought otherwise. Despite being the world's second leading grower of tobacco, the prevalence of cigarette smoking among adolescent is lower than has been reported elsewhere.

Reflections on the first twenty-five years of the University of Malawi ...

African Journals Online (AJOL)

September 2016 marks 25 years since the College of Medicine of the University of Malawi was established. In this article we reflect on its conception, birth, adolescence, and youth. The contributions of multiple stakeholders are celebrated while being mindful of the ongoing efforts to consolidate past and current gains.

Strengthening community health supply chain performance through an integrated approach: Using mHealth technology and multilevel teams in Malawi.

Science.gov (United States)

Shieshia, Mildred; Noel, Megan; Andersson, Sarah; Felling, Barbara; Alva, Soumya; Agarwal, Smisha; Lefevre, Amnesty; Misomali, Amos; Chimphanga, Boniface; Nsona, Humphreys; Chandani, Yasmin

2014-12-01

In 2010, 7.6 million children under five died globally - largely due to preventable diseases. Majority of these deaths occurred in sub-Saharan Africa. As a strategy to reduce child mortality, the Government of Malawi, in 2008, initiated integrated community case management allowing health surveillance assistants (HSAs) to treat sick children in communities. Malawi however, faces health infrastructure challenges, including weak supply chain systems leading to low product availability. A baseline assessment conducted in 2010 identified data visibility, transport and motivation of HSAs as challenges to continuous product availability. The project designed a mHealth tool as part of two interventions to address these challenges. A mobile health (mHealth) technology - cStock, for reporting on community stock data - was designed and implemented as an integral component of Enhanced Management (EM) and Efficient Product Transport (EPT) interventions. We developed a feasibility and acceptability framework to evaluate the effectiveness and predict the likelihood of scalability and ownership of the interventions. Mixed methods were used to conduct baseline and follow up assessments in May 2010 and February 2013, respectively. Routine monitoring data on community stock level reports, from cStock, were used to analyze supply chain performance over 18-month period in the intervention groups. Mean stock reporting rate by HSAs was 94% in EM group (n = 393) and 79% in EPT group (n = 253); mean reporting completeness was 85% and 65%, respectively. Lead time for HSA drug resupply over the 18-month period was, on average, 12.8 days in EM and 26.4 days in EPT, and mean stock out rate for 6 tracer products was significantly lower in EM compared to EPT group. Results demonstrate that cStock was feasible and acceptable to test users in Malawi, and that based on comparison with the EPT group, the team component of the EM group was an essential pairing with cStock to achieve the best

Strengthening community health supply chain performance through an integrated approach: Using mHealth technology and multilevel teams in Malawi

Science.gov (United States)

Shieshia, Mildred; Noel, Megan; Andersson, Sarah; Felling, Barbara; Alva, Soumya; Agarwal, Smisha; Lefevre, Amnesty; Misomali, Amos; Chimphanga, Boniface; Nsona, Humphreys; Chandani, Yasmin

2014-01-01

Background In 2010, 7.6 million children under five died globally – largely due to preventable diseases. Majority of these deaths occurred in sub–Saharan Africa. As a strategy to reduce child mortality, the Government of Malawi, in 2008, initiated integrated community case management allowing health surveillance assistants (HSAs) to treat sick children in communities. Malawi however, faces health infrastructure challenges, including weak supply chain systems leading to low product availability. A baseline assessment conducted in 2010 identified data visibility, transport and motivation of HSAs as challenges to continuous product availability. The project designed a mHealth tool as part of two interventions to address these challenges. Methods A mobile health (mHealth) technology – cStock, for reporting on community stock data – was designed and implemented as an integral component of Enhanced Management (EM) and Efficient Product Transport (EPT) interventions. We developed a feasibility and acceptability framework to evaluate the effectiveness and predict the likelihood of scalability and ownership of the interventions. Mixed methods were used to conduct baseline and follow up assessments in May 2010 and February 2013, respectively. Routine monitoring data on community stock level reports, from cStock, were used to analyze supply chain performance over 18–month period in the intervention groups. Results Mean stock reporting rate by HSAs was 94% in EM group (n = 393) and 79% in EPT group (n = 253); mean reporting completeness was 85% and 65%, respectively. Lead time for HSA drug resupply over the 18–month period was, on average, 12.8 days in EM and 26.4 days in EPT, and mean stock out rate for 6 tracer products was significantly lower in EM compared to EPT group. Conclusions Results demonstrate that cStock was feasible and acceptable to test users in Malawi, and that based on comparison with the EPT group, the team component of the EM group was an

Enhancing global health and education in Malawi, Zambia, and the United States through an interprofessional global health exchange program.

Science.gov (United States)

Wilson, Lynda Law; Somerall, D'Ann; Theus, Lisa; Rankin, Sally; Ngoma, Catherine; Chimwaza, Angela

2014-05-01

This article describes participant outcomes of an interprofessional collaboration between health professionals and faculty in Malawi, Zambia, and the United States (US). One strategy critical for improving global health and addressing Millennium Development goals is promotion of interprofessional education and collaboration. Program participants included 25 health professionals from Malawi and Zambia, and 19 faculty/health professionals from Alabama and California. African Fellows participated in a 2 week workshop on Interprofessional Education in Alabama followed by 2 weeks working on individual goals with faculty collaborators/mentors. The US Fellows also spent 2 weeks visiting their counterparts in Malawi and Zambia to develop plans for sustainable partnerships. Program evaluations demonstrated participants' satisfaction with the program and indicated that the program promoted interprofessional and cross-cultural understanding; fostered development of long-term sustainable partnerships between health professionals and educators in Zambia and the US; and created increased awareness and use of resources for global health education. © 2014.

Does health facility service environment matter for the receipt of essential newborn care? Linking health facility and household survey data in Malawi.

Science.gov (United States)

Carvajal-Aguirre, Liliana; Mehra, Vrinda; Amouzou, Agbessi; Khan, Shane M; Vaz, Lara; Guenther, Tanya; Kalino, Maggie; Zaka, Nabila

2017-12-01

Health facility service environment is an important factor for newborns survival and well-being in general and in particular in high mortality settings such as Malawi where despite high coverage of essential interventions, neonatal mortality remains high. The aim of this study is to assess whether the quality of the health service environment at birth is associated with quality of care received by the newborn. We used data from the Malawi Millennium Development Goals Endline household survey conducted as part of MICS survey program and Service Provision Assessment Survey carried out in 2014. The analysis is based on 6218 facility births that occurred during the past 2 years. Descriptive statistics, bivariate and multivariate random effect models are used to assess the association of health facility service readiness score for normal deliveries and newborn care with newborns receiving appropriate newborn care, defined for this analysis as receiving 5 out of 6 recommended interventions during the first 2 days after birth. Newborns in districts with top facility service readiness score have 1.5 higher odds of receiving appropriate newborn care (adjusted odds ratio (aOR) = 1.52, 95% confidence interval CI = 1.19-1.95, P  = 0.001), as compared to newborns in districts with a lower facility score after adjusting for potential confounders. Newborns in the Northern region were two times more likely to receive 5 newborn care interventions as compared to newborns in the Southern region (aOR = 2.06, 95% CI = 1.50-2.83, P  < 0.001). Living in urban or rural areas did not have an impact on receiving appropriate newborn care. There is need to increase the level of service readiness across all facilities, so that all newborns irrespective of the health facility, district or region of delivery are able to receive all recommended essential interventions. Investments in health systems in Malawi should concentrate on increasing training and availability of

Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border.

Science.gov (United States)

Lutterloh, Emily; Likaka, Andrew; Sejvar, James; Manda, Robert; Naiene, Jeremias; Monroe, Stephan S; Khaila, Tadala; Chilima, Benson; Mallewa, Macpherson; Kampondeni, Sam D; Lowther, Sara A; Capewell, Linda; Date, Kashmira; Townes, David; Redwood, Yanique; Schier, Joshua G; Nygren, Benjamin; Tippett Barr, Beth; Demby, Austin; Phiri, Abel; Lungu, Rudia; Kaphiyo, James; Humphrys, Michael; Talkington, Deborah; Joyce, Kevin; Stockman, Lauren J; Armstrong, Gregory L; Mintz, Eric

2012-04-01

Salmonella enterica serovar Typhi causes an estimated 22 million cases of typhoid fever and 216 000 deaths annually worldwide. We investigated an outbreak of unexplained febrile illnesses with neurologic findings, determined to be typhoid fever, along the Malawi-Mozambique border. The investigation included active surveillance, interviews, examinations of ill and convalescent persons, medical chart reviews, and laboratory testing. Classification as a suspected case required fever and ≥1 other finding (eg, headache or abdominal pain); a probable case required fever and a positive rapid immunoglobulin M antibody test for typhoid (TUBEX TF); a confirmed case required isolation of Salmonella Typhi from blood or stool. Isolates underwent antimicrobial susceptibility testing and subtyping by pulsed-field gel electrophoresis (PFGE). We identified 303 cases from 18 villages with onset during March-November 2009; 214 were suspected, 43 were probable, and 46 were confirmed cases. Forty patients presented with focal neurologic abnormalities, including a constellation of upper motor neuron signs (n = 19), ataxia (n = 22), and parkinsonism (n = 8). Eleven patients died. All 42 isolates tested were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole; 4 were also resistant to nalidixic acid. Thirty-five of 42 isolates were indistinguishable by PFGE. The unusual neurologic manifestations posed a diagnostic challenge that was resolved through rapid typhoid antibody testing in the field and subsequent blood culture confirmation in the Malawi national reference laboratory. Extending laboratory diagnostic capacity, including blood culture, to populations at risk for typhoid fever in Africa will improve outbreak detection, response, and clinical treatment.

Why might clinicians in Malawi not offer HIV testing to their patients ...

African Journals Online (AJOL)

In order to identify reasons clinicians in Malawi might not offer HIV testing to patients, a cross-sectional descriptive postal census with telephone and fax follow-up was conducted. Proportions were calculated for each reason given for not offering HIV testing. Multiple logistic regression was used to determine whether ...

A review of patients with advanced cervical cancer presenting to ...

African Journals Online (AJOL)

outcomes of cervical cancer patients who entered care at Tiyanjane Clinic in Blantyre, Malawi ... a palliative approach from the time of presentation. Opportunities for ... to start on highly active antiretroviral therapy (HAART), irrespective of ..... antenatal care, maternity care, under 5 clinics, family planning clinics, exposed ...

Democracy as a Limiting Factor for Politicised Cultural Populism in Malawi Demokratie und politisierter Kulturpopulismus in Malawi

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Reuben Makayiko Chirambo

2009-01-01

Full Text Available Though Malawian democracy could still be described as in transition from authoritarianism, it has enabled an atmosphere for critical debate of and dissent against seemingly popular opinions, which was not possible during the authoritarian rule of former life president, Dr. H. K. Banda, 1964-1994. This article examines politicised cultural populism in Malawi under the dictatorship and democracy in comparative terms. President Banda, as a political populist, appropriated culture to legitimate and validate his political power as well as to cultivate popular support from the majority of ordinary people. Following reforms towards democracy since 1992, his successors have also tended towards populist politics by similarly appropriating culture and cultural activities, among other means, to cultivate popular support from mostly ordinary people for their regimes. Such politicised cultural populism involves adopting traditional roles, cultural symbols and images of power such as praise-titles, and participating in cultural activities such as traditional dances. This article examines the efforts of President Bingu wa Mutharika in the democratic dispensation to appropriate cultural artefacts used by Banda during a dictatorship in order to cultivate popular support for his regime. The article argues that Bingu’s efforts at politicised cultural populism are constrained, among other factors, by the nature and climate of democratic politics mainly because democracy, unlike a dictatorship, enables critical debate and the questioning of political leader’s behaviour and their motives. Auch wenn die Demokratie in Malawi sich immer noch in einem Übergangsstadium befindet, ist inzwischen eine Atmosphäre entstanden, in der eine kritische Debatte und das Äußern unpopulärer Meinungen möglich sind, was in den Jahren 1964-1994 unter dem früheren Präsidenten auf Lebenszeit, Dr. H. K. Banda, nicht denkbar war. Der Autor vergleicht die Nutzung von Elementen

Presentation of Primary Open Angle Glaucoma (POAG) at Lions ...

African Journals Online (AJOL)

Objective Primary open angle glaucoma (POAG) is the most common type of glaucoma in Africa. We carried out a study to determine the clinical presentation pattern of patients with primary open angle glaucoma (POAG) at a tertiary hospital in Malawi. Design A cross-sectional study. Setting Lions Sight First Eye Hospital—a ...

Participation des jeunes femmes à la vie politique au Malawi | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

Conscients de la corrélation entre la pauvreté, la vulnérabilité sociale et les inégalités entre les sexes, les chercheurs se demanderont dans quelle mesure la situation sociale, économique, culturelle et politique des femmes qui vivent en milieu rural au Malawi influe sur la participation, à la vie politique locale, des jeunes ...

Adaptation aux changements climatiques au Malawi grâce à l ...

International Development Research Centre (IDRC) Digital Library (Canada)

28 avr. 2016 ... Depuis 2001, le programme Écosystèmes et santé humaine du CRDI finance au Malawi des recherches centrées sur les liens entre la fertilité des sols, ... L'équipe examine la façon dont la recherche participative peut guider l'élaboration de stratégies d'adaptation aux changements climatiques, dans un ...

an epidemiologic study of drug abuse and hiv and aids in malawi

African Journals Online (AJOL)

Administrator

1University of Pretoria, School of Health Systems and Public Health, 2Centre for Social Research,. University of Malawi, 3Zomba Mental Hospital, Ministry of Health, 4Zomba Central Hospital,. Ministry of ... childbearing age group of 16.4%. Youth aged 15-24 claim 46% of new HIV ... same drugs are responsible for their.

Post-neonatal mortality, morbidity, and developmental outcome after ultrasound-dated preterm birth in rural Malawi: a community-based cohort study.

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Melissa Gladstone

2011-11-01

Full Text Available Preterm birth is considered to be associated with an estimated 27% of neonatal deaths, the majority in resource-poor countries where rates of prematurity are high. There is no information on medium term outcomes after accurately determined preterm birth in such settings.This community-based stratified cohort study conducted between May-December 2006 in Southern Malawi followed up 840 post-neonatal infants born to mothers who had received antenatal antibiotic prophylaxis/placebo in an attempt to reduce rates of preterm birth (APPLe trial ISRCTN84023116. Gestational age at delivery was based on ultrasound measurement of fetal bi-parietal diameter in early-mid pregnancy. 247 infants born before 37 wk gestation and 593 term infants were assessed at 12, 18, or 24 months. We assessed survival (death, morbidity (reported by carer, admissions, out-patient attendance, growth (weight and height, and development (Ten Question Questionnaire [TQQ] and Malawi Developmental Assessment Tool [MDAT]. Preterm infants were at significantly greater risk of death (hazard ratio 1.79, 95% CI 1.09-2.95. Surviving preterm infants were more likely to be underweight (weight-for-age z score; p<0.001 or wasted (weight-for-length z score; p<0.01 with no effect of gestational age at delivery. Preterm infants more often screened positively for disability on the Ten Question Questionnaire (p = 0.002. They also had higher rates of developmental delay on the MDAT at 18 months (p = 0.009, with gestational age at delivery (p = 0.01 increasing this likelihood. Morbidity-visits to a health centre (93% and admissions to hospital (22%-was similar for both groups.During the first 2 years of life, infants who are born preterm in resource poor countries, continue to be at a disadvantage in terms of mortality, growth, and development. In addition to interventions in the immediate neonatal period, a refocus on early childhood is needed to improve outcomes for infants born preterm

Informal alcohol in Malawi: stakeholder perceptions and policy recommendations.

Science.gov (United States)

Limaye, Rupali J; Rutkow, Lainie; Rimal, Rajiv N; Jernigan, David H

2014-02-01

Through the eyes of those involved in the alcohol policy-making process in Malawi, we explored the role of informal (non-commercial) alcohol in rural communities, its harmful effects, and implications for appropriate national policy. Harms included early drinking initiation, violence, and sexual risk exposure. Informants suggested that policy should address informal alcohol's content, selling times, and easy access. Because most informal alcohol producers are women who rely upon sales for subsistence, policies must avoid limiting women's economic opportunities while protecting community health.

Sociocultural factors contributing to teenage pregnancy in Zomba district, Malawi.

Science.gov (United States)

Kaphagawani, Nanzen Caroline; Kalipeni, Ezekiel

2017-06-01

This study explores sociocultural and other risk factors associated with unplanned teenage pregnancy in Zomba district of Malawi. Data were obtained from 505 participants under the age of 20 years using a questionnaire administered through face-to-face interviews held at five antenatal clinics. The data were analysed using descriptive statistics, frequency tables and chi-square analysis which allowed comparative understanding of the sociocultural risk factors for planned and unplanned teenage pregnancy in Zomba district. The findings revealed that teenage pregnancy is a major health and social problem. Over 76% of the teenage respondents in the study had experienced unplanned pregnancy. Among the prominent factors that stood out in the analysis for this high rate of teenage pregnancy were early sex and marriage, low contraceptive use, low educational levels, low socio-economic status, lack of knowledge of reproductive and sexual health, gender inequity, and physical/sexual violence. The consequences on teenage mothers of unplanned pregnancy have been tragic and have compromised their physical, psychological and socioeconomic wellbeing, not just on them but also their families and society at large. The findings point to the need for a multi-sectoral approach to tackle the problem on teenage pregnancy in this district, and likely throughout Malawi.

Farmer evaluation of phosphorus fertilizer application to annual legumes in Chisepo, Central Malawi

NARCIS (Netherlands)

Kamanga, B.C.G.; Whitbread, A.M.; Wall, P.; Waddington, S.R.; Almekinders, C.J.M.; Giller, K.E.

2010-01-01

Building from the perception that farmers have an intimate knowledge of their local environment, production problems, crop priorities and criteria for evaluation, an on-farm experiment was conducted with farmers in 2003/4 in Chisepo, central Malawi, to evaluate the response of six annual legumes to

Developing a discrete choice experiment in Malawi: eliciting preferences for breast cancer early detection services

Directory of Open Access Journals (Sweden)

Kohler RE

2015-10-01

Full Text Available Racquel E Kohler,1 Clara N Lee,2 Satish Gopal,3 Bryce B Reeve,1 Bryan J Weiner,1 Stephanie B Wheeler11Department of Health Policy and Management, Gillings School of Global Public Health, 2Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3UNC Project-Malawi, Tidziwe Center, Lilongwe, MalawiBackground: In Malawi, routine breast cancer screening is not available and little is known about women’s preferences regarding early detection services. Discrete choice experiments are increasingly used to reveal preferences about new health services; however, selecting appropriate attributes that describe a new health service is imperative to ensure validity of the choice experiment.Objective: To identify important factors that are relevant to Malawian women’s preferences for breast cancer detection services and to select attributes and levels for a discrete choice experiment in a setting where both breast cancer early detection and choice experiments are rare.Methods: We reviewed the literature to establish an initial list of potential attributes and levels for a discrete choice experiment and conducted qualitative interviews with health workers and community women to explore relevant local factors affecting decisions to use cancer detection services. We tested the design through cognitive interviews and refined the levels, descriptions, and designs.Results: Themes that emerged from interviews provided critical information about breast cancer detection services, specifically, that breast cancer interventions should be integrated into other health services because asymptomatic screening may not be practical as an individual service. Based on participants’ responses, the final attributes of the choice experiment included travel time, health encounter, health worker type and sex, and breast cancer early detection strategy. Cognitive testing confirmed the acceptability of the final attributes

Waxing and Waning of Forests: Late Quaternary Biogeography of Lake Malawi, Southeast Africa

Science.gov (United States)

Ivory, S.; Lézine, A. M.; Vincens, A.; Cohen, A. S.

