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Journal articles on the topic 'Family demography – Malawi'
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Grant, Monica J., and Sara Yeatman. "The Impact of Family Transitions on Child Fostering in Rural Malawi." Demography 51, no. 1 (September 10, 2013): 205–28. http://dx.doi.org/10.1007/s13524-013-0239-8.
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Yeatman, Sara, and Jenny Trinitapoli. "Beyond denomination: The relationship between religion and family planning in rural Malawi." Demographic Research 19 (October 24, 2008): 1851–82. http://dx.doi.org/10.4054/demres.2008.19.55.
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Thornton, Arland, Rachael S. Pierotti, Linda Young-DeMarco, and Susan Watkins. "Developmental Idealism and Cultural Models of the Family in Malawi." Population Research and Policy Review 33, no. 5 (February 20, 2014): 693–716. http://dx.doi.org/10.1007/s11113-014-9322-0.
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Paz Soldan, Valerie A. "How Family Planning Ideas Are Spread Within Social Groups in Rural Malawi." Studies in Family Planning 35, no. 4 (December 2004): 275–90. http://dx.doi.org/10.1111/j.0039-3665.2004.00031.x.
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Chirwa, Wiseman Chijere. "“No TEBA …Forget TEBA”: The Plight of Malawian Ex-migrant Workers to South Africa, 1988–1994." International Migration Review 31, no. 3 (September 1997): 628–54. http://dx.doi.org/10.1177/019791839703100305.
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This article is about the process of socioeconomic transformation in rural Malawi. It examines the survival strategies and enterprising spirit of Malawian migrant workers and their households. It argues that the strategies of these people often went beyond survival in the provision of basic necessities. Those who had the economic drive and entrepreneurial skills were able to use the proceeds of labor migration to improve their own and their households’ socioeconomic life. In March 1988, the South African Chamber of Mines stopped a century-old tradition of recruiting migrant workers from Malawi. This has arrested and put to a halt a process of accumulation taking place in the households of the returned migrant workers in the rural economy. Thus, the effects of the retrenchment of the workers will spread from the migrant and his family through the economic and social wellspring of all sectors of rural communities and their commercial lives.
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Madise, Nyovani Janet, and Mabel Mpoma. "Child Malnutrition and Feeding Practices in Malawi." Food and Nutrition Bulletin 18, no. 2 (January 1997): 1–14. http://dx.doi.org/10.1177/156482659701800205.
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The 1992 Malawi and Demographic Health Survey data are used to assess the association between breast-feeding practices, socio-economic and morbidity variables, and the nutritional status of children under the age of five years using multilevel models. About 27% of under-five children in Malawi are underweight, and nearly 50% are stunted. The results of this study suggest that socio-economicfactors, morbidity, and inappropriate feeding practices are some of the factors associated with malnutrition in Malawi. High socio-economic status, as measured by urban residence, the presence of modern amenities, and some maternal education, is associated with better nutritional status, whereas morbidity within two weeks before the survey is associated with low weight-for-age Z scores. Breast-feeding is almost universal and is carried on for about 21 months, but the introduction of complementary food starts much too early; only 3% of Malawian children under the age of 4 months are exclusively breastfed. Children aged 12 months or older who were still breastfeeding at the time of the survey were of lower nutritional status than those who had stopped breastfeeding. The analysis also showed a significant intra-family correlation of weight-for-age Z scores of children of the same family of about 39%.
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KENDALL, JACOB, and PHILIP ANGLEWICZ. "Living arrangements and health at older ages in rural Malawi." Ageing and Society 38, no. 5 (December 29, 2016): 1018–40. http://dx.doi.org/10.1017/s0144686x16001422.
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ABSTRACTSub-Saharan Africa's older population is projected to nearly double in size by 2030. At the same time, demographic changes have caused major shifts in the units primarily responsible for the care of older adults: the family and household. The purpose of this paper is to examine the relationship between household composition and health at older ages in rural Malawi. We use data from the Malawi Longitudinal Study of Families and Health, which contains detailed information on household and family structure, along with measures of mental and physical health (from the Short Form-12). We focus on several measures of living arrangements that are expected to be associated with health: overall household size, sex composition and kin structure (based on co-residence with offspring and grandchildren). Results show that: (a) older women who co-reside with offspring have better mental and physical health compared to those living only with grandchildren; (b) older men who live in larger households or in households with a higher proportion of females have better physical health.
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Anglewicz, Philip, Mark VanLandingham, Lucinda Manda-Taylor, and Hans-Peter Kohler. "Cohort profile: internal migration in sub-Saharan Africa—The Migration and Health in Malawi (MHM) study." BMJ Open 7, no. 5 (May 2017): e014799. http://dx.doi.org/10.1136/bmjopen-2016-014799.
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PurposeThe Migration and Health in Malawi (MHM) study focuses on a key challenge in migration research: although it has long been established that migration and health are closely linked, identifying the effect of migration on various health outcomes is complicated by methodological challenges. The MHM study uses a longitudinal panel premigration and postmigration study design (with a non-migrant comparison group) to measure and/or control for important characteristics that affect both migration and health outcomes.ParticipantsData are available for two waves. The MHM interviewed 398 of 715 migrants in 2007 (55.7%) and 722 of 1013 in 2013 (71.3%); as well as 604 of 751 (80.4%) for a non-migrant reference group in 2013. The total interviewed sample size for the MHM in both waves is 1809. These data include extensive information on lifetime migration, socioeconomic and demographic characteristics, sexual behaviours, marriage, household/family structure, social networks and social capital, HIV/AIDS biomarkers and other dimensions of health.Findings to dateOur result for the relationship between migration and health differs by health measure and analytic approach. Migrants in Malawi have a significantly higher HIV prevalence than non-migrants, which is primarily due to the selection of HIV-positive individuals into migration. We find evidence for health selection; physically healthier men and women are more likely to move, partly because migration selects younger individuals. However, we do not find differences in physical or mental health between migrants and non-migrants after moving.Future plansWe are preparing a third round of data collection for these (and any new) migrants, which will take place in 2018. This cohort will be used to examine the effect of migration on various health measures and behaviours, including general mental and physical health, smoking and alcohol use, access to and use of health services and use of antiretroviral therapy.
