Dissertations / Theses on the topic 'Urban Malawi'

Thesis (PhD)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Cities in Malawi continue to be sites and spaces of resistance, struggle and contest over urban spaces. Since the introduction of colonial modernist planning with its adherence to segregation through functional zoning, homogenisation, and fragmentation of urban areas, squatting and land invasions on urban land have remained one of the widespread struggles for space in urban Malawi. Continued occurrence of squatting, land invasions, and encroachments on urban land reflect the inability of urban planning and its attendant land policies to provide land and housing to the majority of urban dwellers mainly the middle income as well as the marginalised urban poor. Over the years, government efforts have not decisively addressed the issue of land contestations in urban areas in spite of numerous reports of increasing cases of conflicts and competing claims over urban land in Malawi including land dispossessions, conflicts over land uses in urban and peri-urban areas and most significantly contestations manifested in squatting and land invasions on state land leading to growth of spontaneous settlements. In urban areas, efforts to address these competitions have included relocation; titling programmes, sites-and-services schemes, land reform programmes, and forced evictions, but struggles such as squatting and land invasions persist. In urban Malawi, the question is: why is urban planning, as it is conceived and acted upon (i.e. as mode of thought and spatial practice), a creator and not a mediator of urban land conflicts? The study aimed to answer this question, by using Lefebvre’s conceptual triad of social production of space, to gain an in-depth understanding of how the contradictions between people’s perceptions and daily life practices in relation to space, on one hand, and planner’s conceptions of space as informed by colonial, post-colonial, and neoliberal perceptions of space, generate perpetual struggle for urban space in Malawi. The study also investigated spatial strategies and tactics which urban residents employ to shape, produce and defend urban spaces from possible repossession by the state. Finally, the study explored lived experiences and the multiple meanings that urban residents attach to spaces they inhabit and these are used to contest imposition of space by state authorities while at the same time to produce their own spaces. Mixed method approaches were used to gather geodata, quantitative and qualitative data in the two neighbourhoods of Soche West (Blantyre city) and Area 49 (Lilongwe city) where there are on-going tensions over land between state authorities and urban residents. Primary sources of data included household surveys, focus group discussions, key informant interviews, documentary sources, observations, and electronic and print media. In view of the magnitude of the data, three software were used namely, SPSS, ATLAS.ti, and ArcGIS 9.3TM GIS for quantitative, qualitative, and spatial data respectively. Content and discourse analysis were also used to analyse government documents and newspapers. The research found that although planning thought and practice is dominated by imported modernist conceptions of space, planning authorities in Malawi are unable to impose this space on urban residents. Specifically, the research identified a number of constraints faced by planning authorities ranging from human and technical capacity, corruption, cumbersome and bureaucratic procedures, archaic, rigid and contradictory in laws and policies, complexity of land rights, poor enforcement, political influence and emergence of democracy, incomplete reclassification of rural authority into urban authority and shortage of financing mechanisms. In view of these state incapacities coupled with peoples’s perception of the illegitimacy of the state to control urban land, the study found that ‘dobadobas’ (that is middlemen, conmen and tricksters) have taken over to contest planning practices of the state by employing both violent and non-violent spatial tactics to appropriate, and defend their claim for urban spaces, thereby generating conflicts between the state and users of space. Consistent with our argument regarding representations of spaces and representational spaces, the research found that in both Lilongwe and Blantyre cities, the multiple meanings attached to spaces represent divergent but true lived experiences that involve different core values that may or may not be recognised by those residents who do not share them. Finally, planners, therefore, have to reconcile the contradictions between planners’ visions and the experiences of those who experience the city in their everyday life. By way of recommendation, planners, therefore, have to reconcile the contradictions between planners’ visions and the experiences of those who live in the city. Planners’ emphasis on abstract spaces and their modernist images of order imply that viable alternative place-making processes are not well understood, partially because formal discourse in planning and place-making revolves around largely iterative representations of space and the persuasive capacities of one or another representation. Rather, this researcher recommends continued use of the conceptual triad to enable researchers to become more fully aware of complexity in the human dimensions of space before planning. In the same way, by focusing on the two neighbourhoods, the researcher recommends that planning requires considerable time and effort and that it should priotise the human or the micro scale. Planning ought to bring on board the multiple meanings of space as discussed in the study as these are the multiple dimensions that planning has to grapple with in its quest to organise and produce urban space. Since space is never empty as it always embodies meaning, it is imperative to understand various meanings that people attach to the spaces they inhabit and their attachment to these spaces. In the study the fact that spaces carry multiple meanings encompassing exchange value, use value, emotional value, historical value, and sacred values among others, has been explored. Continued advancement of colonial modernist conceptions of orderliness, segregation, functional zoning and commodification which are constructed largely, by dominant economic and political elites, provokes resistance by groups who defend and seek to reconstruct lived space. Also, in view of the incapacity of the state to impose its conceptions of urban space through spatial practice of planning, urban residents continue to devise their own spatial strategies and tactics violent and nonviolent, to shape their own space. In conclusion, the paper stresses that spaces are not exclusively shaped or moulded by planners and planning practices of the state only, but also by spatial practices of everyday life albeit clandestine and unofficial. In this regard, in Malawi, cities including the post-colonial city of Lilongwe should not be understood as being shaped by planners’ space only but also the changing experiences of the city and everyday life and ambiguities of the users of urban space. Thus plans and documents as conceived spaces should not be understood as the only mechanism to shape and organise urban space but also the changing experiences of the city and everyday life and ambiguities of the users of urban space.
AFRIKAANSE OPSOMMING: Stede in Malawi is nog steeds plekke en ruimtes waar daar weerstand, worsteling, en konflik i.v.m. grond plaasvind. Sedert die invoer van koloniale, modernistiese beplanning wat assosieer word met segregasie deur middel van funksionele streekindeling, homogenisasie,en fragmentasie van stadsgebied, is plakkery en beslaglê op grond in stede algemeen in die stede van Malawi. Die aanhoudendende voorkoms van plakkery, indringing en oortreding op grond reflekteer die die onvermoë van stedelike beplanning en grond beleid om grond en behuising aan die meerderheid van die stedelike burgers , meestal die middelinkomste klas en die gemarginaliseerde stedelike armes te verskaf. Die regering het nie oor die jare daarin geslaag om die kwessie van konflik oor grond in stedelike areas suksesvol aan te spreek nie, dit ten spite van die feit dat daar toenemend meer gevalle van konflik en meededingende grondeise bestaan, asook onteiening in stedelike en omstedelike gebiede. Hierdie konflikte manifesteer in plakkery en indringery in staatsgrond wat lei tot die totstandkoming van nie-amptelike nedersettings. In stedelike gebiede het pogings om hierdie kwessies aan te spreek gelei tot onteiening,eiendomsreg-programme, grondhervormings-programme, gedwonge uitsettings, asook gebiede waar daar net grond en dienste verskaf word. Nogtans vind daar plakkery en indringing plaas. Met betrekking tot stedelike Malawi is die vraag: Hoekom is stedelike beplanning soos dit begryp word (d.w.s. as ’n denkwyse en ruimte-praktyk) die skepper en nie die bemiddelaar van konflik oor grond in stede nie? Daar is gepoog om hierdie vraag te beantwoord deur gebruik te maak van Lefebvre se drieledige konsep van die produksie van ruimte, om sodoende ’n in-diepte begrip te verkry van die teenstellings tussen mense se konsepsies en alledaagse praktyke met betrekking tot ruimte, en die beplanners se konsepte van ruimte wat die gevolg is van koloniale, post-koloniale en neoliberale sienings, en hoe dit lei tot ’n aanhoudende konflik oor stedelike grondgebied in Malawi. Strategieë en taktieke wat deur inwoners gebruik word om ruimte te skep en te verdedig teen moontlike onteiening deur die staat, word ondersoek. Laastens word die lewende ondervindings van die stadsbewoners ondersoek, asook die veelvoudige betekenisse wat hulle heg aan die ruimtes wat hulle bewoon. Hoe hulle hierdie betekenisse gebruik om die oorname van hierdie spasies deur die staat, te beveg en terselfdertyd hulle eie ruimtes te skep. Die gemengde-metode benadering is gebruik om geodata, kwantitatiewe en kwalitatiewe data in die twee buurtes van Soche West (Blantyre ) en Area 49 (Lilongwe ) waar daar aanhoudende spanning oor grond tussen die staat en die stadsbewoners is, aan te spreek. Primêre bronne van data sluit huishoudelike opnames, fokus groepbesprekings, sleutelinformant onderhoude, dokumentêre bronne, observasie,en elektroniese en gedrukte media in. Omdat daar so baie data is, is drie sagtewares, naamlik SPSS, ATLAS.ti, and ArcGIS 9.3TM GIS gebruik vir die ontleding van kwantitiewe, kwalitatiewe en ruimtelike data onderskeidelik. Inhouds- en diskoers analise is ook gedoen om die regeringsdokumente en koerantartikels te ontleed. Daar is gevind dat alhoewel beplanningsdenke en –praktyk oorheers word deur ingevoerde, modernistiese konsepte van ruimtes, kry die owerhede dit nie reg om die bewoners te oorreed om hulle siening van stedelike ruimte te aanvaar nie. Daar is tydens die navorsing bevind dat die owerhede die volgende kwessies moet aanspreek: menslike en tegniese bekwaamdede, korrupsie, lomp burokratiese prosedures, uitgediende en weersprekende wette en beleide, die kompleksiteit van grondregte, swak toepassing van wette, politieke invloed, en die opkoms van die demokrasie, onvoltooide reklassifikasiwe van landelike owerhede, en ’n tekort aan finanseringsmeganismes. Die staat se onbekwaamheid tesame met die mense se persepsie dat die staat nie volgens wet stedelike grond kan beheer nie, het gelei daartoe dat Doba Dobas (d.w.s. die middelman, en die skelms) die beplanning van konflik oorgeneem het en geweldadige en nie-geweldadige taktiek gebruik om grond te bekom en te verdedig, en sodoende konflik tussen die staat en die mense laat toeneem. Daar kan gesê word dat in beide Lilongwe en Blantyre die veelvoudige betekenisse wat aan ruimte geheg word, die werklike ondervindinge van die mense verteenwoordig. Hierdie ondervindings behels verskillende kernwaardes wat dalk nie deur ander gedeel word nie. Dit bevestig ook Lefebvre se argumente oor die ruimtes. Laastens moet die beplanners die beplanners se toekomsplanne en die alledaagse ondervindings van die burgers, versoen. Daar word dus aanbeveel dat die beplanners die klem op abstrakte ruimtes en die modernistiese beeld van orde moet versoen met die ondervindings van diegene wat in die stad woon. Die beplanners se klem op abstakte ruimtes en hulle modernistiese beeld van orde impliseer dat lewensvatbare alternatiewe plekmaak prosesse nie goed verstaan word nie, gedeeltelik omdat die formele diskoers in beplanning en plekmaak grootliks draai om herhaaldelike voorstellings van ruimte en die oorrredingskrag van die een of ander voorstelling. Hierdie navorser stel voor dat Lefebvre se drie konsepte liewer gebruik moet word om dit vir navorsers moontlik te maak om voor beplanners bewus te word van die kompleksiteit van die menslike dimensies van ruimte, Nadat hy gefokus het op die twee stede, besef die navorse dat beplanning baie tyd en moeite behels en dat die menslike of die mikroskaal voorrang moet geniet. Die veelvoudige betekenisse van ruimte, soos bespreek, moet in ag geneem word tydens die organiseer en skep van stedelike ruimte. Aangesien ruimte nooit leeg is nie en altyd betekenis het, is dit belangrik om die verskillende betekenisse wat mense aan die plekke waar hulle bly heg, te verstaan, asook hulle gehegtheid aan hierdie plekke. In hierdie studie word die verskillende betekenisse van ruimte, naamlik ruilwaarde, gebruikwaarde, emosionele waarde, historiese waarde, en gewyde waarde. Die bevordering van koloniale.modernistiese konsepte van orde, segregasie, funksionele sonering en kommodifikasie,. grootliks deur die dominante ekonomiese en politiese elite, lei tot weerstand deur groepe wat die ruimtes waarin hulle lewe wil verdedig en rekonstrueer. Omdat die staat nie deur middel van die ruimtelike praktyke van beplanning, sy siening van stedelike ruimte aan die bewoners kan oordra nie, hou die stedelike bewoners aan om hulle strategieë en taktieke, geweldadig en nie-geweldadig, te gebruik, om hul eie ruimtes te skep. Ten slotte word daar tot die slotsom gekom dat ruimte nie eksklusief deur beplanners geskep word nie, maar deur die praktyke van die alledaagse lewe, al is dit ongeoorloofd en nieamptelik. Die stede in Malawi, insluitende die post-koloniale stad, Lilongwe, moet nie beskou word as gevorm alleenlik deur die stadsbeplanners nie, maar ook deur die veranderende ondervindings van die stad en die alledaagse lewe en die dubbelsinnigheid van die gebruikers van stedelike ruimte. Planne en dokumente moet dus nie gesien word as die enigste meganisme wat stedelike ruimte vorm en organiseer nie.

The needs of young people in classroom based HIV/AIDS Education in Malawi, the extent to which current classroom practices respond to these needs, and the factors influencing these responses have been explored using questionnaires, interviews, lesson observations, and document analysis. In contrast to previously reported literature on HIVIAIDS Education in Malawi, the present study has drawn pupils' needs directly from the pupils' themselves, focussed on classroom practice, and triangulated the various data sets to give a comprehensive picture of HIV/AIDS Education in Malawi. Pupils identified a need for open discussion climates on HIV/AIDS issues despite a conservative cultural and religious adult world that is not open. They also identified a need for explicit and accurate knowledge on HIVIAIDS issues, opportunities to acquire behavioural skills for HIV prevention, and involvement of external speakers. The needs of the pupils have not been adequately addressed by the current classroom practice. Factors which influenced this can be linked to lack of policies that are responsive to culture and religion, ineffective and inadequate teaching policy guidelines, and lack of a policy prioritising HIV/AIDS education by making it examinable. The findings suggest that in future, effective HIV/AIDS Education needs to be informed by the pupils' needs. To address these needs, support from the wider society and related policies, coupled with appropriate management and classroom practice will be required.

