Dissertations / Theses on the topic 'Malaria – Zambia'

Magister Public Health - MPH
In Zambia, there had been a large scaling up of new interventions to control malaria since 2003, which included the distribution of rapid diagnostic tests (RDTs), used to immediately determine if someone with symptoms suggestive of malaria actually has malaria; training of health workers in the use of the RDTs; and the prescription of artemisinin-based combination therapy (ACT) to which the malaria parasite is sensitive, rather than the old treatment regime of chloroquine to which the malaria parasite had become resistant. The use of RDTs to confirm the presence of malaria before treating for it with ACT became known as the „test and treat‟ policy. Previously, since the 1960s, in malaria endemic areas such as Zambia, children presenting with fever (the commonest symptom of malaria) without any obvious other cause for the fever, were assumed to have malaria and were hence treated for it with chloroquine. This was known as "presumptive treatment" of malaria. The combination of "presumptive treatment" and the use of a single medication led to the development of high levels of resistance to chloroquine, to the extent that it is now no longer an effective treatment for malaria. Years after the introduction of the "test and treat" policy, it was still unclear to what extent it was being implemented, as there was initial reluctance by health workers to test all children presenting with fever for malaria and if they did test they may not have followed the management guidelines of treating those who test positive with ACT and further investigating those who test negative for the cause of the fever. It seemed that staff had gotten used to the "presumptive treatment" approach to malaria over almost 4 decades and hence were quite reluctant to abandon it. The conflicting guidelines for malaria treatment in children between IMCI and "test and treat‟ has promoted a paradox between presumptive treatment for malaria and "test and treat" approach as IMCI teaches health workers to treat febrile children presumptively for malaria whereas the "test and treat" approach requires them to first make a definitive diagnosis before treating. Hence although the "test and treat" approach was instituted to overcome the problems with presumptive treatment approach it now had to contend with the competing and contradictory influence of the IMCI approach. This study therefore aimed to assess what proportion of children aged five years and younger who presented with fever were managed via the "test and treat" guidelines and which factors were associated with this, in Lusaka District, Zambia. Methodology: A cross sectional analytical study design was used based on a review of medical records. A sample size of 800 medical records of children presenting with fever was selected from 10 out of the 23 health care facilities in Lusaka, using a multistage stratified random sampling technique. Four hundred records were sampled from 2008 records (five years after commencement of the "test and treat" policy) and 400 from 2011 records (eight years after commencement of the "test and treat" policy). Trained data collectors used a data extraction tool to transcribe demographic and clinical data from the medical records in a standardized manner. Data Analysis: Univariate descriptive statistics analysis was performed using measures of central tendency and measures of dispersion to analyze numerical (continuous) variables such as age, weight and body temperature; and using frequencies for categorical variables such as gender, area of residence, RDTs/microscopy malaria tests conducted, received ACT if RDT positive, presence of an ACT treatment chart on the health centre wall and availability of a weighing scale. To determine the relationship between variables, bivariate analysis via the prevalence ratio was conducted. Results: Just over half (55%) of all children with fever were tested for malaria in 2008 and this gratifyingly increased to (73%) in 2011. Overall, the proportion of children correctly and appropriately treated with ACT, which means that those who tested positive for malaria were given ACT, was 85% in 2008 but regrettably dropped to 72% in 2011. Although "presumptive treatment" decreased from 24% in 2008 to 11% in 2011, the proportion of children with fever not tested for malaria, and although not treated for malaria, but left without a definitive diagnosis of their fever being made, remained high but dropping (22% in 2008 and 16% in 2011). Similarly the proportion of children who tested negative for malaria but then did not undergo any further investigation also unfortunately remained very high and rising (57% in 2008 and 89% in 2011). A combination of the above poor clinical management practises resulted in only 38% of children with fever in 2008 and unfortunately dropping to only 33% in 2011 being correctly managed (tested for malaria via RDT or microscopy and treated with ACT if positive, while further investigated for the cause of fever if negative). On preparedness of the health facility to implement the "test and treat" policy, it was noted that only 4 out of 10 health facilities were at least minimally prepared to do so, but paradoxically on bivariate analysis those minimally prepared were less likely (PR 0.62; 95% CI 0.41-0.94) to correctly manage the patients in 2011 than those who were unprepared. A similar paradox occurred for those correctly treated with ACT after testing positive, with facilities which were minimally prepared being less likely to do so (PR 0.28; 95% CI 0.14-0.58) in 2011 than those facilities which were unprepared to implement the "test and treat" policy. However these associations were inconsistent over time, as the associations were not present in 2008. Similarly all other factors such as staff category (doctor, nurse, clinical officer) and type of presenting symptoms besides fever (anorexia, lethargy, pallor) assessed, were not consistently associated with testing for malaria in both 2008 and 2011. The same applied for the other two main outcome variables of 'treated with ACT after test positive for malaria' and 'correctly managed child with fever', in that there were no factors that showed a consistent association with them in both 2008 and 2011. Conclusion: Testing of children with fever for malaria is at a low level but rose between 2008 and 2011. Paradoxically the proportion of those diagnosed with malaria who were correctly treated with ACT dropped between 2008 and 2011, as did the proportion of children with fever who were correctly managed. No factors assessed in this study were found to be consistently associated in both 2008 and 2011 with either testing for malaria, or treating confirmed malaria cases with ACT, or managing patients with fever correctly. Recommendations: In order for health workers to correctly implement the "test and treat" policy, which involves a series of complex steps, they ought to be formally trained to do so, mentored and constructively supervised. Additionally health facilities should be adequately equipped to enable health workers to fully implement the policy. Further studies to assess factors associated with the correct management of malaria via the "test and treat" policy are warranted.

Malaria significantly contributes to morbidity and mortality rates in Zambia. The currently accepted malaria treatment is artemisinin-based combination therapy (ACT); it is more than 97% effective when the regimen is strictly adhered to. However, the mean ACT adherence rate in sub-Saharan Africa is only approximately 38-48%. Poor pharmacoadherence remains a significant barrier to malaria control and elimination. The purpose of this study was to determine if adherence rates to a six-dose ACT antimalarial treatment differ between patients in Zambia who received short message service (SMS) reminders and those who did not. An experimental, randomized, controlled trial was conducted to collect data from a sample of 96 adult patients with malaria who presented to Fisenge Clinic in the Copperbelt Province of Zambia. Participants were randomly assigned to a control or intervention group. The intervention group received SMS messages to remind them to take their medication according to the regimen. An electronic pillbox was used to measure pharmacoadherence for both groups, and patients were classified as probably adherent or probably non-adherent. Data were analyzed using Chi-square for association between the SMS intervention and pharmacoadherence, and logistic regression used for predictors of adherence. No significant association was found between SMS reminders and pharmacoadherence among malaria patients being treated with ACT when evaluated with respect to those who received the SMS reminders and those who did not (?2=0.19, df=1, p=0.67). Binary logistic regression indicated that there were no variables associated with adherence (p>0.05). Findings from this study contribute to the research regarding the use of mobile phones to promote adherence. This is the first study of its kind using SMS directly to the patient for ACT adherence in sub-Saharan Africa known to the author. It is possible that the use of the electronic pillbox and/or the novelty of participating in a research study contributed to higher levels of adherence than previously found in this geographical area. While data suggested that there was no association between SMS and adherence, further research is needed to explore the value of this intervention.
Ph.D.
Doctorate
Nursing
Nursing
Nursing

The study aims to assess the characteristics of donor funding for national tuberculosis, malaria and HIV programmes to Zambia over an 8 year period in order to inform it&rsquo
s more effective and efficient utilization.