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Zungu, Thokozani, Shaffi Mdala, Chatonda Manda, Halima Sumayya Twabi, and Petros Kayange. "Characteristics and visual outcome of ocular trauma patients at Queen Elizabeth Central Hospital in Malawi." PLOS ONE 16, no. 3 (March 29, 2021): e0246155. http://dx.doi.org/10.1371/journal.pone.0246155.
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Background To describe the epidemiology and visual outcome of patients with ocular trauma treated at Queen Elizabeth Central hospital in Malawi. Methods A prospective, observational study was undertaken from September 2017 to December 2017. Data on socio-demographic features, aetiology of trauma, type of ocular injury pre-referral pathway and treatment of ocular trauma was collected as the exposure variables. The main outcome variable was best corrected visual acuity at 8 weeks following initial visit. Results A total of 102 patients (103 eyes) with ocular trauma were recruited with loss of follow up of 11 participants at 8 weeks following recruitment. The most affected age group were children under 11 years old (35.3%), followed by young adults of age between 21–30 years (22.5%). The male-to-female ratio for ocular injury was 2.8:1. Most participants had closed globe injuries (n = 72, 70.6%), with over half the population injured by blunt objects (n = 62, 60.8%). Furthermore, among the adult population, majority (n = 19 38%) were injured on the road during assaults (n = 24, 48%), while most paediatric injuries (n = 32, 61.5%) occurred at home during play. The incidence of monocular blindness was 25.3% at eight weeks after the first presentation. Factors that were associated with monocular blindness on multivariate analysis were living in rural areas and open globe injuries. Conclusion Ocular trauma led to monocular blindness in a quarter of the study population. There is need for preventive education of ocular injuries at both family and community level.
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Hung, N. M., and N. V. Phu. "Déterminants de l’utilisation des services médicaux en régime d’assurance-maladie." Articles 56, no. 2 (January 21, 2009): 164–93. http://dx.doi.org/10.7202/600913ar.
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Abstract Under the regime of public health insurance, the utilization of health cares are determined by various socio-demographic and economic characteristics of the beneficiaries. These determinants are estimated in this study where we apply the dummy variable regression technique to the AMULET data bank, a 1971 cross-section of 8,608 beneficiaries in the province of Québec where most of health cares are free. In increasing order of importance, we find that : i) The individual utilization of health care is increasing with the age of beneficiaries and is higher for women than for the men for the age-group 15-50 years. This tendency is reversed for the age-group 50 years and older since the rate of increase in utilization is higher for men. There is, however, any significant difference in utilization on the basis of sex discrimination for the age-group 0-15 years. The structure age-sex, being of course a proxy of the health status of the beneficiaries, is the most important determinant of health cares utilization. ii) Individual utilization depends on the income class to which belongs the beneficiary. The beneficiaries of the highest and the lowest income class utilize more health care than those belonging to the so called "middle class". Notice however that the lowest income class in the data sample is composed in majority of aged beneficiaries. iii) The size of the beneficiaries' family is not a significant determinant of the utilization of health care for children of age-group 0-15 years. For other age-group however, utilization decreases with this family size for men, but increases for women. iv) The geographic area where the beneficiaries are identified is a weak determinant of utilization. Beneficiaries in urban area utilize more of health care than those living in rural area.
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Sindhu Priya and Pasupathi A A. "Effectiveness of Information Education Communication Knowledge Regarding Dengu Fever Prevention Among Under Five Mothers." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 25, 2020): 848–52. http://dx.doi.org/10.26452/ijrps.v11ispl4.4084.
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Dengue fever is the most well-known mosquito-borne viral contamination globally. It is a significant medical condition, chiefly influencing the kids in the South East Asian area since 1950. In 2012 the World Health Organization (WHO) positioned dengue as the quickest spreading vector-borne viral disease, going through a 30-overlap increment in illness occurrence in the course of recent years. Up to 50-100 million diseases are presently assessed to happen every year in more than 100 endemic nations, putting practically 50% of the total populace in danger. Worldwide circulation of dengue fever is assessed as 100 million new instances of dengue fever and 22,000 deaths generally among youngsters happen worldwide every year including 500,000 instances of a possibly deadly type of malady, Dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The study aim is to assess the effectiveness of an information booklet regarding dengue fever and its prevention among under-five mothers. A descriptive research design with purposing sampling technique was adopted to conduct a study among mothers of under-five children. Data was gathered by using structured questionnaires. Among 100 samples out of 61 samples (61%) have inadequate knowledge, 39 samples (39%) have moderate knowledge and none of them had adequate knowledge in the pre-test. Among 100 samples out of 17 samples (17%) have moderate knowledge, 83 samples (83%) have adequate knowledge and none of them had inadequate knowledge in post-test. The study shows that it is an association between the demographic variables of mothers of under-five children regarding prevention of dengue fever. There was a statistically significant found in significant family income. The studies concluded that there is an association between the demographic variables of mothers of under-five children regarding prevention of dengue fever. There was a statistically significant found in significant family income.