2014-12-01

African ecosystems are at great risk due to climate and land-use change. Despite the status of several of these regions as biodiversity hotspots, long-standing ideas about African ecology and biogeography have been unable to be tested until now due to lack of sufficiently long records. Here, we present the first long, continuous terrestrial record of vegetation from Lake Malawi, East Africa which goes back to the early Late Quaternary, permitting us to investigate changes in physiognomy and forest composition over many transitions. In this record, we observe eight phases of forest expansion and collapse. Although diversity is much greater during forest phases, composition varies little from phase to phase. Very high abundances of afromontane taxa suggest frequent widespread colonization of the lowlands by modern high elevation trees. Although there are clear successional stages within each forest such that turnover is great within a single phase, among forest samples between phases, there is little dissimilarity. Each forest phase is interrupted by rapid decline of arboreal taxa and expansion of semi-arid grasslands or woodlands whose composition varies greatly from phase to phase. The variable composition of the more open phases, all occurring during arid periods, is likely dynamically linked to thresholds in regional hydrology associated with lake level and moisture recycling within the watershed. This vegetation is unlike any found at Malawi today, with assemblages suggesting strong Somali-Masai affinities. Furthermore, nearly all semi-arid assemblages contain small abundances of forest taxa typically growing in areas with wetter edaphic conditions, suggesting that moist lowland gallery forests were present but restricted to waterways during exceptionally arid times. The waxing and waning of forests throughout this interval has important implications for early human biogeography across Africa as well as disturbance regimes that are crucial for the maintenance of

Perceptions and experiences of community members on caring for preterm newborns in rural Mangochi, Malawi: a qualitative study.

Science.gov (United States)

Gondwe, Austrida; Munthali, Alister C; Ashorn, Per; Ashorn, Ulla

2014-12-02

The number of preterm birth is increasing worldwide, especially in low income countries. Malawi has the highest incidence of preterm birth in the world, currently estimated at 18.1 percent. The aim of this study was to explore the perceived causes of preterm birth, care practices for preterm newborn babies and challenges associated with preterm birth among community members in Mangochi District, southern Malawi. We conducted 14 focus group discussions with the following groups of participants: mothers (n = 4), fathers (n = 6) and grandmothers (n = 4) for 110 participants. We conducted 20 IDIs with mothers to preterm newborns (n = 10), TBAs (n = 6) and traditional healers (n = 4). A discussion guide was used to facilitate the focus group and in-depth interview sessions. Data collection took place between October 2012 and January 2013. We used content analysis to analyze data. Participants mentioned a number of perceptions of preterm birth and these included young and old maternal age, heredity, sexual impurity and maternal illness during pregnancy. Provision of warmth was the most commonly reported component of care for preterm newborns. Participants reported several challenges to caring for preterm newborns such as lack of knowledge on how to provide care, poverty, and the high time burden of care leading to neglect of household, farming and business duties. Women had the main responsibility for caring for preterm newborns. In this community, the reported poor care practices for preterm newborns were associated with poverty and lack of knowledge of how to properly care for these babies at home. Action is needed to address the current care practices for preterm babies among the community members.

Sources of Free and Open Source Spatial Data for Natural Disasters and Principles for Use in Developing Country Contexts

Science.gov (United States)

Taylor, Faith E.; Malamud, Bruce D.; Millington, James D. A.

2016-04-01

Access to reliable spatial and quantitative datasets (e.g., infrastructure maps, historical observations, environmental variables) at regional and site specific scales can be a limiting factor for understanding hazards and risks in developing country settings. Here we present a 'living database' of >75 freely available data sources relevant to hazard and risk in Africa (and more globally). Data sources include national scientific foundations, non-governmental bodies, crowd-sourced efforts, academic projects, special interest groups and others. The database is available at http://tinyurl.com/africa-datasets and is continually being updated, particularly in the context of broader natural hazards research we are doing in the context of Malawi and Kenya. For each data source, we review the spatiotemporal resolution and extent and make our own assessments of reliability and usability of datasets. Although such freely available datasets are sometimes presented as a panacea to improving our understanding of hazards and risk in developing countries, there are both pitfalls and opportunities unique to using this type of freely available data. These include factors such as resolution, homogeneity, uncertainty, access to metadata and training for usage. Based on our experience, use in the field and grey/peer-review literature, we present a suggested set of guidelines for using these free and open source data in developing country contexts.

Barriers to Uptake of Conservation Agriculture in southern Africa: Multi-level Analyses from Malawi

Science.gov (United States)

Dougill, Andrew; Stringer, Lindsay; Whitfield, Stephen; Wood, Ben; Chinseu, Edna

2015-04-01

Conservation agriculture is a key set of actions within the growing body of climate-smart agriculture activities being advocated and rolled out across much of the developing world. Conservation agriculture has purported benefits for environmental quality, food security and the sustained delivery of ecosystem services. In this paper, new multi-level analyses are presented, assessing the current barriers to adoption of conservation agriculture practices in Malawi. Despite significant donor initiatives that have targeted conservation agriculture projects, uptake rates remain low. This paper synthesises studies from across 3 levels in Malawi: i.) national level- drawing on policy analysis, interviews and a multi-stakeholder workshop; ii.) district level - via assessments of development plans and District Office and extension service support, and; iii) local level - through data gained during community / household level studies in Dedza District that have gained significant donor support for conservation agriculture as a component of climate smart agriculture initiatives. The national level multi-stakeholder Conservation Agriculture workshop identified three areas requiring collaborative research and outlined routes for the empowerment of the National Conservation Agriculture Task Force to advance uptake of conservation agriculture and deliver associated benefits in terms of agricultural development, climate adaptation and mitigation. District level analyses highlight that whilst District Development Plans are now checked against climate change adaptation and mitigation criteria, capacity and knowledge limitations exist at the District level, preventing project interventions from being successfully up-scaled. Community level assessments highlight the need for increased community participation at the project-design phase and identify a pressing requirement for conservation agriculture planning processes (in particular those driven by investments in climate

Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation.

Science.gov (United States)

Lubinga, Solomon J; Jenny, Alisa M; Larsen-Cooper, Erin; Crawford, Jessica; Matemba, Charles; Stergachis, Andy; Babigumira, Joseph B

2014-10-11

Access to essential medicines is core to saving lives and improving health outcomes of people worldwide, particularly in the low- and middle-income countries. Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes. This study measures the impact of an innovative pharmacy assistant training program in the low-income country of Malawi on access to medicines and health outcomes. We employ a cluster quasi-experimental design with pre-and post-samples and decision analytic modeling to examine access to and the use of medicines for malaria, pneumonia, and diarrhea for children less than 5 years of age. Two intervention districts, with newly trained and deployed pharmacy assistants, and two usual care comparison districts, matched on socio-economic, geographic, and health-care utilization indicators, were selected for the study. A baseline household survey was conducted in March 2014, prior to the deployment of pharmacy assistants to the intervention district health centers. Follow-up surveys are planned at 12- and 24-months post-deployment. In addition, interviews are planned with caregivers, and time-motion studies will be conducted with health-care providers at the health centers to estimate costs and resources use. This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five. The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

Cost-effectiveness and affordability of community mobilisation through women's groups and quality improvement in health facilities (MaiKhanda trial) in Malawi.

Science.gov (United States)

Colbourn, Tim; Pulkki-Brännström, Anni-Maria; Nambiar, Bejoy; Kim, Sungwook; Bondo, Austin; Banda, Lumbani; Makwenda, Charles; Batura, Neha; Haghparast-Bidgoli, Hassan; Hunter, Rachael; Costello, Anthony; Baio, Gianluca; Skordis-Worrall, Jolene

2015-01-01

Understanding the cost-effectiveness and affordability of interventions to reduce maternal and newborn deaths is critical to persuading policymakers and donors to implement at scale. The effectiveness of community mobilisation through women's groups and health facility quality improvement, both aiming to reduce maternal and neonatal mortality, was assessed by a cluster randomised controlled trial conducted in rural Malawi in 2008-2010. In this paper, we calculate intervention cost-effectiveness and model the affordability of the interventions at scale. Bayesian methods are used to estimate the incremental cost-effectiveness of the community and facility interventions on their own (CI, FI), and together (FICI), compared to current practice in rural Malawi. Effects are estimated with Monte Carlo simulation using the combined full probability distributions of intervention effects on stillbirths, neonatal deaths and maternal deaths. Cost data was collected prospectively from a provider perspective using an ingredients approach and disaggregated at the intervention (not cluster or individual) level. Expected Incremental Benefit, Cost-effectiveness Acceptability Curves and Expected Value of Information (EVI) were calculated using a threshold of $780 per disability-adjusted life-year (DALY) averted, the per capita gross domestic product of Malawi in 2013 international $. The incremental cost-effectiveness of CI, FI, and combined FICI was $79, $281, and $146 per DALY averted respectively, compared to current practice. FI is dominated by CI and FICI. Taking into account uncertainty, both CI and combined FICI are highly likely to be cost effective (probability 98% and 93%, EVI $210,423 and $598,177 respectively). Combined FICI is incrementally cost effective compared to either intervention individually (probability 60%, ICER $292, EIB $9,334,580 compared to CI). Future scenarios also found FICI to be the optimal decision. Scaling-up to the whole of Malawi, CI is of greatest

Women's views on consent, counseling and confidentiality in PMTCT : a mixed-methods study in four African countries

OpenAIRE

Hardon, A.; Vernooij, E.; Bongololo-Mbera, G.; Cherutich, P.; Desclaux, Alice; Kyaddondo, D.; Ky-Zerbo, O.; Neuman, M.; Wanyenze, R.; Obermeyer, C.

2012-01-01

Abstract Background Ambitious UN goals to reduce the mother-to-child transmission of HIV have not been met in much of Sub-Saharan Africa. This paper focuses on the quality of information provision and counseling and disclosure patterns in Burkina Faso, Kenya, Malawi and Uganda to identify how services can be improved to enable better PMTCT outcomes. Methods Our mixed-methods study draws on data obtained through: (1) the MATCH (Multi-country African Testing and Counseling for HIV) study's main...

Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi Male Motivator project.

Science.gov (United States)

Shattuck, Dominick; Kerner, Brad; Gilles, Kate; Hartmann, Miriam; Ng'ombe, Thokozani; Guest, Greg

2011-06-01

We examined the effect of a peer-delivered educational intervention, the Malawi Male Motivator intervention, on couples' contraceptive uptake. We based the intervention design on the information-motivation-behavioral skills (IMB) model. In 2008 we recruited 400 men from Malawi's Mangochi province who reported not using any method of contraception. We randomized them into an intervention arm and a control arm, and administered surveys on contraceptive use at baseline and after the intervention. We also conducted in-depth interviews with a subset of intervention participants. After the intervention, contraceptive use increased significantly within both arms (P communication within couples were the only significant predictors of uptake (P communication skills are essential mechanisms for successfully enabling men to help couples use a contraceptive.

Is Fish Farming an Illusion for Lake Malawi Riparian Communities under Environmental Changes?

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Moses Majid Limuwa

2018-05-01

Full Text Available Global environmental changes have negatively affected many food systems while the demand for food has continued to rise. An urgent need exists to identify other sustainable means of producing food. This is a case in Malawi, where capture fisheries and agriculture are not supplying sufficient food. Fish farming food systems by communities who rely on inland fisheries have not been evaluated. Therefore, a study was conducted in two phases: January 2016 to May 2016 and in July 2017 to evaluate if fish farming could sustainably support livelihoods of Lake Malawi riparian communities. We used mixed methods to collect and analyze data. The data collection methods included explorative surveys, household survey interviews, focus group discussion and key informant interviews. Qualitative data was analyzed using content analysis for themes. This identified themes that were quantitatively analyzed using descriptive and inferential statistics. We observed that fish farming was dominated by men and also not the main occupation for the respondents despite owning fishponds. The respondents have water and land, which are prerequisite for any farming. The study also observed fish farming production challenges related to quality fingerlings, formulated diets, and extension services. Cases of food insecurity amongst the respondents were also prevalent due to lack of food to cover the entire year. Weak synergies existed between fish farming and agriculture restricting bio-resource flow and water usage between these two food systems, meaning the outcomes of the food systems provide unsustainable diets. Furthermore, water availability, money spent on food, and cassava cropping increased fish farming participation. Whereas operating a bicycle taxi, casual labor, former fish farming, as well as application of agricultural wastes negatively affected fish farming. On the other hand, extreme weather events (increased incidences of droughts and floods attributed to inter

Burden of leprosy in Malawi: community camp-based cross-sectional study

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Msyamboza Kelias P

2012-08-01

Full Text Available Abstract Background Although leprosy was eliminated globally in 2000, the disease continues to be the significant cause of peripheral neuropathy, disability and disfigurement in some developing countries. However, recent population-based prevalence data are lacking to inform evidence-based renewed commitment for the final push for leprosy elimination at national and sub-national levels. Methods Community camp-based cross-sectional descriptive study was conducted in four selected districts. World Health Organisation guidelines and tools for leprosy elimination monitoring were used to evaluate the Malawi National Leprosy Programme. Results A total of 6,338 people (60% females, 35% children aged less than 15 years were examined for leprosy and other skin diseases. Prevalence of skin diseases was 18%, the commonest being fungal (9%, eczema/dermatitis (3% and leprosy (1%. Of the fungal skin conditions, pityriasis versicolor and Tinea capatis were the commonest (22% and 21% respectively then Tinea corporis (9%, Tinea cruris (6% and Tinea pedis (2%. A total of 66 leprosy cases were detected out of 6,338 people screened giving a prevalence of 104.1 per 10,000 population (range by district 67.1 to 194.1. Of the leprosy cases, 37 were new, 6 were defaulters and 23 were on treatment, 30 were females and 9 were children aged less than 15 years old. Of the 37 new leprosy cases, 9 (24.3% were children, 25 (67.6% had 1–5 leprosy lesions and 8 (21.6% had grade 2 disability. The most frequent location of leprosy lesions was the head and neck (24.1%, arms (24.1%, chest (17.2%, legs (13.8%, back (13.8% and abdomen (7.0%. Between 2006 and 2011, trends of leprosy prevalence and detection increased, prevalence/detection ratios were over 1 and cure rates by cohort analysis of 2009 multibacillary and 2010 paucibacillary cases were 33% and 63% respectively far below the expected 80% although the national prevalence remained at less than 1 case per 10

Real Effective Exchange Rate Dynamics in Malawi and South Africa

OpenAIRE

Kisu Simwaka

2004-01-01

This study investigates the main determinants of real effective exchange rate in Malawi and South Africa. In our empirical analysis, we conducted unit root and cointegration test in order to determine the time series properties of the data and establish whether there is a long run relationship between real effective exchange rate and explanatory variables. Having ascertained that almost all variiables are integrated of order one and cointegrated, an error correction model is formulated and es...

Where Did it Go Wrong? Marriage and Divorce in Malawi

OpenAIRE

Cherchye, Laurens; Rock, Bram; Walther, Selma; Vermeulen, Frederic

2016-01-01

textabstractDo individuals divorce for economic reasons? Can we measure the attractiveness of new matches in the marriage market? We answer these questions using a structural model of the household and a rich panel dataset from Malawi. We propose a model of the household with consumption, production and revealed preference conditions for stability on the marriage market. We define marital instability in terms of the consumption gains to remarrying another individual in the same marriage marke...

Integrated tick and tick-borne disease control trials in crossbred dairy cattle in Malawi

DEFF Research Database (Denmark)

Tjørnehøj, Kirsten; Whiteland, A. P.; Mfitilodze, M. W.

1996-01-01

Crossbred dairy heifers on a farm in an East Coast fever (ECF) endemic area in Malawi were immunised against Theileria parva, Anaplasma spp., Babesia bigemina, Babesia bovis and Cowdria ruminantium. They were treated at infrequent intervals with chlorfenvinphos to limit infestation with adult tic...

Maternal biomass smoke exposure and birth weight in Malawi: Analysis of data from the 2010 Malawi Demographic and Health Survey.

Science.gov (United States)

Milanzi, Edith B; Namacha, Ndifanji M

2017-06-01

Use of biomass fuels has been shown to contribute to ill health and complications in pregnancy outcomes such as low birthweight, neonatal deaths and mortality in developing countries. However, there is insufficient evidence of this association in the Sub-Saharan Africa and the Malawian population. We, therefore, investigated effects of exposure to biomass fuels on reduced birth weight in the Malawian population. We conducted a cross-sectional analysis using secondary data from the 2010 Malawi Demographic Health Survey with a total of 9124 respondents. Information on exposure to biomass fuels, birthweight, and size of child at birth as well as other relevant information on risk factors was obtained through a questionnaire. We used linear regression models for continuous birth weight outcome and logistic regression for the binary outcome. Models were systematically adjusted for relevant confounding factors. Use of high pollution fuels resulted in a 92 g (95% CI: -320.4; 136.4) reduction in mean birth weight compared to low pollution fuel use after adjustment for child, maternal as well as household characteristics. Full adjusted OR (95% CI) for risk of having size below average at birth was 1.29 (0.34; 4.48). Gender and birth order of child were the significant confounders factors in our adjusted models. We observed reduced birth weight in children whose mothers used high pollution fuels suggesting a negative effect of maternal exposure to biomass fuels on birth weight of the child. However, this reduction was not statistically significant. More carefully designed studies need to be carried out to explore effects of biomass fuels on pregnancy outcomes and health outcomes in general.

Present status of uranium resource development in foreign countries, 1984

International Nuclear Information System (INIS)

1984-12-01

The book of the same title as this one was published in 1983. Since then, the situation requiring the correction of the contents, such as the correction of uranium resource policy in various countries accompanying the change of uranium market condition and the change of uranium policy in Australia due to the political situation, has occurred, consequently, the revision has been made adding these new information. The confirmed resources of uranium and the resources of uranium to be added by estimation in the free world are tabulated. About each country, the organization and policy, the policy of exporting uranium and the present status of the export, the quantity of uranium resources, the production of uranium, the state of exploration and development and so on are reported. Japan has taken part in the development of uranium resources in Australia, Canada, Gabon, Zambia, Morocco, Guinea, Mali and so on. (Kako, I.)

Lizzie Shumba, Malawi Intégrer la recherche au travail des ...

International Development Research Centre (IDRC) Digital Library (Canada)

9 déc. 2010 ... Des chercheurs du Malawi et du Canada — spécialistes de l'agriculture, de la nutrition et des sciences sociales —ont collaboré avec le personnel de l'hôpital et des agriculteurs pour trouver les légumineuses les plus adéquates. Ce projet, que le CRDI appuie depuis 2001, a amélioré la nutrition, des ...

Mainstreaming conservation agriculture in Malawi: Knowledge gaps and institutional barriers.