The study aimed at optimally assessing the impact of indoor residual spraying (IRS) and insecticide treated nets (ITNs) on vector species abundance, their infectivity and resistance status, and Plasmodium falciparum prevalence, malaria deaths and case fatality rates in the human population. Malaria prevalence surveys were conducted and routine surveillance data was retrospectively analyzed. The average P. falciparum prevalence in children between the ages of 1 and 14 years was below 10% across the study period. The intervention effect was more pronounced in IRS areas than in ITNs localities but with an incremental protective effect of their combined use. Age-specific comparison showed better intervention effect on children below 5 years than older children 5 to 14 years old. While the average number of deaths and case fatality rates in children under the age of five plunged precipitately, the reductions were more significant in IRS districts than in ITNs districts. Results indicate the need for supplementing parasite prevalence survey data with routine surveillance data in low transmission intensity areas and demonstrate the significance of evidence-based age-specific deployment of interventions. To monitor vector species abundance and infectivity, mosquitoes were collected daily using exit window traps. The three major vectors; An. gambiae s.s, An. arabiensis and An. funestus s.s, and three potential vectors of malaria, An. nili, An. rivulorum and An. funestus-like species were identified. Overall, the biggest impact of IRS and ITNs was on An. gambiae s.s, and An. funestus abundance. No An. gambiae s.s was collected in IRS localities, thus validating the fact that An. gambiae s.s and An. funestus are characteristically more amenable to control by IRS and ITNs than An. arabiensis. The transmission potential for all malaria vectors, as expressed by the calculated transmission index, was zero as none of the trapped mosquitoes tested positive for P. falciparum sporozoites. The identification of An. nili, An. rivulorum and An. funestus-like necessitate further research to determine their role in malaria transmission in the country. The low numbers of mosquitoes collected also indicate a compromise in the efficiency of exit window traps in low transmission settings, suggesting the need for their replacement with a more robust collection tool like the CDC light trap. While the persistence of An. arabiensis suggests the presence of resistance segregating in this population or, that this outdoor species is not in contact with IRS or ITNs, it could as well imply that it’s the one species perpetuating malaria transmission in these meso-to hypo- endemic areas. To determine the impact of interventions on insecticide resistance status of malaria vectors, susceptibility assays using the WHO standard protocol were conducted in 17 localities. High levels of resistance were detected in both An, gambiae s.l and An, funestus s.l to pyrethroids and DDT but with 100% susceptibility to malathion and bendiocarb. The level of resistance was significantly higher in IRS areas than in ITN areas. These findings indicate that resistance has been selected for following extensive vector control. Resistance to both DDT and deltamethrin in IRS localities and ITN areas with intense cotton growing was detected suggesting selection due to either historical use of DDT, gene flow or cross-resistance. All An. gambiae s.s were molecular s-forms and only the west (leu-phe) kdr was detected. Complete susceptibility to the organophosphates and carbamates provides a possibility to switch to these alternative insecticide classes for IRS. The detected increases in the malaria prevalence in localities with high insecticide resistance levels indicate vector control failure. These findings point to the need for information on underlying biochemical and molecular resistance mechanisms to make possible the design of an effective resistance management strategy, and for the assessment of the impact of resistance on interventions. The results indicate that the impact of malaria control can be optimally assessed by using a combination of epidemiological (routine surveillance and prevalence data) and entomological indicators, in the context of a malaria decision support system, to enhance policy formulation for objective implementation of malaria control interventions and rational use of available resources.

Includes bibliographical references (leaves 114-123).
Malaria is a major public health problem in Zambia accounting for more than 3 million clinical cases and about 33,000 deaths annually. Artemether-Iumefantrine, (a relatively expensive drug) is being used for first line treatment of uncomplicated malaria. However, diagnostic capacity in Zambia is low, which has both economical, and health implications for the health system. The current alternatives for diagnosis of malaria are clinical, microscopy and rapid diagnostic tests (RDTs). This study consists of an economic evaluation of the alternative malaria diagnosis methods in outpatient facilities in Zambia. The study is expected to contribute to effective decision-making in Zambia, especially when considering scaling up malaria diagnosis in health facilities.

In the 20th century, microfinance went through a revolution: the number of microfinance was expanding exponentially all over the world. Microfinances are supposed to be one of the most efficient tools in alleviating poverty. The paper, Microfinance: Development Aid tool is analyzing whether microfinance institutions provide, beside the credit services, also preventive antimalarial services so as to lower malaria cases. Theoretical part is focused on definition and familiarization with 'microfinance, development aid and malaria' terms. Practical part analyses the malaria problem in connection with microfinance market and microfinance organizations in the three above mentioned countries.

This study describes the results of a cross-sectional survey conducted in Mambwe district in the Eastern Province in Zambia. It uses a One Health approach to assess the impact of veterinary, medical, environmental and social determinants on animal and human health and wellbeing. One Health is defined as a holistic and interdisciplinary approach that describes the complexities between people, animals, the environment and their health. Human wellbeing is defined in this thesis as 'a condition in which all members of society are able to determine and meet their needs and have a large range of choices to meet their potential' (Prescott-Allen, 2001). As a first step, eight focus group discussions with the inhabitants followed by key informant interviews with stakeholders in the area were conducted to give a primary impression and narrow down the problems in relation to animal and human health of the area in general. Following this, a randomized selection of 210 households was visited and in each household blood samples were taken from all humans and all animals belonging to five animal species, namely cattle, goats, sheep, pigs and dogs. A third of the households did not keep any of the animal species chosen for sampling, but their inclusion was important for the social analysis. In all of these 210 households a wellbeing questionnaire was administered and, for every human and animal sampled, a health questionnaire. The study area falls within the tsetse-infested region of Zambia. It has a high wildlife density reflecting the proximity of several national parks and is historically endemic for both human and animal African trypanosomiasis (HAT&AAT). Therefore humans and animals were tested for trypanosomiasis using internal transcribed spacer (ITS) polymerase chain reaction (PCR). Since it is important as a differential diagnosis, malaria was tested for by a rapid diagnostic test in the field from human blood. Sera from mature individuals from all animal species except pigs were tested in a field laboratory for brucellosis using the Rose Bengal test. Additionally, cattle and dogs were tested for five genera of tick-borne infections (TBI) including Anaplasma, Ehrlichia, Theileria, Babesia and Rickettsia using reverse line blot (RLB) in the laboratory at the University of Edinburgh (UoE). The blood samples for PCR and RLB analysis at UoE were stored on WhatmanTM FTA cards. A total of 1012 human samples were tested for HAT and none found positive. 1005 (seven people had been tested positive or treated against malaria shortly before the sampling) people tested for malaria showed an overall prevalence of 15% (95% CI 13.2-17.7). None of the 734 Rose Bengal tests showed up positive for brucellosis. The prevalence of AAT in 1275 samples tested was much lower compared to former samplings; in cattle 22% (95% CI 18-27.2), in goats 7% (95% CI 4.5-9.2), in pigs 6% (95% CI 3.2-9.4), in dogs 9% (95% CI 5.2-13.6) and no samples were found positive in sheep. The prevalence of TBIs is much more complex with many multiple infections. A total of 340 cattle and 195 dogs were tested. In cattle the number of samples positive for any microorganism was as follows; 92% (95% CI 88- 94.2). Overall there were fewer positive samples from dogs with 25% of animals infected (95% CI 19.2-31.8). The wellbeing and health questionnaires were designed to help to identify possible risk factors for the above-mentioned diseases and signs, such as fever, diarrhoea and seizures, indicative for several other diseases. The results of these surveys might also help to identify potential reasons for a lower or higher prevalence of trypanosomiasis and malaria found than expected from previous studies. Additionally, information on personal happiness, attitudes towards veterinary and medical services, medical treatments received, education, women's reproductive history, drug abuse, people's perceptions of changes in environment and agriculture, demography, poverty and migration were collected via the questionnaires alongside information on livestock demographics and fertility. One of the main conclusions is that both medical and veterinary health care systems suffer from a number of shortcomings. The distance to appropriate treatment and care facilities is far and the necessary drugs are often unavailable. Also, both the knowledge and technology for diagnosing selected diseases is not in place. This study suggests that neurocysticercosis (NCC) plays an important role in this area due to the high number of seizures reported in people, in whom treatment for epilepsy was unsuccessful. Samples taken from a few pigs indicated the presence of Taenia solium, the causal agent of NCC. Furthermore, many of the TBIs are of zoonotic nature and further investigations must be made to begin to assess the burden of these diseases in humans and animals. Environmental changes such as degradation of the vegetation are likely to have an influence on the prevalence of studied diseases and this aspect is being investigated further in other studies. Due to the nature of a cross-sectional study, only limited conclusions can be drawn on the causal relationships of disease prevalence, but the social analysis conducted in this study confirmed the interactions of selected factors related to health and wealth unique for this study area.