Climate change is one of the most pressing concerns facing the twenty-first century. As natural environments change, their ability to support productive and sustainable natural-resource dependent livelihoods is affected. More specifically climate stresses create continuous pressures on rural households and shocks may create dangerous living conditions. As such, migration to areas that can support human survival and aspirations for a stable existence emerges as a possible consequence. In a rapidly urbanising world, a more stable existence may be found outside of the countryside and in a town. If rural dwellers choose to settle permanently in urban centres then urbanisation will occur. This study examines how the stresses and shocks associated with climate change affect rural urban migration in Malawi. More specifically, the study develops a theoretical framework that examines Malawi's migration system through a 'capabilities' and 'aspirations' lens. Using an aspirations and capabilities framework can help explain some key questions of migration system theory including how patterns of movements are determined; what situations may encourage or discourage the rate of movement between the rural area and the city, including stresses and shocks; and, how a rural individual becomes a permanent city dweller. The findings suggest that rural-urban migration aspirations may increase as rural life gets harder and, at the same time, young rural dwellers are exposed to alternative urban lifestyles. However, stresses reduce the migration capabilities that are needed to move to town. This has repercussions across the migration system, which results in fewer people who are able to leave the village. Following shocks, migration aspirations are at their lowest. This is because those who would have once migrated to town now feel an obligation to remain in the village where they are able to help their rural family overcome the shock. At the same time, regional level shocks affect the ability of urban migrants to maintain their urban livelihoods with implications for return migration. The research was approved though the University of Leeds Ethical Review Team and was conducted under the ethical guidelines agreed during the review.

This thesis examines the process of urbanization in Malawi, with special reference to the new capital city, Lilongwe. At independence Malawi inherited an extremely underdeveloped urban system. It is argued that colonial Nyasaland's involvement in the migrant labour system and its reluctant membership of the Federation of Rhodesia and Nyasaland were contributory factors, both of which related to Nyasaland's economically and politically subordinate position in Southern Africa. Analysis of the static and dynamic nature of independent Malawi's urban system shows it to be very simplistic. It is emphasized that the growth of the truly 'urban' population in most of the small centres in the urban hierarchy has been slow, and that institutional hindrances and government perceptions of the urban process may dissipate the impact of policies designed to promote their development. The major aspect of urban policy since 1964 has been the development of Lilongwe, which the government emphasized had two objectives: to create a new capital replacing the colonial creation of Zomba, and to develop a growth centre to promote greater regional equality and act as a counterattraction to the commercial 'capital' of Blantyre. President Banda's key role in the: instigation of this project is empahasized, and it is suggested that the second objective was rhetorically promoted as a justificatory expedient. The results of original research on urban policy implementation and private sector investment in Blantyre and Lilongwe support the contention that government commitment to Lilongwe as a growth centre is weak, and also draws attention to problems inherent in applying such strategies in small, underdeveloped economies such as Malawi's. Lilongwe's economic development has not been in theoretical accordance with that of a growth centre. Nevertheless although it is proposed that a new capital programme per se cannot be used as a surrogate for a regional development policy, major infrastructural developments in Lilongwe have allowed it to provide a degree of economic competition to Blantyre. These are argued to be mainly associated with government commitment to its development as the capital city rather than its weakly developed growth centre role.

Background: Burn injuries disproportionally affect the world’s poorest regions. However, there is a lack of data from these areas to determine the true extent of this public health problem. Children in Malawi are at high risk of burn injuries and poor health because of the nature of their environment, and the paucity of burn prevention programmes. At present, the research that reflects the factors associated with these injuries has been limited to the interpretation of quantitative, hospital based data, which may provide patterns of burns risks, but does not reflect the context or perception of burn injuries necessary to create culturally appropriate and targeted prevention initiatives. Moreover, while it has been suggested that the use of improved cookstoves (ICS) in these areas might mitigate children’s exposure to burn injuries more research is needed. Aim: To explore the factors associated with paediatric burn injuries in rural and peri-urban Malawi. Methods: This study employed a qualitative approach to explore the contextual factors, associated with paediatric burn injuries, across four villages in Malawi. Three of these villages had been previously exposed to an ICS intervention. In addition to conducting observations of household environments, multiple perspectives of burn injuries were sought from 32 parents, 12 health professionals and 6 key stakeholders using semi-structured interviews. Focus groups were conducted with household participants to gain a better understanding of safety in relation to their cooking methods. The data obtained were analysed using thematic analysis. Results: The study revealed a number of environmental and social factors which put children at risk of burn injuries across rural and peri-urban Malawi. Parents are often limited in their ability to provide adequate protection against such injuries because of: a lack of knowledge about injury prevention, a lack of safety equipment, a lack of control to make alterations to their housing and an inability to adequately supervise children. Additionally, health professionals reported that, due to a lack of time and resources, they were unable to consistently provide information to parents and caregivers about preventing burn injuries in the home. Those working with existing ICS initiatives in Malawi revealed that, although kitchen safety is currently discussed as part of organisations’ promotional activities, there is a lack of data measuring the effectiveness of this teaching. Conclusion: The factors associated with paediatric burn injuries and prevention, both actual and perceptual, are multifaceted and intertwined with the complex nature of the household environment and those who live within it. This study has provided a starting point from which to understand these factors and gives a voice to those affected. Overall the results demonstrate that there is an urgent need to raise an awareness of the burns problem to policy makers, key stakeholders, health professionals and parents, to initiate the development of comprehensive prevention initiatives. Future strategies need to consider the integration of multilevel support to address the challenges faced by families living in rural and peri-urban Malawi.

A key feature of urbanisation in African and many other Global South cities is the prevalence and persistence of urban informal settlements. Despite planning attempts and claims to directly address and contain informal settlements, informality nonetheless continues to be the dominant form of shelter. However, there is insufficient understanding of how and why informality persists in the African urban context and why urban planning seems unable to engage with this aspect of urban growth and change. This situation also prevails in Malawian cities. This study sought to explore and understand the role of state-society engagements in the production and proliferation of housing informality in Mzuzu City. The thesis is informed by a recognition that planning theory has predominantly relied on Global North (Western) ideologies such as Habermesian inspired collaborative and communicative planning approaches which argue that consensus can realise planning goals and visions. The appeal, and hence adoption and application of these approaches in the Global South have largely failed to deliver the kind of planning outcomes seen in the Global North for many reasons, including the different political power dynamics and colonial historical contexts within which planning operates. The state-society engagements in the Global South contexts show that the state, rather than regulating development, is implicated in the production of informality in ways similar to those of inhabitants. These contexts point to the need to develop planning concepts which have a better relevance in rapidly growing and under-resourced urban settlements in the Global South. The thesis contributes to an emerging body of knowledge that has come to be called the Global South Planning Theory Project. The scholars promoting this project argue for the importance of context in planning theory development and in this case the need to consider the contribution of the Global South to planning and understanding of the urbanisation processes. In this regard, the thesis draws on various Global South concepts such as informality as a mode of urbanisation (Roy, 2009), gray spaces (Yiftachel, 2009), conflicting rationalities (Watson 2003), quiet encroachment (Bayat, 2010), insurgency (Holston, 2008) and hidden transcripts (Scott,1990) to frame the analysis of housing informality in Mzuzu City. The case study method (Yin 2014) was used to collect and analyse data from three informal settlements of Luwinga, Salisburyline and Geisha each having developed on land of a specific tenure: customary, public and private, respectively. Interviews and discussions were held with state officials, chiefs, block leaders, clan leaders, and senior citizens as well as groups of inhabitants in form of focus group discussions. Observations, literature review and archival data supplemented the information from the interviews and discussions. The analysis of the results indicates that state-society engagement in the informal settlements is about the application of the various strategies by each side in seeking to either achieve planned orderly urban growth or the right to land and life in the city. The study also shows that these strategies manifest, from the perspective of the state, through several laws, policies, regulations, and an assortment of practices that the planning system uses as a tool of the state. Among the state strategies are threats of evictions, demolitions and organising citizens to participate in development committees. However, when the state utilises these strategies, it is not always for the achievement of planned orderly urban growth as professed, but on many occasions for revenue generation through property taxation, for land control, for vote-gaining or for personal gain. On the other hand, inhabitants use threats of court action, violence, collaboration with state actors, hidden transcripts (Scott, 1990), spatial protests ( Yakobi, 2004) and quiet encroachment (Bayat, 2010) to achieve their objectives to retain their land rights, to provide their basic need of shelter and to stay in the city. The inhabitants seeking survival strategies were also found not immune to the clientelist ambitions of local politicians. The study noted the shifting state discourses of informal settlements from a view of them as utter illegality to gradual political acceptance or regularisation of their existence. Finally, the study found many aspects of rationality conflicts, which either occurred between the state and society directly, among state actors, among citizen actors and across the two spheres. Within the state, ethical conflicts in which state officials deliberately frustrated the visioning of planned orderly urban growth were found to be rampant. State-society engagements therefore can be said to be a contributor to housing informality. In the case of Mzuzu, these engagements occur in multiple settlements regardless of land tenure situation. These engagements suggest that rationality conflicts occur within multi-layered settings, across state-society spheres as well as beyond specific project interventions implemented within single settlements.

Thesis (DTh)--University of Stellenbosch, 2002.
ENGLISH ABSTRACT: This dissertation develops a theory for doing Malawian urban ministry called "Holistic hermeneutical practical theology." The effects of urbanization: secularization, disorientation, poverty and pollution in Malawi's urban centers make it difficult for the CCAP to implement successful ministry that deals with the shantytowns' circumstances. Chapter one: The first chapter describes the Malawian urban context. It defines the five components of the researcher's topic of study: "Urban poverty as a challenge for ministry within the Malawian (African) context" and the three components of the methodology: "Holistic hermeneutical practical theology." Four relational hypotheses are formulated to guide the study. Different research methods applied to gathering information for chapters of this dissertation are documented at the end of this chapter. Chapter two: The second chapter examines the CCAP's existing ministry practice and addresses the first hypothesis: "Its rural background and theory of ministry prevent the CCAP from developing an effective urban ministry that adequately addresses the problems of the poor." The missionaries introduced a comprehensive ministry approach to the early leaders of the CCAP Nkhoma Synod. In the process of blending the missionary approach to ministry in the local Chewa context, a philosophy of ministry that emphasizes spiritual salvation (neglecting the physical needs) was developed in the CCAP Nkhoma Synod. This approach poses a problem for the Church to adequately address the physical needs and realities of Malawians in the cities. Chapter three: The third chapter discusses the poverty situations of Malawian and South African shantytowns and slums and is the result of research conducted in order to examine the validity of the four hypotheses. The responses of the groups interviewed were helpful for an understanding of the current congregational challenges and ministry opportunities in urban areas. This chapter addresses issues of this thesis positively: research objectives, the population growth data of urban inter-censal, a brief historical description of Malawian cities, the government efforts to address urban challenges and problems, the CCAP ministry approach to urban ministry, and a brief description of two South African poverty scenarios. The research reveals that the church and the government work independently of each other. In this way the validity of the third hypothesis: "A holistic approach to urban ministry with joint forums for development is needed to address urban poverty problems," is confirmed. Chapter four: This chapter describes the extent of poverty in Malawi, which is most disturbing. The recent studies on Malawian poverty indicate that the poverty scenario is a pervasive problem affecting approximately 60% of the population; urban poverty, in particular, is 65%. Furthermore, chapter four discusses a number of issues, some of which are: a description and Christian views of the poor, an overview definition of urban poverty, the causes of poverty and the vocation of the urban church. The cities' informal economies can make a huge difference in the lives of the poor. All of the four hypotheses form the background to this chapter. Chapter five: Chapter five examines four different approaches of the urban ministry in poverty areas. The purpose of this chapter is to understand the approaches of current work in poverty areas. Various approaches are discussed: community organization, effective congregationally based advocacy ministries, a liberation model, and a church in solidarity with the poor and oppressed. This chapter repeatedly confirms the first and the fourth hypotheses. Chapter six: In this chapter the theory of a holistic, hermeneutical practical theology is applied to a number of activities called pillars, juxtapositioning it with the four hypotheses. This is presented as a model for doing urban ministry in Malawian (African) cities. In the process of describing or developing the model, the four hypotheses - that have already been thoroughly proved and discussed - now serve as orientation markers pointing the CCAP towards its future role in urban ministry. The model emphasizes a hermeneutic-communicative praxis, which makes it constantly concerned with understanding the Christian meaning produced in the past, and relating it to interaction with the present-day faith community. Thus, the church in urban Malawi will address the challenges presented by the effects of urbanization and industrialization. The model's ten pillars are discussed: i) ministry in a new era and context, ii) urban ministry among the poor requires community participation, iii) proclaiming the Gospel in word and deed, iv) Christian faith development, v) urban evangelism, vi) effective pastoral care, vii) the need to build faith communities, viii) the need to equip the urban mission, ix) moving towards ecumenical alliances in African cities, and x) the importance of congregational studies. Chapter seven is a summary and conclusion of the dissertation. It discusses issues of this thesis positively: orientation of the study hypotheses, congregational study methods used in each chapter, the study's path and results, the contribution the study has made to the existing knowledge, and the conclusion of the whole dissertation. Urbanization is Africa's new missionary challenge for this century. The Christian task in Africa is the mission of the continent, which is in the process of rapid urbanization. If the church delays its adaptation to the urban context (the theories of which are changing constantly) it will forsake her strategic mission of being a foreign body in the world, where the old and new overlap in her, rendering her too early for heaven and too late for the earth.
AFRIKAANSE OPSOMMING: Hierdie proefskrif ontwikkel 'n teorie vir die Malawiese stadsbediening wat beskryf word as 'n "Holistiese hermeneutiese praktiese teologie." Die invloed van verstedeliking, sekularisasie, disorientasie, armoede en besoedeling in Malawi se stedelike sentra maak dit moeilik vir die CCAP om suksesvolle bediening, onder plakkersdorp-omstandighede, te implementeer. Hoofstuk een: Die eerste hoofstuk beskryf die Malawiese stedelike konteks. Dit omskryf die vyf komponente van die navorser se studie-onderwerp, "Stedelike armoede as 'n uitdaging vir die bediening binne die Malawiese (Afrika) konteks" en die drie komponente van die metodologie, "Holistiese hermeneutiese praktiese teologie." Vier verwante hipoteses is geformuleer om as riglyn vir die studie te dien. Verskillende navorsingsmetodes, toegepas vir die inwin van inligting vir hierdie tesis se hoofstukke, word aan die einde van hierdie hoofstuk beskryf. Hoofstuk twee: Die tweede hoofstuk ondersoek die CCAP se huidige bedieningspraktyk en is gerig tot die eerste hipotese: "Die CCAP se landelike agtergrond en teorie van bediening verhinder die kerk om 'n doeltreffende stedelike bediening te ontwikkel wat die armes se probleme toereikend kan aanspreek." Die sendelinge het 'n omvattende bedieningsbenadering vir die vroee leiers van die CCAP Nkhoma Sinode ingestel. In die proses om die sendingbenadering tot die bediening in die plaaslike Chewa konteks in te voer, is 'n filosofie van bediening wat die geestelike verlossing beklemtoon (terwyl fisieke behoeftes verwaarloos word) in die CCAP Nkhoma Sinode ontwikkel. Hierdie benadering veroorsaak 'n probleem vir die Kerk om die fisieke behoeftes en realiteite van stedelike Malawiers toereikend aan te spreek. Hoofstuk drie: Die derde hoofstuk bespreek die Malawiese en Suid-Afrikaanse plakkersdorpe en agterbuurtes se toestande van armoede. Die hoofstuk is die produk van navorsing wat die geldigheid van die vier hipoteses ondersoek het. Die reaksies van die groepe met wie onderhoude gevoer is, het bygedra tot 'n begrip van die huidige gemeentelike uitdagings en bedieningsgeleenthede in stedelike gebiede. Die proefskrif spreek die volgende kwessies in hierdie hoofstuk aan: navorsingsdoelstellings, die tussentydse data van die bevolkingsgroei van stedelike gebiede, 'n kort historiese beskrywing van Malawiese stede, die regering se pogings om stedelike uitdagings en probleme aan te spreek, die benadering van die CCAP tot stedelike bediening en 'n kort beskrywing van twee Suid-Afrikaanse armoede-tonele. Die navorsing toon dat die kerk en die regering onafhanklik van mekaar werk. Dus, die geldigheid van die derde hipotesis: "'n Holistiese benadering tot die stedelike bediening met gemeenskaplike forums vir ontwikkeling is nodig om stedelike armoedeprobleme aan te spreek" is hiermee bevestig. Hoofstuk vier: Hierdie hoofstuk beskryf die ontstellende impak van armoede in Malawi. Die onlangse studies, met betrekking tot Malawiese armoede, toon dat die armoede-toneel 'n deurdringende probleem is wat ongeveer 60% van die bevolking raak; stedelike armoede, in die besonder, is 65%. Hoofstuk vier bespreek 'n aantal kwessies, sommige hiervan is: 'n beskrywing en Christelike perspektief op armoede, 'n oorsigtelike definisie van stedelike armoede, die oorsake van armoede en die roeping van die stedelike kerk. Die stede se informele ekonomiee kan 'n baie groot verskil in die lewens van die armes maak. Al vier hipoteses vorm die agtergrond van hierdie hoofstuk. Hoofstuk vyf: Hierdie hoofstuk ondersoek vier verskillende benaderinge tot stedelike bediening in areas van armoede. Die doel van hierdie hoofstuk is om die benaderinge in arm dele te verstaan. Verskeie benaderinge word bespreek: gemeenskapsorganisasie, doeltreffende gemeentelik-gebaseerde voorspraakbedienings, 'n bevrydingsmodel en 'n kerk in solidariteit met die armes en verdruktes. Hierdie hoofstuk bevestig herhaaldelik die eerste en die vierde hipoteses. Hoofstuk ses: In hierdie hoofstuk word die teorie van 'n holisties-hermeneutiese praktiese teologie toegepas op 'n aantal aktiwiteite, wat pillare genoem word, en stel dit naas die vier hipoteses. Dit word voorgestel as 'n model vir stedelike bediening in Malawiese (Afrika) stede. In die proses om die model te beskryf of ontwikkel, dien die vier hipoteses (wat reeds deeglik bewys en bespreek is) nou as orientasie merkers wat die pad vir die CCAP vir sy toekomstige rol in die stedelike bediening aanwys. Die model beklemtoon 'n hermeneuties-kommunikatiewe praktyk, wat gedurig in verband gebring word met die verstaan van die Christelike betekenis wat in die verlede teweeggebring is en wat dit, deur interaksie met die huidige geloofsgemeenskap, in verband bring. Dus, die kerk in stedelike Malawi sal die uitdagings wat deur die uitwerking van verstedeliking en industrialisasie gebied word, aanspreek. Die model se tien pilare word bespreek: i) bediening in 'n nuwe era en konteks, ii) stedelike bediening onder die armes benodig gemeenskapsdeelname, iii) die verkondiging van die Evangelie in woord en daad, iv) Christelike geloofsontwikkeling, v) stedelike evangelisasie, vi) doeltreffende pastorale sorg, vii) die behoefte vir die opbou van geloofsgemeenskappe, viii) die behoefte om die stedelike sending toe te rus, ix) die vorm van ekurneniese alliansies in die stede van Afrika, en x) die belangrikheid van gemeentelike studies. Hoofstuk sewe is 'n opsomming en afsluiting van die proefskrif. Dit bespreek hierdie proefskrif se hoofpunte: die orientasie en die hipoteses van die studie, die navorsingsmetodes geimplementeer in elke hoofstuk, die studie se ontwikkeling en resultate, die bydrae van die studie tot die bestaande kennis, en die afsluiting van die werk. Afrika se stede is die nuwe sendinguitdaging. Die Christelike taak in Afrika is die evangelisasie van die vasteland wat tans in die proses van snelle verstedeliking is. Indien die kerk in gebreke bly om in die stedelike konteks aan te pas, sal die kerk sy strategiese missie versaak om lig in die wereld te wees.