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Ganasegeran, Kurubaran, J. Michael Menke, Vasudeva Murthy Challakere Ramaswamy, Rizal Abdul Manaf, Aied M. Alabsi, and Sami Abdo Radman Al-Dubai. "Level and Determinants of Knowledge of Symptomatic Knee Osteoarthritis among Railway Workers in Malaysia." BioMed Research International 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/370273.
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Background. Symptomatic knee osteoarthritis, an ancient malady greatly impairing modern population quality of life, has stimulated global attention to find effective modes of prevention and intervention.Purpose. This study aimed to assess factors affecting knowledge of symptomatic knee osteoarthritis (knee OA) among Malaysian railway workers.Methods. A cross-sectional study was conducted among 513 railway workers involving eight major states within Peninsular Malaysia using population-based sampling. The assessment instrument was a face-validated, prepiloted, self-administered instrument with sociodemographics and knowledge items on knee OA.Results. Mean (±SD) age of the respondents was 41.4 (±10.7), with the majority aged 50 years or older (34.9%). Of the total respondents, 53.6% had low levels of knowledge of knee OA disease. Multivariate analysis found that four demographic predictors, age ≥50 years, family history of knee OA, self-awareness, and clinical diagnosis of the disease entity, were significantly associated with knowledge scores.Conclusion. The finding of a low level knee OA knowledge among Malaysian railway workers points to an urgent need for massive information to be disseminated among the workers at risk to foster primary prevention and self-care.
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Sherr, Lorraine, Kathryn J. Roberts, Helen Mebrahtu, Mark Tomlinson, Sarah Skeen, and Lucie D. Cluver. "The food of life: an evaluation of the impact of cash grant receipt and good parenting on child nutrition outcomes in South Africa and Malawi." Global Health Promotion 27, no. 4 (September 30, 2020): 131–40. http://dx.doi.org/10.1177/1757975920957598.
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Social protection interventions (inclusive of cash grant receipt and care provision) have been found to be effective in response to some of the negative implications of the HIV epidemic on children and families. This study explores the impact of cash grant receipt and care provision (operationalised as good parenting) on child nutritional outcomes. In this cross-sectional study, 854 children and younger adolescents (5–15 years) and caregivers affected by HIV, attending community-based organisations in South Africa and Malawi, were interviewed. Interviews comprised inventories on socio-demographic information, family data, cash grant receipt and child nutrition. Parenting was measured using a composite scale. Logistic regression and marginal effects analyses were used to explore the associations between differing levels of social protection (none; either cash or good parenting; cash and good parenting) and child nutritional outcomes. One hundred and sixty children (20.3%) received neither cash nor good parenting; 501 (63.5%) received either cash or good parenting and 128 (16.2%) received both cash and good parenting. In comparison to no intervention, receipt of either cash or good parenting was significantly associated with child non-stunting, the child having sufficient food, and the child not looking thin. Three (3/7) nutritional outcomes showed increased improvement amongst children receiving both cash and good parenting care including child-reported non-hunger, child non-stunting and parental report of sufficient food. Marginal effects analyses further identified an additive effect of cash and good parenting on child nutritional outcomes. This study indicates that receipt of combined cash and good parenting, when compared to cash grant receipt alone, has positive effects on nutrition-related child outcomes.
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Satkunam, Natasha Amrita, Johnny Mahlangu, Christoph Bidlingmaier, Maria Eva Mingot-Castellano, Meera B. Chitlur, Patrick F. Fogarty, Adam Cuker, et al. "Characterization of Bleeding in Hemophilia Carriers and Comparison to Women with Type 1 Von Willebrand Disease, Type 3 Von Willebrand Disease Obligate Carriers and Controls." Blood 128, no. 22 (December 2, 2016): 875. http://dx.doi.org/10.1182/blood.v128.22.875.875.