Introduction: Malaria and curable sexually transmitted and reproductive tract infections (STIs/RTIs) are important causes of adverse birth outcomes (ABO) and are both prevalent in most parts of sub-Saharan Africa. From a public health perspective, control of these infections requires interventions that are part of an integrated antenatal care package. The extent to which there may be coinfection increases the importance of such an integrated approach to reduce ABO. A systematic review and meta-analysis published in 2012 showed that the prevalence of malaria and curable STIs/RTIs among antenatal attendees in sub-Saharan Africa is considerable. However, the prevalence of malaria and curable STI/RTI coinfection has not been reported in any epidemiological setting. The primary objective of this thesis is to address this knowledge gap by estimating the prevalence of malaria, curable STIs/RTIs and their coinfection and to highlight the importance of an integrated approach to control malaria and STIs/RTIs in pregnancy. Secondary objectives of the study were to: (1) determine risk factors for malaria, curable STIs/RTIs and their coinfection; (2) estimate the prevalence of ABO and identify risk factors for ABO; (3) measure the in vivo efficacy and the prophylactic effect of sulphadoxine-pyrimethamine (SP) in pregnant women, and (4) characterise the molecular markers associated with parasite resistance to SP among pregnant women. Methods: A prospective cohort study of 1,086 antenatal attendees was conducted in Nchelenge District, Zambia. Consenting women visiting two health centres for their first antenatal care (ANC) visit were screened for malaria and curable STIs/RTIs (Chlamydia, gonorrhoea, trichomoniasis, bacterial vaginosis [BV] and syphilis). Socio-demographic data and maternal characteristics were also collected at enrolment. Sulphadoxine-pyrimethamine was administrated as intermittent preventive treatment to eligible women and they were followed up at day 28 for a second 13 malaria screening to determine the therapeutic and prophylactic failure of SP. At delivery participants were screened for placental malaria and data on birth outcomes were recorded. Univariate and multivariate analyses were conducted to determine the association between the potential risk factors for infection and ABO. Results: Of the 1086 women recruited 729 were successfully followed to delivery. The prevalence of malaria infection measured by microscopy was 31.8% (95% CI, 29.1-34.6) and by PCR was 57.8% (95% CI, 54.9-60.8). The risk of malaria infection was higher among pregnant women recruited from Nchelenge health centre compared to those attending the Kashikishi health centre (adjusted odds ratio [aOR] = 1.81; 95% CI, 1.38-2.37, P < 0.001), and HIV-infected women across health centres had a greater risk of malaria infection compared to HIV-uninfected women (aOR = 1.46; 95%, 1.00-2.13, P = 0.045). Infection with at least one STI/RTI was observed in 64.8% (95% CI, 61-67.4) of the participating women. With the exclusion of BV the prevalence of infection with at least one curable STI was 34.5% (95% CI, 31.7-37.4). Infection with at least one STI was associated with BV. In comparison to uninfected women, women infected with BV were at a higher risk of being infected with at least one STI (aOR 1.44; 95% CI, 1.08-1.92, P = 0.012). HIV-infected women had a higher risk of infection with BV than HIV-uninfected women (aOR 1.87; 95% CI, 1.24-2.83, P = 0.003) and women infected with at least one STI had a higher risk of BV (aOR 1.40; 95% CI (1.07 -1.84, P = 0.01). Among participants with complete results (n=1071), 38.7% (95% CI,35.7-41.6) were coinfected with malaria parasites and at least one STI/RTI; 18.9% (95% CI, 16.5-21.2) were infected with malaria parasites only; 26.0% (95% CI, 23.5-28.8) were infected with at least one STI/RTI but no malaria parasites, and 16.4% (95% CI, 14.1-18.6) had no infection. The risk of malaria and curable STI/RTI coinfection was higher among HIV infected women than HIV-uninfected women (OR; 3.59 [95% CI, 1.73-7.48], P < 0.001). The prevalence of composite ABO was 35.1%. Women shorter than 1.5m were at a higher risk of experiencing at least one ABO (aOR 1.55; 95% CI, 1.10-2.18, P = 0.02). The risk of having ABO among para II was less than half of the risk observed in 14 primiparous women (aOR 0.41; 95% CI, 0.27-0.61, P < 0.001) and much lower among multiparous women (aOR 0.32; 95% CI, 0.22-0.48, P < 0.001). Having taken two or more doses of SP during pregnancy was protective against ABO (aOR 0.47; 95% CI, 0.31-0.72, P = 0.001). None of the infections (malaria, curable STIs/RTIs and their coinfection) diagnosed at first ANC were associated with ABO. The prevalence of highly resistant quintuple mutant was 68.8% among first ANC attendees. Despite the moderate prevalence of the quintuple mutant among pregnant women, SP cleared parasitaemia in 86% of the asymptomatic malaria cases among HIV-negative women Conclusion: The prevalence of malaria, STI/RTI and their coinfection at first ANC in this study population was considerable. However, no association was found between ABO and infection with malaria or STI/RTI or their coinfection. This lack of association is partially a result of interventions within the ANC package including treatment of some STI/RTI, intermittent preventive treatment in pregnancy with SP and iron and folic acid supplementation. Sulphadoxine-pyrimethamine retains partial efficacy against P. falciparum malaria in this area with moderate prevalence of the quintuple mutant. While continuing the policy of offering intermittent preventive treatment with SP during pregnancy, an alternative preventive therapy that is effective against both malaria and STIs/RTIs needs to be considered.