This study investigates the supply and demand side benefits and costs of low cost urban electrification in Mbayani Township in Blantyre City in Malawi. The low cost urban electrification program, which used compact ready boards to provide electricity to poor households in Mbayani, is the first such program in the country. The study therefore examines the strategies used to assess how they impact the service provider and the newly electrified households in terms of benefits and costs in order to draw lesson for similar programs in the future. Using an interview, the study first examines the financing and planning strategies, technologies used, tariff design and cost recovery strategies on the supply side. On users' side, the study uses a sample household survey to examine the effects of electrification on households' expenditures, fuel use and on the small and medium scale enterprises sector in Mbayani. The study conducted key informant interviews to assess community leaders' perception of the program. In addition, the study reviews the South African electrification program from which it draws lessons for Malawi. On the supply side, the strategies used reduced electrification costs and enabled the service provider to use infrastructure that was previously under-utilised. However, limited financing and planning which ignored user needs has negative implications on the program outcomes. Electricity tariffs were based on a monthly flat rate tariff, which is likely to negatively impact on the utility's revenue. However, at the scale that the program was carried out, this impact is negligible. The tariff nevertheless ensures cost recovery over a period of 5 years. While lack of data from the utility hindered detailed analysis of the supply side impacts, the study concluded that the strategies used yielded net costs for the utility. On the demand side, the study found that electrification strategies used had a positive impact on households' energy burden and budget control and that most households have switched to electricity for lighting, powering radios and partly for cooking. Major barriers in maximising benefits are high costs of electrical appliances and poor supply quality. The study recommends that future programs should use holistic participatory planning and should diversify sources of funding. Electrification strategies must also target small and medium enterprises and promote support for acquisition of better quality appliances.

Despite years of investment in urban water infrastructure, and the state-a supposedly benign public entity-being the major actor in governing water, many poor residents in global south cities such as Blantyre experience unprecedented water-related problems. The neoliberal narrative unequivocally advocates privatising water; it frames the water problem as symptomatic of the unravelling of non-economic means of distributing this basic necessity of life while revering the free market as a panacea to this long-standing challenge. This thesis draws from the production/urbanisation of nature/space literature to contribute towards framing an alternative and more just political ecological water narrative. Through a radical critique of capitalist urbanisation, it argues that the contemporary urban water condition is the outcome and symptomatic of the unjust historical geographical legacies of modernist/capitalist means of producing water. It problematises the neo-liberal "tragedy of the commons" discourse that attributes these problems to the non-commodity nature of water. Through a case study of Blantyre City, the thesis frames this critique through two claims (1) that there is no such a thing as non-commodified produced water in contemporary Blantyre; (2) that the commodification of water is nothing new, it is a histo-geographical process deeply rooted in logics and contradictions of capitalist production of nature and space. It traces a critical moment in the capitalist remaking of hydro-social relations to colonial modernisation. British colonisation (late 1850s-early 1960s) inserted money and modern techniques at the heart of human-water interactions thereby significantly transforming traditional modes of accessing water. During this period, water began to change from being a common good to an economic resource that could privately be enclosed and harnessed as a means to economic/private ends through modern techniques. Institutions created to mediate this emergent modernist water architecture were dominated by vested private settler interests, depended heavily on external financing and revenue generated from exchanging water through money. British colonisations then sow first seeds in inserting monetary exchange, class and social power as mediators of the human-water interchange thereby entrenching social inequalities in Blantyre's waterscape. The post-colonial political transition in 1964 did little to radically reconfigure these colonial logics and their contradictions; in fact, albeit in qualitatively different ways, these dynamics intensified. The thesis establishes that these historical geographical dynamics continue to reproduce conditions through which underprivileged residents are alienated from water, and this basic need is commodified in contemporary Blantyre. In locating alienation and commodification within the wider historical geographical context of capitalist urbanisation, this thesis aims to critically engage with debates on neo-liberalisation of water. It takes issue with a particular ahistorical manner commodification of water is read and the failure of these debates to engage critically with the historical/colonial genesis of the present urban water condition in global south cities. The thesis hopes to contribute to academic and practical projects concerned with generating alternative understandings and finding just solutions to persistent water problems in the global south.

Thesis (MSc (Nursing))--Cape Peninsula University of Technology, 2018
Primary health care (PHC) is a frontline health care approach. It is the point of contact where people are kept well and where their quality of life is improved. All people diagnosed as HIV- positive are retested prior to antiretroviral therapy (ART) initiation to verify their serostatus. ART initiation is seen as a non-emergency treatment that provides many benefits if its initiation is accelerated, for example following up pregnant women after being diagnosed with HIV. However, accelerated initiation may lead clients to start treatment before they are ready to adhere to treatment outcomes. The purpose of this study was to describe the nurse support for young adults during a first antiretroviral therapy visit at an urban primary health care clinic in Malawi. A descriptive phenomenological design was followed at an urban setup in Zomba city, Malawi. The sample was selected through purposive sampling until data saturation was obtained. Individual semi- structured interviews were conducted with young adults aged 19 25 who have visited the clinic for their first ART according to an interview schedule and field notes for around 30 minutes in a private room. The data was analysed using distinctive process and a consensus meeting was held between the researcher and independent coder. The findings of the study could help the PHC services to retain and re-engage the young adults in HIV care and aid the Government of Malawi in achieving its Sustainable Development Goal (SDG) 3. Principles of trustworthiness and ethics were adhered to throughout the research process. Six themes, each with separate categories, emerged from the data analysis on the experience of young adults during their first visit for ART at an urban PHC clinic in Malawi. The results indicated the need for an environment that enhances a client-orientated approach with a focus on holistic well-being. Knowledge management should be used to provide relevant and sufficient information to a newcomer while maintaining ethics under difficult circumstances. The legal environment should have a focus on supporting clients that need comprehensive ART treatment. Motivation of the patient regarding taking antiretroviral treatment (ART) is thus essential. Young adults express the need to be supported by nurses with relevant information, privacy and confidentiality and the trusting client/nurse relationship which could help them to retain in ART care. Recommendations of this study was that nurses should be offered in-service training on youthfriendly programmes which focuses on the health care of young adults during their HIV/ART services. Nurses need to create trusting relationship for the young adults and providing in door game at the waiting area to keep them busy as they are waiting for the services. Nursing managers to lobby for funding to extend the clinic and be role models in providing relevant information to young adults. It was concluded that a first visit was both positive and challenging to the participant s; however, they experienced the health providers on the first visit to be caring and supportive.

Over the years, the language profile of Mala?i has transformed from a purist orientation to a hybrid orientation. Apart from the traditional ethnic languages of the country, there is a language practice or speech style that is generally characterised by the mixing of elements from different languages of the country as well as those from outside. This development has been influenced by language contact, a situation that occurs when speakers of different languages or speech varieties interact thereby bringing their respective languages into interaction as well; and ultimately, bringing about changes of different kinds to the linguistic landscape of the area involved. This study refers to this language practice or speech style as Chibrazi, the urban contact vernacular language of Mala?i and defines it as a communication tool in which meaning is encoded by inserting vocabulary drawn from a unique body of lexical items into the grammatical structures of the traditional ethnic languages of Mala?i. Although Chibrazi is widespread across the country, it remains conspicuously absent in scholarly literature as well as in national documents such as the constitution and the national language policy. It can thus be said that Chibrazi largely remains unknown, even though it is very popular. In response to this situation, this study provides a basic descriptive analysis of Chibrazi, focusing on semantic manipulation in the production of the lexicon of the language thereby demonstrating that there is a new mixed language that is emerging within Mala?i s language profile. The research answers questions such as: Over the years, the language profile of Mala?i has transformed from a purist orientation to a hybrid orientation. Apart from the traditional ethnic languages of the country, there is a language practice or speech style that is generally characterised by the mixing of elements from different languages of the country as well as those from outside. This development has been influenced by language contact, a situation that occurs when speakers of different languages or speech varieties interact thereby bringing their respective languages into interaction as well; and ultimately, bringing about changes of different kinds to the linguistic landscape of the area involved. This study refers to this language practice or speech style as Chibrazi, the urban contact vernacular language of Mala?i and defines it as a communication tool in which meaning is encoded by inserting vocabulary drawn from a unique body of lexical items into the grammatical structures of the traditional ethnic languages of Mala?i. Although Chibrazi is widespread across the country, it remains conspicuously absent in scholarly literature as well as in national documents such as the constitution and the national language policy. It can thus be said that Chibrazi largely remains unknown, even though it is very popular. In response to this situation, this study provides a basic descriptive analysis of Chibrazi, focusing on semantic manipulation in the production of the lexicon of the language thereby demonstrating that there is a new mixed language that is emerging within Mala?i s language profile. The research answers questions such as: Over the years, the language profile of Mala?i has transformed from a purist orientation to a hybrid orientation. Apart from the traditional ethnic languages of the country, there is a language practice or speech style that is generally characterised by the mixing of elements from different languages of the country as well as those from outside. This development has been influenced by language contact, a situation that occurs when speakers of different languages or speech varieties interact thereby bringing their respective languages into interaction as well; and ultimately, bringing about changes of different kinds to the linguistic landscape of the area involved. This study refers to this language practice or speech style as Chibrazi, the urban contact vernacular language of Mala?i and defines it as a communication tool in which meaning is encoded by inserting vocabulary drawn from a unique body of lexical items into the grammatical structures of the traditional ethnic languages of Mala?i. Although Chibrazi is widespread across the country, it remains conspicuously absent in scholarly literature as well as in national documents such as the constitution and the national language policy. It can thus be said that Chibrazi largely remains unknown, even though it is very popular. In response to this situation, this study provides a basic descriptive analysis of Chibrazi, focusing on semantic manipulation in the production of the lexicon of the language thereby demonstrating that there is a new mixed language that is emerging within Mala?i s language profile. The research answers questions such as: What is Chibrazi? What are the possible origins of Chibrazi? What are some of the examples of Chibrazi? What are the semantic manipulation strategies that are used in creating the lexicon of Chibrazi? Who speaks Chibrazi? What are some of the people s perceptions of Chibrazi? What are the characteristics that Chibrazi shares with other languages of similar nature? and How can Chibrazi be interpreted as a language phenomenon? The research was designed as a triangulated study that was both theoretical and empirical in nature and which employed both qualitative and quantitative methods of enquiry. The research utilised both linguistic and sociolinguistic data, which was analysed statistically and or thematically in line with the specific objectives of the research based on its nature. All in all, this study unravels some of the fundamental processes that are at the core of language development both at individual level and at societal level thereby demonstrating that contact languages are central to scholars understanding of language in general and language genesis in particular.
Thesis (DPhil)--University of Pretoria, 2015.
Afrikaans
DPhil
Unrestricted