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Abstract Background: Hemophilia carriers report abnormal bleeding, even when factor VIII or IX levels are normal. Information comparing bleeding events between carriers and women with other inherited bleeding disorders is lacking. Purpose: The purpose of our study was to characterize bleeding in hemophilia carriers using the International Society on Thrombosis and Hemostasis Bleeding Assessment Tool (ISTH-BAT) and to compare it with bleeding in normal controls, women with Type 1 VWD and Type 3 VWD obligate carriers (OC). Method: This was a prospective, observational, cross-sectional study performed by members of GEHEP (Global Emerging HEmostasis Panel). Study participants were recruited from GEHEP members' clinics in North America (Kingston, Canada, Detroit and Philadelphia, USA), Europe (Malaga, Spain; Milan, Italy; Munich, Germany; Oslo, Norway) and South Africa (Johannesburg). Potential participants were identified through local patient databases and approached during clinic visits. All participants signed informed consent. Hemophilia carriers were defined by a documented FVIII or FIX mutation and/or by an appropriate family history (daughter of a man with hemophilia or mother of two sons with hemophilia or mother of one son with hemophilia with at least one other affected male relative). Demographic information was collected using a CRF and the ISTH-BAT was completed for each participant by study personnel. Existing ISTH-BAT data for women with Type 1 VWD, Type 3 VWD OC and age-matched female controls were used for comparison. Results: A total of 329 participants were included in this study; 168 hemophilia carriers, 83 women with Type 1 VWD, 32 Type 3 VWD OC and 46 female normal controls. Hemophilia carriers and normal controls were similar in age (40.1 vs 41.6, p=0.445). The mean overall ISTH-BAT bleeding score (BS) was significantly higher in carriers than in controls (5.7 vs 2.48, p<0.0001). Carriers reported significantly more bleeding in the categories of cutaneous, minor wounds, oral cavity bleeding, post-dental bleeding, surgical bleeding, menorrhagia, post-partum bleeding and other when compared with controls. Carriers were older than Type 1 VWD patients (40.1 vs 36.4 years, p=0.042). While women with Type 1 VWD had higher total ISTH-BAT BS (8.7 vs 5.7, p<0.0001) as well as higher scores for epistaxis, cutaneous bleeding, minor wounds, oral cavity bleeding and menorrhagia, hemophilia carriers had significantly higher scores for muscle hematomas and hemarthrosis. Carriers were younger than Type 3 VWD OC (40.1 vs 45.2 years, p = 0.02), had higher overall ISTH-BAT BS (5.7 vs 3.0, p=0.009) and reported more bleeding in the following categories: total score, epistaxis, hematuria, dental, muscle hematomas, hemarthrosis, and other. In fact, hemophilia carriers reported more musculoskeletal bleeding than all other groups. Importantly, given the concern about over-reporting of joint bleeds by hemophilia carriers because of familiarity with hemarthrosis in affected male relatives, no Type 3 VWD OC reported joint bleeds. See Table 1 for detailed results. Conclusion: In summary, our study showed that hemophilia carriers report significantly more bleeding by overall ISTH-BAT BS than age-matched female controls. Carriers experience both mucocutaneous bleeding as well as musculoskeletal bleeding. They score higher for mucocutaneous bleeding when compared with controls and when compared with Type 3 VWD OC. Overall Type 1 VWD patients experience more severe mucocutaneous bleeding than hemophilia carriers. However, hemophilia carriers report more musculoskeletal bleeding in the form of hemarthrosis and hematomas than all other groups. A comparison of overall ISTH-BAT BS between groups shows that bleeding in women with Type 1 VWD > hemophilia carriers > Type 3 VWD OC > controls. Additional research into the underlying pathophysiology of this abnormal bleeding is a critical next step in understanding and determining how to appropriately manage these patients. Disclosures Bidlingmaier: Novo Nordisk: Honoraria; Sobi: Honoraria; Pfizer: Honoraria; Biotest: Honoraria; Baxalta: Honoraria; Bayer: Honoraria; CSL Behring: Honoraria, Research Funding. Mingot-Castellano:Amgen: Consultancy; Pfizer: Consultancy; Novo Nordisk: Consultancy, Research Funding; Baxalta: Consultancy, Research Funding; Novartis: Consultancy; Bayer: Consultancy, Research Funding. Chitlur:Novo Nordisk: Consultancy; Baxalta: Honoraria; Bayer: Honoraria; Biogen-Idec: Honoraria; Pfizer: Honoraria. Fogarty:Bayer Healthcare: Membership on an entity's Board of Directors or advisory committees, Research Funding; Baxter/Baxalta: Membership on an entity's Board of Directors or advisory committees, Research Funding; Biogen: Membership on an entity's Board of Directors or advisory committees, Research Funding; Chugai: Membership on an entity's Board of Directors or advisory committees; CSL Behring: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees; Pfizer: Employment, Membership on an entity's Board of Directors or advisory committees, Research Funding; Spark Therapeutics: Research Funding. Cuker:T2 Biosystems: Research Funding; Genzyme: Consultancy; Biogen-Idec: Consultancy, Research Funding; Amgen: Consultancy; Stago: Consultancy. Mancuso:Bayer Healthcare: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Baxalta: Consultancy, Speakers Bureau; CSL Behring: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novo Nordisk: Consultancy, Speakers Bureau; Sobi/Biogen Idec: Consultancy, Speakers Bureau; Pfizer: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Kedrion: Consultancy. Holme:Baxalta, now part of Shire: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Investigator Clinical Studies. Mathew:Bayer: Employment. James:CSL Behring: Research Funding; Octapharma: Research Funding; Biogen: Consultancy; Basalt: Consultancy; Bayer: Research Funding.
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Alhassan, Nurudeen, and Nyovani Janet Madise. "Demand for Family Planning Satisfied With Modern Methods in Urban Malawi: CHAID Analysis to Identify Predictors and Women Underserved With Family Planning Services." Frontiers in Global Women's Health 2 (May 28, 2021). http://dx.doi.org/10.3389/fgwh.2021.652902.
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Introduction: Family planning progress under the SDGs is measured with a novel indicator, demand for family planning satisfied with modern methods (mDFPS), which provides a better indication of modern contraceptive coverage than unmet need and contraceptive prevalence rate. Yet, few studies have examined the predictors of mDFPS and the sub-groups of women with unsatisfied mDFPS in urban Saharan Africa. The objective of this study was to examine the predictors of mDFPS in urban Malawi and to identify the sub-groups of urban women underserved with modern contraceptives.Methods: The study analysed data from the 2015–16 Malawi Demographic and Health survey. The sample was comprised of 2,917 women in urban Malawi who had a demand for family planning services. We used a Chi-square (χ2) Automatic Interaction Detector (CHAID) model to address the study objectives.Results: The results show that the number of living children a woman had was the most significant predictor of mDFPS. Women with one or more children, who were of Chewa, Lomwe, or Tumbuka ethnic origin and who resided in the central region had the highest mDFPS (87%). On the other hand, women with no children, and who were not exposed to FP information on television, had the lowest mDFPS (41%). Among women in union, ethnicity was the best predictor of mDFPS. Ngoni, Yao, and other ethnic minority women in union who were aged 15–19 and 40 years and above and those who were Catholic, SDA/Baptist, or Muslim had the lowest mDFPS (36%).Conclusion: This study demonstrates significant intra-urban disparities in demand for FP satisfied with modern contraceptives in Malawi. There is a need for policymakers and reproductive health practitioners to recognise these disparities and to prioritise the underserved groups identified in this study.