Aid is an important topic in development sector current discussions are polarised thereby creating a need for further research. This essay assesses the role that Malawi and Zambia plays in realising its development outcomes including in the area of health. There is a need to appreciate the variables that contribute to the inability of most countries in sub-Saharan Africa to finance their domestic expenditure related to healthcare. In this situation, foreign aid which has received marked interest by scholars over the past decade and is used to supplement incomes of developing countries like Malawi and Zambia. Debate on the effectiveness of aid is polarised, while highly concerned scholars see aid as ineffective and a contributor to the poor performance of economies in developing countries, others see it as essential in the achievement of development outcomes. This thesis explores the extent to which development assistance contributes to dependency in Malawi and Zambia. It further examines the link between aid and the Malawian and Zambian health sectors. The study similarly considers the role of development assistance for health in realising outcomes related to maternal health in line with SDG 3.1. By identifying two countries in sub-Saharan Africa, this essay underscores the similarities between Malawi and Zambia analysed through a historical context, health systems structures, child and maternal mortality rates and health programme models. The essay concludesthat social, political and economic barriers present challenges in financing healthcare in Malawi and Zambia. Aid contributes to dependency in the study countries.

The exchange rate is the price of one currency against another currency or currencies of a group of countries. Real exchange rates are important because they show the external competitiveness of a country‟s economy. Thus, when the exchange rate of a country is misaligned, this will affect its trade, production and the welfare of people. This study analysed macroeconomic determinants of the real exchange rate and dynamic adjustment of the real exchange rate as a result of shocks to these determinants. The study also determined the extent of misalignment of the real exchange rate in Malawi and Zambia and identified variables that contributed to it. Such information is important to policy makers. Quarterly data were used for both countries from 1980:1-2008:4. The literature review identified those variables that determine the exchange rate and these include government consumption, foreign aid, net foreign assets, commodity prices, terms of trade, domestic credit, openness and the Balassa Samuelson effect (technological progress). To determine the long-run relationship between the exchange rate and its determinants, we employed the Johansen approach and the Vector Error Correction Model (VECM). For robustness check on the long-run and shortrun effects of determinants on the exchange rate, variance decomposition and impulse response analyses were used. Results in the study show that in Malawi for both models, an increase in LAID, LGCON and LTOT resulted in real exchange rate depreciation and increases in LDC, NFA and LNEER resulted in an appreciation. In Zambia, increases in LAID, LGCON, LOPEN and LTOT caused the real exchange rate to depreciate while increases in LDC, NFA and LCOPPER led to an appreciation. Lagged LREER and LNEER were found to have short run effects on the equilibrium exchange rate for Malawi and lagged LCOPPER and LDC for Zambia. Periods of exchange rate misalignment were found in both countries. It was also found that the coefficient of speed of adjustment in Malawi in models 1 and 2 indicate that 11% and 27% of the variation in the real exchange rate from its equilibrium adjust each quarter respectively. The speed of adjustment for Zambia in both models was 45% and 47% respectively, higher than that of Malawi. Foreign aid has proven to be important in exchange rate misalignment in both countries, though this was not really expected in the case of Zambia. Given these results, it may be of interest to policy makers to understand which variables impact most on the exchange rate and how misalignment due to these determinants can be minimised.

Nyau Masquerades have been studied by missionaries, anthropologists and religious specialists, but have seldom been documented by theatre and performance specialists. This dissertation argues for the acceptance of Ny au performance as a contemporary world theatre form rooted in tradition. Charting the uneasy relationship between the Nyau and those who have sought to record their performances, the author delineates a vivid dramaturgy of this art form. In doing so, the boundaries of what define theatre as it has traditionally been understood in dominant discourses are made more fluid. Nyau performances have been affected by Colonial processes in varied ways. They were banned by the former government of Northern Rhodesia and severely censored by Catholic Mission teachings in the former Nyasaland. Other forms of vilification have been more subtle. Information about performance in Africa has often been collected and arranged in ways which limit the understanding of these genres. Images of Africa which cluster around the notion of the 'Primitive Other' have enabled a representation of Ny au masking as a superstitious and outdated practice with no relevance for contemporary Africa. This work calls for a new examination of the Nyau, through the lens of local discourse as well as contemporary global understandings of performance. Chapter One examines the issue of primitivism and the ways in which Africa has historically been posited as the exotic Other to Europe. Chapter Two examines the Nyau ih terms of specific dramaturgical elements, adjusting previous misconceptions surrounding the theatr~ forms of Chewa and Nyanja people. Chapter Three is devoted to a discussion of space in ritual theatre and Nyau performance, while Chapter Four explores masking and questions of transformation and liminality. In conclusion, it is seen that the use of the mask is a metaphor for the suspension of rigid boundaries separating subject/object, self/other, ritual/theatre, a suspension which needs to take place before an enriched understanding of performance in Africa can be reached.

Philosophiae Doctor - PhD
This study is an investigation of the informal trans-border Chewa ethnic movement of Malawi, Mozambique and Zambia and its relationship to the formal state boundaries defined by the Westphalian model. The Chewa refer themselves as belonging to a Kingdom (formerly the Maravi Kingdom) which currently cuts across the three modern African states of Malawi, Mozambique and Zambia and its paramount, King Gawa Undi, is based in Zambia. The secretariat of the kingdom is Chewa Heritage Foundation (CHEFO), which is headquartered in Malawi. The fundamental quest of this study is to investigate how the Chewa understand, experience, manage and interpret the overlap between formal states (as defined by the Westphalian model) and informal trans-border ethnic identity without raising cross-border conflicts in the process. Indeed, it is this paradoxical co-existence of contradictory features of Westphalian political boundaries and trans-border ethnic identity that initially inspired this study. The main research aim is to interrogate whether the Chewa Kingdom (of Malawi, Mozambique and Zambia) is challenging or confirming state boundaries, and to reflect on what this means for the contemporary Westphalian model. In International Relations (IR), the Westphalian model provides the assumption that states are independent actors with a political authority based on territory and autonomy. Despite a large number of criticisms of the model, it has not completely been dismissed in explaining some elements of the international system. This is evident by the underlying assumptions and perspectives that still persist in IR literature as well as the growing contemporary debates on the model, especially on its related elements of state sovereignty and citizenship. In Africa, the literature focuses on the formal structures and ignores the role of informal trans-border traditional entities - specifically, how trans-border traditional entities affect the re-definition of state and sovereignty in Africa. Such ignorance has led to a vacuum in African IR of the potentiality of the informal to complement the formal intra-regional state entities. Within a historical and socio-cultural framework, the study utilises [social] constructivism and cultural nationalism theories to critically investigate and understand the unfolding relationship between the Westphalian state and Chewa trans-border community. Another supporting debate explored is the relevance of traditional authorities under the ambit of politics of representation. In this case, the study fits in the emerging debate on the meaning, experience and relevance of state sovereignty and national identity (citizenship) in Africa. Drawing on a wide range of sources (informant interviews, focus group discussions, Afrobarometer survey data sets, newspaper articles and comparative literature surveys in Malawi, Mozambique and Zambia), the study finds that although the upsurge of Chewa transborder ethnic identity is theoretically contradictory to the Westphalian model, in practice it is actually complementary. Within the framework of [social] constructivism, the state has with some variations demonstrated flexibility and innovation to remain legitimate by co-opting the Chewa movement. In this case, the study finds that the co-existence of Westphalian model and trans-border Chewa ethnic identity is mainly due to the flexibility of the state to accommodate informal ethnic expressions in ways that ultimately reinforces the mutual dependence of the states and the ethnic group. For instance, during the Chewa Kulamba ceremony held in Zambia, the state borders are „relaxed‟ to allow unhindered crossing for the participants to the ceremony. This does not entail weakness of the state but its immediate relevance by allowing communal cultural expressions. Another finding is that the Chewa expression of ethnic identity could not be complete if it did not take a trans-border perspective. This set-up ensures that each nation-state plays a role in the expression of Chewa ethnic identity - missing one nation-state means that the historical and contemporary relevance of this identity would be lost. It is also this same set-up that limits the movement's possibility to challenge the formal state. This argument reinforces the social constructivist perspective that sovereignty is not static but dynamic because it fulfils different uses in a particular context. The overall argument of this study is that the revival of the informal Chewa trans-border traditional entity offers a new, exciting and unexplored debate on the Westphalian model that is possibly unique to the African set-up. One theoretical/methodological contribution of this study is that it buttresses some suggestions that when studying African IR, we have to move beyond the strict disciplinary boundaries that have defined the field and search for other related African state experiences. The study also strengthens one of the new approaches in understanding IR as social relations - in this approach, individuals and their activities or their social systems play a prominent role.

