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Journal articles on the topic 'Health promotion – Malawi'
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Gennaro, Susan, Daima Thyangathyanga, Rose Kershbaumer, and Joyce Thompson. "Health Promotion and Risk Reduction in Malawi, Africa, Village Women." Journal of Obstetric, Gynecologic & Neonatal Nursing 30, no. 2 (March 2001): 224–30. http://dx.doi.org/10.1111/j.1552-6909.2001.tb01539.x.
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Uwamahoro, Nadege Sandrine, Bagrey Ngwira, Kirsten Vinther-Jensen, and Gill Rowlands. "Health literacy among Malawian HIV-positive youth: a qualitative needs assessment and conceptualization." Health Promotion International 35, no. 5 (November 6, 2019): 1137–49. http://dx.doi.org/10.1093/heapro/daz107.
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Abstract Despite growing evidence of the significance of health literacy in managing and coping with acquired immune deficiency syndrome (HIV), it is not yet an integrated part of HIV/AIDS-related health promotion research and practice in Africa. This article contributes to addressing the gap in research on health literacy and HIV in Sub-Saharan Africa. We aimed to assess health literacy-related needs of young people living with HIV (YPLHIV) and adapt existing health literacy frameworks to the context of HIV/AIDS in Malawi. We used focus group discussions to collect data from a sample of the membership of the national association of YPLHIV. Twenty-four HIV-positive youth (18–29 years) participated in focus group discussions. Participants came from three regions of Malawi. Additionally, we conducted three in-depth interviews with key informants. We used a thematic framework approach to analyse data in MAXQDA. We contextualized definitions of four dimensions of health literacy: functional, interactive, critical and distributed health literacy, which we used as an a priori analytical framework. To further contextualize the framework, we revised it iteratively throughout the analysis process. We identified the need for comprehensive information about HIV and sexual reproductive health, skills to interact with healthcare providers and navigate the health system, and skills to appraise information from different sources, among others. The identified needs were translated into nine action recommendations for the national association of YPLHIV, and with relevance within the wider HIV sector in Malawi and beyond. We found that the dimensions in our analytical framework operate on the individual, system and public policy levels.
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Paliani, Grace. "2. Communication and community services: Malawi Red Cross Society: Communication to promote community services." International Review of the Red Cross 30, no. 276 (June 1990): 216–19. http://dx.doi.org/10.1017/s0020860400075562.
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The topic “Communication to promote community services” sounds simple, but it is vital because it points to the contribution that any health-oriented institution should make towards the general success of its undertakings.On closer examination it will be seen that one basic communication task, which, however, involves a number of sub-tasks all geared towards achieving the same objectives, is the promotion of community services through publicity.
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Scott, Molly, Bansi Malde, Carina King, Tambosi Phiri, Hilda Chapota, Esther Kainja, Florida Banda, and Marcos Vera-Hernandez. "Family networks and infant health promotion: a mixed-methods evaluation from a cluster randomised controlled trial in rural Malawi." BMJ Open 8, no. 6 (June 2018): e019380. http://dx.doi.org/10.1136/bmjopen-2017-019380.
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Rajasingham, Anu, Janell A. Routh, Anagha Loharikar, Elly Chemey, Tracy Ayers, Andrews W. Gunda, Elizabeth T. Russo, Siri Wood, and Robert Quick. "Diffusion of Handwashing Knowledge and Water Treatment Practices From Mothers in an Antenatal Hygiene Promotion Program to Nonpregnant Friends and Relatives, Machinga District, Malawi." International Quarterly of Community Health Education 39, no. 1 (September 5, 2018): 63–69. http://dx.doi.org/10.1177/0272684x18797063.
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Access to safe drinking water and improved hygiene are essential for preventing diarrheal diseases in low- and middle-income countries. Integrating water treatment and hygiene products into antenatal clinic care can motivate water treatment and handwashing among pregnant women. Free water hygiene kits (water storage containers, sodium hypochlorite water treatment solution, and soap) and refills of water treatment solution and soap were integrated into antenatal care and delivery services in Machinga District, Malawi, resulting in improved water treatment and hygiene practices in the home and increased maternal health service use. To determine whether water treatment and hygiene practices diffused from maternal health program participants to friends and relatives households in the same communities, we assessed the practices of 106 nonpregnant friends and relatives of these new mothers at baseline and 1-year follow-up. At follow-up, friends and relatives were more likely than at baseline to have water treatment products observable in the home (33.3% vs. 1.2%, p < 0.00001) and detectable free chlorine residual in their water, confirming water treatment (35.7% vs. 1.4%; p < 0.00001). Qualitative data from in-depth interviews also suggested that program participants helped motivate adoption of water treatment and hygiene behaviors among their friends and relatives.
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Metcalfe, David. "A negative association between condom availability and incidence of urethral discharge in a closed Malawian community." International Journal of STD & AIDS 18, no. 8 (August 1, 2007): 559–62. http://dx.doi.org/10.1258/095646207781439801.
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Condom promotion in sub-Saharan Africa has been accused by some conservative groups of encouraging promiscuity. This study explored the relationship between condom availability and sexually transmitted infection (STI) incidence in a closed Malawian community. An audit of clinic records charted the changing availability of condoms and the concurrent incidence of patients presenting with STI-associated urethral discharge (UD). When condoms first became available, their distribution steadily increased and the UD incidence declined. During a three-month period of unavailability, this previously uninterrupted decline was reversed and UD incidence increased. Once condoms again became available, UD incidence resumed its decline. This association was found to be statistically significant (Spearman's correlation coefficient, −0.499; P = 0.035). In a small community largely isolated from neighbouring towns, condom distribution appeared to negatively correlate with the number of patients presenting with UD. This may challenge the local belief that condoms have a damaging effect on sexual health in Malawi.
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Rimal, Rajiv N., Jane Brown, Glory Mkandawire, Lisa Folda, Kirsten Böse, and Alisha H. Creel. "Audience Segmentation as a Social-Marketing Tool in Health Promotion: Use of the Risk Perception Attitude Framework in HIV Prevention in Malawi." American Journal of Public Health 99, no. 12 (December 2009): 2224–29. http://dx.doi.org/10.2105/ajph.2008.155234.
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Kasteng, Frida, Joanna Murray, Simon Cousens, Sophie Sarrassat, Jennifer Steel, Nicolas Meda, Moctar Ouedraogo, Roy Head, and Josephine Borghi. "Cost-effectiveness and economies of scale of a mass radio campaign to promote household life-saving practices in Burkina Faso." BMJ Global Health 3, no. 4 (July 2018): e000809. http://dx.doi.org/10.1136/bmjgh-2018-000809.
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IntroductionChild health promotion through mass media has not been rigorously evaluated for cost-effectiveness in low-income and middle-income countries. We assessed the cost-effectiveness of a mass radio campaign on health-seeking behaviours for child survival within a trial in Burkina Faso and at national scale.MethodsWe collected provider cost data prospectively alongside a 35-month cluster randomised trial in rural Burkina Faso in 2012–2015. Out-of-pocket costs of care-seeking were estimated through a household survey. We modelled intervention effects on child survival based on increased care-seeking and estimated the intervention’s incremental cost-effectiveness ratio (ICER) in terms of the cost per disability-adjusted life year (DALY) averted versus current practice. Model uncertainty was gauged using one-way and probabilistic sensitivity analyses. We projected the ICER of national-scale implementation in five sub-Saharan countries with differing media structures. All costs are in 2015 USD.ResultsThe provider cost of the campaign was $7 749 128 ($9 146 101 including household costs). The campaign broadcast radio spots 74 480 times and 4610 2-hour shows through seven local radio stations, reaching approximately 2.4 million people including 620 000 direct beneficiaries (pregnant women and children under five). It resulted in an average estimated 24% increase in care-seeking for children under five and a 7% reduction in child mortality per year. The ICER was estimated at $94 ($111 including household costs (95% CI −38 to 320)). The projected provider cost per DALY averted of a national level campaign in Burkina Faso, Burundi, Malawi, Mozambique and Niger in 2018–2020, varied between $7 in Malawi to $27 in Burundi.ConclusionThis study suggests that mass-media campaigns can be very cost-effective in improving child survival in areas with high media penetration and can potentially benefit from considerable economies of scale.Trial registration numberNCT01517230; Results.
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Morse, Tracy, Elizabeth Tilley, Kondwani Chidziwisano, Rossanie Malolo, and Janelisa Musaya. "Health Outcomes of an Integrated Behaviour-Centred Water, Sanitation, Hygiene and Food Safety Intervention–A Randomised before and after Trial." International Journal of Environmental Research and Public Health 17, no. 8 (April 13, 2020): 2648. http://dx.doi.org/10.3390/ijerph17082648.
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Diarrhoeal disease in children under five in low income settings has been associated with multiple environmental exposure pathways, including complementary foods. Conducted from February to December 2018 in rural Malawi, this before and after trial with a control used diarrhoeal disease as a primary outcome, to measure the impact of a food hygiene intervention (food hygiene + handwashing) relative to a food hygiene and water, sanitation and hygiene (WASH) intervention (food hygiene + handwashing + faeces management + water management). The 31-week intervention was delivered by community-based coordinators through community events (n = 2), cluster group meetings (n = 17) and household visits (n = 14). Diarrhoeal disease was self-reported and measured through an end line survey, and daily diaries completed by caregivers. Difference-in-differences results show a 13-percentage point reduction in self-reported diarrhoea compared to the control group. There were also significant increases in the presence of proxy measures in each of the treatment groups (e.g., the presence of soap). We conclude that food hygiene interventions (including hand washing with soap) can significantly reduce diarrhoeal disease prevalence in children under five years in a low-income setting. Therefore, the promotion of food hygiene practices using a behaviour-centred approach should be embedded in nutrition and WASH policies and programming.
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Mlenga, F., and E. G. Mumghamba. "Oral Hygiene Practices, Knowledge, and Self-Reported Dental and Gingival Problems with Rural-Urban Disparities among Primary School children in Lilongwe, Malawi." International Journal of Dentistry 2021 (March 9, 2021): 1–10. http://dx.doi.org/10.1155/2021/8866554.