Thesis (DTh (Practical Theology and Missiology))--University of Stellenbosch, 2011.
ENGLISH ABSTRACT: From within the epistemological framework of missional praxis in Participatory Development Theology, the researcher addresses ethnocentrism, poverty and regionalism in the historical contexts of the CCAP Blantyre Synod and Malawi. Over-against this condition, he advocates for a change in mindset to a hermeneutic of hospitality, respect and caring based on the construct of Interculturalisation in Development Theology. In accordance with his contextual and identity analyses’ and in line with participatory development challenges, he succeeds in designing a model for an intercultural missional approach which he argues would assist the CCAP Blantyre Synod to affect its calling and being as liberating, reconciling and transforming public entity. The thesis also includes thorough background information about Malawi such as of the early history, the geography and aspects of the economy. The role of the missionaries and the colonial administration is highlighted and there is a description of all the churches active in Malawi. ‘Interculturalisation’ has the potential to provide a forum where people of different ethnic, regional, denominational, cultural, national, religious and ideological backgrounds can meet and engage in a respectful intercultural dialogue because of its emphasis on hospitality and interdependence based on the Biblical anthropological principles and Kingdom values of acknowledging the other and the dignity of all human beings. Through intercultural-dialogue they can come to an understanding about the meaning of development as transformation, globally as well as locally. Interculturalisation therefore serves to facilitate and strengthen ecumenical formation and to nurture ecumenical consciousness. This mission model will enable people to concentrate on things that unite them rather than on those that divide them. Our submission here is that it is only with a united voice that other development partners can take the Church seriously. At present, however, the CCAP Blantyre Synod struggles with these issues because of the ongoing divisions among churches (particularly within the CCAP family) and churches not doing mission in unity. The result is that ecumenical work and addressing issues like poverty is difficult because there is no cooperation between denominations. The human dignity of all parties suffers and the gospel is neutralized. Ecumenism does not necessarily focus on individual development. The Church is both social and sacred; it is influenced by what happens outside as well as inside (cf. Heitink 1999: 9). We now live in a globalized world. The CCAP’s social task therefore is to be a missional transformation church – a church for all peoples regardless of class, race, ethnicity or culture. When she does that she will not need to have another social ethic because, by her life and witness, it will be clear that she is already that (Hauerwas 1983:104). White and black missionaries who established Blantyre Mission worked together– when working together, there was real progress, when not working together, there was no tangible progress. So let us also learn to live and work together as brothers and sisters created in the image of God and called into the kingdom of God, who should find our first and primary identity through our baptism into the one body of Christ (Ephesians 4:4-6). The “scandal of the disunity of the CCAP” family is very painful when we consider the church’s social task. This disunity exists in our time in the face of the alarmingly everincreasing proportions of unemployment, poverty, inequality. HIV/Aids, hunger, nepotism, corruption, women and child abuse, property-grabbing and lack of moral fibre adversely affecting the Church and society at large in Malawi. How can we justify the situation in which we who have been called to be the forerunners of God’s peaceable kingdom cannot, it seems, maintain unity among ourselves? Schreiter (1985:29) argues that, “if Christianity is alive at all in a situation, it will certainly change things about the culture. The Christian message, after all, is about change: repentance, salvation, and an eschatological reality to be realized. Therefore, to think that Christianity will not change the situation [in Malawi] is to rob the Christian message of its most important part”. The researcher refers to the fact that some of the earliest Scottish missionaries were culturally sensitive and respected all people. Everybody was treated with dignity. Where and when this was practiced, ethnocentrism did not take hold and the gospel reached across all boundaries. The church should follow this example. As brothers and sisters created in the image of God, we should find our first and primary identity through our baptism into the one body of Jesus Christ (Ephesians 4:4-6; cf. Ephesians 2:14).
AFRIKAANSE OPSOMMING: Die navorser spreek etnosentrisme and armoede in Malawe aan vanuit die epistemologiese raamwerk van die sending benadering. Die navorser pleit vir ’n verandering in denke en houding, en vir ’n nuwe benadering baseer op gasvryheid, respek, besorgheid, meedeelsaamheid, verantwoordelikheid en deelname in vennootskappe vir die behoud en bevryding van mense, in die Afrika gees van “ubuntu“. Die tesis sluit ook agtergronds inligting omtrent Malawi soos die vroee geskiedenis, geografie en aspekte van die ekonomie in. Daar word gefokus op die rol van die sendlinge en daar is n beskrygwing van al die kerke wat in Malawi aktief is. Interkulturele samewerking het die potensiaal om ’n forum te skep waar mense van verskillende streke en etniese, kerklike, kulturele, nasionale, godsdienstige en ideologiese agtergronde mekaar kan ontmoet en deel neem aan dialoog. Dit kan gebeur as gevolg van die klem op gasvryheid en onderafhanklikheid wat baseer is op Bybelse antropologiese beginsels en Koninkryk waardes waar die belangrikheid van ander mense asook die waardigheid van alle menslike wesens erken word. Dialoog tussen lede van verskillende kulturele groepe kan lei tot ’n begrip van die betekenis van ontwikkeling as transformasie, globaal sowel as plaaslik. Interekulturele gesprek fasiliteer en versterk dus ekumeniese formasie en ekumeniese bewustheid. Hierdie model sal mense help om te fokus op dit wat hulle verenig in plaas van op dit wat hulle skei. Dit is net as die Kerk met een stem praat, dat die ander ontwikkelingsvennote die Kerk ernstig sal opneem. Tans egter sukkel die CCAP Blantyre Sinode met hierdie kwessies van langdurige divisies tussen kerke (veral in die CCAP familie) en dat die kerke NIE saam sending werk doen nie. (CCAP staan vir Die Kerk van Sentraal Afrika Prebiteriaans) Die gevolg is die ekumeniese werk en die aanspreek van kwessies soos armoede bemoeilik word omdat daar nie samewerking is tussen die denominasies nie. Die menslike waardigheid van al die partye ly skade en die evangelie word geneutraliseer. Die “skandaal“ van die onenigheid in die CCAP familie is pynlik, veral as ons die Kerk se sosiale taak in ag neem. Hierdie onenigheid bestaan in „“n tyd van die groeiende armoede, ongelykheid, werkloosheid, MIV/VIGS, gebrek aan morele waardes, die gryp van eiendom, nepotisme en korrupsie wat alreeds die Kerk en die gemeenskap negatief affekteer. Hoe kan ons hierdie situasie regverdig as ons wat geroepe is om die verteenwoordigers te wees van God se vreedsame koninkryk, nie eers onderling kan verening nie? Schreiter (1985:29) stel dit so: “ as die Christendom enigsins lewendig is in hierdie stuasie, sal dit sekerlik ’n verskil in die kultuur kan aanbring.. Die Christelike boodskap is per slot van sake ’n boodskap van verandering: bekering, redding en eskatologiese realiteit. Om dus te dink dat die Christelike boodskap nie ’n verskil kan maak aan die situasie [in Malawi] nie, is om ’n belangrike deel van die boodskap mis te kyk. Die navorser verwys na die feit dat sommige van die vroeë Skotse sendelinge kultureel sensitief was en aan alle mense respek bewys het. Almal is met waardigheiod behandel. Waar dit die geval was, het etnosentrisme nie wortel geskiet nie en het die evangelie alle grense oorgesteek. Die Kerk moet hierdie voorbeeld volg. Ons as broeders en susters wat geskep is na die Beeld van God moet ons eerste en primêre identiteit vind in die doop en in ons deel aan die een liggaam van Christus (Efesiers 4: 4-6).

The study is shortly presenting the urbanization-saga and the human settlement progression. It then proceeds to identify different types of tenure and the pertained definitions as such. The thesis will review and assess the strategies for Secure Tenure provided by UN-Habitat on an international and national level, as well as analyze the implementation tools brought forward. Diverse tenure policies and tools will be evaluated with an anchoring in the case study of Malawi and its National Land Policy and the implementation of the same.

To meet the rising food demands of communities in Accra,Ghana, urban agriculture has been popularized as a way to increase food security and improve nutrition (Donovan et al., 2012). Urban agriculture is defined as "the cultivation of crops at both the subsistence and commercial levels including the keeping of livestock in open spaces in urban areas (Adjaye, n.d.). In Accra, urban agriculture covers 1,091 hectares, employs over one thousand people, and supplies residents with 90% of its vegetables ("Accra Metropolitan", n.d.). Further, 60% of households in Accra participate in backyard farming ("Accra Metropolitan", n.d.). Although urban agriculture provides many benefits for communities in Accra, it has been linked to the creation of suitable habitats for Anopheles gambiae complex larvae. In Accra, a spatio-temporal distribution of An. gambiae complex larvae and larvae habitats has not been established. A larval study in two urban agriculture and two non-urban agriculture sites was conducted in the months of May, July, August, and September 2014. When combined together, 3,807 An. gambiae complex larvae were collected from the urban agriculture sites of Korle Bu and Opeibea over the period of the study. When combining the urban non-agriculture sites of Madina and Ashaiman, 2,484 An. gambiae complex larvae were collected over the same period. The results of this study in Accra show that Korle Bu, an urban agriculture site, was the most productive site, with 2,604 An. gambiae complex larvae collected for the months of May, July, August, and September. July was the most productive month for Korle Bu, with 1,653 An. gambiae complex larvae collected. Further investigations of An. gambiae complex larval habitats are necessary to better understand malaria transmission attributes unique to Accra, Ghana.

In rapidly expanding cities worldwide, urban agriculture is being promoted to increase food security, improve nutritional status and contribute to poverty alleviation. However, there is a concern that urban agriculture, especially when irrigated, could increase urban malaria transmission by providing breeding places for Anopheles. To investigate tIus, epidemiological and socio-economic baseline surveys were carried out in tIle two main cities in Ghana, Accra and Kumasi, where communities close to (VA) and far from agriculture (U) were selected. A total of3525 children (1744 in Accra and 1781 in Kumasi) were enrolled in a house to house survey for malaria parasitaemia, Hb concentration and socio-economic factors. Although overall malaria prevalence was higher in Accra than Kumasi (14.8%, 95% CI 13.1-16.5% and 8.6%, 950/oCl 7.3- 9.9%, P=0.001), in bOtIl cities, malaria prevalence was heterogeneous, ranging from 3-35% between conmmnities. Factors associated witIl malaria prevalence were low socio-economic status, higher age and anaenua. In Accra, but not in Kumasi, conmmnities near urban agriculture had significantly lligher malaria prevalence (OR 1.53, 950/oCl 1.10-2.14, P=0.008) and some, but not all, cOimnunities showed a significant inverse link between malaria prevalence and distance from agriculture. A second survey in Accra two years later indicated important inter annual variation in malaria prevalence and importance of risk factors. Travel was an independent risk factor likely due to tIle low malaria prevalence. Entomological indices were measured by human bait catches (HBC), pyretIlfUm knockdown catches (PKD) and larval surveys. In Accra man biting rates by HBC were higher in UA tllan U communities for both Anopheles (8.4 in UA and 2.8 in U) and Culex (171.4 in UA and 41.7 in U). The annual entomological inoculation rate (EIR) was 19.9 in UA and 6.6 in U cOimnunities. Sporozoite infection rate was 0.65% (1111672) indicating local transmission. UrbanA. gambiae s.s. were found breeding in water at broken pipes, construction sites and poorly maintained drains. In the urban agricultural sites irrigation wells were the most common breeding sites, altIlOugh only 6% of wells hosted Anopheles. In a multivariate analysis, agriculture explained only a small proportion of parasitaenua prevalence and it was concluded tllat vector control nught best be directed at adults rather tIlan at breeding sites. In an insecticide-treated bednet trial, a cohort of approximately 250 cluldren in intervention and control areas was followed up at 0, 3 and 6 months after net distribution. After 6 montllS, there were fewer new cases of malaria and significantIy higher scores for nutritional indicators in children under 5 years in tIle intervention area, tIlan in tIle control area. Cluldren in tlle control area living witllin 300m of households that received nets had significantly lligher Hb concentrations and half the cllance of being anaemic compared to tIle children living more tI1an 300m away, suggesting a protective cOimnunity effect. Epidcnuology of urban malaria is complex and lughly heterogenous and as the majority of the African population is moving into tIle city better insight in risk factors and best options for malaria control is urgently needed.