Cette thèse vise à décrire et comprendre, avec un modèle de micro-simulation, comment l’épidémie du VIH s’est répandue en Zambie, où quelques 15% des jeunes adultes sont infectés en 2001. Nous avons tenté de modéliser l’évolution de la population entre 1980, date approximative de l’émergence du virus, et 2005. L’objectif est d’ajuster les profils de séroprévalence du VIH par sexe et âge observés à l’enquête DHS Zambie 2001. Il s’agit d’un modèle de transmission hétérosexuelle gérant les deux sexes. Une modélisation précise du réseau sexuel, incluant la prostitution, distingue divers statuts matrimoniaux et permet une grande hétérogénéité des comportements. Les résultats de nombreuses simulations montrent qu’un bon ajustement est possible en supposant un recours à la prostitution élevé et une susceptibilité différentielle des femmes. Le recours à la prostitution et la modélisation mathématique de l’entrée en situation de risque (vie sexuelle, mariage) font l’objet d’études approfondies.

Previously, strategy formulation for large-scale eradication of tsetse in southern Africawas dominated by straightforward technical considerations. The current shift to localised control of tsetse-transmitted bovine trypanosomosis has changed the emphasis from the vector to the disease. Nagana remains the main reason for intervening but control methods will differ according to the local situation and interventions will be restricted to those areas where the disease is present. As a result, the technical criteria to be considered will differ substantially from those considered in the planning for large-scale eradication. First, a clear picture of the extent and magnitude of the bovine trypanosomosis problem is required. Second, the selection ofthe most efficient intervention methods will vary according to the local epidemiological situation. Hence, the different epidemiological situations need to be identified and the effectiveness of available control methods needs to be evaluated in each of the situations. Finally, the long-term sustainability of an intervention will depend, to a large extent, upon the socio-economic impact of the disease and perceived benefits accruing from its control. Tsetse-transmitted bovine trypanosomosis occurs in large areas of Malawi, Zambia,Zimbabwe and Namibia. The epidemiology of the disease differs substantially between areas. On the plateau of eastern Zambia, for example, cattle are kept in a tsetse infested area. Because of the encroachment of people and cattle into the tsetse infested area and the concomitant reduction in the number of game animals, tsetse have become highly dependent on cattle as their source of food. As a result, the distribution and density of tsetse is determined largely by the distribution and changes in the distribution or grazing pattern of cattle. Trypanosoma congolense is the main.trypanosome species in tsetse and cattle. The prevalence of congolense-type trypanosomal infections in tsetse undergoes little variations between months and is affected mainly by the average age of the tsetse population. The incidence of bovine trypanosomosis is significantly correlated with the density of the tsetse population.Bovine trypanosomosis is also prevalent in areas where cattle are kept adjacent to a tsetse-infested zone or where tsetse occasionally invade a tsetse-free area. In Malawi,for example, the main foci of bovine trypanosomosis are located adjacent to tsetse infested national parks, game reserves or forest reserves. Bovine trypanosomosis also occurs far outside the known tsetse foci because of the seasonal movement of tsetse,along rivers or because of, often small, undetected tsetse foci. Such foci have been detected in Malawi and in Zimbabwe. In most of the areas, bovine trypanosomosis is caused by T congolense. However, the prevalence of T vivax infections is high in areas where tsetse take a large proportion of feeds on game animals. Please read the full abstract in the section 00 front of this document.
Thesis (PhD)--University of Pretoria, 2000.
Veterinary Tropical Diseases
unrestricted

This thesis examines healthcare provision in the Central African Federation, the late colonial union between the British colonies of Southern Rhodesia, Northern Rhodesia, and Nyasaland (the later independent nations of Zimbabwe, Zambia, and Malawi respectively). Unusually in federal formations, healthcare delivery in the Federation of Rhodesia and Nyasaland became a federal function. "Settler Visions of Health" seeks to explain how the white settler elite reconciled the language of development and multiracial partnership with the underlying values of a settler society. Throughout its short existence, the Federal Health Service maintained a celebratory narrative of success designed to legitimize and justify both the decision to federate health and the Federation’s existence. The takeover of health allowed the federal government to project an image of the Federation as a rapidly developing, progressive nation that had brought significant benefits to the standard of living of African people. The reality was more checkered. The Federal Health Service struggled to live up to its promise of benevolent biopower. It largely perpetuated a colonial legacy that neglected to establish solid foundations of health consisting of sufficient infrastructure, adequate training, and equitable healthcare policies. I argue that the decision to federate health is best understood within a context of settler nation building and that paying attention to the rhetoric and realities of healthcare provision in the Federation illustrates how progressive ideas about access to healthcare and medical careers for African people could serve to maintain a settler colonial order. In addition to maintaining earlier colonial inequities of healthcare provision, federal healthcare policies and practices tended to marginalize health delivery in the northern territories contributing to the fragile health systems that Zambia and Malawi inherited when they attained independence.