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Aim. To determine oral hygiene practices, knowledge, and experience of dental caries and gingival problems among urban and rural primary schoolchildren in Lilongwe District, Malawi. Methodology. This was an analytical and quantitative descriptive cross-sectional study. Four urban and four rural primary schools were conveniently sampled. Pupils aged 11–14 years (n = 409) were recruited using self-administered structured questionnaire. Data were analyzed using SPSS program v20.0. Results. Out of 409 pupils, most of them had knowledge that dental caries is caused by consumption of sugary foodstuffs (91.4%), toothache is a symptom of dental caries (77.6%), gingivitis is caused by ineffective tooth brushing (92.7%), and gingival bleeding is a sign of gingivitis (85.3%). Most pupils experienced toothache (30.8%); many of them had parents with secondary education and above (35.0%) compared to those with primary education (23.5%). 24.4% experienced gingival bleeding with higher percentages from urban (30.1%) than rural (18.5%) schools. Plastic toothbrush users (95%) overshadowed chewing stick users (24.9%). The use of chewing stick was significantly higher in rural (49%) than in urban (1.9%) schools. Likewise, tooth brushing before bed was significantly higher in rural (33%) than in urban (17.2%) pupils. The use of toothpaste during tooth brushing was significantly higher among urban (91.9%) than among rural (64%) pupils. The prevalence of tongue cleaning was 70.2%, and the differences were significantly higher among pupils who had parents with secondary and higher education in urban schools and among pupils aged 11–12 years in comparison with their counterparts. Conclusions. Most pupils reported cleaning their teeth regularly, mostly using plastic toothbrush rather than chewing stick, using toothpaste, and having adequate knowledge about dental caries and gingival disease, and a quarter of them had suffered from these diseases with evidence of rural-urban disparities. Integration of oral health in school health promotion program and further research on its impact on oral health status are recommended.
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Maiden, Emily. "Recite the last bylaw: chiefs and child marriage reform in Malawi." Journal of Modern African Studies 59, no. 1 (March 2021): 81–102. http://dx.doi.org/10.1017/s0022278x20000713.
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ABSTRACTIn the study of modern chieftaincy in Africa, scholars have identified chiefs as important intermediaries for promoting increased voter turnout, new health policies and development initiatives. I add to this literature the importance of chiefs as cultural intermediaries. Using recent child marriage reform efforts in Malawi as a case study, I find that chiefs are key actors needed to implement culturally embedded policy changes. Drawing on descriptive evidence from 12 months of fieldwork across all three regions of Malawi, I find that chiefs are responsible for shifting cultural practices related to child marriage. Using a unique blend of democratic and non-democratic powers, chiefs in Malawi are defying expectations and using their position to promote girls’ rights. These findings contribute to our broader understanding of the political and cultural power of modern chiefs.
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Baruwa, Ololade Julius, Acheampong Yaw Amoateng, and Elizabeth Biney. "Socio-demographic changes in age at first marriage in Malawi: evidence from Malawi Demographic and Health Survey data, 1992–2016." Journal of Biosocial Science 52, no. 6 (December 19, 2019): 832–45. http://dx.doi.org/10.1017/s0021932019000816.
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AbstractThis study aimed to identify the social and demographic correlates of the trend in age at first marriage among women in Malawi, using Malawi Demographic and Health Survey data collected between 1992 and 2016. Employing Cox Proportional Hazard modelling, the results showed that the mean age at first marriage during the 18-year period remained constant at 17.4 years. Furthermore, across all the surveys, younger women married at an early age compared with their older counterparts. The results further showed that having no education, residing in the Northern region, working, belonging to the middle and rich wealth index categories, and belonging to Tumbuka, Lomwe, Yao, Ngoni and Amanganja/Anyanja ethnicities increased the risk of early marriage. The findings suggest that policies such as promoting access to education for women and enforcing the law that restricts the legal age at which a woman can marry (18 years) should be maintained and enforced in Malawi.
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Kazanga, Isabel, Alister C. Munthali, Joanne McVeigh, Hasheem Mannan, and Malcolm MacLachlan. "Predictors of Utilisation of Skilled Maternal Healthcare in Lilongwe District, Malawi." International Journal of Health Policy and Management 8, no. 12 (August 13, 2019): 700–710. http://dx.doi.org/10.15171/ijhpm.2019.67.
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Background: Despite numerous efforts to improve maternal and child health in Malawi, maternal and newborn mortality rates remain very high, with the country having one of the highest maternal mortality ratios globally. The aim of this study was to identify which individual factors best predict utilisation of skilled maternal healthcare in a sample of women residing in Lilongwe district of Malawi. Identifying which of these factors play a significant role in determining utilisation of skilled maternal healthcare is required to inform policies and programming in the interest of achieving increased utilisation of skilled maternal healthcare in Malawi. Methods: This study used secondary data from the Woman’s Questionnaire of the 2010 Malawi Demographic and Health Survey (MDHS). Data was analysed from 1126 women aged between 15 and 49 living in Lilongwe. Multivariate logistic regression was conducted to determine significant predictors of maternal healthcare utilisation. Results: Women’s residence (P=.006), education (P=.004), and wealth (P=.018) were significant predictors of utilisation of maternal healthcare provided by a skilled attendant. Urban women were less likely (odds ratio [OR] = 0.47, P=.006, 95% CI = 0.28–0.81) to utilise a continuum of maternal healthcare from a skilled health attendant compared to rural women. Similarly, women with less education (OR = 0.32, P=.001, 95% CI = 0.16–0.64), and poor women (OR = 0.50, P=.04, 95% CI = 0.26–0.97) were less likely to use a continuum of maternal healthcare from a skilled health attendant. Conclusion: Policies and programmes should aim to increase utilisation of skilled maternal healthcare for women with less education and low-income status. Specifically, emphasis should be placed on promoting education and economic empowerment initiatives, and creating awareness about use of maternal healthcare services among girls, women and their respective communities.
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de Kok, Bregje Christina, Isabelle Uny, Mari Immamura, Jacqueline Bell, Jane Geddes, and Ann Phoya. "From Global Rights to Local Relationships: Exploring Disconnects in Respectful Maternity Care in Malawi." Qualitative Health Research 30, no. 3 (October 23, 2019): 341–55. http://dx.doi.org/10.1177/1049732319880538.
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Widespread reports of “disrespect and abuse” in maternity wards in low- and middle-income countries have triggered the development of rights-based respectful maternity care (RMC) standards and initiatives. To explore how international standards translate into local realities, we conducted a team ethnography, involving observations in labor wards in government facilities in central Malawi, and interviews and focus groups with midwives, women, and guardians. We identified a dual disconnect between, first, universal RMC principles and local notions of good care and, second, between midwives and women and guardians. The latter disconnect pertains to fraught relationships, reproduced by and manifested in mechanistic care, mutual responsibilization for trouble, and misunderstandings and distrust. RMC initiatives should be tailored to local contexts and midwife-client relationships. In a hierarchical, resource-strapped context like Malawi, promoting mutual love, understanding, and collaboration may be a more productive way to stimulate “respectful” care than the current emphasis on formal rights and respect.
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Mkandawire-Valhmu, Lucy, and Jennifer Doering. "Study Abroad as a Tool for Promoting Cultural Safety in Nursing Education." Journal of Transcultural Nursing 23, no. 1 (January 2012): 82–89. http://dx.doi.org/10.1177/1043659611423831.
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Nurse educators are calling for the transformation of nursing education toward curricula that promote clinical reasoning through reflective practice and understanding of patient experiences in an effort to motivate students to become change agents. Study abroad programs can play an important role in this transformation through educating nurses in the delivery of culturally safe health care in a diverse world. Exposing nursing students to study abroad experiences that are guided by critical approaches such as a postcolonial feminist framework provides nursing students with opportunities to be immersed in the life and culture of people who have a completely different positioning and location while reflecting on the “us” versus “them” phenomenon that is pervasive in modern Western society and generates negative cultural comparisons. Attention to the design and implementation of such programs is important if nursing schools in the Western world are to uphold ethical standards, promote equality in relationships with host communities and avoid inadvertent exploitation and marginalization of vulnerable peoples. We present the development and implementation of a community health study abroad program for American nursing students in Malawi, Africa using a postcolonial feminist framework.
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Bowles, Betty Carlson, and Marty Gibson. "Exclusive Breastfeeding in the Prevention and Treatment of Cholera in Haiti." Clinical Lactation 3, no. 2 (June 2012): 51–57. http://dx.doi.org/10.1891/215805312807009405.
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It has been two years since an earthquake devastated Haiti, and over a year since the outbreak of cholera. On a recent medical mission to a rural village in Haiti, the authors staffed a medical clinic and made home visits on motorcycle into the remote mountain regions to treat patients who were unable to attend the clinic. Their major emphasis was patient education including the prevention of cholera. Because there is no hospital and no doctor in the area and most births occur in the home, the authors were also charged with teaching homebirth classes to untrained midwives who spoke only Creole. During the clinics, home visits, and classes, they became extremely aware of the importance of breastfeeding in the prevention of cholera. A banner over the main intersection in the village stated in Creole, Bay tibebe yo tete pou pwoteje yo kont malady Kolera(English translation: "Give small babies your breast to protect them from the malady of Cholera"). The banner bears the logos of the Ministry of Public Health and Population (MSPP) and that of UNICEF (see Figure 1). Despite the obviously robust breastfed babies, the authors encountered a pervasive lack of knowledge about breastfeeding, and fielded many questions related to recommended duration of breastfeeding and ways to build a waning milk supply. Many opportunities arose for promotion of exclusive breastfeeding for extended periods to preserve the lives and ensure the health of their infants. The purpose of this article is to describe the conditions in Haiti, the effects of the earthquake and cholera outbreak of 2010, and the importance of promoting exclusive breastfeeding in these extraordinary circumstances.
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Rumsey, DS, L. Brabin, J.-M. Mfutso-Bengo, LE Cuevas, A. Hogg, and BJ Brabin. "Effectiveness of drama in promoting voluntary HIV counselling and testing in rural villages in southern Malawi." International Journal of STD & AIDS 15, no. 7 (July 2004): 494–96. http://dx.doi.org/10.1258/0956462041211270.
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Austin Banda, Owen, Maurice Ongalo Udoto, and Joel Kipkemoi Ng’eno. "Influence of Selected Institutional and Technological Factors on the Adoption of Sustainable Agriculture Technologies in Maize Farming in Mzimba South, Malawi." Journal of Agriculture and Crops, no. 63 (March 20, 2020): 16–26. http://dx.doi.org/10.32861/jac.63.16.26.
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Sustainable Agriculture Technologies (SATs) significantly contribute to addressing the negative effects of land degradation, poor soil health and climate variability in the agriculture sector. Despite efforts made by different stakeholders in promoting SATs to improve maize productivity in Mzimba South in Malawi, the adoption of the technologies among small-scale farmers remains unsatisfactory. As a result, most of the farmers continue to realize low maize yields. A survey was conducted from July to September 2019 to investigate the influence of selected institutional and technological factors on the adoption of SATs in maize farming among the small-scale farmers in Mzimba South. A multi-stage sampling procedure was used to select a representative sample of 132 small-scale maize farming household heads. Data was collected using a researcher-administered questionnaire. Multivariate probit, ordered probit and ordinary least square (OLS) models were applied to determine the influence of the selected factors on the adoption of SATs at α level of .05 using STATA and SPSS. Qualitative data was analyzed by a deductive approach, in which responses were categorized and summarized under the related themes. The study established that the adoption of SATs was significantly influenced by membership in farmer organizations (FOs), access to extension services, and the levels of relative advantage and complexity associated with the SATs. The findings of the study implied that the Government of Malawi and relevant stakeholders in the agriculture sector need to train and recruit more extension field staff to improve coverage and frequency of extension services delivery on sustainable agriculture. The stakeholders should also promote affiliation of the small-scale farmers to FOs to improve access to agricultural extension services and production resources on sustainable farming. In addition, efforts should be made to develop and promote affordable mechanization options for reducing farm drudgery associated with the implementation of SATs. Furthermore, the Government of Malawi should facilitate the formulation, enactment, and enforcement of local by-laws for safeguarding the SATs and their related inputs (or raw materials) against vandalism, livestock damage, and bushfires.