Science.gov (United States)

Dougill, Andrew J; Whitfield, Stephen; Stringer, Lindsay C; Vincent, Katharine; Wood, Benjamin T; Chinseu, Edna L; Steward, Peter; Mkwambisi, David D

2017-06-15

Conservation agriculture (CA) practices of reduced soil tillage, permanent organic soil coverage and intercropping/crop rotation, are being advocated globally, based on perceived benefits for crop yields, soil carbon storage, weed suppression, reduced soil erosion and improved soil water retention. However, some have questioned their efficacy due to uncertainty around the performance and trade-offs associated with CA practices, and their compatibility with the diverse livelihood strategies and varied agro-ecological conditions across African smallholder systems. This paper assesses the role of key institutions in Malawi in shaping pathways towards more sustainable land management based on CA by outlining their impact on national policy-making and the design and implementation of agricultural development projects. It draws on interviews at national, district and project levels and a multi-stakeholder workshop that mapped the institutional landscape of decision-making for agricultural land management practices. Findings identify knowledge gaps and institutional barriers that influence land management decision-making and constrain CA uptake. We use our findings to set out an integrated roadmap of research needs and policy options aimed at supporting CA as a route to enhanced sustainable land management in Malawi. Findings offer lessons that can inform design, planning and implementation of CA projects, and identify the multi-level institutional support structures required for mainstreaming sustainable land management in sub-Saharan Africa. Copyright © 2016 Elsevier Ltd. All rights reserved.

Present state of research and development of atomic energy in five Asian countries

Energy Technology Data Exchange (ETDEWEB)

1981-01-01

The survey group for Asian atomic energy cooperation was dispatched by the Japanese government, and toured Philippines, Indonesia, Malaysia, Thailand and Bangladesh from September 7 to 19, 1980. The present state of atomic energy development and the energy situation in respective countries were surveyed through the exchange of opinion and the inspection of related facilities. The Regional Cooperative Agreement for Research, Development and Training Related to Nuclear Science and Technology was concluded in June, 1972, and 12 countries have participated in it. It was impressive that respective countries have the peculiar energy policies corresponding to their objective conditions. They regard atomic energy as the important substitute energy for petroleum, but the fear about the safety of atomic energy and the movement against nuclear power generation have been growing considerably. The research and development on atomic energy are carried out very actively in respective countries, and the construction of large-scale research centers was commenced in Indonesia, Malaysia and Bangladesh. Research reactors have been operated in Philippines, Indonesia and Thailand since about 20 years ago, and the utilization of radioisotopes and radiation has been studied. The cooperation of Japan with these countries is far behind that of other advanced countries.

Active intra-basin faulting in the Northern Basin of Lake Malawi from seismic reflection data

Science.gov (United States)

Shillington, D. J.; Chindandali, P. R. N.; Scholz, C. A.; Ebinger, C. J.; Onyango, E. A.; Peterson, K.; Gaherty, J. B.; Nyblade, A.; Accardo, N. J.; McCartney, T.; Oliva, S. J.; Kamihanda, G.; Ferdinand, R.; Salima, J.; Mruma, A. H.

2016-12-01

Many questions remain about the development and evolution of fault systems in weakly extended rifts, including the relative roles of border faults and intra-basin faults, and segmentation at various scales. The northern Lake Malawi (Nyasa) rift in the East African Rift System is an early stage rift exhibiting pronounced tectonic segmentation, which is defined by 100-km-long border faults. The basins also contain a series of intrabasinal faults and associated synrift sediments. The occurrence of the 2009 Karonga Earthquake Sequence on one of these intrabasinal faults indicates that some of them are active. Here we present new multichannel seismic reflection data from the Northern Basin of the Malawi Rift collected in 2015 as a part of the SEGMeNT (Study of Extension and maGmatism in Malawi aNd Tanzania) project. This rift basin is bound on its east side by the west-dipping Livingstone border fault. Over 650 km of seismic reflection profiles were acquired in the Northern Basin using a 500 to 1540 cu in air gun array and a 1200- to 1500-m seismic streamer. Dip lines image a series of north-south oriented west-dipping intra-basin faults and basement reflections up to 5 s twtt near the border fault. Cumulative offsets on intra-basin faults decrease to the west. The largest intra-basin fault has a vertical displacement of >2 s two-way travel time, indicating that it has accommodated significant total extension. Some of these intra-basin faults offset the lake bottom and the youngest sediments by up to 50 s twtt ( 37 m), demonstrating they are still active. The two largest intra-basin faults exhibit the largest offsets of young sediments and also correspond to the area of highest seismicity based on analysis of seismic data from the 89-station SEGMeNT onshore/offshore network (see Peterson et al, this session). Fault patterns in MCS profiles vary along the basin, suggesting a smaller scale of segmentation of faults within the basin; these variations in fault patterns

An Assessment of Peri-Urban Groundwater Quality from Shallow Dug Wells, Mzuzu, Malawi

Science.gov (United States)

Holm, R.; Felsot, A.

2012-12-01

Throughout Malawi, governmental, non-governmental, religious and civic organizations are targeting the human need for water. Diarrheal diseases, often associated with unsafe drinking water, are a leading cause of mortality in children under five in Malawi with over 6,000 deaths per year (World Health Organization, 2010). From January to March 2012, a field study was undertaken in Malawi to study water quality and develop a public health risk communication strategy. The region studied, Area 1B, represents a comparatively new peri-urban area on the edge of Mzuzu city. Area 1B is serviced by a piped municipal water supply, but many shallow dug wells are also used for household water. Groundwater samples were collected from 30 shallow dug well sites and analyzed for nitrate, total coliform, Escherichia coli, total hardness, total alkalinity and pH. In addition to water quality analyses, a structured household questionnaire was administered to address water use, sanitation, health, consumption patterns, and socioeconomics. Results showed that more than half of the groundwater samples would be considered of unacceptable quality based on World Health Organization (WHO) standards for E. coli contamination. Low levels of nitrate were found in groundwater, but only one well exceeded WHO standards. The structured questionnaire revealed that some residents were still consuming groundwater despite the access to safer municipal water. In general, the widespread E. coli contamination was not statistically correlated with well depth, latrine proximity, or surface features. Similarly, nitrate concentrations were not significantly correlated with proximity to latrines. On the other hand, nitrate was correlated with well depth, which is expected given the high potential for leaching of anionic highly water soluble compounds. E. coli was significantly correlated with nitrate concentration. Projects targeting the need for clean water need to recognize that households with access to a

Undergraduate physiotherapy education in Malawi--the views of students on disability.

Science.gov (United States)

Amosun, S; Kambalametore, S; Maart, S; Ferguson, G

2013-06-01

The College of Medicine in Malawi offers an undergraduate physiotherapy programme which started in 2010. The programme aims at training competent physiotherapists who can address the needs of people with disabilities. Therefore it is important to ensure that the perceptions of physiotherapy students towards disability are appropriate. The study explored the views of the first cohort of physiotherapy students (n=19) in the pre-medical class in the College of Medicine, University of Malawi, on disability. An audit of the views of premedical physiotherapy students was carried out in 2010 using the Q methodology. Two independent factors emerged which captured the views of 19 students on disability. Most of the views expressed suggest that the students empathised with people with disabilities. Participants perceived that people with disabilities can have a good quality of life like everyone else, and are as intelligent as people without disabilities. However, some participants also expressed some discomfort when around people with disabilities. While there was consensus on some positive views, the negative viewpoints have the potential to act as a barrier to the rehabilitation of people with disabilities. The curriculum should ensure that the positive views are reinforced throughout the training programme, while the negative viewpoints are reversed.

Health Care Factors Influencing Teen Mothers' Use Of Contraceptives in Malawi.

Science.gov (United States)

Machira, Kennedy; Palamuleni, Martin E

2017-06-01

The study seeks to examine factors associated with teen mothers' use of modern contraceptives after giving birth. The 2010 Malawi Demographic and Health Survey data was used to test the study objective. A sample of 12, 911 teen mothers aged between 10 and 18 years were extracted from 23, 020 women and were asked of contraceptive usage after first birth experiences, in which, a logistic regression model was employed to estimate correlates of contraceptive usage. The study found that 54.8% of the teen mothers are still at a risk of having a repeat teenage pregnancy due to their non-use of contraceptives. This implies that less than 50% of teen mothers use contraceptives after experiencing teen birth. It is noted that health care factors such as use of antenatal care, awareness of pregnancy complications, attainment of primary education and exposure to media predict teen mothers' use of modern contraceptives. Despite endeavours made by government to improve access to family planning, health care challenges still exist affecting women's use of contraceptives in Malawi. Ameliorating these health encounters call for wide-range approaches aimed at addressing teen birth comprehensively in order to prevent early motherhood and subsequently high fertility. None declared.

Feasibility and acceptability of oral cholera vaccine mass vaccination campaign in response to an outbreak and floods in Malawi.

Science.gov (United States)

Msyamboza, Kelias Phiri; M'bang'ombe, Maurice; Hausi, Hannah; Chijuwa, Alexander; Nkukumila, Veronica; Kubwalo, Hudson Wenji; Desai, Sachin; Pezzoli, Lorenzo; Legros, Dominique

2016-01-01

Despite some improvement in provision of safe drinking water, proper sanitation and hygiene promotion, cholera still remains a major public health problem in Malawi with outbreaks occurring almost every year since 1998. In response to 2014/2015 cholera outbreak, ministry of health and partners made a decision to assess the feasibility and acceptability of conducting a mass oral cholera vaccine (OCV) as an additional public health measure. This paper highlights the burden of the 2014/15 cholera outbreak, successes and challenges of OCV campaign conducted in March and April 2015. This was a documentation of the first OCV campaign conducted in Malawi. The campaign targeted over 160,000 people aged one year or more living in 19 camps of people internally displaced by floods and their surrounding communities in Nsanje district. It was a reactive campaign as additional measure to improved water, sanitation and hygiene in response to the laboratory confirmed cholera outbreak. During the first round of the OCV campaign conducted from 30 March to 4 April 2015, a total of 156,592 (97.6%) people out of 160,482 target population received OCV. During the second round (20 to 25 April 2015), a total of 137,629 (85.8%) people received OCV. Of these, 108,247 (67.6%) people received their second dose while 29,382 (18.3%) were their first dose. Of the 134,836 people with known gender and sex who received 1 or 2 doses, 54.4% were females and over half (55.4%) were children under the age of 15 years. Among 108,237 people who received 2 doses (fully immunized), 54.4% were females and 51.9% were children under 15 years of age. No severe adverse event following immunization was reported. The main reason for non-vaccination or failure to take the 2 doses was absence during the period of the campaign. This documentation has demonstrated that it was feasible, acceptable by the community to conduct a large-scale mass OCV campaign in Malawi within five weeks. Of 320,000 OCV doses received

"My House Is the Hospital": Housing and Health and Wellbeing among Persons Living with HIV/AIDS in Northern Malawi.

Science.gov (United States)

Mkandawire, Paul; Arku, Godwin; Atari, Odwa; Madut, Kon; Luginaah, Isaac; Dixon, Jenna

2015-11-01

This paper reports findings of a qualitative study and draws on the political ecology of health framework to examine the links between housing and health among people living with HIV/AIDS (PLWAs) in Northern Malawi in a wider context in which the epidemic has overburdened the country's hospitals, thereby transferring the responsibility for care from government to families. The findings suggest that poor housing conditions, rooted in colonial and postcolonial policy failure, may undermine the amount, as well as the quality, of palliative care available to PLWAs. It was also found that the high cost of renting, discrimination, and poor landlord-tenant relationships imposed significant financial and emotional burden on PLWAs, thereby undermining their ability to meet dietary needs, stay healthy, and adhere to treatment. Furthermore, customary norms around property inheritance hampered women's housing security and their ability to cope with the disease. The paper concludes by making relevant policy recommendations.

Impact and economic evaluation of a novel HIV service delivery model in rural Malawi.

Science.gov (United States)

McBain, Ryan K; Petersen, Elizabeth; Tophof, Nora; Dunbar, Elizabeth L; Kalanga, Noel; Nazimera, Lawrence; Mganga, Andrew; Dullie, Luckson; Mukherjee, Joia; Wroe, Emily B

2017-09-10

We performed an impact and cost-effectiveness analysis of a novel HIV service delivery model in a high prevalence, remote district of Malawi with a population of 143 800 people. A population-based retrospective analysis of 1-year survival rates among newly enrolled HIV-positive patients at 682 health facilities throughout Malawi, comparing facilities implementing the service delivery model (n = 13) and those implementing care-as-usual (n = 669). Through district-level health surveillance data, we evaluated 1-year survival rates among HIV patients newly enrolled between July 2013 and June 2014 - representing 129 938 patients in care across 682 health facilities - using a multilevel modeling framework. The model, focused on social determinants of health, was implemented throughout Neno District at 13 facilities and compared with facilities in all other districts. Activity-based costing was used to annualize financial and economic costs from a societal perspective. Incremental cost-effectiveness ratios were expressed as quality-adjusted life-years gained. The national average 1-year survival rate for newly enrolled antiretroviral therapy clients was 78.9%: this rate was 87.9% in Neno District, compared with 78.8% across all other districts in Malawi (P cost of receiving care in Neno district (n = 6541 patients) was $317/patient/year, compared with an estimated $219/patient in other districts. This translated to $906 per quality-adjusted life-year gained. Neno District's comprehensive model of care, featuring a strong focus on the community, is $98 more expensive per capita per annum but demonstrates superior 1-year survival rates, despite its remote location. Moreover, it should be considered cost-effective by traditional international standards.

Medical imaging education in africa: Past, present and future

International Nuclear Information System (INIS)

Vries de, W.

2006-01-01

What started as a one person activity is grown to a successful company branch with two person's staff and about twenty part-time teachers, curriculum experts and IT experts. The success of Fontys activities is due to the introduction of new didactical teacher-skills, re-curriculation, skill-labs and communication facilities. In this presentation the Fontys activities in the past as well as in the present in Kenya, Malawi, Tanzania, Ghana, Zambia and Uganda will pass by

Present and future of bioleaching in developing countries

OpenAIRE

Acevedo, Fernando

2002-01-01

Nowadays bioleaching occupies an increasingly important place among the available mining technologies. Today bioleaching is no longer a promising technology but an actual economical alternative for treating specific mineral ores. An important number of the current large-scale bioleaching operations are located in developing countries. This situation is determined by the fact that several developing countries have significant mineral reserves and by the characteristics of bioleaching that make...

A Lactobacillus-Deficient Vaginal Microbiota Dominates Postpartum Women in Rural Malawi

Science.gov (United States)

2018-01-01

ABSTRACT The bacterial community found in the vagina is an important determinant of a woman's health and disease status. A healthy vaginal microbiota is associated with low species richness and a high proportion of one of a number of different Lactobacillus spp. When disrupted, the resulting abnormal vaginal microbiota is associated with a number of disease states and poor pregnancy outcomes. Studies up until now have concentrated on relatively small numbers of American and European populations that may not capture the full complexity of the community or adequately predict what constitutes a healthy microbiota in all populations. In this study, we sampled and characterized the vaginal microbiota found on vaginal swabs taken postpartum from a cohort of 1,107 women in rural Malawi. We found a population dominated by Gardnerella vaginalis and devoid of the most common vaginal Lactobacillus species, even if the vagina was sampled over a year postpartum. This Lactobacillus-deficient anaerobic community, commonly labeled community state type (CST) 4, could be subdivided into four further communities. A Lactobacillus iners-dominated vaginal microbiota became more common the longer after delivery the vagina was sampled, but G. vaginalis remained the dominant organism. These results outline the difficulty in all-encompassing definitions of what a healthy or abnormal postpartum vaginal microbiota is. Previous identification of community state types and associations among bacterial species, bacterial vaginosis, and adverse birth outcomes may not represent the complex heterogeneity of the microbiota present. (This study has been registered at ClinicalTrials.gov as NCT01239693.) IMPORTANCE A bacterial community in the vaginal tract is dominated by a small number of Lactobacillus species, and when not present there is an increased incidence of inflammatory conditions and adverse birth outcomes. A switch to a vaginal bacterial community lacking in Lactobacillus species is common

Lactobacillus-deficient vaginal microbiota dominate post-partum women in rural Malawi.

Science.gov (United States)

Doyle, Ronan; Gondwe, Austridia; Fan, Yue-Mei; Maleta, Kenneth; Ashorn, Per; Klein, Nigel; Harris, Kathryn

2018-01-05

The bacterial community found in the vagina is an important determinant of a woman's health and disease. A healthy vaginal microbiota is associated with a lower species richness and high proportions of one of a number of different Lactobacillus spp.. When disrupted the resulting abnormal vaginal microbiota is associated with a number of disease states and poor pregnancy outcomes. Studies up until now have concentrated on relatively small numbers of American and European populations which may not capture the full complexity of the community, nor adequately predict what constitutes a healthy microbiota in all populations. In this study we sampled and characterised the vaginal microbiota from a cohort of 1107 women in rural Malawi found on vaginal swabs taken post-partum. We found a population dominated by Gardnerella vaginalis and devoid of the most common vaginal Lactobacillus species, even if the vagina was sampled over a year post-partum. The Lactobacillus -deficient anaerobic community commonly labelled community state type (CST) 4 could be sub-divided into four further communities. A Lactobacillus iners dominated vaginal microbiota became more common the longer after delivery the vagina was sampled, but G. vaginalis remained the dominant organism. These results outline the difficulty in all-encompassing definitions of what a healthy or abnormal vaginal microbiota is post-partum. Previous identification of community state types and associations between bacterial species, bacterial vaginosis and adverse birth outcomes may not represent the complex heterogeneity of the microbiota present. Importance A bacterial community in the vaginal tract that is dominated by small number of bacterial Lactobacillus species and when they are not present, there is a greater incidence of inflammatory conditions and adverse birth outcomes. A switch to a vaginal bacterial community lacking in Lactobacillus species is common after pregnancy. In this study we characterised the vaginal

76 FR 21044 - Notice of Entering Into a Compact With the Republic of Malawi

Science.gov (United States)

2011-04-14

... Malawi in connection with the Program, (ii) sales tax, value added tax, excise tax, property transfer tax... Resources; Budget Section 2.7 Limitations of the Use of MCC Funding Section 2.8 Taxes Article 3... means of family planning. Section 2.8 Taxes (a) Unless the Parties specifically agree otherwise in...

Use of short tandem repeat sequences to study Mycobacterium leprae in leprosy patients in Malawi and India.

Directory of Open Access Journals (Sweden)

Saroj K Young

2008-04-01

Full Text Available Inadequate understanding of the transmission of Mycobacterium leprae makes it difficult to predict the impact of leprosy control interventions. Genotypic tests that allow tracking of individual bacterial strains would strengthen epidemiological studies and contribute to our understanding of the disease.Genotyping assays based on variation in the copy number of short tandem repeat sequences were applied to biopsies collected in population-based epidemiological studies of leprosy in northern Malawi, and from members of multi-case households in Hyderabad, India. In the Malawi series, considerable genotypic variability was observed between patients, and also within patients, when isolates were collected at different times or from different tissues. Less within-patient variability was observed when isolates were collected from similar tissues at the same time. Less genotypic variability was noted amongst the closely related Indian patients than in the Malawi series.Lineages of M. leprae undergo changes in their pattern of short tandem repeat sequences over time. Genetic divergence is particularly likely between bacilli inhabiting different (e.g., skin and nerve tissues. Such variability makes short tandem repeat sequences unsuitable as a general tool for population-based strain typing of M. leprae, or for distinguishing relapse from reinfection. Careful use of these markers may provide insights into the development of disease within individuals and for tracking of short transmission chains.