Nearly half of the world's population lives in tropical and temperate climates where they may be at risk from one or more vector borne diseases. Approximately 2.1 billion people, living in more than 100 countries are at risk from malaria. While the malaria situation has improved in some places, the overall prevalence in Africa, Asia and the Americas continues to deteriorate. This has led nations, institutions, organisations and agencies including the World Health Organisation to call for development of new and innovative approaches to its surveillance and control. In nature, maintenance of malaria transmission involves a complex interaction between the mosquito vector, the human host, the disease organism, and both the internal and external environments. An understanding of this complex relationship is the key to the prevention, control and eventual eradication of malaria. Malaria prevention and control programmes do not only have to be based on sound knowledge of how these factors interrelate, but also on an application of the political will of the concerned authorities. This study attempts to identify some determinants of malaria and to characterise it in epidemiological zones in Zambia. The study aims at contributing to the body of knowledge that would support implementation of an evidence-based national malaria programme. This study has come at an opportune time when there is renewed focus on malaria prevention and control globally. It is hoped that these aspects of the malaria programme in Zambia will not have to be rewritten in the foreseeable future, instead will be improved upon in order to progress to the delivery of quality assured malaria services as close to the family as possible based on the principles of community-health partnerships. The study is presented in a series of chapters; each developed as a follow up to the previous one and forms a bridge to the next. In this way, it enables the reader to build a relatively complete picture of the malaria situation in the country. However, some repetitions could not be avoided with regard to descriptions of study sites. In the chapters dealing with health systems and quantification of malaria risk, the country (Zambia) is taken as the study site. The remaining sections are based on specific sites, selected on the basis of their representing different aspects of the malaria situation in the country. Mapping of households and other referral points provided the basis upon which a Malaria Information System would in future be built. One of the two study sites was special because most of the previously conducted malaria research in Zambia has been conducted at this site. While the other was not only new in terms of malaria research, it also represented locations in the high rainfall zone in Zambia. The introductory chapter sets out the general principles of Geographical Information System (GIS), malariology, entomology, and health systems. The chapter reviews the current global burden of malaria including its implications for economic development of endemic subSaharan African countries, and discusses progress made in the light of drug and insecticide resistance and the changing global weather patterns. This section examines the position of the African continent in relation to the global malaria eradication era and the possible reasons why it was excluded from the global malaria eradication campaign of 1956-1969. It goes on to analyse new obstacles being faced in rejuvenating global interest in malaria programmes, starting with Primary Health Care through to the principles of Roll Back Malaria (RBM). It also emphasizes special Africa-specific initiatives related to malaria, such as the MARA/ARMA collaboration which (through the use of GIS) is providing a basis for evidence-based decision making. The fist chapter deals with the historical aspects of malaria control in Zambia. It traces how malaria was successfully controlled over a period of 46 years. It starts with a rural set up where copper mineral deposits were discovered. From there it traces the history of malaria control spanning almost eight decades to the present day. It outlines the major milestones in both the malaria programme and in the political history of the country; from a British protectorate , through Federation to the present day nation, Zambia. The chapter demonstrates how malaria can be controlled in an intense transmission situation, using a combination of simple and relatively cost-effective interventions. It also demonstrates that political will is an essential element to disease control. The second chapter examines the role of health systems in the delivery of quality, efficient and cost-effective services to the population. It examines the adequacy of health services in the light of time-limited Roll Back Malaria goals, according to the Abuja Declaration of 2000. This chapter analyses the capacity of the local health system to deliver on its health vision of taking quality assured health services (Malaria services) as close to the family as possible. Together, these goals are examined in terms of population accessing the facilities within 30 minutes' walking distance. Chapter three focuses on identifying factors that facilitate or hinder households acquiring and using Insecticide Treated Nets (ITNs) in the same locality. Specifically, distance of households to some reference points is examined. Also the effects of social, economic and educational status of heads of households are analysed. Together all parameters are analysed statistically to isolate the important reasons why some homes acquire ITNs while others do not. The study concludes with an analysis of the importance of ITN s in averting malaria among users. Some anecdotal evidence resented on the value of ITN s in reducing malaria incidence in the general population is presented. GIS is employed in the fourth chapter to produce a malaria endemicity risk map for the country. It employs population Plasmodjum faldparum infection rates. It proposes stratification and compares it with existing expert opinions and the climate-based Fuzzy Logic predictive model. The resultant malaria risk map is verified against existing maps and expert opinions. The chapter then discusses application for local decision making on policy and action. Chapter number five is dedicated to identifying and studying the bionomics of malaria vectors at two sites. It reviews existing literature on this subject, from 1929 to date. It identifies possible malaria vectors, their behaviour and ecology at two sites representing two extreme situations of malaria endemicity in the country. The combination of Anopheles vector densities and their reliance on temperature and rainfall are analysed and the implications discussed. The chapter also looks at possible ways forward for the country in the light of the paucity of information in this respect. P. faldparum infection rates are estimated together with their entomological inoculation rates and possible implications for malaria transmission potential. The final section (chapter six), highlights the major lessons and their implications for global goals and local health policies. It also outlines the way forward chapter by chapter.
Thesis (Ph.D.)-University of Natal, Durban, 2003.

acase@tulane.edu
The Zambian Ministry of Health (MOH) National Malaria Control center (NMCC) adopted artemisinin combination therapy (ACT) as a first-line antimalarial drug for uncomplicated malaria in 2003, and included rapid diagnostic testing (RDT) in its case management guidelines to reduce over-diagnosis of malaria and over-prescription of antimalarials. Prior research has highlighted gaps in the malaria case management process in Zambia, especially in diagnosis and treatment. The first paper of this study aimed to build quality indices or indicators for the four components of malaria case management: assessment, diagnosis, treatment and counseling. The Zambia MOH/NMCC conducted a nationally representative health facility survey in 2011 with the Malaria Control and Evaluation Partnership in Africa. The mean assessment quality (percentage of assessment items correctly completed) rate was 49.9%. The diagnostic quality (concordance with gold standard diagnosis) rate was 82.4%, with 86.9% sensitivity and 79.4% specificity. The treatment quality rate (correct treatment for those needing antimalarials and no treatment for patients not needing it) was 89.6%, and the mean counseling quality (percentage of counseling items correctly completed) rate was 48.6%. The second paper investigated factors association with each of the four components of malaria case management. Supervision was significantly associated with assessment and counseling but not diagnosis and treatment. Health facility managing authority was associated with assessment and diagnosis. Availability of blood tests was associated with correct diagnosis, and diagnosis was strongly associated with treatment. Malaria endemicity and availability of IMCI guidelines were associated with counseling quality. The third paper investigated the associated between counseling and patient recall of treatment regimen, and found that they were associated as hypothesized. The Zambia NMCC has improved the quality of malaria case management over previous years, although it is recommended that more health facility surveys are conducted in order to study the change in health worker performance over time.
1
Louie Rosencrans

Malaria is known to be endemic throughout Zambia and continues to be a major public health problem. Eighty three percent (83 %) of Zambian population is reported to be living in malaria high risk areas and the remaining 17 percent is reported living in malaria low risk areas. Zambia has a 16 percent malaria national prevalence. Malaria peak transmission periods are usually during the rainy season ? from November to April and the main transmitting vectors are anopheles species; funestus, gambiae and arabiensis. Plasmodium falciparum is the main transmitting parasite accounting for about 98 percent of all malaria infections in the country. Other species of plasmodium that can be found in Zambia are ovale and malariae. The main intervention measures used in the prevention and control of malaria in Zambia are; Indoor Residual spray (IRS), mass distribution of insecticide treated mosquito nets (ITNs) and Intermittent Prevention Treatment (IPT). The main aim of this thesis is to analyze the efficiency and effectiveness of the the current intervention measures used to prevent and control malaria in Zambia. I approached this issue from time the ?roll back malaria ? project was intiated in 1998 up to 2011. With help of the changes introduced to the health sector under the sector wide approach reforms in 1995, the public health approach in the fight against malaria was even much widened. The second aim of my thesis is to offer acceptable alternative interventions that can used in the prevention and control of malaria. In this qualitative type of research, I chose to use secondary analyzation of data as my research method. I obtained much of the information from studying health literature, journals, laws and other online publications, which I found to be relevant to the topic at hand. I also consulted with the Zambian ministry of health through provincial health offices as well as via district health offices. A series of three open research questions was used as a guide to obtaining the much needed data. However, the results revealed that the current intervention measures used in the prevention and control of malaria are efficient and effective. In 2009, Zambia recorded a 66 percent reduction in deaths due to malaria. This success recorded clearly surpasses the target set by the ?roll back malaria? 2006 which was aimed at reducing mortality due to malaria by 50 percent by year 2010. However, parasitemia results still show great variation in prevalence between urban areas and rural. This inequality is also evident in the access to health care as well. There is much need to scale up on intervention measures if a Zambia without malaria is to be achieved. This work can as used as a public health tool in the prevention of malaria in Zambia and also as a road map to future research concerning malaria and public health.