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Manda-Taylor, Lucinda, Alice Liomba, Terrie E. Taylor, and Kristan Elwell. "Barriers and Facilitators to Obtaining Informed Consent in a Critical Care Pediatric Research Ward in Southern Malawi." Journal of Empirical Research on Human Research Ethics 14, no. 2 (March 13, 2019): 152–68. http://dx.doi.org/10.1177/1556264619830859.
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Informed consent is an ethical requirement in clinical research. Obtaining informed consent is challenging in resource-constrained settings. We report results of a formative qualitative study that examined factors that facilitate and hinder informed consent for clinical research among critically ill children in Malawi. We argue that truly informed consent in a pediatric intensive care unit (PICU) is challenged by parental distress, time constraints when balancing care for critically ill patients with research-related tasks, and social hierarchies and community mistrust toward certain research procedures. We interviewed health care providers and parents of children attending a critical care unit to identify potential challenges and solicit strategies for addressing them. Providers and caregivers suggested practical solutions to enhance research participant understanding of clinical trial research, including the use of visual materials, community engagement strategies, and using patients as advocates in promoting understanding of research procedures.
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Martın, Marta Cornax, Nuria Nebot Gomez De Salazar, Ana Luque Gil, and Carlos Rosa-Jimenez. "How New Technologies Can Promote an Active and Healthy City. Digital Platform to Identify Areas of Informal Sport Practice in the City of Malaga." Academic Research Community publication 3, no. 2 (May 1, 2019): 129. http://dx.doi.org/10.21625/archive.v3i2.506.
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In recent years the urban public space has become the largest casual sports infrastructure in cities and suburbs. WHO establishes a direct relationship between the Active Healthy City, social cohesion of communities and public space. This approach provides a framework for research and work on the design of the city and urban space as support for this sport practice. Moreover, new technologies provide an opportunity to promote the sport in the city.“Malaga Activa” digital platform project is an initiative that wants to promote the informal sport practice on the urban public space (outside the regulated sports facilities) and healthy living in the neighborhoods of the city of Malaga. This paper presents the results of the first phase of the project identifying the active sport areas in the public space -those in which physical and casual sport activities take place-. It also includes a methodology for the analisys and promotion of public space as an activator of phsycal activity, which includes a performance test of the created digital platform, as well as an assessment of the experience and possible improvements to be incorporated in the successive phases of the project.
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Bellefleur, Olivier, and Marianne Jacques. "Le Centre de collaboration nationale sur les politiques publiques et la santé au temps de la COVID-19 : développer les compétences pour «rebâtir en mieux»." Relevé des maladies transmissibles au Canada 47, no. 04 (May 7, 2021): 254–58. http://dx.doi.org/10.14745/ccdr.v47i04a08f.
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Ce deuxième article d’une série sur les six Centres de collaboration nationale en santé publique porte sur le Centre de collaboration nationale sur les politiques publiques et la santé (CCNPPS), un centre d’expertise, de synthèse et de partage des connaissances qui soutient les acteurs de la santé publique au Canada dans leurs efforts d’élaboration et de promotion de politiques publiques favorables à la santé. L’article présente brièvement le mandat du CCNPPS et sa programmation, en mentionnant quelques-unes des ressources particulièrement pertinentes dans le contexte actuel de la maladie à coronavirus 2019 (COVID-19). Il s’attarde ensuite aux adaptations apportées à la programmation du CCNPPS pour répondre aux besoins changeants des acteurs de la santé publique au fil de la pandémie. Ces besoins ont été fortement liés aux décisions visant à contenir la propagation du virus SRAS-CoV-2 et à mitiger ses impacts immédiats dans les différents secteurs de la société depuis le début de la crise. Des besoins ont aussi progressivement émergé en lien avec la contribution attendue de la santé publique pour informer le développement de politiques publiques qui permettront de « rebâtir en mieux » nos sociétés lors du rétablissement de la pandémie. L’article se termine en mentionnant les orientations du CCNPPS pour ses travaux à venir dans un contexte de sortie de crise de la COVID-19.
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Ohkubo, Saori, Sarah V. Harlan, Naheed Ahmed, and Ruwaida M. Salem. "Conceptualising a New Knowledge Management Logic Model for Global Health: A Case-Study Approach." Journal of Information & Knowledge Management 14, no. 02 (June 2015): 1550015. http://dx.doi.org/10.1142/s021964921550015x.
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Over the past few decades, knowledge management (KM) has become well-established in many fields, particularly in business. Several KM models have been at the forefront of promoting KM in businesses and organisations. However, the applicability of these traditional KM models to the global health field is limited by their focus on KM processes and activities with few linkages to intended outcomes. This paper presents the new Knowledge Management for Global Health (KM4GH) Logic Model, a practical tool that helps global health professionals plan ways in which resources and specific KM activities can work together to achieve desired health program outcomes. We test the validity of this model through three case studies of global and field-level health initiatives: an SMS-based mobile phone network among community health workers (CHWs) and their supervisors in Malawi, a global electronic Toolkits platform that provides health professionals access to health information resources, and a netbook-based eHealth pilot among CHWs and their clients in Bangladesh. The case studies demonstrate the flexibility of the KM4GH Logic Model in designing various KM activities while defining a common set of metrics to measure their outcomes, providing global health organisations with a tool to select the most appropriate KM activities to meet specific knowledge needs of an audience. The three levels of outcomes depicted in the model, which are grounded in behavioural theory, show the progression in the behaviour change process, or in this case, the knowledge use process, from raising awareness of and using the new knowledge to contributing to better health systems and behaviours of the public, and ultimately to improving the health status of communities and individuals. The KM4GH Logic Model makes a unique contribution to the global health field by helping health professionals plan KM activities with the end goal in mind.
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Yamaguchi, Mirian Ueda, Josiane Kelly de Barros, Rosane Clys de Barros Souza, Marcelo Picinin Bernuci, and Leonardo Pestillo de Oliveira. "O papel das mídias digitais e da literacia digital na educação não-formal em saúde (The role of digital media and digital literacy in non-formal health education)." Revista Eletrônica de Educação 14 (January 15, 2020): 3761017. http://dx.doi.org/10.14244/198271993761.
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Digital health literacy involves the individual's ability to effectively interpret, evaluate and use health information obtained through digital media, enabling them to make decisions and have greater autonomy over their health. Considering the increasing use of digital media as a source of health information for the population, the present study aimed to evaluate the digital health literacy level of individuals who use social media. The study was conducted with a sample of 423 individuals using a digital questionnaire to obtain socioeconomic data, and the eHealth literacy scale (eHeals) instrument was used to assess the level of digital health literacy. The results indicated that higher levels of education and income correlate with higher levels of digital health literacy. The biological determinants of age and gender did not correlate with digital literacy. It is concluded that government strategies that seek to use social media such as Facebook, Instagram and Twiter as an alternative to non-formal health education should consider that the success of these strategies depends on first investing in the formal education of the population.ResumoLiteracia digital em saúde envolve a capacidade do indivíduo em interpretar, avaliar e usar de forma eficaz as informações de saúde obtidas por meio das mídias digitais, permitindo-o tomar decisões e ter maior autonomia sobre sua saúde. Considerando a crescente utilização das mídias digitais como fonte de informações em saúde para população, o presente estudo objetivou avaliar o nível de literacia digital em saúde de indivíduos que fazem uso das mídias digitais. O estudo foi desenvolvido com uma amostra de 423 indivíduos por meio de questionário digital para obtenção de dados socioeconômicos e o instrumento eHealth literacy scale (eHeals) foi utilizado para avaliar o nível de literacia digital em saúde. Os resultados indicaram que maior nível de escolaridade e renda correlaciona com maiores níveis de literacia digital em saúde. Os determinantes biológicos idade e sexo não apresentaram correlação com a literacia digital. Conclui-se que a estratégia do governo que busca, por exemplo, utilizar as redes sociais online Facebook, Instagram e Twiter como alternativa de educação não-formal em saúde deve considerar que o êxito dessa estratégia perpassa pela necessidade de investir na educação formal.Palavras-chave: Educação não-formal, Educação para saúde, Política de saúde.Keywords: Non-formal education, Health education, Health policy.ReferencesBARROS, Josiane Kelly. Adaptação transcultural e análise das propriedades psicométricas de instrumento para avaliação da literacia digital em saúde. 2019. 77 f.. Dissertação (Mestrado em Promoção da Saúde) – Centro Universitário de Maringá – UNICESUMAR, Maringá, 2019.BIRCH, David. Improving schools, improving school education health education, improving public health: The role of SOPHE members. Health Education & Behavior, v. 44, n. 6, p. 839-844, 2017. http://dx.doi: 10.1177/1090198117736353.Cohen, Jacob. Statistical Power Analysis. Current Directions in Psychological Science. v.1, n.3, p. 98–101, 1992. https://doi.org/10.1111/1467-8721.ep10768783DINO. 62% da População Brasileira está Ativa nas Redes Sociais. Disponível em: <https://exame.abril.com.br/negocios/dino/62-da-populacao-brasileira-esta-ativa-nas-redes-sociais/>. Acesso em: 22 setembro 2019.GABARRON, Elia; ARSAND, Eirik; WYNN, Rolf. Social Media Use in Interventions for Diabetes: Rapid Evidence-Based Review. Journal of Medical Internet Research. v. 10, n.11, 2018, e-10303. https://doi: 10.2196/10303Guntzviller, Lisa; King, Andy; Jensen, Jacob; Davis. Self-Efficacy, Health Literacy, and Nutrition and Exercise Behaviors in a Low-Income, Hispanic Population. Journal of Immigrant and Minority Health, v. 19, n. 2, p. 489–49, 2016. http://dx.doi:10.1007/s10903-016-0384-4 HSU, Michelle; ROUF, Anika; ALLMAN-FARINELLI, Margaret. Effectiveness and Behavioral Mechanisms of Social Media Interventions for Positive Nutrition Behaviors in Adolescents: A Systematic Review. Journal of Adolescent Health. v.63, n.5, p.531-545, 2018.IBGE – Instituto Brasileiro de Geografia e Estatística. Diretoria de Pesquisas, Coordenação de Trabalho e Rendimento, Pesquisa Nacional por Amostra de Domicílios Contínua 2016/2018. LaBARGE, Gene; BROOM, Matt. Social Media in Primary Care. Missouri Medicine. v. 116, n.2, 2019, p.106-110.Loureiro, Luís Manuel de Jesus; Gameiro, Manuel Gonçalves Henriques. 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Available online at https://www.R-project.org/.RAMOS, Francisco Lúzio de Paula; HORA Ádrea Leal; SOUZA, Claudia Tereza Vieria; PEREIRA, Luciana Oliveira; HORA, Dinair Leal da. As contribuições da epidemiologia social para a pesquisa clínica em doenças infecciosas. Revista Pan-Amazônica de Saúde. v.7, n.esp.,p.221-229, 2016. doi: 10.5123/S2176-62232016000500025schwitzer, Gary. Pollution of health news: Time to drain the swamp. BMJ, v. 356, j1262, 2017.SILVA, Marco Antonio Dias; WALMSLEY, Anthony Damien. Fake News and Dental Education. British Dental Journal. v.226, p.397-399, 2019. https://www.nature.com/articles/s41415-019-0079-zTENGLAND, Per-Anders. Behavior Change or Empowerment: On the Ethics of Health-Promotion Goals. Health Care Analysis, v. 24, n. 1, p. 24–46, 2016.TOMÁS, Catarina Cardoso; QUEIRÓS, Paulo Joaquim Pina; FERREIRA, Teresa de Jasus Rodrigues. Revista de Enfermagem Referência. série IV, n. 2, p.19-28, 2014.VAART, Rosalie van der; DROSSAERT, Constance. Development of the Digital Health Literacy Instrument: Measuring a Broad Spectrum of Health 1.0 and Health 2.0 Skills. Journal of Medical Internet Research, v. 19, n. 1, p.01-13, 2017. http://dx.doi.org/10.2196/jmir.6709.VOSOUGHI, Soroush; ROY, Deb; ARAL, Sinan. The spread of true and false news online. Science, v. 359, p. 1146-1151, 2018.WANG, Yuxi; McKEE, Martin; TORBICA, Aleksandra; STUCKLER, David. Systematic Literatura Review on the Spread of Health-related Misinformation on Social Media. Social Science & Medicine. v.240, 112552, 2019.WASZAK, Przemyslaw M; KASPRZYCKA-WASZAK, Wioleta; KUBANEK, Alicja. Health Policy and Technology, The spread of medical fake news in social media – the pilot quantitative study, v. 7, n. 2, 115-118, 2018.e3761017
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Chunga, Richard, M. W. Jenkins, Jeroen Ensink, and Joe Brown. "Moving up the sanitation ladder with the help of microfinance in urban Malawi." Journal of Water, Sanitation and Hygiene for Development 8, no. 1 (December 8, 2017): 100–112. http://dx.doi.org/10.2166/washdev.2017.186.