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Although several studies on malaria have provided much information about their biological and behavioral, this illness is still a major social problem, especially in the Amazon region which has favorable conditions for proliferation and maintenance of the transmission vector, given that it feeds on human blood and has a tendency to domesticity, which in turn, is facilitated by the housing situation of people living in these endemic areas. Aiming to analyze pregnant women exposed to malaria and their relationship with the urban space they inhabit, we found their housing conditions and housing and related to the incidence of infection with the characteristics of urban space that are involved. Thus, this study aimed to associate the female gender studies to studies of urban space, linking them with the results of observations and applied questionnaires at the time of the visits to the houses of these women, trying to understand how socio-spatial context makes them vulnerable to catch malaria. In this sense, we tried to understand the malaria as a disease caused by multiple factors, and, through this perspective were considered possible determinants that contribute to its incidence in pregnant women living in the neighborhood Jorge Teixeira in Manaus-AM. Thus, a link was made between the conditions of housing, the transmission vector behavior, the environment changes, as well as the incidence of the disease within the context of urban space production where the pregnant women enrolled in this study live. According to the collected data, most pregnant women do not have a job outside the home and therefore do not tend to leave their homes frequently throughout the day period. In their homes usually can be found standing or stored water for their own consumption, or accumulated in the vicinity. Their homes generally do not have screens on windows or doors and there are few who have the ceiling liners. In principle, both, those with a history of malaria as those without a history of malaria, have the same habits and maintain relations of friendship/neighborhood. Due to this, the conclusion is that exposure and incidence of malaria in pregnant women involved in this study are related to their unstructured housing, therefore the analysis of this situation showed that the quality of housing conditions is important to overcome infectious and parasitic diseases.
Embora vários estudos sobre a malária tenham fornecido muitas informações a respeito de seus aspectos biológicos e comportamentais, essa doença ainda é um grande problema social, principalmente na região amazônica que detém as condições propícias para a proliferação e manutenção do vetor transmissor, haja vista, que ele se alimenta de sangue humano e possui tendência à domesticidade, que, por sua vez, são facilitados pela situação de moradia das populações que vivem nessas áreas consideradas endêmicas. Objetivando analisar a exposição de mulheres grávidas à malária e suas relações com o espaço urbano em que habitam, observou-se suas condições de habitação e moradia e relacionou-se os índices de infecção com as características do espaço urbano no qual estão envolvidas. Assim, esta pesquisa buscou associar os estudos do gênero feminino aos estudos do espaço urbano relacionando-os com os resultados das observações e questionários aplicados no momento da visita à casa das gestantes, buscando compreender como seu contexto socioespacial a torna vulnerável à contração de malária. Nesse sentido, procurou-se entender a malária como uma doença multicausada, e, por meio dessa perspectiva, foram levadas em consideração possíveis determinantes que contribuem para sua incidência em grávidas moradoras do bairro Jorge Teixeira em Manaus-AM. Assim, foi feito uma junção das condições de moradias, o comportamento do vetor transmissor, o ambiente alterado, bem como a verificação da incidência da doença dentro do contexto de produção do espaço urbano das grávidas arroladas neste estudo. De acordo com os dados coletados, a maioria das grávidas não exerce trabalho fora de casa, e por isso não costumam se ausentar com frequência durante todo o período do dia. Em suas moradias, costuma-se encontrar água parada, seja do armazenamento que precisa fazer para consumo próprio ou acumulada nas adjacências. Suas casas geralmente não possuem telas nas janelas e nas portas, e poucas são as que têm forros no teto. A princípio, tanto aquelas com histórico de malária quanto aquelas sem histórico de malária possuem os mesmos hábitos e mantêm relações de amizade/vizinhança. Dessa forma, chegou-se à conclusão de que a exposição e incidência da malária nas mulheres grávidas, envolvidas neste estudo, estão relacionadas à sua moradia desestruturada, pois a análise desse quadro apontou a qualidade de habitar na superação das doenças infecto-parasitárias.

Recent increase in political and funding commitments to malaria control have resulted in rapid scale up of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) as priority vector control interventions. Despite this increasing coverage and consequent substantial reductions of malaria burden, residual malaria transmission by outdoor-biting mosquitoes in particular, necessitates complimentary vector control strategies such as larval source management. More sensitive and scalable entomological surveillance tools are required to monitor the resultant lower transmission levels that persist across much of the tropics. The Urban Malaria Control Program (UMCP) in Dar es Salaam, Tanzania, implements a large-scale community-based (CB) larviciding programme with the aim of demonstrating operational feasibility of integrating larval control into routine municipal services, while utilizing community-owned resource personnel (CORPs) for its implementation. The goal of this study was to a better understanding of community participation in larval-stage vector surveillance and control, and to develop a practical, safe and affordable prototype for routine programmatic adult mosquito surveillance. Qualitative methods involving administering a set of unstructured interviews to CORPs were used to investigate their performance and demographic characteristics, their perceptions and reasons for participating in the UMCP. Ethnographic and historical resources were used to examine how ‘participation in’ and ‘responsibility for’ larval control is inter-articulated through scientific protocols, development practices, and the specific political history of Tanzania. Cross-sectional surveys were later used to assess the effectiveness of operational, community-based larval habitat surveillance systems within the UMCP by estimating the respective detection coverage and sensitivity levels by CORPs. Additionally, an intensive and extensive CB system for routine, longitudinal, programmatic surveillance of mosquitoes using the Ifakara Tent Trap (ITT) was developed and evaluated in comparison with quality assurance (QA) surveys using either ITT or human landing catches (HLC) and with malaria parasite prevalence from the cross-sectional surveys. Overall, CORPs’ individual detection coverage and sensitivity levels were poor, influenced by his/her unfamiliarity with the area, habitat type, fencing and inclusion within larviciding roll out. These indicators were particularly low among CORPs recruited through programme management staff, compared to those recruited by local government officials or health committees, and among staff living outside their areas of responsibility. The CORPs perceived their role to be professional rather than voluntary, with participation being a de facto form of employment. In spite of all challenges, the central coordination role played by the city council, coupled with catalytic donor funding and technical support from expert research partners, enabled institutionalization of strengthened management and planning and improved community mobilization. Capacity to exploit national and international funding systems was enhanced and a sustainable implementation program was ultimately established with funding from the Ministry of Health and Social Welfare, overseen by the National Malaria Control Programme and implemented by the City and Municipal Councils. Management of this program is currently supported by a spatially extensive and temporally intensive community-based longitudinal adult mosquito vector surveillance system with predictive power for parasite infection risk.

Malaria is a health, social and economic burden in Nigeria and consistently ranks amongst the four most common causes of childhood deaths. Treatment of malaria is usually started at home
care is only sought from the health facility when the treatment is ineffective (McCombie, 1996). Patent medicine vendors (PMVs) have been identified as a widely patronized source for drugs used in the home treatment of malaria (Breiger et al, 2001
Goodman, et al, 2007
Salako et al, 2001). Inadequate or poor knowledge and practices in the use of anti-malaria drugs (AMDs) increases morbidity and mortality, undermines therapeutic efficacy, and promotes the emergence and spread of drugresistant malaria. Aim: The aim of the study was to describe and quantify the knowledge and self-reported practices of PMVs in the use of antimalarials, particularly artemisinin-based combination therapies (ACTs), in a poor urban community in Lagos state, Nigeria.

Les inegalites sociales de sante ont ete denoncees a maintes reprises par des etudes en sante publique. Plusieurs d'entre elles ont permis d'identifie les taux de morbidite et de mortalite tres eleves des hommes issus de milieux socioeconomiquement defavorises. Par exemple, au Canada, cette sous-population souffre 3,4 fois plus de maladies cardiovasculaires que son homologue plus aise et, malgre les avances medicales, elle est plus a risque de succomber a cette maladie. Ce type d'inegalites a ete explique en partie par la variation sociale des styles de vie entre les classes sociales. Cette etude porte sur les pratiques des hommes socioeconomiquement defavorises (SED) en contexte de readaptation cardiaque. Elle identifie les mecanismes sociaux explicatifs des styles de vie des hommes SED ayant subit des MCV dans le but d'ameliorer les connaissances en promotion de la sante. L'etude emploie la theorie socioculturelle de Pierre Bourdieu afm, d'une part, de comprendre leurs conceptions du corps, de la sante et de la maladie pour identifier leurs strategies, s'il y a lieu, pour maintenir et ameliorer leur sante et, d'autre part, de saisir leur perception des ressources materielles et humaines necessaires a l'adhesion a un regime de sante. Les resultats reposent sur une analyse qualitative d'entrevues menees aupres de vingt hommes ayant souffert d'une maladie cardiovasculaire. Ils indiquent que, de maniere generale, la defavorisation materielle et sociale de ce groupe faconne un rapport au corps qui est peu propice a l'adoption d'un regime de sante. Une analyse plus fine est presentee a l'interieur de deux articles scientifiques. Le premier article presente la hierarchie des pratiques des participants et le deuxieme permet de souligner davantage les effets du fatalisme et du rapport au temps a court terme sur leurs styles de vie. L'etude conclut qu'il est souhaitable que des politiques qui cherchent a reduire les inegalites sociales soient mises en place afin de permettre aux populations SED d'avoir acces a des conditions de vie plus adequates; necessaires a l'adoption d'un regime de sante recommande par les acteurs en sante publique.

La recolonisation des Hautes terres par l’An. funestus dont les gîtes larvaires principaux sont les rizières a été l’origine de l’épidémie des années 1980s. La pulvérisation intra domiciliaire d’insecticide a constitué l’une des stratégies adoptées pour contrôler l’épidémie. Notre étude s’est intéressée à six zones des Hautes Terres centrales. Les résultats de la détermination des rizières utilisant la télédétection, combinés à d’autres facteurs connus influençant la transmission du paludisme ont permis d’établir des cartes de zones à risque prioritaires pour la pulvérisation d’insecticide à l’aide de l’analyse multicritère par la méthode de combinaison linéaire pondérée. Le paludisme urbain d’Antananarivo diffère du reste de celui des Hautes Terres. Un Système d’Information Géographique a été utilisé pour étudier l’impact des facteurs environnementaux sur le faible taux d’incidence du paludisme observé à partir de neuf Centres de Santé de Base ayant participé à l’étude du paludisme urbain
The reappearance of epidemic malaria in the highlands of Madagascar during the late 1980’s has been attributed to the reestablishment of Anopheles funestus. Rice fields constitute their principal larval habitats. Control strategies to prevent epidemic malaria, have been based on indoor residual spraying of insecticides. Our study was conducted in six zones in the Highlands. Rice fields were determined using remote sensing imagery. Results were combined with factors known to influence the transmission of malaria. Multicriteria evaluation, by the method of weighted linear combination, was used as basis for improved targeting of actions by determining priority zones for intervention. The factors driving malaria transmission in urban Antananarivo differ from the other regions of the highlands. A Geographical Information System was used to study the role of environmental factors on the low malarial incidence rates observed in nine community based health centres in Antananarivo

Résumé: Objectifs : Comparer la prévalence de la multimorbidité selon trois définitions opérationnelles de multimorbidité avec un même mode de collecte de données entre la population générale et la population des salies d'attente de cliniques de médecine familiale, et entre les milieux ruraux et urbains en tenant compte de l'âge et du sexe. Approche : Nous avons utilisé la première collecte de données d'une étude de cohorte dont le but est d'examiner l'effet des soins de première ligne sur l'évolution de l'état de santé dans la population. L'étude a été effectuée dans quatre réseaux locaux de services du Québec. Au total, 3 449 participants ont été recrutés, soit 2 409 personnes pour constituer la cohorte populationnelle et 1 040 personnes pour la cohorte clinique (taux de réponse 71,35 % en population vs 75,67 % en clinique). Un questionnaire auto administré a été utilisé. Nous avons utilisé trois définitions opérationnelles de multimorbidité en accord avec la littérature pour estimer les prévalences. Résultats : La prévalence d'avoir deux maladies ou plus chez les 25-44 ans, 45-59 ans et 60-75 ans est, respectivement, 38,7 %, 64,2 % et 80,5 % dans la cohorte populationnelle, et 48,5 %, 69,9 % et 88,4 % dans la cohorte clinique. En utilisant la définition de trois maladies ou plus, les prévalences sont pour ces mêmes groupes de 19,8 %, 48,1 % et 66,3 % vs 33,8 %, 55,9 % et 76,8 % respectivement. En utilisant la troisième définition avec score DiseaseBurdenMobidityAssessment de 10 ou plus les prévalences sont de 6,6 %, 19,6 % et 29,3 % vs 16,7 % 19,6 % et 29,3 %. Les différences entre les cohortes selon l'âge sont moindres que celles retrouvées dans la littérature. Une différence significative a été observée dans la population générale entre les milieux rural et urbain pour les définitions deux maladies ou plus et trois maladies ou plus. On n'a pas retrouvé de différences entre les sexes. Conclusions : La prévalence de la muitimorbidité augmente avec l'âge selon les trois définitions utilisées. Le fait d'avoir utilisé les mêmes méthodes de collectes de données a réduit les différences de prévalence observées dans la littérature entre les cohortes clinique et populationnelle.||Abstract: Objectives: To compare the estimated prevalence of multimorbidity, using three operational definitions of multimorbidity with the same mode of data collection, among the general population and the population of the waiting rooms of family medicine clinics, and between urban and rural areas taking into account age and sex. Approach: We used the first data set of a cohort study that aims to examine the effect of primary core on the evolution of health status in the population. The study was conducted in four local health networks in Quebec. In total, 3 449 participants were recruited, 2 409 for the population-based cohort and 1 040 individuals for the clinical cohort (response rate 71.35% in the population vs. 75.67% in clinics). The self-administered Disease Burden Morbidity Assessment (DBMA) instrument was used. We used three operational definitions of multimorbidity commonly used in the literature to estimate the prevalence. Results: The prevalence of having two or more diseases among the 25-44 year olds, 45-59 year olds and 60-75 year olds is 38.7 %, 64.2% and 80.5 %, respectively, in population-based cohort, and 48.5 %, 69.9 % and 88.4 % in the clinical cohort. Using the definition of three diseases or more. prevalence for those same groups is 19.8 %, 48.1 % and 66.3 % vs. 33.8 %, 55.9 % and 76,8 % respectively. Using the third definition with a DBMA score of 10 or more, prevalence is 6.6 %, 19.6 % and 29.3 % vs 16.7 % and 19.6 % 29.3 %. The differences between age cohorts are lower than that found in the literature. A significant difference was observed in the general population between rural and urban definitions for two or more diseases and three or more diseases. No gender-related differences were found. Conclusions: Prevalence of multimorbidity increases with age according to three definitions. Having used the same methods of data collection reduced the differences in the prevalence between clinical and population cohorts observed in the literature.