A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy in Media Studies University of the Witwatersrand Johannesburg September 2015
The year 2000 witnessed a significant convergence of global policy positions. These positions range from the neoliberal regime which gained traction in the mid-1990s, participatory development models of the 1980s, and the technocratic approach to development of the late 1990s. Despite their ideological differences, these policy positions found co-existence in the (MDGs) and have framed how poverty is globally understood and how it should be addressed, including the use of communication especially the media to promote or fast track poverty reduction projects. This thesis is a critical analysis of the extent to which the United Nations (UN) Communication for Development strategy of 2007 has been used in Kamaila Village in Zambia and Mwandama Village in Malawi to implement MDG-related projects. The two villages were chosen because they have been exposed to different models of poverty reduction activities. The Mwandama Village project is part of the Millennium Village Project where a holistic approach is applied to address poverty, while the Kamaila Village is a beneficiary of a water project which is considered to be important to kick-start village-driven poverty reduction activities. Even though the two villages have been used as units of analysis, the main goal of this study was to examine the two policy documents as texts – the MDG and the UN Communication for strategy – how the discourse and narratives that inform them and their relationship with power, shape social practices and behaviour at national and village level. The study also sought to establish how language operates within the context of power relations by applying theories of global governance, knowledge and power, hegemony, participatory and media communication. The methodology used to gather data consists of a critical discourse analysis on the policy documents and qualitative interviews with different respondents from the villagers, the UN system, NGOs, media and governments. Through a combination of these theoretical frameworks and methodologies, this study has shown that the narratives and discourses that inform the MDGs are influenced by western actors who use the power of money to pursue their neoliberal interests under the guise of reducing poverty. The link between political power, the poverty reduction ideas and interests of elite actors saturates and remotely controls available policy spaces for participation with external knowledge and rules, starting from the UN system down to the villages thereby enabling neoliberal ideas to control the flow of knowledge and the construction of discourses. Despite attempts to harness local modes of social communication to transmit the neoliberal notions of poverty in the villages, individual villagers have discursively devised ways of maintaining their own ‘traditional’ ways of life. This highlights that poverty reduction discussions must not be too obsessed with controlling or changing people’s minds and behaviour but seek to understand the grassroots’ lifestyles as a baseline for informed intervention. Ignoring this baseline knowledge is one of the many reasons development has failed dismally since the 1950s because it is driven by capital interests from the top to bottom with less or no intentions to address poverty. In addition, the ability of media messages to influence practices and behaviour remains a contested arena. But as this study established, the strength of messages to alter social practices has its limitations because behaviour is a manifestation of several factors such as environment, context, biology, genealogy and culture, some of which are not linked to communication. However, communication within the context of the villagers is part of their way of exchanging or transmitting ideas and knowledge in producing and reproducing their culture and not to eliminate it. This thesis makes scholarly contribution through the use of a critical approach to international policy formulation, and participation within a globalised world. While several studies have analysed the link between communication and poverty reduction privileging the neoliberal construction of these themes, this study has demonstrated that the grassroots are not unthinking; they have a well-being, cultural context and communication ecology which needs to be understood first and respected. These findings expose the tensions between the neoliberal interests-driven elite view of poverty and the local way of viewing well-being.

The study has empirically examined the relative impact of public and private investment on economic growth and has also tested the crowding in or crowding out effect of public investment on private investment in four Southern African economies – Malawi, South Africa, Zambia and Zimbabwe. The analysis used annual time-series data covering the period from 1970 to 2014. The study provides new evidence to contribute firstly to the current debate regarding the relative importance of public and private investment in economic growth processes and secondly, on whether public investment crowds in or crowds out private investment in the selected countries. For this purpose, the study employed two empirical models using the recently developed Autoregressive Distributed Lag (ARDL)-bounds testing approach to cointegration. Model 1 examines the relative impact of public and private investment on economic growth while Model 2 investigates the crowding in or crowding out effect of gross public investment and its subcomponents (infrastructural and non-infrastructural) on private investment. The results of Model 1 largely supported the private investment-led economic growth strategy. In all the study countries, private investment had a positive impact on economic growth. Also, public investment positively contributed to economic growth in Zimbabwe, but in the remaining study countries, public investment had a negative relationship with economic growth. Results from Model 2 reveal that: (i) the crowding out effect of gross public investment on private investment predominates in the study countries; (ii) infrastructural public investment crowds in private investment in South Africa and Zimbabwe in the long run while it crowds out private investment in Malawi and Zambia in the short run; and (iii) non-infrastructural public investment crowds out private investment in South Africa and Zambia. On balance, the results from Model 2 show that public investment tends to crowd out private investment in the selected countries and this further underscore the importance of the private sector-led economic growth processes in the study countries.
Economics
D. Phil. (Economics)

Education broadens the life choices and capabilities of those who receive it, and confers external benefits to society as a whole. In sub-Saharan Africa, a major issue concerning school attendance among the poor has been the direct monetary costs represented by primary school “user” fees, which became particularly commonplace in sub-Saharan African countries during the post-colonial period. While fees have been advocated in the past as a way for impoverished governments to fund the improvement and expansion of primary education, in more recent years the position of the international development community has shifted in favour of fee abolition as a means of achieving Universal Primary Education. This thesis examines the long-term relationship between school fees and education quality and access over the past 40 years in seven sub-Saharan African countries. I find that the introduction of fees decreased primary school enrolment, primarily by keeping the poorest children out of school, without achieving significant quality improvements. A fall-off in government spending following the introduction of fees is presented as a possible explanation. I also focus on the quality impacts associated with the major increases in enrolment following fee abolition, and emphasize the importance of government commitment to making up the funding shortfall generated by this policy change.