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Abstract 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 settlements in the two largest cities, Lilongwe and Blantyre. When we gave respondents a microfinance option, the proportion of households stating an intention to install improved and unimproved pit latrines decreased significantly, while the proportion stating an intention to upgrade to alternative improved sanitation technologies increased significantly. However, households in the lowest wealth quintile were more likely to state a preference for unimproved pit latrines, suggesting that the benefits of microfinance for sanitation may not accrue equally across wealth strata. Organisations seeking to improve access to safely managed sanitation by promoting alternative sanitation technologies would succeed if households have access to affordable alternative sanitation technologies and microfinance for sanitation. However, poorer households would need more affordable improved sanitation technologies, flexible microfinance options and possibly targeted subsidies to gain access to safely managed sanitation.
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Schiariti, Verónica, Egmar Longo, Alexander Shoshmin, Ludmila Kozhushko, Yanina Besstrashnova, Maria Król, Taynah Neri Correia Campos, et al. "Implementation of the International Classification of Functioning, Disability, and Health (ICF) Core Sets for Children and Youth with Cerebral Palsy: Global Initiatives Promoting Optimal Functioning." International Journal of Environmental Research and Public Health 15, no. 9 (September 1, 2018): 1899. http://dx.doi.org/10.3390/ijerph15091899.
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Background: The International Classification of Functioning, Disability, and Health (ICF) Core Sets for children and youth with cerebral palsy (CP) offer service providers and stakeholders a specific framework to explore functioning and disability for assessment, treatment, evaluation, and policy purposes in a global context. Objective: Describe global initiatives applying the ICF Core Sets for children and youth with CP, with a focus on contributions to clinical practice and challenges in their implementation. Methods: This is a descriptive cross-sectional study. Ongoing initiatives applying the ICF Core Sets for CP in Russia, Poland, Malawi, and Brazil are included. Results: The main contributions of applying the ICF Core Sets for children and youth with CP include: (1) an objective description of abilities and limitations in everyday activities; (2) a consistent identification of facilitators and barriers influencing functioning; (3) a practical communication tool promoting client-centered care and multidisciplinary teamwork; and, (4) a useful guideline for measurement selection. The main challenges of adopting the ICF Core Sets are related to lack of ICF knowledge requiring intense training and translating results from standardized measures into the ICF qualifiers in a consistent way. Conclusions: Global initiatives include research and clinical applications at the program, service and system levels. The ICF Core Sets for CP are useful tools to guide service provision and build profiles of functioning and disability. Global interprofessional collaboration, capacity training, and informatics (e-records) will maximize their applications and accelerate adoption.
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Oh, Jiwon, Marie-Sarah Gagné-Brosseau, Melanie Guenette, Catherine Larochelle, François Lemieux, Suresh Menon, Sarah A. Morrow, et al. "Toward a Shared-Care Model of Relapsing-Remitting Multiple Sclerosis: Role of the Primary Care Practitioner." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 45, no. 3 (May 2018): 304–12. http://dx.doi.org/10.1017/cjn.2018.7.
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AbstractThe objective of this study was to develop a shared-care model to enable primary-care physicians to participate more fully in meeting the complex, multidisciplinary healthcare needs of patients with multiple sclerosis (MS).Design:The design consisted of development of consensus recommendations and a shared-care algorithm.Participants:A working group of 11 Canadian neurologists involved in the management of patients with MS were included in this study.Main message:The clinical management of patients with multiple sclerosis is increasing in complexity as new disease-modifying therapies (DMTs) become available, and ongoing safety monitoring is required. A shared-care model that includes primary care physicians is needed. Primary care physicians can assist in the early detection of MS of individuals presenting with neurological symptoms. Additional key roles for family physicians are health promotion, symptom management, and safety and relapse monitoring of DMT-treated patients. General principles of health promotion include counseling MS patients on maintaining a healthy lifestyle; performing standard screening measures; and identifying and treating comorbidities. Of particular importance are depression and anxiety, which occur in >20% of MS patients. Standard work-ups and treatments are needed for common MS-related symptoms, such as fatigue, pain, bladder dysfunction, sexual dysfunction, spasticity, and sleep disorders. Ongoing safety monitoring is required for patients receiving specific DMTs. Multiple sclerosis medications are generally contraindicated during pregnancy, and patients should be counseled to practice effective contraception.Conclusions:Multiple sclerosis is a complex, disabling illness, which, similar to other chronic diseases, requires ongoing multidisciplinary care to meet the evolving needs of patients throughout the clinical course. Family physicians can play an invaluable role in maintaining general health, managing MS-related symptoms and comorbidities, monitoring for treatment-related adverse effects and MS relapses, and coordinating allied health services to ensure continuity of care to meet the complex and evolving needs of MS patients through the disease course.RÉSUMÉ:Élaborer un modèle de soins partagés dans les cas de sclérose en plaques récurrente-rémittente.Objectif:Élaborer un modèle de soins partagés afin de permettre aux médecins de première ligne de mieux répondre aux besoins complexes et multidisciplinaires de patients atteints de la sclérose en plaques (SP).Conception :Recommandations résultant d’un consensus et élaboration d’un algorithme en matière de soins partagés.Participants :Un groupe de travail formé de onze neurologues canadiens impliqués dans la prise en charge de patients atteints de la SP.Message-clé :La prise en charge clinique de patients atteints de la SP est de plus en plus complexe dans la mesure où des médicaments modificateurs de l’évolution de la maladie (MMSP) deviennent accessibles et où un suivi permanent en matière de sécurité est nécessaire. Soulignons aussi qu’un modèle de soins partagés incluant les médecins de première ligne est nécessaire. Ces professionnels peuvent permettre un dépistage plus rapide de la SP chez des individus présentant des symptômes neurologiques. Ils peuvent aussi jouer un rôle de premier plan en matière de promotion de la santé, de soulagement des symptômes et de suivi de patients traités avec des MMSP en ce qui a trait à leur sécurité et à de possibles rechutes. Parmi les principes généraux de promotion de la santé, on peut inclure les suivants : offrir aux patients atteints de la SP des conseils leur permettant de maintenir de saines habitudes de vie ; adopter des mesures de dépistage standards ; identifier et traiter les comorbidités. À cet égard, l’anxiété et la dépression sont d’une importance particulière et sont fréquemment signalées (> 20 %) chez les patients atteints de SP. Des démarches d’investigation et des traitements standards sont nécessaires dans le cas des symptômes courants reliés à la SP, par exemple de la fatigue, des douleurs, une dysfonction vésicale, des dysfonctions sexuelles, de la spasticité et des troubles du sommeil. On l’a dit, un suivi permanent s’impose dans le cas de patients bénéficiant d’un traitement spécifique avec des MMSP. Les médicaments associés à la SP sont généralement contre-indiqués durant la grossesse de sorte qu’on devrait conseiller aux patients d’adopter des méthodes de contraception efficaces.Conclusions :La SP est une maladie complexe et invalidante qui, à l’instar d’autres maladies chroniques, exige des soins multidisciplinaires continus afin de répondre, en lien avec un tableau clinique précis, aux besoins en constante évolution des patients. Les médecins de première ligne peuvent jouer un rôle irremplaçable à plusieurs égards : dans le maintien d’une bonne santé ; le suivi et le soulagement des symptômes et des comorbidités reliés à la SP ; le suivi des rechutes et des effets indésirables associés aux traitements. N’oublions pas non plus la coordination des services paramédicaux afin d’assurer, durant l’évolution de la SP, une continuité des soins répondant aux besoins complexes et en constante évolution des patients atteints de cette maladie.
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Uny, Isabelle, Bregje de Kok, and Suzanne Fustukian. "Weighing the options for delivery care in rural Malawi: community perceptions of a policy promoting exclusive skilled birth attendance and banning traditional birth attendants." Health Policy and Planning 34, no. 3 (April 1, 2019): 161–69. http://dx.doi.org/10.1093/heapol/czz020.
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Alfred Maroyi. "Review of phytochemistry, biological activities and therapeutic potential of Cleistochlamys kirkii." International Journal of Research in Pharmaceutical Sciences 11, no. 4 (September 28, 2020): 5596–602. http://dx.doi.org/10.26452/ijrps.v11i4.3197.