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The present thesis has objective to carry through studies of Medical Geography of the Heath, in three cities of the African continent, located in Angola: Benguela, Lobito and Commune of the Catumbela, in the period of 1615 the 1940. This research about in such a way promotes quarrel of the Theory of the Pathogenic Complex of the Malaria ( elaborated for the French geographer Max Sorre), as well as, through the re reading of the European colonized, that considers the Malaria in the colonies a regional- cultural problem. I display the application of a Medical Geography imperialist occidental person, who almost sends the extinguishing of the local Medicine. It has a recurrent fight in these Kingdoms, to inside determiner the great epidemics of Malaria of its territorial occupation. In century XX, although the biotechnological advances, still take advantage the receptive and the vulnerability of the Malaria. It has crisis of the Angolan Public Health. In a retrospect of the description social process, in the above described period, I search an assay of relative form, a proposal of reconstruction of the relations between the man, the environment, and the pathological complexity of the Malaria in the Republic of Angola
A presente tese tem como objetivo realizar estudos da Geografia Médica e da Saúde, em três cidades do continente africano, localizados em Angola: Benguela, Lobito e Comuna da Catumbela, no período de 1615 a 1940. Esta pesquisa promove uma discussão acerca da Teoria do Complexo Patogênico da Malária (elaborada pelo geógrafo Francês Max Sorre), como também, através da re leitura da Antropogeografia (de Friedrich Ratzel). Neste contexto, relato o olhar do colonizador europeu, que considerava a Malária nas colônias um problema regional cultural. Exponho a aplicação de uma Geografia Médica imperialista ocidental, que remete a quase extinção da Medicina local. Há uma luta recorrente nestes reinos, para exterminar as grandes epidemias de Malária dentro da sua ocupação territorial. No século XX, apesar dos avanços bio-tecnológicos, ainda prevalece a receptividade e a vulnerabilidade da Malária. Há crise da Saúde Pública angolana para controlar epidemias, com a ausência de uma Geografia da Saúde. Numa retrospectiva do processo histórico social, no período acima descrito, busco um ensaio de forma relativa, uma proposta de reconstrução das relações entre o homem, o meio ambiente, e a complexidade patológica da Malária na República de Angola

CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico
A urbanização determina fortes pressões sobre as populações naturais. A riqueza e a abundância de espécies mais sensíveis à urbanização diminuem, enquanto espécies generalistas e/ou oportunistas tendem a se tornar mais comuns, gerando um processo de homogeneização biótica. Outra mudança importante é representada pelo aumento de níveis de transmissão de parasitos, aspecto que vem sendo investigado, principalmente entre aves. Nesse sentido, o objetivo deste estudo foi avaliar se os indivíduos de Columbina talpacoti respondem de formas diferentes em relação aos ambientes naturais e ambientes urbanizados através da análise de índices hematológicos (razão heterófilos/linfócitos e leucócitos globais), parasitológicos (prevalência e parasitemia de hemoparasitos causadores da malária aviária) e índice de condição corporal. O estudo foi realizado no município de Uberlândia (MG). Foram estabelecidos 4 pontos de coleta dentro da cidade e 7 pontos de coleta na Reserva particular do Clube Caça e Pesca Itororó de Uberlândia. As capturas foram realizadas de março/2016 à outubro/2016, com redes de neblina. As aves foram capturadas e submetidas a procedimentos de coleta de sangue e medições biológicas. A coleta do sangue foi realizada através de venopunção braquial, com uma gota de sangue não heparinizado foi confeccionado o esfregaço sanguíneo, duas gotas de sangue foram acondicionadas em álcool absoluto em microtubos para posterior extração do DNA e investigação de haemosporídeos por PCR. A análise dos dados foi realizada através do teste-t e U-Mann-Whitney para verificar a existência de diferenças significativas entre os parâmetros analisados entre áreas urbanas e naturais. Para avaliar se há correlação nos parâmetros avaliados, os dados foram submetidos a correlação de Pearson e de Spearmann. Apenas a razão de heterófilos/linfócitos, que indica estresse, foi maior para área urbana do que na natural (t=3,673; p<0,05), os demais índices avaliados não apresentaram diferenças significativas. Também não foram observadas diferenças significativas entre os parâmetros avaliados com o sexo. O teste de correlação mostrou que apenas o índice de H/L relacionou-se positivamente com os leucócitos totais (rs=0.394; p<0,05), os demais itens não apresentaram correlação entre si. Estes resultados indicam que os animais estão mais estressados no ambiente urbano, mas que com a disponibilidade alta de recursos alimentares em conjunto com a plasticidade fenotípica dos indivíduos, a condição corporal não se altera em nenhuma das áreas. Além disso, como as infecções avaliadas estão em estágio crônico, os sintomas da doença são brandos e quase inexistentes.
Urbanization creates strong pressures on natural populations. Both richness and abundance of more susceptible species diminish due to urbanization, while generalized and / or opportunistic species tend to become more common, leading to a process known as biotic homogenization. Another important contribution of Urbanization is represented by the increasing rates in parasite transmission, mainly among birds. In this sense, the main purpose of this study was to evaluate how individuals of Columbina talpacoti respond in different special gradients: natural and urbanized environments. Three indices were analyzed: hematological, parasitological (avian malaria prevalence and parasitemia) and body condition. The study was carried out in the city of Uberlândia (MG). There were 4 collection points within the city and 7 collection points in the Clube de Caça e Pesca Itororó de Uberlândia. Captures were carried out from March 2016 to October 2016, by using mist nets, and collecting a blood sample and morphometric measurements from each individual. Blood collection was done through a venipuncture, getting a drop of non-heparinized blood to make three blood smears. Two blood drops were conditioned in absolute alcohol in microtubes for later DNA extraction and PCR procedures. Data analysis was performed using Mann-Whitney test to verify the existence of significant differences between the patterns analyzed between urban and natural areas. The data was submitted to both Pearson and Spearmann correlation test to check for possible correlation among the variables. Only one hematological index (heterophilic / lymphocyte ratio), which indicates stress, was higher for the urban than natural area (t = 3.673, p <0.05). The other indices were not statistically significant. There were also no significant differences between sex identities as well. Only the H/L index was positively related to the total leukocytes (rs = 0.394, p <0.05), shown by the correlation tests. These results indicate that animals are more stressed in the urban environment. Having high food availability coupled with a phenotypic plasticity of individuals, body condition did not change in any of the areas. In addition, since the infections evaluated are in the chronic stage, the symptoms of the disease are mild and almost non-existent.
Dissertação (Mestrado)

Cette thèse défend l’intérêt d’appliquer une démarche d’analyse exploratoire de données spatiales pour examiner un phénomène complexe irréductible, dans un contexte limité en données : le paludisme-infection à Dakar. Chaque partie du système pathogène du paludisme est nécessaire mais non suffisante au fonctionnement du système. Il n’y a paludisme-infection que lorsque les trois composantes sont en contact : le parasite, le vecteur et l’hôte humain. La recherche des lieux où ces contacts peuvent s’opérer facilement est donc primordiale dans la lutte contre le paludisme et l’amélioration des programmes visant à la diminution voire l’élimination de la maladie. L’analyse exploratoire, encore très peu appliquée dans les pays dits du Sud, se définit ainsi comme une démarche de recherche mais aussi comme un moyen d’apporter des réponses aux besoins sanitaires. Elle pousse à l’observation, sous différents angles, des déterminants sociaux qui sont impliqués dans la réalisation du phénomène, tout comme à l’examen des interactions existantes entre eux. Nous avons récolté des informations quantitatives variées, en lien direct et indirect avec l’étude du paludisme. Interprétation d’images satellites, données censitaires, résultats d’enquêtes sociales et sanitaires ont été intégrées dans un système d’information géographique pour décrire la ville et ses habitants. Le croisement de ces sources a permis d’étudier les faces spatiales du risque épidémique palustre. Le recours à des analyses statistiques et géostatistiques, bivariées et multivariées, a permis de souligner que le risque d’infection des populations dépendait fortement d’une distance, que l’on a qualifié de sociale
This thesis applies an Exploratory Spatial Data Analysis (ESDA) approach to study a complex phenomenon in a data scarce environment: malaria infection in Dakar. Each component of the malaria pathogenic system is necessary but not sufficient to result in an infection when acting in isolation. For malaria infection to occur, three components need to interact: the parasite, the vector, and the human host. The identification of areas where these three components can easily interact is therefore essential in the fight against malaria and the improvement of programs for the prevention and control or elimination of the disease. ESDA, still rarely applied in developing countries, is thus defined as a research approach but also as a way to provide answers to global health challenges. It leads to observation, from different angles, on the social and spatial determinants of malaria infection, as well as the examination of existing interactions between its three components. Several streams of quantitative information were collected, both directly and indirectly related to the study of malaria. More specifically, multi-temporal satellite imagery, census data, and results from social and health surveys have been integrated into a Geographic Information System (GIS) to describe the city and its inhabitants. Combining these datasets has enabled to study the spatial variability of the risk of malaria infection

La ville d’Abidjan est localisée au Sud de la Côte d’Ivoire. Elle est la capitale économique depuis 1983 et la première ville du pays. Elle concentre le potentiel humain et une offre de soins dense et diversifiée répartie sur de faibles distances physiques, donnant l’impression que tout est accessible. En effet, l’État Ivoirien a consenti d’importants investissements pour construire et équiper des services de santé depuis l’émergence de la ville au début du siècle dernier pour améliorer l’accès aux soins des abidjanais. Pourtant, malgré une augmentation considérable du nombre d’infrastructures sanitaires et de leur disponibilité, les taux d’utilisations et de fréquentations des services de santé modernes dans les communes de la ville d’Abidjan restent faibles et les indicateurs de santé demeurent très préoccupants et les besoins de soins sont importants. En plus, la croissance spatiale et démographique accélérée que connaît la ville entraînent des changements rapides dans son organisation territoriale empêchant les autorités publiques chargées de la planification de suivre le rythme de sa croissance urbaine. Ils ne sont pas toujours parvenus à équiper en services urbains les nouveaux espaces au fur et à mesure de leur création et à intégrer les nouveaux citadins aux origines diverses. Cette thèse permet d’étudier, comment, dans un contexte considéré comme privilégié, se pose la problématique de l’accès et du recours aux services de santé modernes. Pour réaliser ce projet, cette étude, à partir des combinaisons d’analyses spatiales, statistiques, et d’un travail de terrain, analyse les inégalités socio-spatiales d’accès aux services de santé pour mettre en exergue le problème de l’accessibilité aux soins, tant physique, culturelle, matérielle que sociale. Elle mesure également l’adéquation de cette offre de soins moderne aux besoins de soins des populations pour identifier les zones et les populations défavorisées pour l’accès aux soins. Et enfin, cette étude analyse les pratiques citadines du recours aux soins, ainsi que les déterminants qui limitent ou facilitent l’accès aux soins dans la ville d’Abidjan. Les résultats des études montrent que les services de santé existent, ils sont denses et diversifiés, mais ils ne sont pas repartis là où il y a le plus de besoins de soins. Dans notre étude, on souligne aussi une prédominance de la prise en charge à domicile des épisodes morbides notamment à travers l’automédication et une diminution de l’utilisation des services de soins modernes. Le recours aux structures de soins se fait rare dans les quartiers où les besoins en soins de santé sont les plus importants. L’automédication ou la médecine de rue sont généralement les plus privilégiées. Les structures de soins sont sollicitées que lorsque la maladie devient très grave. Nos résultats montrent également qu’il est difficile d’attribuer à un facteur le rôle déterminant des recours thérapeutiques, car les comportements sont à la fois déterminés par les caractéristiques socio-démographiques de l’individu, de sa famille et par des paramètres contextuels, mais aussi par les caractéristiques de l’épisode morbide, par la connaissance du système de soins environnant et les attitudes vis-à-vis du système de soins. Néanmoins, nous pouvons dire qu’à Abidjan, les pratiques citadines du recours aux soins sont tributaires de la capacité économique des ménages avec le risque accru de marginaliser les personnes les plus vulnérables
The city of Abidjan is located in the South of the Ivory Coast. It is the economic capital since 1983 and the first city of the country. It concentrates human potential and health of dense care supply modern and diversified divided on weak physical distance, giving the impression that everything is approachable. In effect, the State Of the Ivory Coast approved important investments to construct and equip services of health care since the emergence of the city at the beginning of last century to ameliorate the access to health care of abidjanais. However, in spite of a considerable increase among health facilities and among their availability, the rates of uses and company of the services of modern health care in the spaces of the city of Abidjan remain weak and the indicators of health remain very worrying and the needs in care of health are important. On top of that, the space and demographic speeded up growth which knows the city draw away quick changes in her territorial organization preventing the public authorities made responsible with planning for following the rhythm of its urban growth. They did not always manage to equip new urban spaces with timely urban services and to integrate new citizens at the various origins. This thesis allows to be studying, how, in a considered context as privileged, settle the problems of access and health care seeking in the services of modern health. To accomplish this plan, this study, from the combination of spatial analysis, statistics, and field work, analyses the socio- spatial inequality of access to the services of health to head with the problem of accessibility in care, so physical, cultural, material that social. It also measures the adequacy of health care supply at the Needs in care of health of populations to identify zones and populations discriminated for the access to health care. And finally, this study analyses the city practices in the use of health care, as well as the determinants that hinder or facilitate access to health care in the city of Abidjan. Study results show that the services of health exist, they are dense and manifold, but they did not leave again where there are most needs in care of health. In our study, they also underline a predominance of the taking care at home of morbid episodes notably across self-medication and a reduction of the use of the services of modern care. The seeking in structures of health care becomes rare in the space where the needs in care of health are the most important. Self-medication or street medicine are the most favouring in general. Structures of health care are solicited that when illness becomes very serious. Our results also show that it is difficult to allocate to a factor the role determining therapeutic seeking, because behaviours are determined at the same time by the socio-demographic characteristics of the individual, his family and by contextual parameters, but also by the characteristics of morbid episode, by the knowledge of the ambient the health care system and attitudes in relation to the health care system. However, we can say that in Abidjan, the city practices of health care seeking are dependent on the economic capacity of household with risk augmented to marginalize the most vulnerable persons

The study was done to assess the information and care the men and women have on PCC and develop strategies that could improve provision of PCC that could advance maternal and newborn outcome after pregnancy in Malawi. Most for the interventions to improve pregnancy outcome are done too late in Malawi but there is an opportunity during preconception period to plan to improve the health of the couple so that the goal of a healthy mother and baby is attained. The objectives were to: explore and describe the knowledge men and women of childbearing age have on HTSP and PCC, identify variables that influence men and women to acquire appropriate knowledge on PCC and finally to develop strategies that could assist provision of PCC in developing countries like Malawi. Adverse issues that affect the couples could be addressed promptly before the occurrence of pregnancy. A quantitative non-experimental descriptive-correlation design method was used to determine the knowledge men and women of childbearing have on HTSP and PCC. A structured questionnaire was used to collect data from 300 men and women of childbearing age. The target population for the study was prospective parents that are couples that have an intention to conceive, women of childbearing age that could be accessible at family planning, gyneacological and under-five clinics between the ages of 18-35 years. A questionnaire was adapted from a study conducted in Texas. SPSS version 20 was used to analyse the data by generating frequencies and chi- square. Kruskal Wallis test was used to determine relationship between variables and knowledge on preconception care. The constructs examined were psychological preparation, reproductive health care and the physical care that are provided to ensure a healthy pregnancy outcome. With a 100% response rate the findings indicated a gap of information and care on PCC.Services on PCC were not available in the clinics which indicated a great need to empower health care providers on PCC that could reduce maternal and neonatal mortality rate. The findings were used to develop relevant preconception strategies that would assist health providers to give PCC that would improve maternal and newborn outcomes in Malawi.
D. Litt. et Phil. (Health Studies)