M.A. (Politics)
This study examines the four democratic elections that have been held in Malawi, Zambia, South Africa and Madagascar in order to establish whether there has been an improvement in the quality of elections over the years, to ascertain the challenges faced in each country, and to determine the possible implications for the future of democracy in each of the countries. The criteria according to which elections are assessed in the SADC region guided the investigation. These are the PEMMO standards which, in contrast to a reliance on generalised terms such as „free and fair‟, offer practical guidelines on establishing progress in the electoral process, as well as the SADC-PF and SADC standards. The discussion has been structured along the lines of the three phases of the electoral process, namely, the pre-election period, the election period, and the post-election period, each with its own set of indicators to be met. The study finds that despite the minimal achievements, the overall management of the electoral processes in Malawi, Zambia and Madagascar has stagnated over the years. The institutional and legal framework is one of the major areas that need improvement in Malawi. The Malawi Electoral Commission (MEC), which was charged with the responsibility of organising the various elections, experienced enormous difficulties in establishing a level playing field as well as in exercising its full mandate. Other problem areas include the voter registration process, the use of state resources by the incumbent party, and the acceptance of the electoral outcome by some opposition leaders. In the case of Zambia, the procedure for the appointment of members of the Electoral Commission of Zambia (ECZ) undermines the independence of this body. The other difficult aspects (as in the case of Malawi) are the lack of public funding of political parties, the use of state resources by the ruling party, biased media access and coverage for the ruling party, and the acceptance of election results by some of the opposition parties. The inadequate training of the electoral staff has also been a major contributing factor to these challenges. In contrast to the abovementioned countries (including South Africa), the legal framework in Madagascar did not provide for the establishment of an independent electoral management body. Consequently, the various elections resulted in recurrent shortcomings in the voter registration process, the use of state resources, and the management of election material. However, despite the above bleak picture regarding the elections in Malawi, Zambia and Madagascar, there were some marginal improvements in the conduct of the elections over the years. The polling and counting exercises in Malawi, for instance, proved to be generally well-managed by the fourth election. Similarly, the Zambian elections over the years have improved in terms of the voter registration process, and the decrease in acts of political violence and intimidation. In Madagascar the campaign periods were generally peaceful. However, the government has since been overthrown in a coup d’état in 2009. In contrast with Malawi, Zambia and Madagascar, the four elections in South Africa have been of a high standard, notwithstanding the few flaws, particularly during the first elections in 1994. The independence and credibility of the Independent Electoral Commission (IEC) over the years, as well as its continuation of members for all the elections, have among other reasons, contributed to the high standard of elections in the country. The continuous significant flaws in the elections in Malawi and Zambia pose a serious problem for the advancement of democracy in these countries. In other words, if the basic requirements of democracy – that is "free and fair" elections – are not met it does not bode well for the democratic future of these countries. The legitimacy of the elections and that of the resultant governments can be undermined, as has since been illustrated in the instance of Madagascar. The case of South Africa demonstrates the direct link between the "freeness" and "fairness" of elections and the extent to which its political system is labelled a democracy.

Os estudos sobre a Teoria e Doutrina da Guerra Justa em Relações Internacionais tornaram-se recorrentes nos últimos anos desde a Invasão do Iraque em 2003, tendo havido desde então um crescente interesse do público em geral e da comunidade académica em particular. Mais do que uma corrente de análise jurídica, à luz do Direito Internacional, é também uma reflexão filosófico/política ou mesmo do âmbito da ciência política, sobre uma nova ética a aplicar na contemporaneidade com vista à possibilidade, sempre atual, do Concerto das Nações e da paz. O presente trabalho de investigação pretende incorporar na historiografia moderna um estudo de caso durante o Renascimento português - que eu argumento ser – a primeira declaração de guerra de um soberano Europeu a um Estado e a um soberano na África subsariana, – o Império ou Reino do Monomotapa no século XVI, geograficamente entre o Zimbabwe, Zâmbia, Malawi, Moçambique, Suazilândia, Lesoto e parte da África do Sul. A febre do ouro e a cobiça pelas riquezas de tão importante Império africano, levaram o poder político de Lisboa a despoletar um conflito sem tréguas aos muçulmanos que aí se haviam instalado há muito, assim como aos seus aliados africanos dos povos suaílis. Uma estratégia alargada ao Oceano Índico e ao Oriente contra a influência, o comércio e as fontes de abastecimento e financiamento do Império Otomano, com consequências irreversíveis para as grandes unidades políticas africanas do interior do Continente.
Just War Theory in International Relations studies have become more common in recent years since the Iraq Invasion in 2003. A growing interest from the general public and the academic community in particular, developed the thinking on the Just War Tradition concepts. More than a legal analysis in International Law is also a philosophical reflection within the scope of political science about the new ethics to be applied in contemporary times within the possibility, always required, of the Concert of Nations and international peace. The present research in modern historiography is a case study during the Portuguese Renaissance - which I argue to be - the first declaration of war from an European sovereign State to a sovereign State in sub-Saharan Africa - the Empire or Kingdom of Monomotapa in the XVI century, geographically located between Zimbabwe, Zambia, Malawi, Mozambique, Swaziland, Lesotho and part of South Africa. A gold fever and the greed for the wealth of such an important African Empire, led the political power in Lisbon to trigger a relentless conflict against the Muslims, who had settled there for long time, as well as against their African allies, the Swahili peoples of the coast. A strategy that extended across the Indian Ocean and the Middle and far East against the influence, trade, finance and supply chain of the Ottoman Empire, with irreversible consequences for the African political units in the inner land of the African continent.

This study empirically investigates the key macroeconomic determinants of economic growth in three Southern African Development Community countries, namely: Malawi, Zambia, and South Africa, using annual data for the period 1970-2013. The study uses the recently developed Autoregressive Distributed Lag bounds-testing approach to co-integration and error correction model. In Malawi, the study finds that investment, human capital development, and international trade are positively associated, while inflation is negatively associated with economic growth in the short run. In the long run, the results reveal that investment, human capital development, and international trade are positively and significantly associated, while population growth and inflation are negatively and significantly associated with economic growth. In Zambia, the short-run results reveal that investment and human capital development are positively and significantly associated, while government consumption, international trade, and foreign aid are negatively and significantly associated with economic growth. The long-run results reveal that investment and human capital development are positively and significantly associated, while foreign aid is negatively and significantly associated with economic growth. In South Africa, the study results show that in the short run, investment is positively and significantly associated, while population growth and government consumption are negatively and significantly associated with economic growth. In the long run, the results reveal that economic growth is positively and significantly associated with investment, human capital development, and international trade, but negatively and significantly associated with population growth, government consumption, and inflation. These results all have significant policy implications. It is recommended that Malawian authorities should focus on strategies that attract investment: in addition there is a need to improve the quality of education, encourage export diversification, reduce population growth, and ensure inflation stability. Similarly Zambian authorities should focus on creation of incentives that attract investment, provision of quality education: moreover they need to improve government effectiveness, encourage international trade and ensure the effectiveness of development aid. South African authorities are recommended to focus on policies that attract investments, the provision of quality education, and trade liberalisation: concomitantly there is also a need to reduce population growth, government consumption and inflation.
Economics
Ph.D. (Economics)

Public programming initiatives are considered as an integral part of archival operations because they support greater use of archival records. This study investigated public programming practises in the ESARBICA region. The findings of the study were determined after applying methodological triangulation, within a quantitative research context. This included the use of self-administered questionnaires, semi-structured interviews and the analysis of documents and websites. Participants in this study were ESARBICA board members, Directors of the National Archives and archivists from the ESARBICA region. Nine (69.2%) national directors representing different member states completed the questionnaire and eight archivists from the same region were interviewed. Furthermore, three ESARBICA board members were also interviwed. Legislation and country reports from ESARBICA member states were reviewed, together with websites of institutions within the ESARBICA region that offered archival education and training. Findings of the study indicated that public programming initiatives were not a priority. Reasons for this included lack of public programming policies, budgetary constraints, shortage of staff and lack of transport. Furthermore, the national archives were reluctant to rope in technology to promote their archives. Collaboration efforts with regard to promoting archives were shallow. Moreover, the investigation of user needs was restricted to existing users of the archives. In addition to all this, the archivists felt that they needed to improve their public programming skills. The study therefore suggests that the national archives of ESARBICA should focus on: legislation, public programming policies, advocacy, users, partnerships and skills. Taking these factors into consideration, an inclusive and integrated public programming framework was developed and proposed as a possible measure for improving public programming efforts in the ESARBICA region.
Information Science
D. Litt. et Phil. (Information Science)