School and Community Screening Shows Malawi, Africa, to Have a High Prevalence of Latent Rheumatic Heart Disease.

Science.gov (United States)

Sims Sanyahumbi, Amy; Sable, Craig A; Beaton, Andrea; Chimalizeni, Yamikani; Guffey, Danielle; Hosseinipour, Mina; Karlsten, Melissa; Kazembe, Peter N; Kennedy, Neil; Minard, Charles G; Penny, Daniel J

2016-12-01

Rheumatic heart disease (RHD) is the largest cardiac cause of morbidity and mortality in the world's youth. Early detection of RHD through echocardiographic screening in asymptomatic children may identify an early stage of disease, when secondary prophylaxis has the greatest chance of stopping disease progression. Latent RHD signifies echocardiographic evidence of RHD with no known history of acute rheumatic fever and no clinical symptoms. Determine the prevalence of latent RHD among children ages 5-16 in Lilongwe, Malawi. This is a cross-sectional study in which children ages 5 through 16 were screened for RHD using echocardiography. Screening was conducted in 3 schools and surrounding communities in the Lilongwe district of Malawi between February and April 2014. Children were diagnosed as having no, borderline, or definite RHD as defined by World Heart Federation criteria. The primary reader completed offline reads of all studies. A second reader reviewed all of the studies diagnosed as RHD, plus a selection of normal studies. A third reader served as tiebreaker for discordant diagnoses. The distribution of results was compared between gender, location, and age categories using Fisher's exact test. The prevalence of latent RHD was 3.4% (95% CI = 2.45, 4.31), with 0.7% definite RHD and 2.7% borderline RHD. There was no significant differences in prevalence between gender (P = .44), site (P = .6), urban vs. peri-urban (P = .75), or age (P = .79). Of those with definite RHD, all were diagnosed because of pathologic mitral regurgitation (MR) and 2 morphologic features of the mitral valve. Of those with borderline RHD, most met the criteria by having pathological MR (92.3%). Malawi has a high rate of latent RHD, which is consistent with other results from sub-Saharan Africa. This study strongly supports the need for a RHD prevention and control program in Malawi. © 2016 Wiley Periodicals, Inc.

Elitist Land and Agriculture Policies and the Food Problem in Malawi

OpenAIRE

Kalonga Stambuli

2002-01-01

The author argues that conversion of over 1 million hectares of customary land to leasehold land tenure merely endowed the elite with excessive landholdings they did not fully utilise for tobacco production because it exceeded the requirement for production of the quota of tobacco output allocated to Malawi. However, as a result of population growth food demands exceeded the carrying capacity of household land whose quality also diminished resulting in steep decline in food productivity. The ...

Dynamics of real effective exchange rate in Malawi and South Africa

OpenAIRE

Kisukyabo Simwaka

2004-01-01

This study investigates the main determinants of real effective exchange rate in Malawi and South Africa. In our empirical analysis, we conducted unit root and cointegration test in order to determine the time series properties of the data and establish whether there is a long run relationship between real effective exchange rate and explanatory variables. Having ascertained that almost all variables are integrated of order one and cointegrated, an error correction model is formulated and est...

The difficulty with responding to policy changes for HIV and infant feeding in Malawi

Directory of Open Access Journals (Sweden)

de Paoli Marina

2010-10-01

Full Text Available Abstract Background When and how to wean breastfed infants exposed to HIV infection has provoked extensive debate, particularly in low-income countries where safe alternatives to breastfeeding are rarely available. Although there is global consensus on optimal infant-feeding practices in the form of guidelines, practices are sub-optimal in much of sub-Saharan Africa. Policy-makers and health workers face many challenges in adapting and implementing these guidelines. Methods This paper is based on in-depth interviews with five policy-makers and 11 providers of interventions to prevent mother-to-child transmission (PMTCT of HIV, participant observations during clinic sessions and site visits. Results The difficulties with adapting the global infant-feeding guidelines in Malawi have affected the provision of services. There was a lack of consensus on HIV and infant-feeding at all levels and general confusion about the 2006 guidelines, particularly those recommending continued breastfeeding after six months if replacement feeding is not acceptable, feasible, affordable, sustainable and safe. Health workers found it particularly difficult to advise women to continue breastfeeding after six months. They worried that they would lose the trust of the PMTCT clients and the population at large, and they feared that continued breastfeeding was unsafe. Optimal support for HIV-infected women was noted in programmes where health workers were multi-skilled; coordinated their efforts and had functional, multidisciplinary task forces and engaged communities. The recent 2009 recommendations are the first to support antiretroviral (ARV use by mothers or children during breastfeeding. Besides promoting maternal health and providing protection against HIV infection in children, the new Rapid Advice has the potential to resolve the difficulties and confusion experienced by health workers in Malawi. Conclusions The process of integrating new evidence into

Local health workers' perceptions of substandard care in the management of obstetric hemorrhage in rural Malawi

NARCIS (Netherlands)

Beltman, Jogchum Jan; van den Akker, Thomas; Bwirire, Dieudonne; Korevaar, Anneke; Chidakwani, Richard; van Lonkhuijzen, Luc; van Roosmalen, Jos

2013-01-01

Background: To identify factors contributing to the high incidence of facility-based obstetric hemorrhage in Thyolo District, Malawi, according to local health workers. Methods: Three focus group discussions among 29 health workers, including nurse-midwives and non-physician clinicians ('medical

Local health workers' perceptions of substandard care in the management of obstetric hemorrhage in rural Malawi

NARCIS (Netherlands)

Beltman, J.J.; van den Akker, T.; Bwirire, D.; Korevaar, A.; Chidakwani, R.; van Lonkhuijzen, L.; van Roosmalen, J.

2013-01-01

Background: To identify factors contributing to the high incidence of facility-based obstetric hemorrhage in Thyolo District, Malawi, according to local health workers.Methods: Three focus group discussions among 29 health workers, including nurse-midwives and non-physician clinicians ('medical

Prevalence and correlates of hunger among primary and secondary school children in Malawi: results from the 2009 Global School-based Health Survey.

Science.gov (United States)

Mwambene, J B; Muula, A S; Leo, J C

2013-06-01

Education is important in improving economies and creating literate, self-reliant and healthy societies. However, hunger is a barrier to basic education in Malawi. Hunger is also associated with a number of health risk behaviours, such as bullying, suicide ideation and unhygienic behaviours that may jeopardize the future of children. There are, however, limited data on the prevalence and associated factors of hunger among school children in Malawi. The study used data from the Malawi Global School-Based Health Survey conducted in 2009 to estimate the prevalence of self-reported hunger within the last 30 days among primary and secondary school age group. It also assessed the association between self-reported hunger and some selected list of independent variables using frequency distribution, chi-squared test and logistic regression. A total of 2359 students were available for analysis. The overall self-reported prevalence of hunger within the last 30 days was 12.5% (18.9% (172) in the rural and 8.3% (115) in urban areas; and 11.9%(123) for male and 12.5(148) for female children). In the final analysis, geographical location, eating fruits, having been bullied, suicide ideation, and washing hands with soap were significantly associated with hunger. Hunger in both primary and secondary school children in Malawi is a major social problem. The design of school feeding programmes aimed to reduce hunger should incorporate the factors identified as associated with hunger.

A comparative value chain analysis of burley tobacco in Malawi: 2003/04 and 2009/10

DEFF Research Database (Denmark)

Prowse, Martin

2011-01-01

This article conducts a value chain analysis of smallholder burley tobacco production in Malawi for the 2003/04 and 2009/10 agricultural seasons. The comparison suggests in 2003/04 smallholder profits from growing burley were limited by two main factors: first, the practices of leaf merchant...

Epidemiology of measles in Blantyre, Malawi: analyses of passive surveillance data from 1996 to 1998

NARCIS (Netherlands)

Yamaguchi, S.; Dunga, A.; Broadhead, R. L.; Brabin, B. J.

2002-01-01

Measles surveillance data in Blantyre, Malawi were reviewed for 1996-8 to describe the epidemiology of infection and to estimate vaccine efficacy (VE) by the screening method. A total of 674 measles cases were reported to the Blantyre District Health Office during this period. Age distribution

Too few staff, too many patients: a qualitative study of the impact on obstetric care providers and on quality of care in Malawi.

Science.gov (United States)

Bradley, Susan; Kamwendo, Francis; Chipeta, Effie; Chimwaza, Wanangwa; de Pinho, Helen; McAuliffe, Eilish

2015-03-21

Shortages of staff have a significant and negative impact on maternal outcomes in low-income countries, but the impact on obstetric care providers in these contexts is less well documented. Despite the government of Malawi's efforts to increase the number of human resources for health, maternal mortality rates remain persistently high. Health workers' perceptions of insufficient staff or time to carry out their work can predict key variables concerning motivation and attrition, while the resulting sub-standard care and poor attitudes towards women dissuade women from facility-based delivery. Understanding the situation from the health worker perspective can inform policy options that may contribute to a better working environment for staff and improved quality of care for Malawi's women. A qualitative research design, using critical incident interviews, was used to generate a deep and textured understanding of participants' experiences. Eligible participants had performed at least one of the emergency obstetric care signal functions (a) in the previous three months and had experienced a demotivating critical incident within the same timeframe. Data were analysed using NVivo software. Eighty-four interviews were conducted. Concerns about staff shortages and workload were key factors for over 40% of staff who stated their intention to leave their current post and for nearly two-thirds of the remaining health workers who were interviewed. The main themes emerging were: too few staff, too many patients; lack of clinical officers/doctors; inadequate obstetric skills; undermining performance and professionalism; and physical and psychological consequences for staff. Underlying factors were inflexible scheduling and staff allocations that made it impossible to deliver quality care. This study revealed the difficult circumstances under which maternity staff are operating and the professional and emotional toll this exacts. Systems failures and inadequate human resource

Distribution and determinants of pneumonia diagnosis using Integrated Management of Childhood Illness guidelines: a nationally representative study in Malawi.

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Uwemedimo, Omolara T; Lewis, Todd P; Essien, Elsie A; Chan, Grace J; Nsona, Humphreys; Kruk, Margaret E; Leslie, Hannah H

2018-01-01

Pneumonia remains the leading cause of child mortality in sub-Saharan Africa. The Integrated Management of Childhood Illness (IMCI) strategy was developed to standardise care in low-income and middle-income countries for major childhood illnesses and can effectively improve healthcare worker performance. Suboptimal clinical evaluation can result in missed diagnoses and excess morbidity and mortality. We estimate the sensitivity of pneumonia diagnosis and investigate its determinants among children in Malawi. Data were obtained from the 2013-2014 Service Provision Assessment survey, a census of health facilities in Malawi that included direct observation of care and re-examination of children by trained observers. We calculated sensitivity of pneumonia diagnosis and used multilevel log-binomial regression to assess factors associated with diagnostic sensitivity. 3136 clinical visits for children 2-59 months old were observed at 742 health facilities. Healthcare workers completed an average of 30% (SD 13%) of IMCI guidelines in each encounter. 573 children met the IMCI criteria for pneumonia; 118 (21%) were correctly diagnosed. Advanced practice clinicians were more likely than other providers to diagnose pneumonia correctly (adjusted relative risk 2.00, 95% CI 1.21 to 3.29). Clinical quality was strongly associated with correct diagnosis: sensitivity was 23% in providers at the 75th percentile for guideline adherence compared with 14% for those at the 25th percentile. Contextual factors, facility structural readiness, and training or supervision were not associated with sensitivity. Care quality for Malawian children is poor, with low guideline adherence and missed diagnosis for four of five children with pneumonia. Better sensitivity is associated with provider type and higher adherence to IMCI. Existing interventions such as training and supportive supervision are associated with higher guideline adherence, but are insufficient to meaningfully improve sensitivity

The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi.

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Kathryn Elizabeth Lancaster

Full Text Available The HIV care continuum among female sex workers (FSW, a key population, has not been well characterized, especially within the generalized epidemics of sub-Saharan Africa. This was the first study to characterize the HIV care continuum among FSW in Lilongwe, Malawi.From July through September 2014, we used venue-based sampling to enroll 200 adult FSW in Lilongwe, Malawi into a cross-sectional evaluation assessing HIV care continuum outcomes. Seropositive FSW, identified using HIV rapid testing, received rapid CD4 counts in addition to viral loads using dried blood spots. We calculated proportions of HIV-infected FSW who had history of care, were on ART, and had suppressed viral load and we used Poisson regression to estimate the associations of demographic characteristics and transmission risk behaviors with each outcome.HIV seroprevalence was 69% (n = 138. Among all FSW the median age was 24 years (IQR: 22-28. Among the 20% who were newly diagnosed and reported previously testing negative, the median time since last HIV test was 11 months (interquartile range: 3-17. The majority (69% of HIV-infected FSW had a history of HIV care, 52% reported current ART use, and 45% were virally suppressed. Of the FSW who reported current ART use, 86% were virally suppressed. Transmission risk behaviors were not associated with continuum outcomes.FSW in Lilongwe were predominately young and have a high HIV prevalence. Only half of HIV-infected FSW reported current ART use, but the majority of those on ART were virally suppressed. To reduce ongoing transmission and improve health outcomes, increased HIV testing, care engagement, and ART coverage is urgently needed among FSW. Universal testing and treatment strategies for all FSW in Malawi must be strongly considered.

Men's controlling behaviors and women's experiences of physical violence in Malawi.

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Mandal, Mahua; Hindin, Michelle J

2013-09-01

In the feminist paradigm, intimate partner violence (IPV) among heterosexual couples is gender asymmetric and largely a tactic of male control. However, research on the relationship between men's controlling behavior and physical violence against women is limited. This study examines whether having a controlling partner is associated with women's reports of experiencing physical violence in Malawi. Bivariate and multivariate analyses were conducted using data from 8,385 women who completed the domestic violence module of the Malawi 2004 Demographic and Health Survey. About 18 % of women reported they had experienced moderately severe physical violence and 1 % experienced very severe violence in the past 12 months. A third of women reported their partners had ever been controlling. Results from multivariable ordinal logistic regression showed that women who had controlling partners were significantly more likely to report experiencing physical violence. Other factors significantly associated with women's experience of physical violence included women who reported initiating physical violence against their partners, women's work status, partners' lower education level, and partners' alcohol consumption. Women with controlling partners were at increased risk of experiencing physical violence in the past year. However, women who reported initiating physical violence in the past year were nearly four times more likely to experience partner violence in the same time period. Future research should attempt to elucidate these two important risk factors for IPV.

Disclosure of Sexual Violence Among Girls and Young Women Aged 13 to 24 Years: Results From the Violence Against Children Surveys in Nigeria and Malawi.

Science.gov (United States)

Nguyen, Kimberly H; Kress, Howard; Atuchukwu, Victor; Onotu, Dennis; Swaminathan, Mahesh; Ogbanufe, Obinna; Msungama, Wezi; Sumner, Steven A

2018-02-01

Understanding factors that are associated with disclosure of sexual violence (SV) is important for the delivery of health services as well as developing strategies for prevention and response. The Violence Against Children Surveys were conducted in Malawi and Nigeria. We examined the prevalence of SV, help-seeking behaviors, and factors associated with disclosure among girls and young women aged 13 to 24. The self-reported prevalence of SV was similar in Nigeria (26%) and Malawi (27%). Among females who experienced SV, approximately one third (37%) in Nigeria and one half (55%) in Malawi ever disclosed their experience of SV. Females in Nigeria were significantly more likely to disclose to their parents (31.8%) than females in Malawi (9.5%). The most common reason for nondisclosure in Nigeria was not feeling a need or desire to tell anyone (34.9%) and in Malawi was embarrassment (29.3%). Very close relationships with one or both parents were significantly associated with disclosure among Nigerian females (odds ratio [OR] = 5.5, 95% confidence interval [CI] = [2.1, 14.6]) but were inversely associated with disclosure among Malawian females (OR = 0.05, 95% CI = [0.01, 0.33]). Reasons for nondisclosure of SV and factors associated with disclosure among females differ in the African nations studied. The stigma associated with shame of SV may prevent females from disclosing and thus receiving necessary support and health, social, and other services. This study demonstrates a need to reduce barriers for disclosure to improve the delivery of health, social, and other response services across African nations, as well as to develop culturally appropriate strategies for its response.

Sugarcane ethanol production in Malawi: Measures to optimize the carbon footprint and to avoid indirect emissions

International Nuclear Information System (INIS)

Dunkelberg, Elisa; Finkbeiner, Matthias; Hirschl, Bernd

2014-01-01

Sugarcane ethanol is considered to be one of the most efficient first-generation biofuels in terms of greenhouse gas (GHG) emissions. The carbon footprint (CF), however, increases significantly when taking into account emissions induced by indirect land-use changes (ILUC). This case study investigates sugarcane ethanol production in the Republic of Malawi, in Sub-Sahara Africa (SSA); the research objectives were to identify and quantify direct and indirect emissions and to identify measures to optimize the CF. The CF has been calculated with a life cycle approach and with data obtained from the involved companies; our estimations with regard to ILUC take into account further expansion plans for sugarcane crop production. Under existing production conditions ethanol produced in Malawi leads to GHG emissions expressed as CO 2eq of 116 g MJ −1 of ethanol. However, high optimization potentials exist when the vinasse is used as an input for biogas production and the harvesting switches from pre-harvest burning to green harvesting. ILUC induced by prospective sugarcane expansions in the Southern Region will, according to current planning, probably not occur since these expansions are linked to the implementation of a large-scale irrigation project. However if ILUC takes place, high levels of additional CO 2 emissions of about 77 g MJ −1 of ethanol are to be expected. Although the case study results are only valid for a specific region, some of the findings, such as the high compensation potential regarding ILUC through investments in irrigation systems, may be transferable to other regions in SSA. - Highlights: • We conducted a case study on sugarcane ethanol production in Malawi and calculated its carbon footprint (CF). • The current CF of sugarcane ethanol produced in the Southern Region in Malawi amounts for 116 g MJ −1 of ethanol. • The usage of vinasse in biogas plants would significantly improve the CF. • Another optimization measure is to

Structural and social constraints influencing HIV/AIDS teaching in Malawi primary schools

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Grames Ghirwa

2014-07-01

Full Text Available The Ministry of Education in Malawi introduced a Life Skills Education programwith the intention to empower children with appropriate information and skills to deal with social and health problems affecting the nation including the fight against HIV infections. This study investigated factors affecting the teaching of the Life skills education in four primary schools in the Zomba District, Malawi. Cornbleth’s (1990 notions of the structural and social contexts and Whitaker’s (1993 identification of key role players in curriculum implementation framed the study. Findings suggest that the teaching of Life skills is constrained by a variety of social and structural contextual factors such as the poor conditions under which teachers are working; greater attention given to subjects such as Maths and Languages; the cascade model of training teachers and the short duration of training; the language in teachers guides were not accesibile to teachers; hunger and poverty of learners; lack of community support for sexual education; both teachers and learners being infected or affected by the AIDS/HIV pandemic; teachers felt it is inappropriate to teach sexual education to 9 and 10 year old learners.  These findings indicate structural and social barriers to effective life skills education within the current framework.