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Nkoka, Owen, Watanja M. Mphande, Peter A. M. Ntenda, Edith B. Milanzi, Victor Kanje, and Shiaau J. G. Guo. "Multilevel analysis of factors associated with unmet need for family planning among Malawian women." BMC Public Health 20, no. 1 (May 15, 2020). http://dx.doi.org/10.1186/s12889-020-08885-1.
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Abstract Background Malawi has a high fertility rate which is also characterized by a relatively high prevalence of unmet need for contraception. However, little is known about the influence of individual- and community- level characteristics on unmet need in Malawi. This study examined the individual- and community- level factors associated with unmet need for family planning (FP) among Malawian women. Methods Data from the 2015–16 Malawi demographic and health survey were used to analyze 15, 931 women. The association between individual- and community- level factors and unmet need was assessed using multilevel binary logistic regression models. Results The prevalence of total unmet need was 21.0%. Women aged ≥35 years were more likely to have total unmet need [adjusted odds ratio (aOR) = 1.19, 95% confidence interval (CI) = 1.04–1.35] compared with those aged 15–24 years. Women who were married [aOR = 0.41, 95% CI = 0.35–0.48], and those employed [aOR = 0.78, 95% CI = 0.71–0.85] were associated with less likelihood of having total unmet need compared with unmarried, and unemployed women, respectively. At community-level, women from communities with a high percentage of women from rich households [aOR = 0.81, 95% CI = 0.67–0.96], and those from communities with a middle and high percentage of educated women [aOR = 0.86, 95% CI = 0.76–0.96 and aOR = 0.81, 95% CI = 0.70–0.93, respectively] were less likely to have total unmet need for FP compared with those from communities with low percentages of rich and educated women, respectively. The proportional change in variance showed that about 36.0% of total variations in the odds of unmet need across the communities were explained by both individual- and community-level factors. Moreover, the intraclass correlation showed that about 3.0% of the total variation remained unexplained even after controlling for both individual- and community-level factors. Conclusion Both individual- and community- level factors influenced unmet need for FP in Malawi. Public health practitioners should conduct community profiling and consider individual and community factors when designing FP programs.
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Chilinda, Zizwani Brian, Mark L. Wahlqvist, Meei-Shyuan Lee, and Yi-Chen Huang. "Higher maternal autonomy is associated with reduced child stunting in Malawi." Scientific Reports 11, no. 1 (February 16, 2021). http://dx.doi.org/10.1038/s41598-021-83346-2.
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AbstractChild undernutrition is a major health problem in Malawi. We assessed the association between maternal autonomy and child stunting in Malawi. We utilized nationally representative pooled cross-sectional data from the 2010 and 2015/16 Malawi Demographic and Health Surveys (MDHS), which included 7348 mother (28.1 ± 6.8 years, range 15–49 years)—child (27.6 ± 16.7 months, range 0–59 months) pairs. Maternal autonomy composite scores captured decision-making power, tolerance of domestic violence, and financial independence. The nutritional outcome measure was stunting (height-for-age z score < – 2). Logistic regression assessed associations between maternal autonomy and stunting, and dominance analysis evaluated the relative importance of the associated factors. From the two surveys combined, 39.2% were stunted. Stunting decreased from 45.0% in 2010 to 34.6% in 2015/16; concurrently, maternal autonomy improved and was evidently associated with stunting (aOR = 0.81, 95% CI = 0.71, 0.93;p = 0.002). However, this association was probably mediated by other factors associated with improved child nutrition, including maternal education and family wealth, which, along with child age, were associated with stunting in the dominance analysis. Concurrent interventional programs may also have contributed to the decrease in stunting between the surveys, thus moderating the effect of maternal autonomy.
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Sliep, Y., M. Poggenpoel, and A. Gmeiner. "A care counselling model for HIV reactive patients in rural Malawi - Part II." Curationis 24, no. 3 (September 28, 2001). http://dx.doi.org/10.4102/curationis.v24i3.855.
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The purpose of the research conducted was to explore and describe HIV patients experience of their illness within the context of rural Malawi and, based on the results of the study, to describe a model for counselling HIV reactive patients in rural Malawi which would meet both the internal and external needs of the patient. Nursing for the Whole Person Theory, as well as symbolic interactionism and the research model of Botes, were used as paradigm, as the researcher believes a person is fundamentally a historical social being who can only be understood in a specific cultural context of space and time. The research was also conducted within a counselling context and different disciplines were integrated in the study. The research method followed two phases each addressing a different objective. Firstly, exploration and description of the HIV reactive individual’s experience of illness, compilation of a demographic profile of the patients in the study and a description of their identified needs as well as possible resources, exploration and description of the primary care givers’ experience of HIV reactive patients and the exploration and description of the viewpoint of counsellors in terms of counselling HIV reactive patients. In the first phase of the study in-depth phenomenological interviews were conducted with identified groups. Focus interviews were conducted with a hundred AIDS patients to identify the needs and resources of the patients and to compile a demographic profile. Focus groups discussions were conducted with counsellors for more complete comprehension. Data-analysis and literature control was undertaken. In the second phase of the study theory generation was used in order to develop a counselling model for AIDS patients and guidelines for implementing the model were generated. Based on the results of the analysis the major concept enable was identified as the essence of a model for counselling AIDS patients in rural Malawi. The visual model developed described a process of enablement with the counsellor as negotiator and the patient as a narrator in which the patient, family and community are encouraged to participate actively. By utilising the deductive reasoning strategy, relationship statements were inferred from the model. Guidelines were described for all three phases of the model, namely pretest counselling, post-test counselling and community care, in terms of objectives, strategies and activities. The value of this research was embodied in addressing a very real and urgent need in Malawi and proposing a solution with practical guidelines.