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Cleistochlamys kirkii (Benth.) Oliv is a shrub or small tree widely used as a traditional medicine in the east and central Africa. Cleistochlamys kirkii is indigenous to Malawi, Mozambique, Tanzania, Zambia and Zimbabwe. This study is aimed at evaluating the phytochemistry, biological activities and therapeutic potential of C. kirkii. Results of the current study are based on data derived from several online databases such as Scopus, Google Scholar, PubMed and Science Direct, and pre-electronic sources such as scientific publications, books, dissertations, book chapters and journal articles. This study revealed that the leaf and root infusion, maceration and decoction of C. kirkii are mainly used as traditional medicines for haemorrhoid wounds, rheumatism and tuberculosis. Phytochemical compounds identified from the species include α,β-unsaturated lactone, acetogenin, benzyl benzoate derivatives, c-benzylated flavanone, heptanolide, an indole alkaloid, phenolics, polyoxygenated cyclohexene and derivatives, sesquiterpene and tetracyclic triterpenes. In vitro studies have confirmed the biological activities of C. kirkii crude extracts and compounds isolated from the species which include antibacterial, antifungal, antiplasmodial and cytotoxicity. Documentation of the medicinal uses, phytochemistry and pharmacological properties of C. kirkii is essential as this information provides baseline data required for future research and development of health-promoting and pharmaceutical products. Cleistochlamys kirkii should be subjected to detailed ethnopharmacological and toxicological evaluations aimed at correlating its medicinal uses with its phytochemistry and pharmacological properties.
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Chilale, Harris K., Ndumanene Devlin Silungwe, Saulos Gondwe, and Charles Masulani-Mwale. "Clients and carers perception of mental illness and factors that influence help-seeking: Where they go first and why." International Journal of Social Psychiatry 63, no. 5 (June 12, 2017): 418–25. http://dx.doi.org/10.1177/0020764017709848.
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Objective: In Northern Malawi, the duration of untreated psychosis (DUP) is longer than that in high-income countries. The reasons for the delay in help-seeking are not known, although studies show multiple reasons. This research was conducted to establish health care help-seeking behaviours and identify barriers that exist between service users and health care providers. The study also intended to establish the beliefs that clients and family members have regarding the causes of mental illness which profoundly shape help-seeking, care giving process and outcomes. Methodology: The study employed the exploratory phenomenological method, utilizing focus group discussions (FGDs) in the sampled population. The Health Belief Model and Disease Explanatory Models were conveniently chosen a priori by researchers to develop guide questions to explore clients’ and carers’ perceptions of the illness and their health care help-seeking behaviours. Results: Results show a bio-psycho-social inclination of disease causation and help-seeking behaviour. Causes of mental illness are understood in three categories, namely: physical/biological, psychological and socio-cultural. The majority of participants attributed mental illness to socio-cultural factors, with witchcraft, spirit possession and curses as main determinants. Causal perceptions also influenced help-seeking pathways. Many participants reported consulting traditional healers first, for diagnosis and to know who was responsible. Conclusion: In this study, it has been found that help-seeking is influenced by the understanding of the source of the illness – which has a bio-psychosocial inclination. The socio-cultural explanation of witchcraft and spirit possession is dominant and a determinant of help-seeking behaviour. While participants noted benefits to hospital treatment, barriers and bio-psychosocial in nature were also noted. Guardians and not clients hold the key to choice of treatment modality and therefore a potential ally in all treatment interventions promotive, preventive and curative. There is need for strengthening of a bio-psychosocial intervention model in the treatment of mental illness.
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Greacen, T. "Pair-aidance, job coaching, des outils pour le rétablissement." European Psychiatry 28, S2 (November 2013): 81. http://dx.doi.org/10.1016/j.eurpsy.2013.09.216.
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La recherche-action EMILIA (2005–2010), financée par la Commission européenne, a décrit sur huit sites européens les obstacles et les facilitateurs à l’accès à la formation et à l’emploi des personnes vivant avec un trouble psychique [1,3]. Ce programme a vu la création, à Paris, du Centre EMILIA, qui propose aujourd’hui d’expérimenter une double approche vers l’inclusion dans le monde de l’emploi. D’un côté, il s’agit de soutenir l’entreprise quant à la problématique de l’apparition d’un trouble de santé mentale chez un salarié et, de l’autre, d’intégrer des personnes handicapées psychiques directement dans l’emploi en milieu ordinaire. Le centre propose un programme de formation et de job coaching qui repense non seulement le retour ou l’accès à l’emploi mais qui crée aussi une véritable politique d’entreprise sur l’inclusion sociale des personnes vivant avec un trouble psychique. Au travers du Centre Emilia et en lien avec le médecin de santé au travail, l’entreprise propose un accompagnement, en forme de coaching individuel couplé à des formations collectives. Les formations, basées sur le modèle du rétablissement, s’appuient sur le soutien par les pairs, notamment par d’autres professionnels qui ont déjà vécu un trouble psychique, des pairs aidants [2]. Les formations collectives inter-entreprises s’avèrent être une des voies les plus efficaces pour la personne de réussir son projet de retour ou d’accès à l’emploi, en raison de la dynamique de soutien par les pairs et de mutualisation des compétences acquises lors de l’expérience du vécu de la maladie. Ces démarches individuelles de formation et de job coaching s’inscrivent dans une offre de formations pour l’ensemble des salariés à la promotion de la santé mentale en milieu professionnel, à la lutte contre la stigmatisation de la maladie mentale et à la solidarité avec les personnes vivant avec un trouble psychique.
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Ziyenda Katenga-Kaunda, Lillian, Per Ole Iversen, Gerd Holmboe-Ottesen, Heidi Fjeld, Ibrahimu Mdala, and Penjani Rhoda Kamudoni. "Dietary intake and processes of behaviour change in a nutrition education intervention for pregnant women in rural Malawi: a cluster-randomised controlled trial." Public Health Nutrition 23, no. 13 (May 18, 2020): 2345–54. http://dx.doi.org/10.1017/s1368980020000294.
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AbstractObjective:To examine if increased intake of locally available nutrient-dense foods among pregnant women improved the quality of their dietary intake and if use of the Theory of Planned Behaviour could explain changes in their dietary behaviour.Design:We used data from a randomised controlled trial where the intervention group received nutrition education and dietary counselling. We promoted the use of recipes that utilised powders to enhance dietary diversity. We examined how the intervention achieved changes in dietary intakes and used mixed effects logistic regression models with random effects at village level to explore changes over time of the outcomes, adjusted for selected explanatory variables.Setting:The study was conducted in twenty villages in rural Malawi.Participants:Data from 257 pregnant women who were enrolled during late first trimester and followed until birth.Results:The intervention achieved improvements in the Dietary Diversity Score (DDS) and the Six Food Group Pyramid (SFG) score, especially in intakes of micronutrient-rich foods. A third of the women in the intervention group attained optimal DDS, whereas about 50 % attained optimal SFG. The theorised behaviour mediators (i.e. nutrition attitudes, nutrition behaviour control and subjective norm) that had improved were also significantly associated with high DDS.Conclusions:Improved dietary intakes were achieved through promoting the use of locally available nutrient-dense foods. Attainment of high DDS was a consequence of the women’s belief in the effectiveness of the proposed nutrition recommendations. We identified critical personal and environmental constraints related to dietary intakes during pregnancy in a low-resource setting.
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Geneste-Saelens, J. "Quels programmes d’éducation thérapeutiques pour les patients alcoolodépendants ?" European Psychiatry 28, S2 (November 2013): 3. http://dx.doi.org/10.1016/j.eurpsy.2013.09.007.
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Dans sa définition classique l’éducation thérapeutique est conçue comme l’aide apportée au patient pour comprendre sa maladie et les traitements, collaborer aux soins et devenir compétent dans la gestion de sa pathologie. Les programmes de prise en charge addictologiques en thérapie comportementale et cognitive rencontrés dans les établissements de soins, notamment centré sur la prévention de la rechute, sont déjà largement centrés sur ces objectifs.La difficulté pour nous, intervenant dans le champ de l’alcoologie, est sans doute de redéfinir le champ de l’éducation thérapeutique au sein de l’ensemble des soins apportés, ce qui revient en partie à se poser la question de l’intérêt que nous avons à rebaptiser une partie de nos prises en charge « éducation thérapeutique ».En ce qui concerne leurs finalités, on pourrait ici résumer celle des soins par la sortie de la dépendance et celle de l’éducation thérapeutique par la gestion des contraintes que cette dépendance induit au long cours, même stabilisée. Le temps de l’éducation thérapeutique serait alors secondaire à la stabilisation de la maladie.Si nous retenons comme cible principale de l’éducation thérapeutique, l’objectif de vivre avec sa maladie, il va de soi que cela engage, en plus des compétences, des réaménagements psychologiques et identitaires nécessitant un accompagnement ne pouvant se limiter à l’apprentissage d’outils et/ou de transmission de savoirs. Il s’agit d’un vrai travail d’acceptation à accompagner et à ne surtout pas réduire à la simple question de reconnaissance du trouble (de façon catégorielle) face à un tiers.Les programmes d’éducation thérapeutique en alcoologie se doivent d’être particulièrement attentifs aux différents aspects du trouble (cognitif, émotionnel et comportemental) afin de permettre cette acceptation.Enfin, au sujet de l’acceptation, un dernier point mérite d’être soulevé en ce qui concerne l’objectif de consommation « contrôlée » ou d’abstinence qui sera choisi. En effet, qui dit « éducation thérapeutique » dit promotion de l’autonomie du patient, et, dans ce contexte, il est important d’appréhender la capacité des soignants à accepter et accompagner les patients, à travers ces programmes, dans leurs objectifs de consommation.
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SIDIO, Serge-Roland, Koffi N'GUESSAN, N'gouan Emmanuel Joël ABROU, and Venance-pâques G. KOUADIO. "Plantes employées en médecine traditionnelle contre la pathologie hémorroïdaire par les Bété de la sous-préfecture d’Ouragahio, département de Gagnoa (Côte d’Ivoire)." Journal of Applied Biosciences 150 (December 30, 2020): 15403–18. http://dx.doi.org/10.35759/jabs.150.2.