Present status of practical aspects of individual dosimetry. Pt. 2. Eastern European countries

International Nuclear Information System (INIS)

Goeksu, H.Y.; Regulla, D.; Drexler, G.

1995-01-01

The report is prepared in a historically rather unstable period concerning the Eastern European countries. Many independent states are formed which brought political, economical and administrative changes in the region. However such changes had not direct effect on the radiation protection practices concerning the occupationally exposed persons. In general all the newly formed states have adopted the former laws and regulation. Therefore we kept the names of the country of the origin. In near future laws and regulations are expected to be altered in many of these new states. The present laws and regulations are in great extent very similar to each other. However there are variations in practical aspects of the individual dosimetry due to the size of the country and their involvement with nuclear activities. Almost all countries based their regulations on International Safety Standards of IAEA and ICRP-26 recommendations. Since the Chernobyl accident, very many bilateral agreements have been concluded between Eastern European and OECD for the transfer of technology on the radiation safety of the public as well as occupationally exposed persons. (orig./HP)

HIV testing and care in Burkina Faso, Kenya, Malawi and Uganda: ethics on the ground

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Obermeyer Carla Makhlouf

2013-01-01

Full Text Available Abstract Background The ethical discourse about HIV testing has undergone a profound transformation in recent years. The greater availability of antiretroviral therapy (ART has led to a global scaling up of HIV testing and counseling as a gateway to prevention, treatment and care. In response, critics raised important ethical questions, including: How do different testing policies and practices undermine or strengthen informed consent and medical confidentiality? How well do different modalities of testing provide benefits that outweigh risks of harm? To what degree do current testing policies and programs provide equitable access to HIV services? And finally, what lessons have been learned from the field about how to improve the delivery of HIV services to achieve public health objectives and protections for human rights? This article reviews the empirical evidence that has emerged to answer these questions, from four sub-Saharan African countries, namely: Burkina Faso, Kenya, Malawi and Uganda. Discussion Expanding access to treatment and prevention in these four countries has made the biomedical benefits of HIV testing increasingly clear. But serious challenges remain with regard to protecting human rights, informed consent and ensuring linkages to care. Policy makers and practitioners are grappling with difficult ethical issues, including how to protect confidentiality, how to strengthen linkages to care, and how to provide equitable access to services, especially for most at risk populations, including men who have sex with men. Summary The most salient policy questions about HIV testing in these countries no longer address whether to scale up routine PITC (and other strategies, but how. Instead, individuals, health care providers and policy makers are struggling with a host of difficult ethical questions about how to protect rights, maximize benefits, and mitigate risks in the face of resource scarcity.

Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi.

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Pitchford, Nicola J

2015-01-01

Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-weeks period, for the equivalent of 30-min per day. Technical support was provided from the local Voluntary Service Overseas (VSO). Children were then post-tested on the same assessments as given at pre-test. A final sample of 283 children, from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standards 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child's developmental

Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi

Directory of Open Access Journals (Sweden)

Nicola ePitchford

2015-04-01

Full Text Available Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-week period, for the equivalent of 30-minutes per day. Technical support was provided from the local Voluntary Service Overseas. Children were then post-tested on the same assessments as given at pre-test.A final sample of 283 children from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standard 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child�

Age structure of elephants in Liwonde National Park, Malawi

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R. Bhima

1997-08-01

Full Text Available The age structure of the elephant population in Liwonde National Park, Malawi was determined for the first time in 1993 and again in 1995 using the photogrammetric method. Sampling was done during a four year-long severe drought from 1991/92 to 1994/95. The drought reached its highest intensity in the first year. Therefore, the study also attempted to assess the impact of the drought on the population. The results show that the population consisted of mostly young animals 20 years old - 18.3 and 20.5 . The population is young and growing. The prolonged drought did not have any significant impact on the population.

Applying a Reading Program Based on Cognitive Science in Rural Areas of Malawi: Preliminary Results

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Iyengar, Radhika; Karim, Alia; Chagwira, Florie

2016-01-01

Reading fluency is a skill foundational to academic performance, and acquiring this skill in early grades is crucial. Throughout sub-Saharan Africa, reading levels of students are far below grade level, and Malawi is no exception. Research suggests that students, particularly in consistently spelled languages, acquire automaticity most easily by…

"Home is always home" : (former) street youth in Blantyre, Malawi, and the fluidity of constructing home

NARCIS (Netherlands)

Hendriks, T.D.

2016-01-01

For many Malawians the concept of home is strongly associated with the rural areas and one's (supposedly rural) place of birth. This 'grand narrative about home', though often reiterated, doesn't necessarily depict lived reality. Malawi's history of movement and labor migration coupled with

"Home is always home" : (former) street youth in Blantyre, Malawi, and the fluidity of constructing home

NARCIS (Netherlands)

Hendriks, T.D.

2017-01-01

For many Malawians the concept of home is strongly associated with the rural areas and one's (supposedly rural) place of birth. This 'grand narrative about home', though often reiterated, doesn't necessarily depict lived reality. Malawi's history of movement and labor migration coupled with

The prevalence and causes of decreased visual acuity – a study based on vision screening conducted at Enukweni and Mzuzu Foundation Primary Schools, Malawi

OpenAIRE

Thom L; Jogessar S; McGowan SL; Lawless F

2016-01-01

Leaveson Thom,1 Sanchia Jogessar,1,2 Sara L McGowan,1 Fiona Lawless,1,2 1Department of Optometry, Mzuzu University, Mzuzu, Malawi; 2Brienholden Vision Institute, Durban, South Africa Aim: To determine the prevalence and causes of decreased visual acuity (VA) among pupils recruited in two primary schools in Mzimba district, northern region of Malawi.Materials and methods: The study was based on the vision screening which was conducted by optometrists at Enukweni and Mzuzu Foundation Primary Sc...

The prevalence and causes of decreased visual acuity – a study based on vision screening conducted at Enukweni and Mzuzu Foundation Primary Schools, Malawi

OpenAIRE

Thom,Leaveson; Jogessar,Sanchia; McGowan,Sara L; Lawless,Fiona

2016-01-01

Leaveson Thom,1 Sanchia Jogessar,1,2 Sara L McGowan,1 Fiona Lawless,1,2 1Department of Optometry, Mzuzu University, Mzuzu, Malawi; 2Brienholden Vision Institute, Durban, South Africa Aim: To determine the prevalence and causes of decreased visual acuity (VA) among pupils recruited in two primary schools in Mzimba district, northern region of Malawi.Materials and methods: The study was based on the vision screening which was conducted by optometrists at Enukweni and Mzuzu Foundation Primary Sc...

Off-grid energy services for the poor: Introducing LED lighting in the Millennium Villages Project in Malawi

International Nuclear Information System (INIS)

Adkins, Edwin; Eapen, Sandy; Kaluwile, Flora; Nair, Gautam; Modi, Vijay

2010-01-01

Lanterns that use light-emitting diodes (LEDs) powered by batteries, which are in turn charged by grid electricity or small solar panels, have emerged as a cost-competitive alternative to kerosene and other fuel-based lighting technologies, offering brighter light for longer duration at equal or lower cost over time. This paper presents lessons learned from the introduction of solar LED lanterns in rural Malawi. We discuss a market-based program using new and existing local commercial structures such as vendors and cooperatives to sell lanterns to village households without subsidy. The paper addresses issues of enterprise development, community interactions, and survey data on lighting use and expenditure patterns before and after LED lantern introduction. Households that purchased a lantern reported high levels of satisfaction with the LED lanterns as well as savings in annual kerosene expenditure comparable to the price of the lantern. These households also reported monthly incomes comparable to the price of the LED lanterns whereas non-adopters surveyed reported monthly incomes about half this level, suggesting a need for financing options to maximize adoption among poorer populations in rural areas. These results suggest that similar market based models of LED lighting technology dissemination have the potential to be replicated and scaled up in other off-grid regions in developing countries. However, viability of local cooperatives and supply chains for lantern products over the medium-to-long term remain to be assessed.

Physical attractiveness and women’s HIV risk in rural Malawi

Science.gov (United States)

Frye, Margaret; Chae, Sophia

2017-01-01

BACKGROUND Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. OBJECTIVE We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country’s severe AIDS epidemic. METHODS We use interviewers’ ratings of respondents’ attractiveness, along with HIV test results and women’s assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15–35. RESULTS Results show that women who are rated by interviewers as ‘much less’ or ‘less’ attractive than other women their age are 9% more likely to test positive for HIV. We also find that attractiveness is associated with women’s own assessments of their HIV risk: Among women who tested negative, those perceived as ‘much less’ or ‘less’ attractive than average report themselves to be at greater risk of HIV infection. CONCLUSIONS These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. CONTRIBUTION This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings. PMID:29242708

Poor people and poor fields? : integrating legumes for smallholder soil fertility management in Chisepo, central Malawi

NARCIS (Netherlands)

Kamanga, B.

2011-01-01

Soil infertility undermines the agriculture-based livelihoods in Malawi, where it is blamed for poor crop yields and the creation of cycles of poverty. Although technologies and management strategies have been developed to reverse the decline in soil fertility, they are under-used by smallholder

Why did the scale-up of HIV treatment work? A case example from Malawi.

Science.gov (United States)

Harries, Anthony D; Makombe, Simon D; Libamba, Edwin; Schouten, Erik J

2011-08-01

The national scale-up of antiretroviral therapy (ART) in Malawi is based on a public health approach, with principles and practices borrowed from the successful DOTS (directly observed treatment short course-the system used to successfully deliver antituberculosis treatment to people in some of the poorest countries of the world) tuberculosis control framework. During the first 6 years, the number of patients registered on treatment increased from 3000 to >350,000 in both the public and private sectors. The most important reasons for this success have been strong international and national leadership combined with adequate funds, a standardized approach to ART with practical guidelines, an approved national scale-up plan with clear, time-bound milestones; investment in an intensive program of training and accreditation of ART sites, quarterly supervision and monitoring of ART and operational research, rational drug forecasting and no stock-outs of drugs during the first few years, and involvement of the private sector. The looming challenges of human resources, guaranteed financial support, better but also more expensive ART regimens, use of electronic medical records to monitor response to therapy, and attention to HIV prevention need to be met head-on and solved if the momentum of the earlier years is to be maintained.

Teleseismic Investigations of the Malawi and Luangwa Rift Zones: Ongoing Observations From the SAFARI Experiment

Science.gov (United States)

Reed, C. A.; Gao, S. S.; Liu, K. H.; Yu, Y.; Chindandali, P. R. N.; Massinque, B.; Mdala, H. S.; Mutamina, D. M.

2015-12-01

In order to evaluate the influence of crustal and mantle heterogeneities upon the initiation of the Malawi rift zone (MRZ) and reactivation of the Zambian Luangwa rift zone (LRZ) subject to Cenozoic plate boundary stress fields and mantle buoyancy forces, we installed and operated 33 Seismic Arrays For African Rift Initiation (SAFARI) three-component broadband seismic stations in Malawi, Mozambique, and Zambia from 2012 to 2014. During the twenty-four month acquisition period, nearly 6200 radial receiver functions (RFs) were recorded. Stations situated within the MRZ, either along the coastal plains or within the Shire Graben toward the south, report an average crustal thickness of 42 km relative to approximately 46 km observed at stations located along the rift flanks. This implies the juvenile MRZ is characterized by a stretching factor not exceeding 1.1. Meanwhile, P-to-S velocity ratios within the MRZ increase from 1.71 to 1.82 in southernmost Malawi, indicating a substantial modification of the crust during Recent rifting. Time-series stacking of approximately 5500 RFs recorded by the SAFARI and 44 neighboring network stations reveals an apparent uplift of 10 to 15 km along both the 410- and 660-km mantle transition zone (MTZ) discontinuities beneath the MRZ and LRZ which, coupled with an apparently normal 250-km MTZ thickness, implies a first-order high-velocity contribution from thickened lithosphere. Preliminary manual checking of SAFARI shear-wave splitting (SWS) measurements provides roughly 650 high-quality XKS phases following a component re-orientation to correct station misalignments. Regional azimuthal variations in SWS fast orientations are observed, from rift-parallel in the vicinity of the LRZ to rift-oblique in the MRZ. A major 60° rotation in the fast orientation occurs at approximately 31°E, possibly resulting from the modulation of mantle flow around a relatively thick lithospheric keel situated between the two rift zones.

Factors associated with milk producer's awareness and practices in relation to zoonoses in northern Malawi

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Stanly Fon Tebug

2013-10-01

Full Text Available Background: Many diseases are known to be naturally transmissible between vertebrate animals, including cattle and humans. Currently, much effort is being made to promote dairy farming in Malawi but there is limited information about zoonotic diseases including public awareness and practices. This study was designed to determine factors associated with dairy producer's awareness and practices with regard to zoonoses in Northern Region of Malawi. Materials and Methods: A structured questionnaire was used to collect information from 140 randomly selected dairy producers between January and June 2011. Level of awareness and practices with respect to zoonotic infections was evaluated using a score ranging from 0 to 11. Chi-squared test followed by a multivariable logistic model were used to assess potential factors associated farmer's awareness and practices. Results: Awareness and practice level was unsatisfactory. Significantly higher number of respondents (75.7 vs. 32.9%,x2 = 51.81, df =1, p< 0.001 had satisfactory level of awareness when compared to those who practiced preventive measures. Awareness of the existence of zoonotic infections and practices was higher in farmers who acquired animals through loan (p =0.008, farmers with above primary education (p = 0.002 and farmers with more than six years of dairy farming experience (p= 0.010. Most farmers (59.3% received information about zoonoses through Agricultural extension services. Conclusion: Awareness and practices with respect to zoonotic infections was dependent on farmer's formal educational level, dairy farming experience and means of acquiring parent stock. Regular disease surveillance and promotion of education on the risk associated with zoonotic infections through dairy extension and medical services should result in increased awareness and efficient control of zoonoses in Malawi. [Vet World 2013; 6(5.000: 249-253

Au Malawi et au Cameroun, le progrès passe par des mentalités ...

International Development Research Centre (IDRC) Digital Library (Canada)

8 nov. 2011 ... Télécharger le PDF. Renseignements. Maggie Banda Women's Legal Resources Centre PO Box 31472. Chichiri, Blantyre 3. Malawi wolrec@broadbandmw.com. Lotsmart Fonjong Faculté des sciences sociales et de gestion. Université de Buéa CP 63, Buéa Cameroun lotsmart@yahoo.com · www.ubuea.

An Analysis of the Extent of Social Inclusion and Equity Consideration in Malawi's National HIV and AIDS Policy Review Process.

Science.gov (United States)

Chinyama, Mathews Junior; MacLachlan, Malcolm; McVeigh, Joanne; Huss, Tessy; Gawamadzi, Sylvester

2017-07-29

Equity and social inclusion for vulnerable groups in policy development processes and resulting documents remain a challenge globally. Most often, the marginalization of vulnerable groups is overlooked in both the planning and practice of health service delivery. Such marginalization may occur because authorities deem the targeting of those who already have better access to healthcare a cheaper and easier way to achieve short-term health gains. The Government of Malawi wishes to achieve an equitable and inclusive HIV and AIDS Policy. The aim of this study is to assess the extent to which the Malawi Policy review process addressed regional and international health priorities of equity and social inclusion for vulnerable groups in the policy content and policy revision process. This research design comprised two phases. First, the content of the Malawi HIV and AIDS Policy was assessed using EquiFrame regarding its coverage of 21 Core Concepts of human rights and inclusion of 12 Vulnerable Groups. Second, the engagement of vulnerable groups in the policy process was assessed using the EquIPP matrix. For the latter, 10 interviews were conducted with a purposive sample of representatives of public sector, civil society organizations and development partners who participated in the policy revision process. Data was also collected from documented information of the policy processes. Our analyses indicated that the Malawi HIV and AIDS Policy had a relatively high coverage of Core Concepts of human rights and Vulnerable Groups; although with some notable omissions. The analyses also found that reasonable steps were taken to engage and promote participation of vulnerable groups in the planning, development, implementation, monitoring and evaluation processes of the HIV and AIDS Policy, although again, with some notable exceptions. This is the first study to use both EquiFrame and EquIPP as complimentary tools to assess the content and process of policy. While the findings

HIV prevalence, risks for HIV infection, and human rights among men who have sex with men (MSM in Malawi, Namibia, and Botswana.

Directory of Open Access Journals (Sweden)

Stefan Baral

Full Text Available BACKGROUND: In the generalized epidemics of HIV in southern Sub-Saharan Africa, men who have sex with men have been largely excluded from HIV surveillance and research. Epidemiologic data for MSM in southern Africa are among the sparsest globally, and HIV risk among these men has yet to be characterized in the majority of countries. METHODOLOGY: A cross-sectional anonymous probe of 537 men recruited with non-probability sampling among men who reported ever having had sex with another man in Malawi, Namibia, and Botswana using a structured survey instrument and HIV screening with the OraQuick(c rapid test kit. PRINCIPAL FINDINGS: The HIV prevalence among those between the ages of 18 and 23 was 8.3% (20/241; 20.0% (42/210 among those 24-29; and 35.7% (30/84 among those older than 30 for an overall prevalence of 17.4% (95% CI 14.4-20.8. In multivariate logistic regressions, being older than 25 (aOR 4.0, 95% CI 2.0-8.0, and not always wearing condoms during sex (aOR 2.6, 95% CI 1.3-4.9 were significantly associated with being HIV-positive. Sexual concurrency was common with 16.6% having ongoing concurrent stable relationships with a man and a woman and 53.7% had both male and female sexual partners in proceeding 6 months. Unprotected anal intercourse was common and the use of petroleum-based lubricants was also common when using condoms. Human rights abuses, including blackmail and denial of housing and health care was prevalent with 42.1% (222/527 reporting at least one abuse. CONCLUSIONS: MSM are a high-risk group for HIV infection and human rights abuses in Malawi, Namibia, and Botswana. Concurrency of sexual partnerships with partners of both genders may play important roles in HIV spread in these populations. Further epidemiologic and evaluative research is needed to assess the contribution of MSM to southern Africa's HIV epidemics and how best to mitigate this. These countries should initiate and adequately fund evidence-based and targeted HIV

Health seeking behaviour and the related household out-of-pocket expenditure for chronic non-communicable diseases in rural Malawi.