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Forty, James, Serai Daniel Rakgoasi, and Mpho Keetile. "Patterns and determinants of modern contraceptive use and intention to usecontraceptives among Malawian women of reproductive ages (15–49 years)." Contraception and Reproductive Medicine 6, no. 1 (July 1, 2021). http://dx.doi.org/10.1186/s40834-021-00163-8.
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Abstract Background Malawi is one of the countries in SSA with the highest TFR. This study aimed to explore factors associated with modern contraceptive use and intention to use contraceptives among women of reproductive ages (15–49 years) in Malawi. Methods The study used secondary data from 2015 to 16 Malawi Demographic and Health Survey (MDHS) dataset. Logistic regression models were used to derive adjusted odd ratios as the measures of association between need, predisposing and enabling factors, and contraceptive use and the intention to use contraceptives among women. The sample constituted 24,562 women who were successfully interviewed during the MDHS. All comparisons are considered statistically significant at 5% level. Results Overall 54.8% of women were currently using contraceptives, while 69.1% had the intention to use contraceptives. The odds of contraceptive use were significantly low among, women aged 15–19 years, 20–24 years, 25–29 years, 30–34 years, 35–39 years and 40–44 years compared to women aged 45–49 years; women of Tonga ethnic group (OR = O.60, CI = 0.43 0.84) compared to women of Nyanga ethnic group; women from poor households (OR = 0.78, CI = 0.68–0.90) and middle income households (OR = 0.84, CI = 0.74–0.95) compared to women from rich household. Nonetheless, women with no past experience of terminated pregnancy (OR = 1.50, CI = 1.34–1.68) were more likely to use contraceptives compared to women with past experience of terminated pregnancy. Similarly, Women with primary education (OR = 1.56, CI = 1.16–2.09) and secondary education (OR = 1.39, CI = 1.04–1.85) were more likely to use contraceptives compared to women with higher education. While the odds of intending to use contraceptives were significantly high with age only thus among women aged 15–19 years, (OR = 15.18, CI = 5.94–38.77); 20–24 years (OR = 16.77, CI = 7.46–37.71); 25–29 years (OR = 6.75, CI = 3.16–14.45); 30–34 years (OR = 7.75, CI = 3.61–16.65) and 35–39 years (OR = 5.05, CI = 2.29–11.12) compared to women aged 45–49 years. Conclusion As direct policy measure; information, education and communication programmes on family planning among poor and middle income women, and all women in reproductive ages should be strengthened.
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Peters, Michael A., Diwakar Mohan, Patrick Naphini, Emily Carter, and Melissa A. Marx. "Linking household surveys and facility assessments: a comparison of geospatial methods using nationally representative data from Malawi." Population Health Metrics 18, no. 1 (December 2020). http://dx.doi.org/10.1186/s12963-020-00242-z.
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Abstract Background Linking facility and household surveys through geographic methods is a popular technique to draw conclusions about the relationship between health services and population health outcomes at local levels. These methods are useful tools for measuring effective coverage and tracking progress towards Universal Health Coverage, but are understudied. This paper compares the appropriateness of several geospatial methods used for linking individuals (within displaced survey cluster locations) to their source of family planning (at undisplaced health facilities) at a national level. Methods In Malawi, geographic methods linked a population health survey, rural clusters from the Woman’s Questionnaire of the 2015 Malawi Demographic and Health Survey (MDHS 2015), to Malawi’s national health facility census to understand the service environment where women receive family planning services. Individuals from MDHS 2015 clusters were linked to health facilities through four geographic methods: (i) closest facility, (ii) buffer (5 km), (iii) administrative boundary, and (iv) a newly described theoretical catchment area method. Results were compared across metrics to assess the number of unlinked clusters (data lost), the number of linkages per cluster (precision of linkage), and the number of women linked to their last source of modern contraceptive (appropriateness of linkage). Results The closest facility and administrative boundary methods linked every cluster to at least one facility, while the 5-km buffer method left 288 clusters (35.3%) unlinked. The theoretical catchment area method linked all but one cluster to at least one facility (99.9% linked). Closest facility, 5-km buffer, administrative boundary, and catchment methods linked clusters to 1.0, 1.4, 21.1, and 3.3 facilities on average, respectively. Overall, the closest facility, 5-km buffer, administrative boundary, and catchment methods appropriately linked 64.8%, 51.9%, 97.5%, and 88.9% of women to their last source of modern contraceptive, respectively. Conclusions Of the methods studied, the theoretical catchment area linking method loses a marginal amount of population data, links clusters to a relatively low number of facilities, and maintains a high level of appropriate linkages. This linking method is demonstrated at scale and can be used to link individuals to qualities of their service environments and better understand the pathways through which interventions impact health.
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Ngwira, Alfred. "Spatial quantile regression with application to high and low child birth weight in Malawi." BMC Public Health 19, no. 1 (November 29, 2019). http://dx.doi.org/10.1186/s12889-019-7949-9.