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Objectifs : Cette étude a été réalisée avec pour objectif de recenser les connaissances ancestrales relatives au traitement traditionnel de la maladie hémorroïdaire auprès des tradipraticiens de santé de la sous-préfecture d’Ouragahio (Côte d’Ivoire) et ainsi contribuer à la valorisation de la médecine traditionnelle. Méthodologie et Résultats : Une collecte de données a été effectuée à travers des enquêtes ethnobotaniques grâce au concours de 33 guérisseurs et herboristes natifs de la localité visitée. Les informations recueillies ont été statistiquement traitées et ont permis de calculer des indices spécifiques. Il en ressort que dix-sept (17) espèces de plantes médicinales réparties en 15 genres appartenant à 11 familles sont recommandées pour la préparation de 19 recettes majoritairement monospécifiques (63,16%). Les Fabaceae forment la famille la plus représentée. Les feuilles (41,94%) sont les organes les plus sollicités. Le mode de récolte prépondérant est la cueillette (61,29%), la pulvérisation (45%) est la technique de préparation dominante et l’administration se fait majoritairement par voie orale (52,63%). Alchornea cordifolia est l’espèce la plus mentionnée (FC = 87,87%) et détient l’indice de consensus maximum de cette étude (IC = 0,76). Elle constitue avec Rhygiocarya racemiflora les plantes anti hémorroïdaires préférées des répondants (NP= 15,15%). Conclusion et Application des résultats : Les résultats de cette étude s’avèrent déterminantes étant donné qu’ils pourraient orienter des phytochimistes, des toxicologues et des pharmacologues sur de nouvelles pistes de recherches pouvant aboutir à la mise au point de médicaments traditionnels améliorés accessibles aux ménages à revenus modestes. Mots clés : Ethnobotanique, médecine traditionnelle, hémorroïdes, Ouragahio, Côte d’Ivoire. Plants used in traditional medicine against haemorrhoidal pathology by Beté of the Ouragahio sub-prefecture, department of Gagnoa (Côte d’Ivoire). ABSTRACT Objectives: The purpose of this study was to identify ancestral knowledge of the traditional treatment of haemorrhoid disease among health traditional practitioners in the sub-prefecture of Ouragahio (Côte d’Ivoire) and contribute to the promotion of traditional medicine. Methodology and Results: A data collection was carried out through ethnobotanical surveys with the help of 33 healers and herbalists from the locality visited. The information collected was statistically processed and made it possible to calculate specific indices. Asa result, seventeen (17) species of medicinal plants, divided into 15 genera belonging to 11 families, are recommended for the preparation of 19 recipes that are predominantly monospecific (63.16%). Fabaceae is the most represented family. Leaves (41.94%) are the most stressed organs. The predominant method of harvesting is picking (61.29%), spraying (45%) is the dominant preparation technique and administration is mainly by oral means (52.63%). Alchornea cordifolia is the most mentioned species (CF = 87.87%)and holds the maximum consensus index for this study (CI = 0.76). With Rhygiocarya racemiflora, it is the preferred haemorrhoid treatment plant of the respondents (NP = 15.15%). Conclusions and application of findings: The results of this study are decisive since they could be found in plant chemists, toxicologists and pharmacologists on new avenues of research that could lead to the development of improved traditional medicines for low-income households. Keywords: Ethnobotany, traditional medicine, haemorrhoids, Ouragahio, Côte d’Ivoire.
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Kim, Jong Seok. "Measuring willingness-to-pay for mobile phone features: a multi-region study." Journal of Research in Marketing and Entrepreneurship 20, no. 2 (October 15, 2018): 189–213. http://dx.doi.org/10.1108/jrme-02-2016-0003.
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Purpose A method is proposed for handling multi-attribute judgment problems with a large number of attributes such as mobile phone features. To minimize the complication of multi-attributes and reduce the consumers’ choice task burden, this paper aims to suggest an integrated hierarchical survey design (IHSD) with the Kano model. The author compared the utility of mobile phone’s attributes for each market and for customer segment by analyzing empirical data on wear obtained from six Middle East and African countries, five Asia-Pacific countries and three European countries. Based on an IHSD of 10,200 respondents, brand, camera, memory and LTE (4G) play vital roles in all regions. In contrast, Wi-Fi, file-editor, MMS, LCD size and phone type are displayed as the least important attributes. The results of this study were successfully implemented for product planning, product development and marketing strategy in terms of price setting, features prioritizing and optimal designing for new products in the mobile phone company. Design/methodology/approach The first step was to list all possible features with the product planning team, product development team and market research specialists. The second step divided the selected features for designing a mobile phone into subgroups based on their functional characteristics by using the Kano model. The method for classifying features was determined using Kano questionnaire. The third step incorporated a fractional factorial design for the “must-be” choice-based conjoint (CBC) (Oppewal et al., 1994) which includes two factors: whether customers required the “one-dimensional” feature or the “attractive” feature, along with the “must-be” attributes. The consumers who selected the “must-be” features could choose both the “one-dimensional” feature and the “attractive” feature groups or one of the two feature groups in no particular order. Fractional factorial design was applied to both the “one-dimensional” features and the “attractive” features for individual CBCs. Random sequences of the combinations of attribute levels were generated for each of the three types of CBC analyses (“must-be”, “one-dimensional” and “attractive”). At the same time, the fourth step conducted a survey of the individual groups for the conjoint analysis on the functional characteristics of a mobile phone. The analysis of the accumulated data obtained from all the feature groups was completed using conditional logit models as part of the fifth step. In addition, the “must-be” CBC design was linked with the “one-dimensional” and “attractive” CBC designs. The sixth step was to analyze the accumulated results obtained from all the feature groups and estimate the usefulness of each feature’s level in the context of the CBC. Based on the results of the sixth step, the importance and willingness-to-pay of each attribute were estimated in the seventh step. Findings Use of the conjoint important score is aimed to expand the market by finding the different consumers’ needs across the regions. In detail, attributes such as “FM Transmitter”, “Touch screen” and “Health (heart rate)” are considered consumers’ new crucial needs in Europe, which would enable the product to superiorly differentiate itself from others to dominate the current market. On the other hand, it is shown that attributes such as “brand”, “mobile TV”, “external memory”, “mobile tracker” and “4G” are more important in Asia-Pacific. Therefore, if mobile manufacturers develop this sector more, it will grant mobile manufacturers the opportunity to lead the market. The only difference of the Middle East and African consumers is that “NFC” has a higher importance while the rest of the needs are very similar to those of Asia-Pacific. Regarding willingness-to-pay (WTP) among countries, the highest scoring utility, besides brand, appeared to be associated with the camera function in all countries. Especially, relatively low utility value was given in Wi-Fi and File-editer, MMS, LCD size and Phone type. In a value-based approach, the price of a product is based on the perceived valuation by the target customers. The research in the field of pricing is of ample importance. This is because price is the only element of the marketing mix that generates income. All other elements, such as advertising and promotion, product development, selling effort, distribution and packaging, involve expenditures (Monroe, 2003). Regarding among regions, the needs for 3G and the internet-related feature (WAP, Wi-Fi, etc.) in the emerging market are low compared to those for 4G and internet-related feature in the mature market. Also, the needs for productivity and advanced features, such as camera and e-mail, are lower in Asia-Pacific than in Europe. It is therefore recommended that manufactures and marketers of mobile phones should consider producing and selling phones with modern technology features that are more durable and of highly quality. Research limitations/implications The integrated hierarchical survey by function with the Kano model proves to be a highly useful, efficient and accurate methodology for understanding a consumer mobile phone behavior. Although the proposed method was applied to designs of mobile phones in the emerging and mature markets, its accuracy was not compared with the traditionally used methods such as CBC, adaptive conjoint analysis and hybrid method. This is left for further areas of research. Practical implications The results of this research study correspond with previous studies conducted (Pakola et al., 2010; Das, 2012; Malaasi, 2012, 2008; Dziwornu, 2013), which consider the features of mobile phone as a crucial factor in consumer buying decision in all countries. It is significant that this study made huge impact on mobile phone manufacturers in several ways. It has been converted into product development with consumer-oriented approach. The pricing policy has been changed from cost-based pricing into value-based pricing; and marketing strategy has been changed from an unsystematic function into a systematic and consistent one. Originality/value The proposed method with the Kano model proved to be a practical and efficient tool for decision-making, as it helped mobile manufacturers to better understand how customers evaluate and perceive quality attributes. The Kano model was used to explain how the quality attributes can be classified into mainly three categories of perceived quality: “must-be”, “one-dimensional” and “attractive”. It has lots of benefits in terms of cost and time reduction and is expected to bring a great effect into the industrial field.
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Kutcher, S., H. Gilberds, C. Morgan, R. Greene, K. Hamwaka, and K. Perkins. "Improving Malawian teachers' mental health knowledge and attitudes: an integrated school mental health literacy approach." Global Mental Health 2 (2015). http://dx.doi.org/10.1017/gmh.2014.8.
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Background.Mental health literacy is foundational for mental health promotion, prevention, stigma reduction and care. Integrated school mental health literacy interventions may offer an effective and sustainable approach to enhancing mental health literacy for educators and students globally.Methods.Through a Grand Challenges Canada funded initiative called ‘An Integrated Approach to Addressing the Issue of Youth Depression in Malawi and Tanzania’, we culturally adapted a previously demonstrated effective Canadian school mental health curriculum resource (the Guide) for use in Malawi, the African Guide: Malawi version (AGMv), and evaluated its impact on enhancing mental health literacy for educators (teachers and youth club leaders) in 35 schools and 15 out-of-school youth clubs in the central region of Malawi. The pre- and post-test study designs were used to assess mental health literacy – knowledge and attitudes – of 218 educators before and immediately following completion of a 3-day training programme on the use of the AGMv.Results.Results demonstrated a highly significant and substantial improvement in knowledge (p < 0.0001, d = 1.16) and attitudes (p < 0.0001, d = 0.79) pertaining to mental health literacy in study participants. There were no significant differences in outcomes related to sex or location.Conclusions.These positive results suggest that an approach that integrates mental health literacy into the existing school curriculum may be an effective, significant and sustainable method of enhancing mental health literacy for educators in Malawi. If these results are further found to be sustained over time, and demonstrated to be effective when extended to students, then this model may be a useful and widely applicable method for improving mental health literacy among both educators and students across Africa.
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Maluwa, Veronica Mary, Alfred Ochanza Maluwa, Gertrude Mwalabu, and Gladys Msiska. "Assessment of ethical competence among clinical nurses in health facilities." Nursing Ethics, August 4, 2021, 096973302110102. http://dx.doi.org/10.1177/09697330211010259.
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Background: Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. Objectives: The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. Methodology: A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. Ethical consideration: The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. Results: The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p < 0.05) of nurses 57% (n = 135) with low ethical competence. There was no significant association between respondents’ demographic variables and level of ethical competence (p > 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. Conclusion: The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence.
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Kululanga, Lucy Ida, Alice Kadango, Gaily Lungu, Diana Jere, Matthews Ngwale, and Lily Caroline Kumbani. "Knowledge deficit on health promotion activities during pregnancy: the case for adolescent pregnant women at Chiladzulu District, Malawi." BMC Pregnancy and Childbirth 20, no. 1 (November 16, 2020). http://dx.doi.org/10.1186/s12884-020-03386-w.