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Wang, Qun; Brenner, Stephan; Leppert, Gerald; Banda, Thomas Hastings; Kalmus, Olivier; De Allegri, Manuela

2015-03-01

Malawi is facing a rising chronic non-communicable disease (CNCD) epidemic. This study explored health seeking behaviour and related expenditure on CNCDs in rural Malawi, with specific focus on detecting potential differences across population groups. We used data from the first round of a panel household health survey conducted in rural Malawi between August and October 2012 on a sample of 1199 households. Multinomial logistic regression was used to analyse factors associated with health seeking choices for CNCDs, distinguishing between no care, informal care and formal care. Descriptive statistics (mean, standard deviation and median) were used to describe related household out-of-pocket expenditure. There were 475 individuals (equivalent to 8.4% of all respondents) reporting at least one CNCD. Among them, 37.3% did not seek any care, 42.5% sought formal care (facility-based care), and 20.2% opted for informal care (traditional or home treatment). Regression analysis showed that illness severity and duration, socio-economic status, being a household head, and the proportion of household members living with a CNCD were significantly associated with health care utilization. Among those seeking care, 65.8% incurred out-of-pocket expenditure with an average of USD 1.49 spent on medical treatment and an additional USD 0.50 spent on transport. Further qualitative inquiry is needed to understand the reasons for low service utilization and to explore the potential role of supply-side factors. To increase access to care for people suffering from CNCDs, the provision of a free Essential Health Package in Malawi ought to be strengthened through the integration of system-wide screening, risk factor modification and continuity of care options for people suffering from CNCDs. This would ensure affordable services to modulate health seeking behaviour of patients at risk of major chronic illnesses. Published by Oxford University Press in association with The London School of

The Score Reliability of Draw-a-Person Intellectual Ability Test (DAP: IQ) for Rural Malawi Students

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Khasu, Denis S.; Williams, Thomas O., Jr.

2016-01-01

In this brief article, the reliability of scores for the Draw-A-Person Intellectual Ability Test for Children, Adolescents, and Adults (DAP: IQ; Reynolds & Hickman, 2004) was examined through several analyses with a sample of 147 children from rural Malawi, Africa using a Chichewa translation of instructions. Cronbach alpha coefficients for…

Sexual Behavior and Scholastic Success: Moral Codes and Behavioral Outcomes in Malawi

OpenAIRE

Frye, Margaret Taylor

2013-01-01

Access to formal education has expanded across sub-Saharan Africa over the past 20 years, as a result of a global policy commitment to provide "Education for All." In Malawi, an ambitious 1994 policy eliminated primary school fees, causing primary school enrollment to increase by over 60 percent in a single year. Yet these new opportunities to attend primary school have not been paired with similar expansions at higher levels, and in 2010, less than one percent of Malawian youth who entered s...

Universal Basic Education and the Provision of Quality Mathematics in Southern Africa

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Kazima, Mercy

2014-01-01

In this paper, I discuss Universal Basic Education (UBE) in relation to the teaching and learning of mathematics in Southern Africa. I present the status of UBE for all countries in the region and then use 3 selected examples: Botswana, Malawi, and Zambia, to illustrate the provision of mathematics in the general framework of UBE in the countries.…

Further Validation of a Rapid Screening Semiquantitative Thin-Layer Chromatographic Method for Marketed Antimalarial Medicines for Adoption in Malawi

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Dorcas Osei-Safo

2018-01-01

Full Text Available A recently developed semiquantitative thin-layer chromatographic (SQ-TLC assay has been employed in postmarketing surveillance of antimalarial medicines used in Malawi prior to HPLC assay. Both methods gave analogous results in a significant majority of the samples, with a good correlation (r = 0.9012 for the active pharmaceutical ingredients of the dosage forms assayed. Artemether-containing medicines had the highest percentage (92.67% of samples with comparable results for both assays. The lowest percentage (66.67% was observed in artesunate-containing medicines. The SQ-TLC method was validated for specificity, accuracy, precision, linearity, and stability according to the International Conference on Harmonisation guidelines, with the results falling within acceptable limits. For specificity, retention factor values of the test samples and reference standards were comparable, while accuracy and precision of 91.1 ± 5.7% were obtained for all samples. The method was linear in the range 1.0–2.0 µg/spot with a correlation coefficient of r = 0.9783. Stability tests also fell within acceptable limits. In this study, we present the validation of the SQ-TLC method and propose its adoption as a rapid screening tool for field estimation of the quality of antimalarial and other essential medicines in Malawi and other parts of the developing world prior to a more accurate HPLC assay.

Sexual and reproductive health and HIV/AIDS risk perception in the Malawi tourism industry.

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Bisika, Thomas

2009-06-01

Malawi has for a long time relied on agriculture for the generation of foreign exchange. Due to varied reasons like climate change, the Malawi government has, therefore, identified tourism as one way of boosting foreign exchange earnings and is already in the process of developing the sector especially in the area of ecotourism. However, tourism is associated with increasing prostitution, drug abuse and a whole range of other sexual and reproductive health (SRH) problems such as teenage pregnancies, HIV/AIDS and sexually transmitted infections (STIs). This paper examines the knowledge, attitudes, practices and behaviour as well as risk perceptions associated with HIV/AIDS, sexually transmitted infections and unwanted pregnancies among staff in the tourism industry and communities around tourist facilities in Malawi. The study was descriptive in nature and used both qualitative and quantitative research methods. The qualitative methods involved in-depth interviews and focus group discussions. The quantitative technique employed a survey of 205 purposively selected subjects from the tourism sector. The study concludes that people in the tourism sector are at high risk of HIV/AIDS, sexually transmitted infections and unwanted pregnancies and should be considered as a vulnerable group. The study further observes that this group of people has not adopted behaviours that can protect them from HIV/AIDS, sexually transmitted infections and unwanted pregnancies although there is high demand for voluntary counselling and testing (VCT) which offers a very good entry point for HIV prevention and treatment in the tourism sector. The study recommends that a comprehensive tourism policy covering tourists, employees and communities around tourist facilities is required. Such a policy should address the rights of HIV infected employees and the provision of prevention and treatment services for HIV/AIDS and STIs as well as a broad range of SRH and family planning services especially

Attitudes towards mental illness in Malawi: a cross-sectional survey

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Crabb Jim

2012-07-01

Full Text Available Abstract Background Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi. Methods A cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the “World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia”. Results 210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%. This was closely followed by brain disease (92.8%, spirit possession (82.8% and psychological trauma (76.1%. There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample. Conclusions Our study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue.

Inclusion and Human Rights in Health Policies: Comparative and Benchmarking Analysis of 51 Policies from Malawi, Sudan, South Africa and Namibia

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MacLachlan, Malcolm; Amin, Mutamad; Mannan, Hasheem; El Tayeb, Shahla; Bedri, Nafisa; Swartz, Leslie; Munthali, Alister; Van Rooy, Gert; McVeigh, Joanne

2012-01-01

While many health services strive to be equitable, accessible and inclusive, peoples’ right to health often goes unrealized, particularly among vulnerable groups. The extent to which health policies explicitly seek to achieve such goals sets the policy context in which services are delivered and evaluated. An analytical framework was developed – EquiFrame – to evaluate 1) the extent to which 21 Core Concepts of human rights were addressed in policy documents, and 2) coverage of 12 Vulnerable Groups who might benefit from such policies. Using this framework, analysis of 51 policies across Malawi, Namibia, South Africa and Sudan, confirmed the relevance of all Core Concepts and Vulnerable Groups. Further, our analysis highlighted some very strong policies, serious shortcomings in others as well as country-specific patterns. If social inclusion and human rights do not underpin policy formation, it is unlikely they will be inculcated in service delivery. EquiFrame facilitates policy analysis and benchmarking, and provides a means for evaluating policy revision and development. PMID:22649488

Inclusion and human rights in health policies: comparative and benchmarking analysis of 51 policies from Malawi, Sudan, South Africa and Namibia.

Directory of Open Access Journals (Sweden)

Malcolm MacLachlan

Full Text Available While many health services strive to be equitable, accessible and inclusive, peoples' right to health often goes unrealized, particularly among vulnerable groups. The extent to which health policies explicitly seek to achieve such goals sets the policy context in which services are delivered and evaluated. An analytical framework was developed--EquiFrame--to evaluate 1 the extent to which 21 Core Concepts of human rights were addressed in policy documents, and 2 coverage of 12 Vulnerable Groups who might benefit from such policies. Using this framework, analysis of 51 policies across Malawi, Namibia, South Africa and Sudan, confirmed the relevance of all Core Concepts and Vulnerable Groups. Further, our analysis highlighted some very strong policies, serious shortcomings in others as well as country-specific patterns. If social inclusion and human rights do not underpin policy formation, it is unlikely they will be inculcated in service delivery. EquiFrame facilitates policy analysis and benchmarking, and provides a means for evaluating policy revision and development.

Antiretroviral therapy (ART) rationing and access mechanisms and their impact on youth ART utilization in Malawi.

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Dixon, Jimmy-Gama; Gibson, Sarah; McPake, Barbara; Maleta, Ken

2011-06-01

The World Health Organization (WHO) staging is a commonly used rationing mechanism for highly active antiretroviral therapy (HAART) among various HIV infected populations including youths in most developing countries. Rationing is defined as any policy or practice that restricts consumption of or access to certain goods due to its limited supply. However, as HIV prevalence is rapidly increasing among youth, understanding the capacity of the staging approach to achieve HAART uptake in youth is of considerable importance. This study aimed to explore how HAART rationing and access mechanisms impact on youth's utilization of HAART in Malawi. The study used mixed methods with quantitative analysis of existing Ministry of Health Clinical HIV Unit data used to determine existing levels of youth HAART use. Qualitative methods employed in-depth interviews that interviewed nine ART providers, nine HIV positive youth on HAART and nine HIV positive youth not on HAART; and field observations to nine ART clinics were used to understand HAART rationing and access mechanisms and how such mechanisms impact youth uptake of HAART. The findings revealed that ART providers use both explicit rationing mechanisms like WHO clinical staging and implicit rationing mechanisms like use of waiting lists, queues and referral in ART provision. However, the WHO staging approach had some challenges in its implementation. It was also observed that factors like non-comprehensive approach to HAART provision, costs incurred to access HAART, negative beliefs and misconceptions about HAART and HIV were among the key factors that limit youth access to HAART. The study recommends that while WHO staging is successful as a rationing mechanism in Malawi, measures should be put in place to improve access to CD4 assessment for clients who may need it. ART providers also need to be made aware of the implicit rationing mechanisms that may affect HAART access. There is also need to improve monitoring of those HIV

Does a ban on informal health providers save lives? Evidence from Malawi

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Godlonton, Susan; Okeke, Edward N.

2015-01-01

Informal health providers ranging from drug vendors to traditional healers account for a large fraction of health care provision in developing countries. They are, however, largely unlicensed and unregulated leading to concern that they provide ineffective and, in some cases, even harmful care. A new and controversial policy tool that has been proposed to alter household health seeking behavior is an outright ban on these informal providers. The theoretical effects of such a ban are ambiguous. In this paper, we study the effect of a ban on informal (traditional) birth attendants imposed by the Malawi government in 2007. To measure the effect of the ban, we use a difference-in-difference strategy exploiting variation across time and space in the intensity of exposure to the ban. Our most conservative estimates suggest that the ban decreased use of traditional attendants by about 15 percentage points. Approximately three quarters of this decline can be attributed to an increase in use of the formal sector and the remainder is accounted for by an increase in relative/friend-attended births. Despite the rather large shift from the informal to the formal sector, we do not find any evidence of a statistically significant reduction in newborn mortality on average. The results are robust to a triple difference specification using young children as a control group. We examine several explanations for this result and find evidence consistent with quality of formal care acting as a constraint on improvements in newborn health. PMID:26681821

Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies

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Bettega Nadia

2011-05-01

Full Text Available Abstract Background Many people live and die in pain in Africa. We set out to describe patient, family and local community perspectives on the impact of three community based palliative care interventions in sub-Saharan Africa. Methods Three palliative care programmes in Uganda, Kenya and Malawi were studied using rapid evaluation field techniques in each country, triangulating data from three sources: interviews with key informants, observations of clinical encounters and the local health and social care context, and routine data from local reports and statistics. Results We interviewed 33 patients with advanced illness, 27 family carers, 36 staff, 25 volunteers, and 29 community leaders and observed clinical care of 12 patients. In each site, oral morphine was being used effectively. Patients valued being treated with dignity and respect. Being supported at home reduced physical, emotional and financial burden of travel to, and care at health facilities. Practical support and instruction in feeding and bathing patients facilitated good deaths at home. In each country mobile phones enabled rapid access to clinical and social support networks. Staff and volunteers generally reported that caring for the dying in the face of poverty was stressful, but also rewarding, with resilience fostered by having effective analgesia, and community support networks. Conclusions Programmes were reported to be successful because they integrated symptom control with practical and emotional care, education, and spiritual care. Holistic palliative care can be delivered effectively in the face of poverty, but a public health approach is needed to ensure equitable provision.

Extra-marital sexual partnerships and male friendships in rural Malawi

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Shelley Clark

2010-01-01

Full Text Available Extra-marital sexual partnerships (EMSPs are a major route of HIV/AIDS transmission in sub-Saharan Africa. In this paper, we investigate the roles of two types of male friendships - best friends and friends with whom they talk about AIDS - in determining whether men have EMSPs. Using data from men in rural Malawi, we find that men's current extra-marital sexual behavior is most closely correlated with their best friends', but that the behaviors of both types of friends are associated with men's subsequent EMSPs. These findings suggest that men's friendships could be used to help combat the AIDS epidemic.

Adopters and Non-Adopters of Low-Cost Household Latrines: A Study of Corbelled Pit Latrines in 15 Districts of Malawi

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Rochelle Holm

2016-09-01

Full Text Available The Sustainable Development Goals will challenge low- and middle-income settings to look at new approaches for rural sanitation. In 2013, Mzuzu University, in partnership with United Nations Children’s Fund (UNICEF Malawi, started a low-cost latrine program in rural areas using the corbelled latrine design supported by locally owned sustainable businesses. The objective of this work was to trace customers (early household adopters and non-customers through field observations and interviews in 15 districts of Malawi. The research team spent 193 personnel work days in data collection and found 21 households as adopters in 7 districts. Most respondents had a preference with regard to the design of the sanitation facility they would like to use. Although sharing of sanitation facilities was common, the corbelled latrine is promoted as a single household pit latrine design. Unfortunately, 8% (23/304 of non-adopters responded they practiced open defecation. Households were satisfied with the corbelled latrine design, and no latrine was found to have collapsed during field visits. To promote the corbelled latrine in Malawi, the following are recommended: (1 education of frontline government extension workers towards non-subsidized household latrines; (2 identification of rural low-income households as the best target for potential adopters; and (3 linkage of low-cost sanitation technologies to community mobilization campaigns led by the government, such as Community Led Total Sanitation.

Associations between Violence in School and at Home and Education Outcomes in Rural Malawi: A Longitudinal Analysis

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Psaki, Stephanie R.; Mensch, Barbara S.; Soler-Hampejsek, Erica

2017-01-01

Growing evidence of the prevalence of school-related gender-based violence (SRGBV) has raised concerns about negative effects on education. Previous quantitative research on this topic has been limited by descriptive and cross-sectional data. Using longitudinal data from the Malawi Schooling and Adolescent Study, we investigate associations…

Preferences for food and nutritional supplements among adult people living with HIV in Malawi

OpenAIRE

Rodas Moya, Carlos; Kodish, Stephen; Manary, Mark; Grede, Nils; Pee, de, Saskia

2016-01-01

Objective: To elucidate the factors influencing food intake and preferences for potential nutritional supplements to treat mild and moderate malnutrition among adult people living with HIV (PLHIV). Design: Qualitative research using in-depth interviews with a triangulation of participants and an iterative approach to data collection. Setting: The study was conducted in a health clinic of rural Chilomoni, a southern town of Blantyre district, Malawi. Subjects: Male and female participants, age...

1 IN TR ODU CT ION Knowledge about diffuse irradiance is required ...

African Journals Online (AJOL)

, P/Bag 303, Blantyre 3, Malawi. Accepted 2003 December 11. Received 2002 March 17. ABSTRACT. Solar radiation measurements are taken at 25 locations in Malawi, a tropical country. Nev- ertheless, for a long time only Chileka weather ...

Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

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Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

2013-01-01

this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics

Effect of iodine and iron supplementation on physical, psychomotor and mental development in primary school children in Malawi

NARCIS (Netherlands)

Shrestha, R.M.

1994-01-01

Primary school children (n = 424) from the Ntcheu District, Malawi, aged 6 - 8 years, were selected for a double-blind placebo-controlled study to evaluate the effect of iodine and iron supplementation on physical, psychomotor and mental development. After the baseline measurements were

From Community Laywomen to Breast Health Workers: A Pilot Training Model to Implement Clinical Breast Exam Screening in Malawi.

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Gutnik, Lily; Moses, Agnes; Stanley, Christopher; Tembo, Tapiwa; Lee, Clara; Gopal, Satish

2016-01-01

Breast cancer burden is high in low-income countries. Inadequate early detection contributes to late diagnosis and increased mortality. We describe the training program for Malawi's first clinical breast exam (CBE) screening effort. Laywomen were recruited as Breast Health Workers (BHWs) with the help of local staff and breast cancer advocates. The four-week training consisted of lectures, online modules, role-playing, case discussions, CBE using simulators and patients, and practice presentations. Ministry of Health trainers taught health communication, promotion, and education skills. Breast cancer survivors shared their experiences. Clinicians taught breast cancer epidemiology, prevention, detection, and clinical care. Clinicians and research staff taught research ethics, informed consent, data collection, and professionalism. Breast cancer knowledge was measured using pre- and post-training surveys. Concordance between BHW and clinician CBE was assessed. Breast cancer talks by BHW were evaluated on a 5-point scale in 22 areas by 3 judges. We interviewed 12 women, and 4 were selected as BHWs including 1 breast cancer survivor. Training was dynamic with modification based on trainee response and progress. A higher-than-anticipated level of comprehension and interest led to inclusion of additional topics like breast reconstruction. Pre-training knowledge increased from 49% to 91% correct (peducational talks was 4.4 (standard deviation 0.7). Malawian laywomen successfully completed training and demonstrated competency to conduct CBE and deliver breast cancer educational talks. Knowledge increased after training, and concordance was high between BHW and clinician CBE.

Trace elements geochemistry of fractured basement aquifer in southern Malawi: A case of Blantyre rural

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Mapoma, Harold Wilson Tumwitike; Xie, Xianjun; Nyirenda, Mathews Tananga; Zhang, Liping; Kaonga, Chikumbusko Chiziwa; Mbewe, Rex

2017-07-01

In this study, twenty one (21) trace elements in the basement complex groundwater of Blantyre district, Malawi were analyzed. The majority of the analyzed trace elements in the water were within the standards set by World Health Organization (WHO) and Malawi Standards Board (MSB). But, iron (Fe) (BH16 and 21), manganese (Mn) (BH01) and selenium (Se) (BH02, 13, 18, 19 and 20) were higher than the WHO and MSB standards. Factor analysis (FA) revealed up to five significant factors which accounted for 87.4% of the variance. Factor 1, 2 and 3 suggest evaporite dissolution and silicate weathering processes while the fourth factor may explain carbonate dissolution and pH influence on trace element geochemistry of the studied groundwater samples. According to PHREEQC computed saturation indices, dissolution, precipitation and rock-water-interaction control the levels of trace elements in this aquifer. Elevated concentrations of Fe, Mn and Se in certain boreholes are due to the geology of the aquifer and probable redox status of groundwater. From PHREEQC speciation results, variations in trace element species were observed. Based on this study, boreholes need constant monitoring and assessment for human consumption to avoid health related issues.

Social networks, social participation, and health among youth living in extreme poverty in rural Malawi.