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Abstract Background Child low and high birth weight are important public health problems. Many studies have looked at factors of low and high birth weight using mean regression. This study aimed at using quantile regression to find out determinants of low and high birth weight. Methods Spatial quantile regression models at 0.05 and 0.95 percentiles of birth weight were fitted to 13,087 children birth weight in kilograms using Malawi demographic health survey data of 2010 study. Full Bayesian method by integrated nested Laplace approximations (INLA) was used to estimate the model. Second order random walk priors were assigned for mother age and antenatal visits for pregnancy while Gaussian markov random field prior was used for district of the child. Results Residual spatial patterns reveal areas in the southern region promoting high birth weight while areas in the central and northern region promote low birth weight. Most fixed effects findings are consistent with the literature. Richest family, normal mother body mass index (BMI), mother over weight (BMI > 25 kg/m2), birth order 2–3, mother secondary education and height (≥150 cm) negate low birth weight while weight 45–70 kg promote low birth weight. Birth order category 6+, mother height (≥150 cm) and poor wealth quintile, promote high birth weight, while richer and richest wealth quintiles and education categories: primary, secondary, and higher, and mother overweight (BMI > 25 kg/m2) reduce high birth weight. Antenatal visits for pregnancy reduce both low and high birth weight. Conclusion Strategies to reduce low and high birth weight should simultaneously address mother education, weight gain during pregnancy and poverty while targeting areas increasing low and high birth weight.
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Hu, Yingying, Rui Huang, Bishwajit Ghose, and Shangfeng Tang. "SMS-based family planning communication and its association with modern contraception and maternal healthcare use in selected low-middle-income countries." BMC Medical Informatics and Decision Making 20, no. 1 (September 10, 2020). http://dx.doi.org/10.1186/s12911-020-01228-5.
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Abstract Background The objectives of this study were to 1) measure the percentage of women who received SMS-based family planning communication, and 2) its association with modern contraception and maternal healthcare services among mothers. In recent years, there has been a growing interest surrounding mobile phone-based health communication and service delivery methods especially in the areas of family planning and reproductive health. However, little is known regarding the role of SMS-based family planning communication on the utilisation of modern contraception and maternal healthcare services in low-resource settings. Methods Cross-sectional data on 94,675 mothers (15–49 years) were collected from the latest Demographic and Health Surveys in 14 low-and-middle-income countries. The outcome variables were self-reported use of modern contraception and basic maternal healthcare services (timely and adequate use of antenatal care, and of facility delivery services). Data were analysed using multivariate regression and random effect meta-analyses. Results The coverage of SMS-based family planning communication for the pooled sample was 5.4% (95%CI = 3.71, 7.21), and was slightly higher in Africa (6.04, 95%CI = 3.38, 8.70) compared with Asia (5.23, 95%CI = 1.60, 8.86). Among the countries from sub-Saharan Africa, Malawi (11.92, 95%CI = 11.17, 12.70) had the highest percent of receiving SMS while Senegal (1.24, 95%CI = 1.00, 1.53) had the lowest. In the multivariate analysis, SMS communication shown significant association with the use of facility delivery only (2.22 (95%CI = 1.95, 2.83). The strength of the association was highest for Senegal (OR = 4.70, 95%CI = 1.14, 7.33) and lowest for Burundi (OR = 1.5; 95%CI = 1.01, 2.74). Meta analyses revealed moderate heterogeneity both in the prevalence and the association between SMS communication and the utilisation of facility delivery. Conclusion Although positively associated with using facility delivery services, receiving SMS on family planning does not appear to affect modern contraceptive use and other components of maternal healthcare services such as timely and adequate utilisation of antenatal care.
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Gahungu, Jumaine, Mariam Vahdaninia, and Pramod R. Regmi. "The unmet needs for modern family planning methods among postpartum women in Sub-Saharan Africa: a systematic review of the literature." Reproductive Health 18, no. 1 (February 10, 2021). http://dx.doi.org/10.1186/s12978-021-01089-9.
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Abstract Background Sub-Saharan Africa has the highest fertility rate in the world, with the highest unmet need for family planning (FP). Yet, there is a lack of knowledge about the determinants for non-utilisation of modern contraceptive methods among women of reproductive age. This systematic review of literature assessed factors affecting the unmet need and reasons for non-utilisation of modern contraceptive methods during the postpartum period in Sub-Saharan African women. Methods An online literature search was conducted in several databases: MEDLINE, Cochrane Review, PubMed, Elsevier's Science Direct and Web of Science. The search was completed by hand searching. Data were extracted and summarised using the Arksey and O’Malley methodology. Results In total, 19 studies were included; one qualitative study, seventeen quantitative, and one used a mixed-methods approach. Studies were conducted in Ethiopia (n = 11), Nigeria (n = 3), Kenya (n = 2), Malawi (n = 2) and Uganda (n = 1). Factors affecting the unmet need for modern contraceptive methods were described at three levels: (a) individual; (b) household; and (c) healthcare facility level. Reasons for non-use of FP included: fear of side effects; husband’s disapproval; the absence of menses; abstinence; and low perception of risk of pregnancy. Conclusion Unmet needs in postpartum FP in women from Sub-Saharan Africa were associated with health-system and socio-demographic determinants. We suggest that there is a need to improve the awareness of modern contraceptive methods through effective interventions. Further research is needed for under-studied countries in this continent.