Despite the availability, accessibility and affordability of cervical cancer screening (CCS) in Malawi, many women do not utilize the CCS services. This research was conducted in Blantyre district, Malawi. The main objective of the study was to identify factors that act as barriers to the uptake of cervical cancer screening programs among urban and rural women in the Blantyre district of Malawi. A quantitative design was used and convenience sampling was applied in selecting a sample of 196 women from the population of women aged 18 and over in two Reproductive Health clinics, one urban clinic at Queen Elizabeth Central Hospital and one rural clinic at Mlambe hospital in Blantyre district, Malawi. A structured questionnaire was used to collect data. The questionnaire was translated from English into the local Chichewa language so that respondents were interviewed and responded in a language that they were able to comprehend. Analysis and discussion of findings are presented in five sections. Data were processed into numeric values using SPSS version 15.0 and Microsoft Excel to give meaning to the findings of the study. In order to test for statistically significant associations between variables, the Pearson correlation was applied. The study revealed that the main barrier to CCS was that women lack knowledge and information about cervical cancer and there is a lack of publicity about CCS services. Lack of knowledge was found in relation to - risk factors, prevention of, detection of and benefits of cervical cancer screening with a greater knowledge deficit being found in the rural women. Higher levels of education in both the urban and rural groups did not have a positive influence on the screening behaviours of the women. Commencing sexual intercourse at ages 15 to 19 years and having multiple sexual partners were the main risk factors to cervical cancer among the women in the study. It was also found that although rural women perceived themselves being very likely to be at risk of cervical cancer, this perception did not translate into CCS behaviour. v
Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

A Research Report submitted to the School of Public Health, University of the Witwatersrand in partial fulfillment of the requirements for the degree of Master of Public Health. May 27, 2015
Introduction: Studies across Sub-Sahara have established transactional sex as one of the of the keys factors contributing to young people’s risk of HIV infection. However, there are few studies that have explored the dynamics of transactional sex among young people in Malawi. The aim of this study was to investigate the extent of, and risk factors associated with transactional sex among (in and out of school) young men and women of ages 18 – 23 years in urban informal settlements in Blantyre, Malawi. Methods: This was a secondary analysis of data from a cross-sectional study conducted in 2013 on sexual risk-taking among young people aged 18 – 23 years in urban informal settlements in the city of Blantyre, Malawi. The analysis was restricted to sexually active young men and women (those respondents who reported ever having sexual intercourse in the primary study). Bivariate and multivariate analyses were conducted to detect associations between socio-demographic factors (i.e. age, socio-economic status, relationship status and education, as well as behavioral factors (i.e. sexual debut, number of partners, age disparity with sexual partner, coercive sex and alcohol consumption), and transactional sex. Results: The majority (60.06%) of the study population reported involvement in transactional sex. Stratified by sex, 67.10% of young men had ever given cash or material goods in order to get sex, and 53.45% of young women had ever received cash or material goods in exchange for sex. Half (50.75%) of the transactional sex reported was in exchange for cash and consumption/lifestyle goods and from this, over half of the young women (58.67%) reported receiving consumption and lifestyle goods in exchange for sex, and slightly over a quarter (26.32%) of the young men reported giving survival needs in exchange for sex. Among men, household structure (AOR 2.07, 95% CI 1.37 – 3.13) and severe food insecurity (AOR 1.67, 95% CI 1.05 – 2.67) emerged as important socio-demographic predictors of transactional sex, and number of sexual partners (AOR 2.67, 95% CI 1.78 – 4.08) and age disparity (AOR 0.34, 95% CI 0.21 – 0.57) were shown to be the behavioral factors that influence giving cash/material goods for sex. Among young women, only age at sexual debut (AOR 2.07, 95% CI 1.37 – 3.13) and number of sexual partners (AOR 3.02, 95% CI 1.65 – 5.52), were significantly associated with receiving cash or goods in exchange for sex. Conclusions: Overall, the study findings show that transactional sex is a common practice among young men and women, and that both young and women exchange luxury or aspirational items more than survival items for sex. Among young men, household structure, food security, age at sexual debut, number of sexual partners and age differentials with sexual partner were associated with giving material goods or money for sex. Among women on the other hand, age at sexual debut and number of sexual partners were associated with receiving material goods or money in exchange with sex. These findings suggest that young people in poor urban settings engage in risky sexual behavior such as Transactional sex, and highlight the need for HIV prevention interventions to deliberately target this group. Programmers should consider designing interventions that suit the needs of the different gender groups. The study findings also highlight the importance of targeting young women with behavioral change interventions before sexual debut, and integrating transactional sex interventions with those focused on reduction of multiple sexual partnerships may have beneficial implications for transactional sex among young people in poor urban settings. Further research should explore the influence of materialist and consumeristic cultures on transactional sex among young people.

Thesis submitted for the degree of Doctor of Philosophy School of Public Health Faculty of Health Sciences University of the Witwatersrand, Johannesburg 26th April, 2016
Rationale Young people aged 15-24 years account for nearly half (41 percent) of new HIV (Human Immunodeficiency Virus) infections in people over 15 years globally and 52 percent of this number occurs in the SEA region (UNICEF, 2011). Unprecedented urban growth in cities is occurring in this region and approximately 75 percent of the urban population are young people (UN-HABITAT, 2008). This urban growth has been accompanied by urbanisation of poverty in the growing urban slums or urban informal settlements1, where approximately 70 percent of the urban residents live (UN-HABITAT, 2010b). The UN Human Settlements Programme has identified five characteristics that define an urban slum, namely poor structural quality of housing, overcrowding, insecure residential status, inadequate access to safe water, inadequate access to sanitation and infrastructure (UN-HABITAT, 2010b). Research from some countries in the SEA region has shown that the HIV prevalence and incidence in urban slum populations is double (or more) that in the non-urban slum population of the same city (see, for example, Thomas et al., 2011; Madise et al., 2012; Rehle et al., 2007; Kyobutungi et al., 2008). This difference might be partly due to HIV-related sexual risk behaviour of young people living in urban slums (Mmari and Astone, 2013; Unger, 2013). Given that urban slums are home to a growing number of young people in the SEA region, there is the need for more innovative research on context-specific factors associated with HIV-related sexual risk behaviour to inform a specific combination prevention framework that will impact strongly on the HIV epidemic. 1 In this thesis, I will focus on the term urban slum rather than urban informal settlement as per definition by the United Nations that I have given. Malawi and South Africa are helpful examples of the currently urbanising and the most urbanised countries in the SEA region with some similarities between urban slum contexts, but also with large variations due to the historical, political and economic situations of the respective countries. For example, existing studies in Malawi (Mkandawire, 2011; Mkandawire et al., 2011a; Madise et al., 2007) and South Africa (Tenkorang et al., 2011; Burns and Snow, 2012) have highlighted that young people living in urban slum settings are at high risk of HIV acquisition. In addition, these studies highlight similar challenges faced by the growing numbers of young people living in urban slum settings, which include unemployment, poor access to education, health care, food, and continue to experience high levels of sexual abuse (Mkandawire, 2011; Tenkorang et al., 2011). Although these studies have provided important information, there are significant gaps in knowledge regarding context-specific (or local) indicators of disadvantage associated with sexual risk behaviour. Specifically, existing studies have focused on income-related measures of poverty (for example, low levels of income, unemployment, and education) to predict sexual risk2. One of the strongest critiques emerging of income-related measures of poverty is that they do not reflect access to basic needs and services (Thomas et al., 2011; Vearey et al., 2010). Such a critique has led some researchers to call for moving away from income-related measures of poverty to measures capturing critical aspects of poverty – that is, capturing material deprivation – that best represent the conditions and realities of living experiences in urban slums to predict sexual risk (Greif, 2012; Kunnuji, 2014; Mberu et al., 2013). 2 In this research, I define HIV-related sexual risk (or sexual risk for short) as those sexual practices that have been found to be associated with high risk of HIV acquisition. These sexual practices considered in this research are: (1) non-use of condom at last sex; (2) multiple (two or more) sexual partners; (3) transactional sex; and (4) coercive sex. I use the term sexual risk as an umbrella term of these sexual practices in this thesis. Specific definitions of these sexual practices used in this research are provided in the published papers. To this end, three measures of disadvantage – housing and food insecurity, and poor access to health care – have been highlighted as critical living conditions associated with sexual risk in urban slums in the SEA region (Greif, 2012; Mberu et al., 2013). Housing, food and health care access are multidimensional concepts that encompass aspects of housing quality, instability and overcrowding (Aidala et al., 2005); availability, accessibility and utilisation of food (Ivers and Cullen, 2011) and affordability, acceptability and availability of health care (Peters et al., 2008; Thiede and McIntyre, 2008). My review of the literature confirms that there is no consistency on what constitutes and how to measure these critical living conditions in relation to HIV sexual risk in urban slums of the SEA region. Another limitation in existing studies is that the association between material deprivation and sexual risk is most frequently examined through the inclusion of either one dimension of deprivation or a single deprivation-related item (Greif, 2012). The lack of data on multiple-item measurement of the components of material deprivation has always been cited as a reason for considering one dimension of deprivation or a single deprivation-related item. It is likely that additional nuance underlying this association is not yet examined given that single-item measures of deprivations overestimate or underestimate the statistical significance leading to biased results (Noble et al., 2010). My research contributes in this direction by using multiple measures of housing and food insecurity and poor access to health care to conceptualise material deprivation in relation to sexual risk. Aim Based on the findings from two sub studies, this PhD aims to better understand relationships between local measures of material deprivation, economic deprivation, and dimensions of sexual risk that will inform the development of an urban slum-specific combination HIV prevention framework to reduce the HIV risk of young people in Malawi and South Africa. Methods Two sub studies were undertaken: one in South Africa (Sub study I) and another one in Malawi (Sub study II). Sub study I was a secondary analysis of a cross-sectional survey of young people (n = 530) living in urban slum households extracted from the 2011 loveLife survey with young people aged 18-23 years old in South African four of nine provinces – KwaZulu Natal, Mpumalanga, Eastern Cape, and Gauteng. Young people in the age cohort of 18-23 years old are important given that they transition rapidly from low HIV vulnerability when they are 10-19 years old to high HIV vulnerability (UNICEF, 2011). Sub study II included five focus group discussions and 12 in-depth interviews, undertaken with a total of 60 young people aged 18-23 years old, exploring living experiences and sexual risk practices in the urban slums of Blantyre, Malawi. This exploratory qualitative study informed a cross-sectional survey that explored material deprivation and sexual practices among young people (n = 1,071) in the urban slums of Blantyre, Malawi. The focal research variables in Sub study I were ‘material deprivation’, ‘financial difficulty’ and ‘sexual risk-taking’. Material deprivation was assessed by summing the single-item measures of housing and food insecurity, and poor access to health care to create a dichotomous measure that indicated the presence of one or more hardships. Financial difficulty was defined by assessing items that asked respondents if they received any income from any source last month or if anyone in the household receive a grant. The dependent variable, sexual risk-taking, was defined from a series of items about condom use, multiple (two or more) sexual partners and transactional sex. Variables from these measures were dichotomous, indicating whether a respondent used condom(s) at last sex or not, had two or more sexual partners or not, and exchanged sex for money or goods in the last 12 months or not. The variable on transactional sex involved the giving of cash or goods for males and receiving for females. Given this information, ‘high sexual risk-taking’ was defined by those who reported that they had not used condoms at last sex or exchanged sex for money or goods in the last 12 months irrespective of the number of sexual partners they had or those who reported use of condoms at last sexual intercourse, but had more than one sexual partner. In Sub study II, material deprivation was defined by a total of 20 indicators of insufficient housing, food insecurity, and poor access to health care (see Paper II, Table 1). From these indicators, all households in the study sites were assigned a deprivation sum score based on 17 items (11 on food insecurity, five on housing and one on poor access to health care) available from the survey instrument (see Paper III). Households with the highest scores were defined as ‘deprived households’ (Dodoo et al., 2007; Kuipers et al., 2013). Unemployment was determined by asking the young people their primary occupation – the work from which they earn most of their income (Dzator, 2013). Six occupational categories (construction, trading, services, industry, agriculture, and unemployed) were created from the responses and used in the analysis. Coercive sex was measured asking whether a respondent had been forced by a partner or non-partner to have sex when he or she did not want to. Through synthesis of the findings from the two sub studies, four central themes were identified: (1) patterns of sexual risk; (2) underlying reasons for decisions to engage in transactional sex; (3) measures of disadvantage associated with sexual risk; and (4) study design and methods. These four themes assist me in making recommendations for a new urban slum-specific combination HIV prevention model for young people in the SEA region. Key findings Prevalence of no condom use at last sex was significantly higher in both young men and young women living in urban slums in Malawi than their counterparts in South Africa (p<0.001, respectively). With regards to multiple sexual partners, young people in Malawi were less likely to report having multiple partners than their counterparts in South Africa (49.3% vs. 64.1% (p=0.002) for young men, and 18.7% vs. 28.7% (p=0.032) for young women). Prevalence of coercive sex in Malawi was 15.8% and 44.4% in young men and young women respectively. Lastly, transactional sex was significantly higher in young men and young women in Malawi than their counterparts in South Africa (p<0.001, respectively). The qualitative data analysis reveals that housing and food insecurity influenced both young men’s and young women’s motivations for engaging in transactional sex. Poor access to health care and a desire for high-value social goods (such as cellular phones, the latest hair, and clothing styles) influenced the young women’s motivations for transactional sex. Adjusted logistic regression models show that material deprivation was significantly associated with increased odds of high sexual risk-taking for young men (adjusted odds ratio [AOR]=1.20; 95% confidence interval [CI]=1.10, 5.58) and young women (AOR=1.43; 95%CI=1.35, 3.28). However, financial difficulty is the most salient influence on young women’s high sexual risk-taking (AOR=2.11; 95%CI=1.66, 2.70) (Paper I). A multi-level model adjusted for other risk behaviours, age, marital status, duration of residence, household structure, school status, level of education and received money from relatives shows that unemployment was associated with young men to report experiencing coercive sex (AOR=1.77, 95%CI: 1.09, 3.21) while material deprivation (AOR=1.34, 95%CI: 0.75, 2.39) was not. Young women in deprived households were more likely to report experiencing coercive sex (AOR=1.37, 95%CI: 1.07, 2.22) than in less deprived households (Paper III). A further analysis of logged coefficients from the regression models (Model 2 in Paper I, Table 4, and Paper III, Table 5) multiplied by their standard deviations shows that: (1) for young women, financial difficulty (0.16 = (log 2.11)*(0.50)) exerted the strongest effects on sexual risk-taking followed by material deprivation (0.10 = (log 1.43)*(0.66)) (Paper I). In the same Paper I, material deprivation (0.04 = (log 1.20)*(0.50)) shows noteworthy and significant effects on sexual risk-taking for young men; (2) material deprivation (0.08 = (log 1.37)*(0.58)) and unemployment (0.12 = (log 1.77)*(0.50)) were the most influential variables associated with coercive sex among young men and young women respectively. Based on this further analysis, I argue that existing HIV prevention efforts based on research that employed only measures of economic deprivation – and did not explore material deprivation – may not be effectively responding to the specific conditions found to be critical in the urban slum settings in Malawi and South Africa. With regard to the strengths of association between various deprivations and dimensions of sexual risk, this research shows what the gaps are in understanding the differences between South Africa and Malawi and therefore what future research is needed to develop tools to assess the generic and specific settings in different countries in the SEA region regarding HIV risk. Material deprivation has been shown in this study to remain a robust predictor of sexual risk in statistical models (Papers I and III). Furthermore, findings from the qualitative study (Paper II) indicate that a desire for high-value social items (for example, latest clothing styles, hair products, and cellular phones) underlie young women’s motivations for transactional sex in urban slums. Thus, it is argued that responses to material deprivation, to reach full potential, need to engage with a desire for fashionable goods as well. Through the synthesis of the findings from the two studies, I have suggested key recommendations and strategies required for responses that prioritise young people in urban slums in Malawi and South Africa. Implications Based on the findings of this research, an urban-slum specific combination HIV prevention framework is suggested for young people in the SEA region. It is argued that a combination HIV prevention framework targeting young people living in these settings requires understanding of both material disadvantage and desire for high-value social goods, since intervention efforts that focus on a purely income-related measure of poverty of levels of income are likely to fail. This requirement is likely to be useful for addressing the unique challenges faced by young people residing in urban slums. Moreover, the understanding suggested here will enable countries in the SEA region to reduce health risks among young people living in urban slums. This research contributes a new methodological approach that highlights what data are needed in order to better understand context-specific measures of disadvantage associated with sexual risk among young people living in urban slum settings in the SEA region. The study findings suggest that there is need to develop appropriate tools to collect more detailed research data on the generic and context-specific issues in different urban slum settings in the SEA region regarding structural determinants of HIV sexual risk that would inform context-specific responses. Future multi-country study should employ a settings approach to assess HIV-related sexual risks and guide the development of appropriate responses for young people living in urban slums of the SEA region. Keywords: Material deprivation, young people, urban slums, HIV, sexual risk, combination HIV prevention.
MB2016