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Abstract Background Adolescent pregnancy is a public health concern in Malawi as it is associated with high risks of adverse pregnancy outcomes. Almost 29% of adolescent women aged 15–19 years are already mothers and adolescent fertility rate is also high estimated at 136 per 1000 women. Therefore, the aim of the study was to explore knowledge of pregnant adolescents on importance of antenatal care and health promotion during pregnancy. Methods A qualitative descriptive design was used to solicit information on significance of antenatal care and how adolescents promote their health during pregnancy. Data was collected from 77 pregnant adolescents, purposively sampled from Namitambo and Namadzi Heath Centres in Chiladzulu District, Malawi. A semi-structured interview guide was used for data collection. Data were analysed manually following principles of qualitative content analysis. Results Themes that emerged from the qualitative data included: knowledge deficit on the purpose and benefits of antenatal care; knowledge deficit on services offered at antenatal care clinic; knowledge deficit on danger signs during antenatal period and antenatal emergency care; knowledge deficit on effects of alcohol and smoking; knowledge deficit on nutrition during pregnancy; and knowledge deficit on importance of rest during pregnancy. Conclusion This study has shown knowledge deficit among adolescent mothers that may contribute to poor pregnancy outcomes. Several factors could be attributed to such knowledge deficit. Therefore, healthcare systems and healthcare professionals have a responsibility to enhance health literacy of pregnant adolescents with an ultimate goal of improving maternal and neonatal health outcomes.
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Muula, Adamson, Alinafe C. Lusinje, Chetimila Phiri, and Prisca Majawa. "Youth clubs’ contributions towards promotion of Sexual and Reproductive Health Services in Machinga District, Malawi." Tanzania Journal of Health Research 17, no. 3 (July 26, 2015). http://dx.doi.org/10.4314/thrb.v17i3.6.
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Background: In Malawi more than 50% of the population are young people less than 24 years old. Adolescents and young people face a lot of sexual and reproductive health (SRH) challenges such as unplanned and early pregnancies, sexually transmitted infections (STIs) including HIV and AIDS and abusive intimate relationships. Provision of SRH services through Youth clubs is one strategy that has potential to contribute to addressing the SRH challenges. We conducted a study in Machinga district, southern Malawi to assess the contributions of youth clubs towards promotion of SRH services.Methods: A cross sectional study was conducted in 2014 among youths aged 15 – 24 years. The participants were drawn from Machinga boma and Liwonde Township. We used both quantitative and qualitative methods. Quantitative data were collected using questionnaires, while Focus Group Discussions (FGDs) and Key informant interviews were used to collect qualitative data. Quantitative data were analysed by estimating proportions and Chi square tests while thematic content analysis was used for qualitative data. The study was approved by University of Malawi’s College of Medicine Research and Ethics Committee (COMREC).Results: Frequently offered services in youth clubs were HIV and AIDS education reported by 48.4% of the study participants, STI education (16.7%), family planning(16.7%) and life skills education (9.7%). On service utilisation there was no association between attendance to youth clubs and HIV Testing Counselling (χ2 =0.76, p=0.4) and there was no association between attendance to the youth clubs and family planning utilisation (χ2 =3.1, p=0.3). Condom use was the most used contraceptive method among the study participants. Misconception, accessibility and poor attitude of health workers were some of the factors reported as contributing to low utilisation of family planning methods. All youth club participants, reported by 89 study participants and only 29.4% of club non-attendees had adequate SRH knowledge. The services provided by health workers to youth clubs reported by study participants were HIV and AIDS education, HIV testing and counselling (HTC) and condom distribution.Conclusion: Our findings highlight the need of youth clubs to promote SRH services.Efforts should be made to ensure that the identified challenges are dealt with to ensure effective participation of youth clubs.
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Callaghan-Koru, Jennifer A., Bareng AS Nonyane, Tanya Guenther, Deborah Sitrin, Reuben Ligowe, Emmanuel Chimbalanga, Evelyn Zimba, Fannie Kachale, Rashed Shah, and Abdullah H. Baqui. "Contribution of community-based newborn health promotion to reducing inequities in healthy newborn care practices and knowledge: evidence of improvement from a three-district pilot program in Malawi." BMC Public Health 13, no. 1 (November 7, 2013). http://dx.doi.org/10.1186/1471-2458-13-1052.
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M’baya Kansinjiro, Beatrice, and Alinane Linda Nyondo-Mipando. "A qualitative exploration of roles and expectations of male partners from PMTCT services in rural Malawi." BMC Public Health 21, no. 1 (March 31, 2021). http://dx.doi.org/10.1186/s12889-021-10640-z.
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Abstract Background Prevention of mother-to-child transmission of HIV (PMTCT) is effective in curbing rates of HIV infection in children because its interventions reduce the rates of transmission during pregnancy, in labour, and in breastfeeding. Male involvement (MI) greatly influences uptake and adherence to PMTCT services. Lack of clarity on the roles and expectations of men in PMTCT is one of the main barriers to MI. The main aim of the study was to explore the roles and expectations of male partners from PMTCT services in Malawi. Methods This was a descriptive qualitative study that involved men whose partners were either pregnant or breastfeeding a child, health care workers working in PMTCT services for over six months, and traditional leaders. We conducted 9 in-depth interviews and 12 key informant interviews from January to March 2018. All interviews were audio-recorded, transcribed, and translated. Thematic analysis was employed to analyze data. Results The subjective and community norms and attitudes of men towards PMTCT provide the context in which male partners define the specific roles they render and the services they expect from PMTCT services. The roles of men in PMTCT service were contextualized in what is socially acceptable and normalized in the setting and include supportive roles expressed as accompanying the wife to attend; antenatal care services, Dry blood sample collection (DBS) when its due, keeping appointments when is due to take the ARVs, providing financial support; HIV prevention behavior change and decision-making roles. The desired services within PMTCT include health assessment such as checking their weight; blood pressure; blood sugar and promotion activities such as education sessions that are provided in a male-friendly manner that is in tandem with existing socio-cultural norms and attitudes of men towards such services. Conclusion The roles of male partners in PMTCT services are underpinned by subjective norms and what is socially acceptable within a specific context. The services that men require from PMTCT services are influenced by their attitudes and beliefs towards PMTCT interventions. Services should be male-tailored provided in an atmosphere that allows and accepts male partners to exercise their roles in PMTCT services.
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Komakech, Joel, Christine Walters, Hasina Rakotomanana, Deana Hildebrand, and Barbara Stoecker. "Women's Empowerment Measures and Their Association with Child Dietary Diversity and Child Nutritional Status: Findings from DHS Form Eight East African Countries (P10-007-19)." Current Developments in Nutrition 3, Supplement_1 (June 1, 2019). http://dx.doi.org/10.1093/cdn/nzz034.p10-007-19.
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Abstract Objectives Research on the efficacy of women's empowerment measures to improve child dietary diversity Scores (CDDS) and child nutritional status in the East African region is limited. Our study examined the association between maternal economic autonomy, social-familial freedom, self-esteem, health decisiveness and legal empowerment and CDDS, length-for-age z scores (LAZ), weight-for-height z scores (WHZ) and weight-for-age z scores (WAZ). Methods The most recent Demographic and Health Surveys (DHS) data from eight countries in the East African Region were used; (Burundi 2016–2017, Ethiopia 2016, Kenya 2014, Malawi 2015–2016, Rwanda 2014–2015, Tanzania 2015–2016, Uganda 2016 and Zambia 2013–2014). Mother (15–49 years) and index child (6–23 months) dyads data was used as the main inclusion criteria. Frequency statistics described selected child, maternal, household and women's empowerment characteristics. Logistic and linear regression models tested the association between each of the women's empowerment measures and CDDS, and child nutritional status respectively. The models were adjusted for household, maternal and child covariates. Statistical significance was set at P < 0.05. Results Over half (>55.5%) of the mothers in their respective countries had control over health-related decisions. Most of the mothers (>58.7%) perceived that domestic violence was wrong. Significant bivariate associations were observed between specific women's empowerment measures with CDDS in all countries except Malawi and Uganda. After adjustment in multivariate models, the economic empowerment domain remained significantly associated with CDDS in Ethiopia, Kenya and Tanzania, and the legal empowerment domain remained significantly associated with CDDS in five of eight countries. Individual women's empowerment measures remained significantly associated with higher LAZ, WAZ and WHZ each in a different combination within four of the eight countries. Conclusions Women's empowerment measures were associated with higher child dietary diversity score and better child nutritional status in these East African Countries. Interventions aimed at improving CDDS and child nutrition outcomes should include promotion of women's empowerment across multiple dimensions. Funding Sources This study had no funding sources.
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Twizelimana, Donatien, and Adamson S. Muula. "Unmet contraceptive needs among female sex workers (FSWs) in semi urban Blantyre, Malawi." Reproductive Health 18, no. 1 (January 19, 2021). http://dx.doi.org/10.1186/s12978-020-01064-w.
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Abstract Background Research has paid limited attention to understanding factors that are associated with unmet contraceptive needs among female sex workers. In order to fill this knowledge gap, we estimated the prevalence of unmet contraceptive needs and examined associated factors among FSWs in semi urban Blantyre, Malawi. Methods We used systematic sampling to recruit 290 female sex workers in semi urban Blantyre between February and March 2019. In this cross sectional study, we used questionnaire interviews to collect quantitative data. We calculated the mean and standard deviation for continuous variables and proportions for categorical variables to describe the data. Logistic regression analysis was used to investigate the association between unmet needs (the outcome variable) and explanatory variables such as: having a steady partner, fear of contraceptives’ side effects and having a history of sexually transmitted infections. Results Out of the 290 study participants 102 (35.2%) reported unmet contraceptive needs. The following factors were significantly associated with unmet contraceptive needs in multivariate analysis: female sex workers’ history of physical and sexual violence by clients [OR 3.38, 95% CI (1.10, 10.43)], p < 0.03, participants with a steady partner [OR 3.28, 95% CI (1.89, 5.68)], p < 0.001, and participants who feared side effects of contraceptives [OR 2.99, 95% CI (1.73, 5.20)], p < 0.001. Conclusion Reproductive Health services should address barriers to contraceptives use for instance: violence by female sex workers’ clients, fear and misinformation on contraceptives. There is need to improve awareness of contraceptives. Specific health promotion interventions on female sex workers engaged in a steady partnership are recommended. It is important to enhance the knowledge, attitudes, and counseling skills of health care providers in order to address unmet contraceptive needs among female sex workers in semi-urban Blantyre. Plain English summary Unmet contraceptive needs are defined as lack of contraceptives use in heterosexually active women of childbearing age who do not wish to become pregnant. Unmet contraceptive needs are the main cause of short inter-pregnancy intervals, early childbearing, physical abuse, unintended pregnancy, poor maternal and child health outcomes. Several studies have documented low contraceptives use among female sex workers (FSWs), but research has paid limited attention to understanding factors associated with unmet contraceptive needs among this population in semi urban Blantyre Malawi. In order to fill this knowledge gap, we estimated the prevalence of unmet contraceptive needs and examined factors that were associated with unmet contraceptive needs among FSWs in semi urban Blantyre, Malawi. We recruited 290 FSWs and collected quantitative data. These data were analyzed to obtain descriptive statistics. Logistic regression analysis was used to investigate the association between unmet contraceptive needs (the outcome variable) and explanatory variables such as: FSWs with history of physical and sexual violence by clients, having a steady partner, fear of contraceptives’ side effects and having a history of sexually transmitted infections. Out of the 290 FSWs, 35% reported unmet contraceptive needs. The following factors were significantly associated with unmet contraceptive needs in multivariate analysis: FSWs’ history of physical and sexual violence by clients, participants with a steady partner and participants who feared contraceptive side effects. Sexual and Reproductive Health services should address barriers to contraceptives use, female sex workers exposure to violence, having a steady partners and concerns about side effects. There is also a need to improve the knowledge, attitudes, and counseling skills of health providers in order to address unmet contraceptive needs among FSWs.