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Rock, Amelia; Barrington, Clare; Abdoulayi, Sara; Tsoka, Maxton; Mvula, Peter; Handa, Sudhanshu

2016-12-01

Extensive research documents that social network characteristics affect health, but knowledge of peer networks of youth in Malawi and sub-Saharan Africa is limited. We examine the networks and social participation of youth living in extreme poverty in rural Malawi, using in-depth interviews with 32 youth and caregivers. We describe youth's peer networks and assess how gender and the context of extreme poverty influence their networks and participation, and how their networks influence health. In-school youth had larger, more interactive, and more supportive networks than out-of-school youth, and girls described less social participation and more isolation than boys. Youth exchanged social support and influence within their networks that helped cope with poverty-induced stress and sadness, and encouraged protective sexual health practices. However, poverty hampered their involvement in school, religious schools, and community organizations, directly by denying them required material means, and indirectly by reducing time and emotional resources and creating shame and stigma. Poverty alleviation policy holds promise for improving youth's social wellbeing and mental and physical health by increasing their opportunities to form networks, receive social support, and experience positive influence. Copyright © 2016 Elsevier Ltd. All rights reserved.

From Early Childhood Development Policy to Sustainability: The Fragility of Community-Based Childcare Services in Malawi

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Neuman, Michelle J.; McConnell, Christin; Kholowa, Foster

2014-01-01

Over the past 20 years, more than 6,000 community-based childcare centers (CBCCs) have been created in mostly rural areas of Malawi. Although the original purpose of these CBCCs was to meet the care needs of orphans and vulnerable children affected by the HIV/AIDS pandemic, the services have since expanded their mandate to provide early…

Teachers' Views about Technical Education: Implications for Reforms towards a Broad Based Technology Curriculum in Malawi

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Chikasanda, Vanwyk Khobidi; Otrel-Cass, Kathrin; Jones, Alister

2011-01-01

Internationally there has been concern about the direction of technical education and how it is positioned in schools. This has also been the case in Malawi where the curriculum has had a strong focus on skills development. However, lately there has been a call for enhancing technological literacy of students, yet little support has been provided…

Factors affecting availability of essential medicines among community health workers in Ethiopia, Malawi, and Rwanda: solving the last mile puzzle.

Science.gov (United States)

Chandani, Yasmin; Noel, Megan; Pomeroy, Amanda; Andersson, Sarah; Pahl, Michelle K; Williams, Timothy

2012-11-01

To understand how supply chain factors affect product availability at the community level, the Improving Supply Chains for Community Case Management of Pneumonia and Other Common Diseases of Childhood Project developed a theory of change (TOC) framework for gathering, organizing, and interpreting evidence about supply constraints to community case management (CCM). Baseline assessments in Ethiopia, Malawi, and Rwanda conducted in 2010 provided information on the strengths and weaknesses of existing CCM supply chains for five main products: antibiotics for pneumonia, oral rehydration solution, ready to use therapeutic food, zinc, and artemether/lumefantrine. The assessments tested the strength and validity of causal pathways identified in the TOC that were believed to influence availability of CCM products among community health workers (CHWs) for treating common childhood illnesses. Results of the assessments showed product availability to be weak in each country, with more than half of CHWs stocked out of at least one tracer product on the day of the assessment. This report will focus on the findings related to three key preconditions of the TOC and how these were used to inform the design of the CCM supply chain improvement strategy in each country. The three key preconditions include product availability at CHW resupply points, supply chain knowledge and capacity among CHWs and their supervisors, and availability of appropriate transportation.

Hydrochemical assessment of groundwater used for irrigation in Rumphi and Karonga districts, Northern Malawi

Science.gov (United States)

Wanda, Elijah M. M.; Gulula, Lewis C.; Phiri, Ambrose

Irrigation water quality is an essential component of sustainable agriculture. Irrigation water quality concerns have often been neglected over concerns of quantity in most irrigation projects in Malawi. In this study, a hydrochemical assessment of groundwater was carried out to characterize, classify groundwater and evaluate its suitability for irrigation use in Karonga and Rumphi districts, Northern Malawi. Groundwater samples were collected during wet (January-April 2011) and dry (July-September 2011) seasons from 107 shallow wells and boreholes drilled for rural water supply using standard sampling procedures. The water samples were analysed for pH, major ions, total dissolved solids and electrical conductivity (EC), using standard methods. Multivariate chemometric (such as Kruskal Wallis test), hydrographical methods (i.e. Piper diagram) and PHREEQC geochemical modelling program were used to characterise the groundwater quality. Electrical conductivity, percentage sodium ion (% Na+), residual sodium carbonate (RSC), total dissolved solids (TDS), sodium adsorption ratio (SAR), Kelly’s ratio (KR) and permeability index (PI) were used to evaluate the suitability of water for irrigation. It was established that groundwater is neutral to alkaline and mostly freshwater (TDS management is suggested for sustainable development of the water resources for better plant growth, long-term as well as maintaining human health in the study area.

Problems Facing Disabled People in Malawi : A Critical Reflection on My Encounter with a Disabled Woman in a Rural Area in Malawi

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Memory J. Tembo

2015-03-01

Full Text Available This critical reflection is based on my encounter with a disabled woman in a district in Malawi, and how I have reflected and analyzed the encounter using social work theories. The essay reflects on the story of the disabled woman and my own perception at that time, in addition to my analysis of these perceptions using different perspectives in social work based on my current understanding of these perspectives. In line with Fook’s (2002; 68 critical reflection techniques, social work theories will be applied to deconstruct and reconstruct the critical incident. The essay highlights the challenges and dilemmas I encountered in attempting to make meaning out of this encounter, which left me helpless and powerless, as I could not offer her any sustainable help at the time.

Baseline characteristics of study sites and women enrolled in a three-arm cluster randomized controlled trial: PMTCT uptake and retention (pure) Malawi.

Science.gov (United States)

van Lettow, Monique; Tweya, Hannock; Rosenberg, Nora E; Trapence, Clement; Kayoyo, Virginia; Kasende, Florence; Kaunda, Blessings; Hosseinipour, Mina C; Eliya, Michael; Cataldo, Fabian; Gugsa, Salem; Phiri, Sam

2017-07-11

Malawi introduced an ambitious public health program known as "Option B+" which provides all HIV-infected pregnant and breastfeeding women with lifelong combination antiretroviral therapy, regardless of WHO clinical stage or CD4 cell count. The PMTCT Uptake and REtention (PURE) study aimed at evaluating the effect of peer-support on care-seeking and retention in care. PURE Malawi was a three-arm cluster randomized controlled trial that compared facility-based and community-based models of peer support to standard of care under Option B+ strategy. Each arm was expected to enroll a minimum of 360 women with a total minimum sample size of 1080 participants. 21 sites (clusters) were selected for inclusion in the study. This paper describes the site selection, recruitment, enrollment process and baseline characteristics of study sites and women enrolled in the trial. Study implementation was managed by 3 partner organizations; each responsible for 7 study sites. The trial was conducted in the South East, South West, and Central West zones of Malawi, the zones where the implementing partners operate. Study sites included 2 district hospitals, 2 mission hospitals, 2 rural hospitals, 13 health centers and 1 private clinic. Enrollment occurred from November 2013 to November 2014, over a median period of 31 weeks (range 17-51) by site. A total of 1269 HIV-infected pregnant (1094) and breastfeeding (175) women, who were eligible to initiate ART under Option B+, were enrolled. Each site reached or surpassed the minimum sample size. Comparing the number of women enrolled versus antenatal cohort reports, sites recruited a median of 90% (IQR 75-100) of eligible reported women. In the majority of sites the ratio of pregnant and lactating women enrolled in the study was similar to the ratio of reported pregnant and lactating women starting ART in the same sites. The median age of all women was 27 (IQR 22-31) years. All women have ≥20 months of possible follow-up time; 96%�

Quality of malaria case management in Malawi: results from a nationally representative health facility survey.

Science.gov (United States)

Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

2014-01-01

Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have

Haemorrhage in pregnancy: information given to women in Chiradzulu (Malawi

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H Kapyepye

2006-09-01

Full Text Available Advising women on , haemorrhage in pregnancy could, be viewed, as an integral aspect of maternal health care in M alawi. The WHO (1999 confirmed, that haemorrhage in pregnancy was not only a direct reason for maternal mortality but also a major cause of maternal death. The question on the nature of information that midwives and traditional birth attendants (referred to as TBA’s in the Chiradzulu district in Malawi gave with regard to haemorrhage in pregnancy, therefore arose. Research available focused on the women’s knowledge about the complications of pregnancy but not on the nature of information women received from midwives and TBA’s. This study explored and described the nature of information that was given to rural women in the Chiradzulu district by the midwives and TBA’s regarding haemorrhage in pregnancy. The findings revealed that although both the midwives and TBA’s included important information about haemorrhage in pregnancy, there were deficiencies in some critical areas. Examples of these deficiencies were the definition of haemorrhage in pregnancy; the predisposing factors for antepartum and postpartum haemorrhage and deficiencies in the nature of information on the management and referral of haemorrhaging patients. The findings provided insights into the nature of the information that was provided to the women regarding haemorrhage in pregnancy in the Chiradzulu district in Malawi. Thereafter guidelines were developed for the provision of this information. Finally a follow-up study was recommended after implementation of these guidelines in the district to evaluate the change in the nature of the information communicated to patients regarding haemorrhage by midwives and TBA’s. In this study, haemorrhage during pregnancy referred to the perinatal phase, including antepartum, intrapartum and postpartum haemorrhage.

Genomic characterisation of invasive non-typhoidal Salmonella enterica Subspecies enterica Serovar Bovismorbificans isolates from Malawi.

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Christina Bronowski

2013-11-01

Full Text Available Invasive Non-typhoidal Salmonella (iNTS are an important cause of bacteraemia in children and HIV-infected adults in sub-Saharan Africa. Previous research has shown that iNTS strains exhibit a pattern of gene loss that resembles that of host adapted serovars such as Salmonella Typhi and Paratyphi A. Salmonella enterica serovar Bovismorbificans was a common serovar in Malawi between 1997 and 2004.We sequenced the genomes of 14 Malawian bacteraemia and four veterinary isolates from the UK, to identify genomic variations and signs of host adaptation in the Malawian strains.Whole genome phylogeny of invasive and veterinary S. Bovismorbificans isolates showed that the isolates are highly related, belonging to the most common international S. Bovismorbificans Sequence Type, ST142, in contrast to the findings for S. Typhimurium, where a distinct Sequence Type, ST313, is associated with invasive disease in sub-Saharan Africa. Although genome degradation through pseudogene formation was observed in ST142 isolates, there were no clear overlaps with the patterns of gene loss seen in iNTS ST313 isolates previously described from Malawi, and no clear distinction between S. Bovismorbificans isolates from Malawi and the UK. The only defining differences between S. Bovismorbificans bacteraemia and veterinary isolates were prophage-related regions and the carriage of a S. Bovismorbificans virulence plasmid (pVIRBov.iNTS S. Bovismorbificans isolates, unlike iNTS S. Typhiumrium isolates, are only distinguished from those circulating elsewhere by differences in the mobile genome. It is likely that these strains have entered a susceptible population and are able to take advantage of this niche. There are tentative signs of convergent evolution to a more human adapted iNTS variant. Considering its importance in causing disease in this region, S. Bovismorbificans may be at the beginning of this process, providing a reference against which to compare changes that may

Preliminary Studies of the Performance of Quinoa (Chenopodium quinoa Willd.) Genotypes under Irrigated and Rainfed Conditions of Central Malawi.

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Maliro, Moses F A; Guwela, Veronica F; Nyaika, Jacinta; Murphy, Kevin M

2017-01-01

The goal of sustainable intensification of agriculture in Malawi has led to the evaluation of innovative, regionally novel or under-utilized crop species. Quinoa ( Chenopodium quinoa Willd.) has the potential to provide a drought tolerant, nutritious alternative to maize. We evaluated 11 diverse varieties of quinoa for their yield and agronomic performance at two locations, Bunda and Bembeke, in Malawi. The varieties originated from Ecuador, Chile and Bolivia in South America; the United States and Canada in North America; and, Denmark in Europe, and were chosen based on their variation in morphological and agronomic traits, and their potential for adaptation to the climate of Malawi. Plant height, panicle length, days to maturity, harvest index, and seed yield were recorded for each variety under irrigation at Bunda and Bembeke, and under rainfed conditions at Bunda. Plant height was significantly influenced by both genotype and environment. There were also significant differences between the two locations for panicle length whereas genotype and genotype × environment (G × E) interaction were not significantly different. Differences were found for genotype and G × E interaction for harvest index. Notably, differences for genotype, environment and G × E were found for grain yield. Seed yield was higher at Bunda (237-3019 kg/ha) than Bembeke (62-692 kg/ha) under irrigated conditions. The highest yielding genotype at Bunda was Titicaca (3019 kg/ha) whereas Multi-Hued was the highest (692 kg/ha) at Bembeke. Strong positive correlations between seed yield and (1) plant height ( r = 0.74), (2) days to maturity ( r = 0.76), and (3) biomass ( r = 0.87) were found under irrigated conditions. The rainfed evaluations at Bunda revealed significant differences in seed yield, plant biomass, and seed size among the genotypes. The highest yielding genotype was Black Seeded (2050 kg/ha) followed by Multi-Hued (1603 kg/ha) and Bio-Bio (1446 kg/ha). Ecuadorian (257 kg/ha) was

Seasonal and geographic differences in treatment-seeking and household cost of febrile illness among children in Malawi

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Roca-Feltrer Arantxa

2011-02-01

Full Text Available Abstract Background Households in malaria endemic countries experience considerable costs in accessing formal health facilities because of childhood malaria. The Ministry of Health in Malawi has defined certain villages as hard-to-reach on the basis of either their distance from health facilities or inaccessibility. Some of these villages have been assigned a community health worker, responsible for referring febrile children to a health facility. Health facility utilization and household costs of attending a health facility were compared between individuals living near the district hospital and those in hard-to-reach villages. Methods Two cross-sectional household surveys were conducted in the Chikhwawa district of Malawi; one during each of the wet and dry seasons. Half the participating villages were located near the hospital, the others were in areas defined as hard-to-reach. Data were collected on attendance to formal health facilities and economic costs incurred due to recent childhood febrile illness. Results Those living in hard-to-reach villages were less likely to attend a formal health facility compared to those living near the hospital (Dry season: OR 0.35, 95%CI0.18-0.67; Wet season: OR 0.46, 95%CI0.27-0.80. Analyses including community health workers (CHW as a source of formal health-care decreased the strength of this relationship, and suggested that consulting a CHW may reduce attendance at health facilities, even if indicated. Although those in hard-to-reach villages were still less likely to attend in both the dry (OR 0.53, 95%CI 0.25-1.11 and wet (OR 0.60, 95%CI 0.37-0.98 seasons. Household costs for those who attended a health facility were greater for those in HTR villages (Dry: USD5.24; Wet: USD5.60 than for those living near the district hospital (Dry: USD3.45; Wet: USD4.46. Conclusion Those living in hard-to-reach areas were less likely to attend a health facility for a childhood febrile event and experienced greater

The Quiet Rise of Medium-Scale Farms in Malawi

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Ward Anseeuw

2016-06-01

Full Text Available Medium-scale farms have become a major force in Malawi’s agricultural sector. Malawi’s most recent official agricultural survey indicates that these account for over a quarter of all land under cultivation in Malawi. This study explores the causes and multifaceted consequences of the rising importance of medium-scale farms in Malawi. We identify the characteristics and pathways of entry into farming based on surveys of 300 medium-scale farmers undertaken in 2014 in the districts of Mchinji, Kasungu and Lilongwe. The area of land acquired by medium-scale farmers in these three districts is found to have almost doubled between 2000 and 2015. Just over half of the medium-scale farmers represent cases of successful expansion out of small-scale farming status; the other significant proportion of medium-scale farmers are found to be urban-based professionals, entrepreneurs and/or civil servants who acquired land, some very recently, and started farming in mid-life. We also find that a significant portion of the land acquired by medium-scale farmers was utilized by others prior to acquisition, that most of the acquired land was under customary tenure, and that the current owners were often successful in transferring the ownership structure of the acquired land to a long-term leaseholding with a title deed. The study finds that, instead of just strong endogenous growth of small-scale famers as a route for the emergence of medium-scale farms, significant farm consolidation is occurring through land acquisitions, often by urban-based people. The effects of farmland acquisitions by domestic investors on the country’s primary development goals, such as food security, poverty reduction and employment, are not yet clear, though some trends appear to be emerging. We consider future research questions that may more fully shed light on the implications of policies that would continue to promote land acquisitions by medium-scale farms.

Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi.

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Fasawe, Olufunke; Avila, Carlos; Shaffer, Nathan; Schouten, Erik; Chimbwandira, Frank; Hoos, David; Nakakeeto, Olive; De Lay, Paul

2013-01-01

The Ministry of Health in Malawi is implementing a pragmatic and innovative approach for the management of all HIV-infected pregnant women, termed Option B+, which consists of providing life-long antiretroviral treatment, regardless of their CD4 count or clinical stage. Our objective was to determine if Option B+ represents a cost-effective option. A decision model simulates the disease progression of a cohort of HIV-infected pregnant women receiving prophylaxis and antiretroviral therapy, and estimates the number of paediatric infections averted and maternal life years gained over a ten-year time horizon. We assess the cost-effectiveness from the Ministry of Health perspective while taking into account the practical realities of implementing ART services in Malawi. If implemented as recommended by the World Health Organization, options A, B and B+ are equivalent in preventing new infant infections, yielding cost effectiveness ratios between US$ 37 and US$ 69 per disability adjusted life year averted in children. However, when the three options are compared to the current practice, the provision of antiretroviral therapy to all mothers (Option B+) not only prevents infant infections, but also improves the ten-year survival in mothers more than four-fold. This translates into saving more than 250,000 maternal life years, as compared to mothers receiving only Option A or B, with savings of 153,000 and 172,000 life years respectively. Option B+ also yields favourable incremental cost effectiveness ratios (ICER) of US$ 455 per life year gained over the current practice. In Malawi, Option B+ represents a favorable policy option from a cost-effectiveness perspective to prevent future infant infections, save mothers' lives and reduce orphanhood. Although Option B+ would require more financial resources initially, it would save societal resources in the long-term and represents a strategic option to simplify and integrate HIV services into maternal, newborn and child

Explanations for Child Sexual Abuse Given by Convicted Offenders in Malawi: No Evidence for "HIV Cleansing"

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Mtibo, Charles; Kennedy, Neil; Umar, Eric

2011-01-01

Objective: A commonly cited, but unproven reason given for the rise in reported cases of child sexual abuse in Sub-Saharan Africa is the "HIV cleansing myth"--the belief that an HIV infected individual can be cured by having sex with a child virgin. The purpose of this study was to explore in Malawi the reasons given by convicted sex…

Six-month mortality among HIV-infected adults presenting for antiretroviral therapy with unexplained weight loss, chronic fever or chronic diarrhea in Malawi.