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Wu, Hilary, Mazen Sharaf, Karen Shalansky, and Nadia Zalunardo. "Evaluation of Statin Use and Prescribing in Patients with Chronic Kidney Disease Not Receiving Treatment with Kidney Transplant or Dialysis." Canadian Journal of Hospital Pharmacy 74, no. 3 (July 5, 2021). http://dx.doi.org/10.4212/cjhp.v74i3.3149.
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Background: Chronic kidney disease (CKD) is a risk factor for cardiovascular disease. The Kidney Disease Improving Global Outcomes 2013 guidelines and the Canadian Cardiovascular Society 2016 guidelines recommend statins for primary prevention of cardiovascular disease in CKD patients aged 50 years or older who are not receiving treatment with kidney transplant or dialysis. Objectives: To evaluate statin use for patients in the Vancouver General Hospital Kidney Care Clinic (VGH KCC) and to gain insight into the KCC nephrologists’ practices and perspectives regarding the prescribing of statins for patients with CKD. Methods: The study comprised 2 parts. Part 1 consisted of a cross-sectional study of all statin-eligible patients in the VGH KCC followed by a retrospective chart review. In the chart review, data were collected for 250 statin users and 250 non-users. Logistic regression analyses were performed to determine associations between demographic variables and statin use or non-use. Part 2 was an electronic survey of VGH KCC nephrologists. Results: Of the 813 statin-eligible patients, 512 (63%) were taking a statin. Patients were approximately 5 times more likely to be receiving statin therapy when it was indicated for secondary versus primary prevention (adjusted odds ratio 4.64, 95% confidence interval 2.95–7.47). Eight of the 9 KCC nephrologists completed the survey, and 7 (87.5%) of these respondents indicated that they never or rarely prescribed statins themselves to KCC patients for primary prevention. However, the same number reported that they sometimes or often suggested statin initiation to family physicians. Three of the respondents indicated agreement with guideline recommendations, but many stated that the decision for statin initiation should be individualized to the patient. Strategies to improve statin prescribing rates that were endorsed by respondents included educating family physicians, creating preprinted orders and laboratory requisitions for statin initiation, providing educational materials about statins to patients, and implementing a protocol for KCC pharmacists to counsel patients about statins. Conclusions: Many statin-eligible VGH KCC patients were not receiving statin therapy, and most of the KCC nephrologists considered statin prescribing as a role for family physicians. Within the KCC, future directions will be to develop a standardized approach to identify patients who would benefit from statin therapy, and to implement strategies to improve statin prescribing rates in appropriate patients. RÉSUMÉ Contexte : L’insuffisance rénale chronique (IRC) est un facteur de risque de maladie cardiovasculaire. Les directives du Kidney Disease Improving Global Outcomes de 2013 et celles de la Société canadienne de cardiologie de 2016 recommandent l’utilisation de statines comme mode de prévention principal des maladies cardiovasculaires par les patients âgés d’au moins 50 ans et souffrant d’IRC, qui ne reçoivent pas de traitement par greffe rénale ou dialyse. Objectifs : Évaluer l’utilisation des statines pour les patients résidant au Vancouver General Hospital Kidney Care Clinic (VGH KCC) et améliorer la compréhension des pratiques et points de vue des néphrologues de la KCC concernant la prescription de statines aux patients souffrant d’une IRC. Méthodes : L’étude comportait deux parties. La première consistait en une étude transversale de tous les patients admis à recevoir des statines au VGH KCC, suivie d’un examen rétrospectif des dossiers. Les données destinées à cet examen ont été recueillies auprès de 250 utilisateurs de statines et de 250 non-utilisateurs. Les analyses de régression logistique ont permis de déterminer les associations entre les variables démographiques et l’utilisation (ou non) de statines. La deuxième partie consistait en une enquête menée électroniquement auprès des néphrologues du VGH KCC. Résultats : Des 813 patients admissibles à l’utilisation de statines, 512 (63 %) en prenaient déjà. Les patients avaient environ cinq fois plus de chances de recevoir un traitement par statines, lorsque celles-ci étaient indiquées pour la prévention secondaire ou primaire (rapport de cote révisé 4,64, 95 % intervalle de confiance 2,95 - 7,47). Huit des neuf néphrologues de la KCC ont participé à l’enquête et sept (87,5 %) d’entre eux ont indiqué qu’ils n’avaient jamais, ou rarement, prescrit de statines aux patients du KCC dans le cadre d’une intervention primaire. Cependant, le même nombre de répondants a indiqué avoir parfois ou souvent proposé aux médecins de famille de commencer un traitement aux statines. Trois répondants ont indiqué être d’accord avec les recommandations préconisées dans les directives, mais bon nombre des néphrologues interrogés ont signalé que la décision d’entreprendre un tel traitement devait être individualisée. Les stratégies visant à améliorer les taux de prescription de statines approuvées par les répondants comprenaient la sensibilisation des médecins de famille, la création d’ordonnances et de demandes d’analyse en laboratoire préimprimées pour entreprendre un traitement aux statines, l’offre aux patients de matériel de formation sur le sujet et la mise en place d’un protocole pour les pharmaciens de la KCC leur permettant de conseiller les patients. Conclusions : Beaucoup de patients admissibles à un traitement aux statines du VGH KCC ne le recevaient pas, et la plupart des néphrologues de la KCC considéraient que la prescription de ce type de traitement relevait des médecins de famille. Au sein de la KCC, les orientations futures consisteront à élaborer une approche standardisée pour identifier les patients qui tireraient profit d’une thérapie aux statines et à mettre en place des stratégies visant à améliorer les taux de prescription de statines aux patients concernés.