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Chikhungu, Lana Clara, Tamsin Bradley, Monica Jamali, and Ottis Mubaiwa. "Culture and domestic violence amongst ever-married women in Malawi: an analysis of emotional, sexual, less-severe physical and severe physical violence." Journal of Biosocial Science, April 6, 2020, 1–15. http://dx.doi.org/10.1017/s0021932020000140.
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Abstract Nearly 42% of ever-married women in Malawi have experienced some form of physical, sexual or emotional violence perpetrated by their current or most recent spouse – higher than the global estimate of 35%. This study used national-level data for ever-married women aged 15–49 years from the 2015 Malawi Demographic and Health Survey to explore the association between cultural factors and the likelihood of women experiencing sexual, physical and emotional violence after controlling for socioeconomic factors using multilevel logistic regression modelling. Key cultural factors found to be associated with violence against ever-married women in Malawi were type of marriage (polygynous or monogamous), age at marriage, religion and ethnicity. Husband's consumption of alcohol also emerged as a very important factor in violence against married women. Interventions to tackle violence against married women in Malawi should aim at promoting monogamous marriages and discouraging polygynous marriages, and address the culture of heavy alcohol consumption amongst husbands. Future studies could explore further if there are key lessons that families can learn from Muslim families and across ethnic groups.
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Gona, Philimon N., Clara M. Gona, Vasco Chikwasha, Clara Haruzivishe, Sowmya R. Rao, and Chabila C. Mapoma. "Oral rehydration solution coverage in under 5 children with diarrhea: a tri-country, subnational, cross-sectional comparative analysis of two demographic health surveys cycles." BMC Public Health 20, no. 1 (November 16, 2020). http://dx.doi.org/10.1186/s12889-020-09811-1.
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Abstract Background More than 3 million children under 5 years in developing countries die from dehydration due to diarrhea, a preventable and treatable disease. We conducted a comparative analysis of two Demographic Health Survey (DHS) cycles to examine changes in ORS coverage in Zimbabwe, Zambia and Malawi. These surveys are cross-sectional conducted on a representative sample of the non-institutionalized individuals. Methods The sample is drawn using a stratified two-stage cluster sampling design with census enumeration areas, typically, selected first as primary sampling units (PSUs) and then a fixed number of households from each PSU. We examined national and sub-regional prevalence of ORS use during a recent episode of diarrhea (within 2 weeks of survey) using DHSs for 2007–2010 (1st Period), and 2013–2016 (2nd Period). Weighted proportions of ORS were obtained and multivariable- design-adjusted logistic regression analysis was used to obtain Odds Ratios (aORs) and 95% confidence intervals (CIs) and weighted proportions of ORS coverage. Results Crude ORS coverage increased from 21.0% (95% CI: 17.4–24.9) in 1st Period to 40.5% (36.5–44.6) in 2nd Period in Zimbabwe; increased from 60.8% (56.1–65.3) to 64.7% (61.8–67.5) in Zambia; and decreased from 72.3% (68.4–75.9) to 64.6% (60.9–68.1) in Malawi. The rates of change in coverage among provinces in Zimbabwe ranged from 10.3% over the three cycles (approximately 10 years) in Midlands to 44.2% in Matabeleland South; in Zambia from − 9.5% in Eastern Province to 24.4% in Luapula; and in Malawi from − 16.5% in the Northern Province to − 3.2% in Southern Province. The aORs for ORS use was 3.95(2.66–5.86) for Zimbabwe, 2.83 (2.35–3.40) for Zambia, and, 0.71(0.59–0.87) for Malawi. Conclusion ORS coverage increased in Zimbabwe, stagnated in Zambia, but declined in Malawi. Monitoring national and province-level trends of ORS use illuminates geographic inequalities and helps identify priority areas for targeting resource allocation.. Provision of safe drinking-water, adequate sanitation and hygiene will help reduce the causes and the incidence of diarrhea. Health policies to strengthen access to appropriate treatments such as vaccines for rotavirus and cholera and promoting use of ORS to reduce the burden of diarrhea should be developed and implemented.
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Kamga, Serges. "Promoting the Right to Healthcare Services for HIV-positive Persons with Disabilities in Malawi: Incorporating Disability into HIV Programming." Journal of Law, Society and Development 5, no. 1 (December 31, 2018). http://dx.doi.org/10.25159/2520-9515/7081.
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African countries at the epicentre of the HIV/AIDS pandemic have been working hard to confront the scourge. Malawi is one of the continent’s most affected countries and has been attempting to remedy the situation by providing healthcare services, promoting sexual and reproductive rights, and putting in place numerous HIV-programming initiatives such as HIV education, prevention, care and treatment. However, persons with disabilities have not been included in this initiative in spite of their vulnerability to the disease and their high rates of exposure to HIV risk factors. Their exclusion from HIV/AIDS programming is a product of the incorrect perception that they are asexual or are not vulnerable to the illness. As a result, the mainstreaming of people with a disability into HIV/AIDS programming has not been taking place. Such mainstreaming should take the form of the reasonable accommodation and adoption of universal design measures which ensure that persons with disabilities enjoy the right to health on an equal basis with others. This article seeks to close this gap in Malawi by calling for the inclusion of disability in HIV programming. To this end, and on the basis of desktop research, it examines the laws and policies that assess the extent to which persons with disabilities are able to participate in the response to HIV. It also considers whether they have access to HIV services that are both customised to their diverse needs and equal to the services available to others in society. The author finds that the failure to mainstream disability into HIV programming is a serious problem that will hinder the fight against the pandemic in Malawi.
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Chirwa, Maureen L., Isabel Kazanga, Giulia Faedo, and Stephen Thomas. "Promoting universal financial protection: contracting faith-based health facilities to expand access – lessons learned from Malawi." Health Research Policy and Systems 11, no. 1 (August 19, 2013). http://dx.doi.org/10.1186/1478-4505-11-27.
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McCartney, Laura E., Vicky Northe, Susannah Gordon, Evan Symons, Robert Shields, Anthony Kennedy, and Stuart J. Lee. "Promoting cross-sector collaboration and input into care planning via an integrated problem gambling and mental health service." Journal of Gambling Issues 42 (June 20, 2019). http://dx.doi.org/10.4309/jgi.2019.42.7.
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While problem gambling and mental illnesses are highly comorbid, there are few examples of integrated problem gambling and mental illness services. This has meant that it is unclear whether such services are needed, why they may be utilised, and how they operate to support clients impacted by the comorbidity and clinicians providing them care. This study reported on data collected via telephone questionnaire-assisted interviews of 20 clients and 19 referrers who had accessed one such Australian integrated problem gambling and mental illness program between July 2014 and June 2016. Data revealed that clients often were referred in the context of psychiatric or psychosocial crisis, or when clinicians encountered clients who were not making progress and wanted a second opinion about diagnosis and treatment. Improved management of illness symptoms or gambling behaviour were commonly reported benefits and a number of clients reported gaining a feeling of reassurance and hope following assessment due to gaining a deeper understanding of their issues and available treatment options. Access to dual specialist problem gambling and mental illness expertise may therefore enhance treatment planning, management during crises and cross-sector collaboration to enhance access to and the impact of care for people experiencing comorbidity.ResumeBien que le jeu problématique et les maladies mentales aient un taux élevé de comorbidité, il existe peu d’exemples de services intégrés pour le jeu et la maladie mentale. En d’autres termes, il n’est pas clair si de tels services sont nécessaires, à quelles fins ils peuvent être utilisés et la manière dont ils fonctionnent pour aider les clients touchés par cette comorbidité et les cliniciens qui leur fournissent des soins. La présente étude a rendu compte des données recueillies lors d’entretiens assistés par un questionnaire téléphonique menés auprès de 20 clients et de 19 répondants qui avaient eu accès à l’un des programmes australiens intégrés de lutte contre le jeu problématique et la maladie mentale entre juillet 2014 et juin 2016. Les données révèlent que les clients étaient souvent recommandés à d’autres services dans le contexte d’une crise psychiatrique ou psychosociale ou lorsque les cliniciens rencontraient des clients qui n’avaient pas fait de progrès et qui souhaitaient obtenir un deuxième avis sur le diagnostic et le traitement. Une gestion améliorée des symptômes de la maladie ou du comportement de jeu constituait des avantages souvent rapportés, et un certain nombre de clients ont déclaré avoir ressenti du réconfort et de l’espoir après une évaluation, en raison d’une meilleure compréhension de leurs problèmes et des options de traitement disponibles. L’accès à une double expertise en matière de jeu problématique et de maladie mentale peut donc améliorer la planification du traitement, la gestion de crise et la collaboration intersectorielle afin d’améliorer l’accès aux soins et l’incidence des soins pour les personnes souffrant de cette comorbidité.
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Dahane, Neyla, and Béatrice Godard. "Perspective sur la responsabilité de l’industrie pharmaceutique dans la promotion de la recherche pédiatrique et dans l’accès aux médicaments essentiels." Global Health Promotion, October 30, 2020, 175797592096388. http://dx.doi.org/10.1177/1757975920963886.
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Resumé : L’industrie pharmaceutique a permis à de nombreux patients d’améliorer leur santé. Mais elle reste critiquée à cause d’un certain désengagement envers les maladies dans les pays en voie de développement et notamment les maladies pédiatriques. Considérant le cercle vicieux de la pauvreté et de la maladie affectant les enfants dans ces pays, il apparait primordial que les multinationales pharmaceutiques impliquent leur responsabilité à plusieurs niveaux : par la mise en place d’actions concrètes pour mener plus de recherches sur les enfants, vu leurs besoins ; puis en rendant les médicaments accessibles à un plus grand nombre d’enfants.
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Kataika, E., J. Kemp, P. Revill, B. N. Simwaka, I. Cardinal, and S. Theobald. "The Equity and Access Sub Group: current achievements and future challenges in promoting equity in the health sector in Malawi." Malawi Medical Journal 18, no. 2 (October 15, 2007). http://dx.doi.org/10.4314/mmj.v18i2.10905.
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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.