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Monique van Lettow

Full Text Available In sub-Saharan Africa, early mortality is high following initiation of antiretroviral therapy (ART. We investigated 6-month outcomes and factors associated with mortality in HIV-infected adults being assessed for ART initiation and presenting with weight loss, chronic fever or diarrhea, and with negative TB sputum microscopy.A prospective cohort study was conducted in Malawi, investigating mortality in relation to ART uptake, microbiological findings and treatment of opportunistic infection (OIs, 6 months after meeting ART eligibility criteria.Of 469 consecutive adults eligible for ART, 74(16% died within 6 months of enrolment, at a median of 41 days (IQR 20-81. 370(79% started ART at a median time of 18 days (IQR 7-40 after enrolment. Six-month case-fatality rates were higher in patients with OIs; 25/121(21% in confirmed/clinical TB and 10/50(20% with blood stream infection (BSI compared to 41/308(13% in patients with no infection identified. Median TB treatment start was 27 days (IQR 17-65 after enrolment and mortality [8 deaths (44%] was significantly higher among 18 culture-positive patients with delayed TB diagnosis compared to patients diagnosed clinically and treated promptly with subsequent culture confirmation [6/34 (18%;p = 0.04]. Adjusted multivariable analysis, excluding deaths in the first 21 days, showed weight loss >10%, low CD4 count, severe anemia, laboratory-only TB diagnosis, and not initiating ART to be independently associated with increased risk of death.Mortality remains high among chronically ill patients eligible for ART. Prompt initiation of ART is vital: more than half of deaths were among patients who never started ART. Diagnostic and treatment delay for TB was strongly associated with risk of death. More than half of deaths occurred without identification of a specific infection. ART programmes need access to rapid point-of-care-diagnostic tools for OIs. The role of early empiric OI treatment in this population

Overview | Kowero | Zimbabwe Science News

African Journals Online (AJOL)

Articles presented in this special issue are drawn from research findings of the project “Management of Miombo Woodlands”. This is being implemented in five Southern Africa Development Community (SADC) countries (Zimbabwe, Zambia, Malawi, Mozambique, Tanzania) by the Center for International Forestry Research ...

Technical Meeting on Establishing Networks for Countries Introducing Nuclear Power. Presentations

International Nuclear Information System (INIS)

2013-01-01

The objectives of the meeting were to: • Learn about existing networking opportunities that may be of interest for embarking countries; • Discuss common challenges among Member States that could be addressed through better networking opportunities; • Determine appropriate sub-networks, such as future owner/operator organizations, heads of nuclear energy programme implementing organizations (NEPIOs), embarking countries and countries with current civil nuclear programmes; and • Discuss effective strategies for creating networks using existing social media platforms

Paediatric burns in LMICs: An evaluation of the barriers and facilitators faced by staff involved in burns education training programmes in Blantyre, Malawi.

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Harris, Lyndsey; Fioratou, Evridiki; Broadis, Emily

2016-08-01

A burn prevention and education programme - the Reduction of Burn and Scald Mortality and Morbidity in Children in Malawi project - was implemented from January 2010-2013 in Queen Elizabeth Central Hospital, Malawi. This study aimed to investigate the barriers and facilitators of implementing education-training programmes. Semi-structured interviews with 14 Scottish and Malawian staff delivering and receiving teaching at training education programmes were conducted. All interviews were recorded, transcribed and analysed using thematic analysis. Overarching barriers and facilitators were similar for both sets of staff. Scottish participants recognised that limited experience working in LMICs narrowed the challenges they anticipated. Time was a significant barrier to implementation of training courses for both sets of participants. Lack of hands on practical experience was the greatest barrier to implementing the skills learnt for Malawian staff. Sustainability was a significant facilitator to successful implementation of training programmes. Encouraging involvement of Malawian staff in the co-ordination and delivery of teaching enabled those who attend courses to teach others. A recognition of and response to the barriers and facilitators associated with introducing paediatric burn education training programmes can contribute to the development of sustainable programme implementation in Malawi and other LMICs. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania.

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Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

2017-12-01

Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women's use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities' capacity to provide newborn care services in low and middle income countries. In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally-representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn-related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to substantial equity gaps in the availability of essential

Exploring innovative ways to conduct coverage surveys for neglected tropical diseases in Malawi, Mali, and Uganda.

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Woodhall, Dana M; Mkwanda, Square; Dembele, Massitan; Lwanga, Harriet; Drexler, Naomi; Dubray, Christine; Harris, Jennifer; Worrell, Caitlin; Mathieu, Els

2014-04-01

Currently, a 30-cluster survey to monitor drug coverage after mass drug administration for neglected tropical diseases is the most common methodology used by control programs. We investigated alternative survey methodologies that could potentially provide an estimation of drug coverage. Three alternative survey methods (market, village chief, and religious leader) were conducted and compared to the 30-cluster method in Malawi, Mali, and Uganda. In Malawi, drug coverage for the 30-cluster, market, village chief, and religious leader methods were 66.8% (95% CI 60.3-73.4), 74.3%, 76.3%, and 77.8%, respectively. In Mali, results for round 1 were 62.6% (95% CI 54.4-70.7), 56.1%, 74.8%, and 83.2%, and 57.2% (95% CI 49.0-65.4), 54.5%, 72.2%, and 73.3%, respectively, for round 2. Uganda survey results were 65.7% (59.4-72.0), 43.7%, 67.2%, and 77.6% respectively. Further research is needed to test different coverage survey methodologies to determine which survey methods are the most scientifically rigorous and resource efficient. Published by Elsevier B.V.

‘At the hospital I learnt the truth’: diagnosing male infertility in rural Malawi

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Parrott, Fiona R.

2014-01-01

This paper examines how men's reproductive bodies are problematised in rural northern Malawi as access to biomedically defined diagnoses of the health of men's sperm contribute to the visibility of male infertility. Ethnographic research with infertile and fertile men explored pathways into the sexual health and fertility services offered in district hospitals, men's clinical engagements and masculine imaginaries. The research suggested that men's willingness to be referred for semen analysis is an extension of intensive and persistent help-seeking for childlessness instigated by couples and encouraged by families. Within the laboratory, acceptable social arrangements for semen sample collection are negotiated between male clients and laboratory staff, which emphasise heterosexual and marital virility. Following diagnosis, counselling by clinical officers, without any significant therapeutic interventions, focuses on compassion in marriage. This paper considers: what is the role of semen analysis within public health facilities and why do men participate? How do men experience an infertility diagnosis and what do they and their partners do with this knowledge? In addition, how do these practices shape gendered relationships in families and communities? The analysis builds on Inhorn's (2012) concept of ‘emergent masculinities’ to better understand the connections between male subjectivities, medical technologies and the globalisation of male reproductive health, as they relate to men's lives in rural Malawi. PMID:25175293

Mental Health Facilitator (MHF) Service Implementation in Schools in Malawi, Africa: A Strategy for Increasing Community Human Resources

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Luke, Melissa; Hinkle, J. Scott; Schweiger, Wendi; Henderson, Donna

2016-01-01

The Mental Health Facilitator (MHF) program utilizes a population-based curriculum and has been implemented in Malawi for the past seven years. This article reports findings from an ethnographic study that explored how 40 MHF stakeholders have experienced the MHF program. This transdisciplinary program is a 30-hour training in community mental…

Countdown to 2015 country case studies: what have we learned about processes and progress towards MDGs 4 and 5?

Science.gov (United States)

Moucheraud, Corrina; Owen, Helen; Singh, Neha S; Ng, Courtney Kuonin; Requejo, Jennifer; Lawn, Joy E; Berman, Peter

2016-09-12

Countdown to 2015 was a multi-institution consortium tracking progress towards Millennium Development Goals (MDGs) 4 and 5. Case studies to explore factors contributing to progress (or lack of progress) in reproductive, maternal, newborn and child health (RMNCH) were undertaken in: Afghanistan, Bangladesh, China, Ethiopia, Kenya, Malawi, Niger, Pakistan, Peru, and Tanzania. This paper aims to identify cross-cutting themes on how and why these countries achieved or did not achieve MDG progress. Applying a standard evaluation framework, analyses of impact, coverage and equity were undertaken, including a mixed methods analysis of how these were influenced by national context and coverage determinants (including health systems, policies and financing). The majority (7/10) of case study countries met MDG-4 with over two-thirds reduction in child mortality, but none met MDG-5a for 75 % reduction in maternal mortality, although six countries achieved >75 % of this target. None achieved MDG-5b regarding reproductive health. Rates of reduction in neonatal mortality were half or less that for post-neonatal child mortality. Coverage increased most for interventions administered at lower levels of the health system (e.g., immunisation, insecticide treated nets), and these experienced substantial political and financial support. These interventions were associated with ~30-40 % of child lives saved in 2012 compared to 2000, in Ethiopia, Malawi, Peru and Tanzania. Intrapartum care for mothers and newborns -- which require higher-level health workers, more infrastructure, and increased community engagement -- showed variable increases in coverage, and persistent equity gaps. Countries have explored different approaches to address these problems, including shifting interventions to the community setting and tasks to lower-level health workers. These Countdown case studies underline the importance of consistent national investment and global attention for achieving improvements

Communities of Change, Multi Stakeholder Processes, Lobby & Advocacy : More than 100 years of experience on HBC in Malawi & Zambia!

NARCIS (Netherlands)

Vugt, van S.M.; Sloot, H.

2011-01-01

This training of four days focussed on two areas of capacity development of the home-based care (HBC) alliance in Malawi and Zambia: 1. Communities of Change (CoC) concept and practice linked to the Multi Stakeholder Process (MSP), and 2. Lobby & Advocacy (L&A). Since June 2010 Cordaid

Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi.

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Kondwani Kawaza

Full Text Available Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care.We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi. Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups.87 neonates (62 bCPAP, 25 controls were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62 compared with 44.0% (11/25 for controls. 65.5% (19/29 of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13 of controls. 64.6% (31/48 of neonates with respiratory distress syndrome (RDS receiving bCPAP survived to discharge, compared to 23.5% (4/17 of controls. 61.5% (16/26 of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived.Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries.

Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi.

Science.gov (United States)

Kawaza, Kondwani; Machen, Heather E; Brown, Jocelyn; Mwanza, Zondiwe; Iniguez, Suzanne; Gest, Al; Smith, E O'Brian; Oden, Maria; Richards-Kortum, Rebecca R; Molyneux, Elizabeth

2014-01-01

Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care. We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi. Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups. 87 neonates (62 bCPAP, 25 controls) were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62) compared with 44.0% (11/25) for controls. 65.5% (19/29) of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13) of controls. 64.6% (31/48) of neonates with respiratory distress syndrome (RDS) receiving bCPAP survived to discharge, compared to 23.5% (4/17) of controls. 61.5% (16/26) of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived. Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries.

From Community Laywomen to Breast Health Workers: A Pilot Training Model to Implement Clinical Breast Exam Screening in Malawi.

Directory of Open Access Journals (Sweden)

Lily Gutnik

Full Text Available Breast cancer burden is high in low-income countries. Inadequate early detection contributes to late diagnosis and increased mortality. We describe the training program for Malawi's first clinical breast exam (CBE screening effort.Laywomen were recruited as Breast Health Workers (BHWs with the help of local staff and breast cancer advocates. The four-week training consisted of lectures, online modules, role-playing, case discussions, CBE using simulators and patients, and practice presentations. Ministry of Health trainers taught health communication, promotion, and education skills. Breast cancer survivors shared their experiences. Clinicians taught breast cancer epidemiology, prevention, detection, and clinical care. Clinicians and research staff taught research ethics, informed consent, data collection, and professionalism. Breast cancer knowledge was measured using pre- and post-training surveys. Concordance between BHW and clinician CBE was assessed. Breast cancer talks by BHW were evaluated on a 5-point scale in 22 areas by 3 judges.We interviewed 12 women, and 4 were selected as BHWs including 1 breast cancer survivor. Training was dynamic with modification based on trainee response and progress. A higher-than-anticipated level of comprehension and interest led to inclusion of additional topics like breast reconstruction. Pre-training knowledge increased from 49% to 91% correct (p<0.0001. Clinician and BHW CBE had 88% concordance (kappa 0.43. The mean rating of BHW educational talks was 4.4 (standard deviation 0.7.Malawian laywomen successfully completed training and demonstrated competency to conduct CBE and deliver breast cancer educational talks. Knowledge increased after training, and concordance was high between BHW and clinician CBE.

Present regulatory situation in South East European and Black Sea countries

International Nuclear Information System (INIS)

Brenow, K.

2000-01-01

Recently, after the energy reforms beginning, various regulatory models are either actually used or contemplated in the countries of Southeastern Europe and the Black Sea region. The 'models' are country-specific and five of them are described in this report. Certain common issues emerge specific to these countries can be grouped in three categories. The first category, called 'framework issues', includes the policy issues that determine the context in which the regulator will have to evolve. The second category, called 'regulatory issues proper', includes licensing, setting of prices, tariffs, transmission fees, establishment of codes for markets, grids and metering. The third category, called 'international issues', includes these issues requiring the international cooperation among regulators. The countries in Southeastern Europe and around the Black Sea have a long experience with regulation of grid-based energies and this experience should be adapted to the market-oriented context bearing in mind the benefits of competition and of regional integration and markets

Correlated evolution of short wavelength sensitive photoreceptor sensitivity and color pattern in Lake Malawi cichlids

Directory of Open Access Journals (Sweden)

Michael J. Pauers

2016-02-01

Full Text Available For evolutionary ecologists, the holy grail of visual ecology is to establish an unambiguous link between photoreceptor sensitivity, the spectral environment, and the perception of specific visual stimuli (e.g., mates, food, predators, etc.. Due to the bright nuptial colors of the males, and the role female mate choice plays in their evolution, the haplochromine cichlid fishes of the African great lakes are favorite research subjects for such investigations. Despite this attention, current evidence is equivocal; while distinct correlations among photoreceptor sensitivity, photic environment, and male coloration exist in Lake Victorian haplochromines, attempts to find such correlations in Lake Malawian cichlids have failed. Lake Malawi haplochromines have a wide variability in their short-wavelength-sensitive photoreceptors, especially compared to their mid- and long-wavelength-sensitive photoreceptors; these cichlids also vary in the degree to which they express one of three basic color patterns (vertical bars, horizontal stripes, and solid patches of colors, each of which is likely used in a different form of communication. Thus, we hypothesize that, in these fishes, spectral sensitivity and color pattern have evolved in a correlated fashion to maximize visual communication; specifically, ultraviolet sensitivity should be found in vertically-barred species to promote ‘private’ communication, while striped species should be less likely to have ultraviolet sensitivity, since their color pattern carries ‘public’ information. Using phylogenetic independent contrasts, we found that barred species had strong sensitivity to ultraviolet wavelengths, but that striped species typically lacked sensitivity to ultraviolet light. Further, the only variable, even when environmental variables were simultaneously considered, that could predict ultraviolet sensitivity was color pattern. We also found that, using models of correlated evolution, color

Starting the conversation: community perspectives on preterm birth and kangaroo mother care in southern Malawi.

Science.gov (United States)

Lydon, Megan; Longwe, Monica; Likomwa, Dyson; Lwesha, Victoria; Chimtembo, Lydia; Donohue, Pamela; Guenther, Tanya; Valsangar, Bina

2018-06-01

Despite introduction of Kangaroo Mother Care (KMC) in Malawi over a decade ago, preterm birth remains the leading cause of neonatal mortality. Although KMC is initiated in the health care facility, robust community follow-up is critical for survival and optimal development of preterm and low birth weight infants post-discharge. The objective of this qualitative study was to gain insight into community and health worker understanding, attitudes, beliefs and practices around preterm and low birth weight babies and KMC in Malawi. A total of 152 participants were interviewed in two districts in southern Malawi, Machinga and Thyolo, in April 2015. Focus group discussions (groups = 11, n = 132) were conducted with pregnant women, community members and women who have practiced KMC. In-depth interviews (n = 20) were conducted with fathers who have practiced KMC, community and religious leaders, and health workers. Purposive and snowball sampling were employed to identify participants. Thematic content analysis was conducted. KMC mothers and fathers only learned about KMC and care for preterm newborns after delivery of a child in need of this care. Men typically were not included in KMC counseling due to societal gender roles. Health facilities were the main source of information on KMC, however informal networks among women provided some degree of knowledge exchange. Community leaders were regarded as major facilitators of health information, conveners, key influencers, and policy-makers. Religious leaders were regarded as advocates and emotional support for families with preterm infants. Finally, while many participants initially had negative feelings towards preterm births and KMC, the large majority saw a shift in their perceptions through health counseling, peer modeling, and personal success with KMC. The findings offer several opportunities to improve KMC implementation including 1) earlier introduction of KMC to pregnant women and their families that are

HIV treatment optimism and its predictors among young adults in southern Malawi.

Science.gov (United States)

Yeatman, Sara; Dovel, Kathryn; Conroy, Amy; Namadingo, Hazel

2013-08-01

This study measures HIV treatment optimism and its predictors in a representative sample of young adults in southern Malawi. In 2010, 1275 women and 470 men between the ages of 16 and 26 were asked about their exposure to people on antiretroviral therapy (ART), sexual risk behavior, HIV status, and beliefs about ART. We used confirmatory factor analysis to develop a 4-item scale of the belief that HIV is a less serious health threat due to ART (reduced-severity optimism) and used a single measure to capture belief in the reduced infectivity of HIV due to ART (reduced-susceptibility optimism). Overall, respondents reported low levels of HIV treatment optimism. Being female and using ART were the largest predictors of both types of treatment optimism. We found a nonlinear relationship between exposure to people on ART and reduced-severity optimism. People who knew someone on ART but did not discuss it with them had lower levels of reduced-severity optimism than people who did not know anyone on ART and people who regularly discussed treatment with someone on ART. In multivariate regression models, HIV treatment optimism was positively associated with all measures of sexual risk behavior among men, but negatively associated with unprotected sex with a nonprimary partner among women. Our findings suggest that the spread of ART in Malawi has not led to widespread HIV treatment optimism. This may reflect the relatively recent spread of ART, the generalized nature of the HIV epidemic, or the fact that access to ART is complicated by structural limitations that delay treatment and limited availability of second-line medicines.

Climate change in semi-arid Malawi: Perceptions, adaptation strategies and water governance

Directory of Open Access Journals (Sweden)

Miriam K. Joshua

2016-04-01

Full Text Available Climate change and variability are a threat to sustainable agricultural production in semi-arid areas of Malawi. Overdependence on subsistence rain-fed agriculture in these areas calls for the identification of sustainable adaptation strategies. A study was therefore conducted in Chikwawa, a semi-arid district in southern Malawi, to: (1 assess community’s perception of a changing climate against empirical evidence, (2 determine their local adaptive measures, (3 evaluate the potential of irrigated agriculture as an adaptive measure in household food security and (4 challenges over access to available water resources. The study employed focus group discussions and key informant interviews to assess people’s perceptions of climate change and variability and their desired interventions. To validate the people’s perceptions, rainfall and temperature data for the period 1960–2010 were analysed. A participatory complete randomised experimental design in both rain-fed and dry season–irrigated conditions was conducted to assess a maize cropping system that would improve adaptation. The study established persistent declining yields from rain-fed production in part because of perennial rainfall failure. In response, the community has shifted its focus to irrigation as an adaptation strategy, which has in turn triggered water conflicts in the community over the control of the resource. Water legislation however fails to adequately provide for rules governing sharing of water resources between various stakeholders. This article therefore recommends development of an appropriate institutional framework that forms a strong basis for equitable distribution of water for irrigation in areas most vulnerable to extreme climate events – including droughts and floods. Keywords: Food Security; Climate Change and Variability; Rainfall Variability; Irrigation; Water Resources; Governance Crisis