Ph.D. Faculty of Humanities, University of the Witwatersrand, 2011
This study analyses the manner in which animals are represented in selected poetry from Malawi, Zimbabwe and South Africa. It discusses the various modes of animal representation the poets draw on, and the ideological influences on their manner of animal representation. It explores the kinds of poetic forms the poets employ in their representation of animals and examines the manner in which ecological or environmental issues are reflected in the poetry. Further, the study determines the extent to which the values expressed in the poems are consistent with, or different from, current ecological orthodoxies and the ways in which the metaphors generated in relation to animals influence the way we treat them. The study shows that in the selected poetry animals occupy a significant position in the poets’ exploration of social, psychological, political, and cultural issues. As symbols in, and subjects of, the poetry animals, in particular, and nature in general, function as tools for the poets’ conceptualisation and construction of a wide range of cultural, political, and philosophical ideas, including among others, issues of justice, identity, compassion, relational selfhood, heritage, and belonging to the cosmos. Hence, the animal figure in the poetry acts as a site for the convergence of a variety of concepts the poets mobilise to grapple with and understand relevant political, social, psychological and ecological ideas. The study advances the argument that studying animal representation in the selected poetry reveals a range of ecological sensibilities, as well as the limits of these, and opens a window through which to view and appreciate the poets’ conception, construction and handling of a variety of significant ideas about human to human relationships and human-animal/nature relationships. Further, the study argues that the poets’ social vision influences their animal representation and that their failures at times to fully see or address the connection between forms of abuse (nature and human) undercuts their liberationist quests in the poetry.

Thesis (Ph. D.)--Syracuse University, 1986.
Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (p. 196-209).

La recolonisation des Hautes terres par l’An. funestus dont les gîtes larvaires principaux sont les rizières a été l’origine de l’épidémie des années 1980s. La pulvérisation intra domiciliaire d’insecticide a constitué l’une des stratégies adoptées pour contrôler l’épidémie. Notre étude s’est intéressée à six zones des Hautes Terres centrales. Les résultats de la détermination des rizières utilisant la télédétection, combinés à d’autres facteurs connus influençant la transmission du paludisme ont permis d’établir des cartes de zones à risque prioritaires pour la pulvérisation d’insecticide à l’aide de l’analyse multicritère par la méthode de combinaison linéaire pondérée. Le paludisme urbain d’Antananarivo diffère du reste de celui des Hautes Terres. Un Système d’Information Géographique a été utilisé pour étudier l’impact des facteurs environnementaux sur le faible taux d’incidence du paludisme observé à partir de neuf Centres de Santé de Base ayant participé à l’étude du paludisme urbain
The reappearance of epidemic malaria in the highlands of Madagascar during the late 1980’s has been attributed to the reestablishment of Anopheles funestus. Rice fields constitute their principal larval habitats. Control strategies to prevent epidemic malaria, have been based on indoor residual spraying of insecticides. Our study was conducted in six zones in the Highlands. Rice fields were determined using remote sensing imagery. Results were combined with factors known to influence the transmission of malaria. Multicriteria evaluation, by the method of weighted linear combination, was used as basis for improved targeting of actions by determining priority zones for intervention. The factors driving malaria transmission in urban Antananarivo differ from the other regions of the highlands. A Geographical Information System was used to study the role of environmental factors on the low malarial incidence rates observed in nine community based health centres in Antananarivo

The occurrence of potential larval habitat, the use of mosquito control, and reported malaria were studied in relation to community and household level ecological variables. Malindi, Kenya was mapped using global positioning systems (GPS), and a geographic information system (GIS) was used to overlay a measured grid, which served as a sampling frame for this research. Grid cells were stratified and randomly selected according to levels of drainage. A stratified cross-sectional survey was conducted in November and December 2002 to collect entomological and human ecological data at the community, household, and aquatic habitat level. A hierarchical multiple logistic regression model was used to test relationships between the presence of potential anopheline larval habitat and urban agriculture at the community level. Multiple logistic regression was used to test relationships between human activities and the use of mosquito control and reported malaria at the household level. This study demonstrated that urban agriculture was not associated with the development of larval habitat after controlling for potential confounders associated with distance, drainage, access to resources, and the overall abundance of human activity. As well, this study found that few of the human-ecological variables measured were significantly associated with the use of mosquito control or reported malaria at the household level. The geographic sampling strategy employed was effective for linking human survey data with field based entomological data at the community level, but was limited in terms of it's ability to adequately sample human populations at the household level. In the absence of sustainable community level mosquito control mechanisms, many urban residents may be at increased risk of encountering infectious mosquitoes in urban environments
acase@tulane.edu

Au tournant du XXe siècle, la neurasthénie – ou épuisement nerveux – est devenue une maladie populaire en Occident et jusqu’au Japon en raison de son association avec la modernité. De nombreux rapprochements ont été faits entre ce diagnostic introduit en 1869 aux États-Unis et certaines maladies contemporaines comme la dépression, le syndrome de fatigue chronique, l’épuisement professionnel et toute la panoplie des maladies causées par le stress. Les transformations socioculturelles qu’a connues le Viêt Nam sous colonisation, principalement au cours des décennies 1920 et 1930, ont été propices à la dissémination du langage des nerfs et à l’appropriation du diagnostic de neurasthénie. Ce mémoire de maîtrise en histoire se penche sur les transformations sociales survenues sous le gouvernement colonial français, dont l’urbanisation et l’instruction publique, au milieu desquelles ont émergé les nouvelles classes moyennes urbaines qui ont adopté le diagnostic de neurasthénie. À partir de la presse vietnamienne de la période, ce travail met l’accent sur l’appropriation, les causes et les traitements de la maladie. Utilisant une approche comparant la neurasthénie en Occident, au Japon et en Chine, pour ensuite présenter son entrée au Viêt Nam, il montre que la domination et donc la subalternité ont compliqué l’accès des colonisés au diagnostic de la maladie moderne neurasthénie, de même qu’à la modernité. Il fournit toutefois un éclairage sur les débuts de l’histoire du diagnostic, encore utilisé de nos jours au Viêt Nam, d’une maladie appelée « la maladie de l’époque ».
At the turn of the 20th century, the diagnostic term neurasthenia – or nervous exhaustion coined by American neurologist George Miller Beard in 1869 – was associated with modern civilization. Hence, the term rapidly spread to most Western countries and as far as Japan. Our contemporary language of stress, burn-out, depression and chronic fatigue syndrome has a history that goes back to the birth of the term neurasthenia. As Vietnam underwent deep sociocultural transformations during the French colonial era, especially during the 1920s and 1930s, life conditions became increasingly conducive to the dissemination of the language of nerves and to the appropriation of the term neurasthenia by middle class Vietnamese. This Master’s thesis on the early history of neurasthenia in Vietnam looks into the social transformations effected by the French colonial government, mainly urbanization and public education, which lead to the emergence of a new vietnamese urban middle class. Based on the vietnamese press of the period, it analyzes the appropriation of the diagnostic term neurasthenia by the Vietnamese, the causes to which they attributed neurasthenia, as well as the main treatments proposed by Vietnamese doctors. After comparing how neurasthenia was appropriated in a few Western countries, as well as in Japan and China, and then showing its appropriation in Vietnam, it shows that colonized status meant a somehow limited access to the “modern” disease neurasthenia, somehow similar to the access to “modernity”, due to political domination. The thesis then sheds light on the early history of a diagnosis still used nowadays in Vietnam, of a disease still called there “the disease of our time”.

Tese de doutoramento em Patrimónios de Influência Portuguesa, no ramo de Arquitetura e Urbanismo, apresentada ao Instituto de Investigação Interdisciplinar da Universidade de Coimbra
Qual o processo de definição urbanística das cidades construídas pela presença portuguesa no Oriente, entre 1503 e 1663? é a questão fundamental a que esta tese se propõe dar uma resposta, com o objetivo de preencher uma das lacunas que persiste no tema do universo urbanístico português: o conhecimento cabal do elo asiático dentro da problemática da urbanística portuguesa. Entre o estabelecimento do primeiro núcleo urbano, Cochim, em 1503, e a sua capitulação para a Companhia das Índias Orientais holandesa, em 1663, enquadra-se o tempo forte da instalação dos portugueses na Ásia, decorrente da Expansão marítima. O objetivo é analisar, dentro da problemática disciplinar do urbanismo, esta fase de instalação, coincidente com a urbanização dos núcleos onde se instalou a presença portuguesa e se deu o seu alargamento para os territórios envolventes. Cidades cabeças de territórios, ancoraram em terra a rede marítima que serviu a empresa da Expansão e, em grande parte sem uma solução de continuidade, vincularam materialidades e comunidades num tempo longo, extensível ao dia de hoje. A dimensão que a Ásia urbanizada acarreta no estudo da urbanística, em particular, pelo confronto e convívio que ocorreu para ser possível a instalação e permanência portuguesa, amplifica a reflexão e o discurso das relações ou disparidades entre culturas urbanísticas e, assim, o âmbito da própria cultura urbanística portuguesa. As afinidades que as comunidades contemporâneas têm com o espaço que habitam, veem e sentem, passam, de igual modo, pelo entendimento e avaliação não só do resultado no presente, mas dos processos que lhe deu origem e transformou. Porque a urbanística é tão só uma pequena parte da cultura, que informa e forma a identidade de uma comunidade. O registo urbanístico que ficou, e aquele que foi rasurado, no fundo, o património urbanístico, tal como o património material, a língua, a gastronomia, a religião, entre outros, tem assim uma aplicação direta em disciplinas cujos conteúdos culturais e sociais são o mote e nas decisões políticas que gerem os espaços e comunidades urbanos. O esclarecimento destas questões e a variedade dos objetos impôs trilhar a análise num horizonte geográfico alargado, determinando, quase de seguida, quais os núcleos urbanos que valeriam um olhar mais profundo. Cochim, Colombo, Malaca, São Tomé de Meliapor e Macau são os objetos que, constituindo-se como uma rede urbana com variantes, melhor articulam os diversos enquadramentos regionais nos quais existe(m) a(s) rede(s) urbana(s) asiática(s) onde foi exercida influência portuguesa. A variedade definiu, de igual modo, a estratégia da análise. A cada caso corresponde um estudo morfológico dos programas e malhas urbanos, focando-se o como, em que condições, quem e quando se pensou e fez a cidade, e como a partir dessas matrizes ela evoluiu. Extrapola-se depois, nos casos que assim o exigem, numa análise da interferência portuguesa no território envolvente, os arrabaldes e o termo. A par e passo a todo este processo é desenhada a história numa base operativa que, tal como o texto, é uma ferramenta de interpretação e de consolidação do conhecimento. Por fim, uma leitura de confronto entre os objetos visa expor os tipos, os mecanismos de atuação, as particularidades que conduziram o desenho urbano, e o nível de intromissão nos territórios. Em resumo, informa o processo de definição urbanística, o qual abre a discussão para dois âmbitos que lhe estão intimamente relacionados: a cultura e o património urbanísticos, que são simultaneamente produtores e produtos dos processos.
What is the process of urban definition on the cities built by the Portuguese presence in Asia, during 1503 and 1663? is the main question this thesis offers to answer, aiming to fulfill one of the persistent gaps in the theme of the Portuguese urbanistic universe: the full knowledge of the Asian link within the problematic of the Portuguese urbanism. Between the establishment of the first urban core, Cochin, in 1503, and its surrender to the Dutch East Indian Company in 1663, the Portuguese installation in Asia, arising from the maritime Expansion, reached its peak. The intention is to analyze, within the urbanism disciplinary field, this installation phase, coincident with the urbanization process of the cores where the Portuguese presence settled and then extended to the surrounding territories. Cities heads of territories anchored on the ground the maritime network that served the Expansion enterprise and, mostly without a solution of continuity, embed materialities and communities in a long timespan, extendable to the present day. The dimension that urbanized Asia involves in the study of urban planning, in particular, through the confrontation and acquaintanceship that happened in order to the Portuguese installation and permanence be possible, amplifies the understanding and the relations or disparities discourse between urban cultures and, thus, the scope of the Portuguese urban culture itself. The affinities that contemporary communities have with the space they inhabit, see and feel, pass, likewise, through the understanding and evaluation not only of the present result, but also the processes that originated and transformed it. Because urban planning is a small section of the culture, that shapes and informs the identity of a community. The remaining urbanistic register, and the one erased, meaning, the urbanistic heritage, as material heritage, language, gastronomy, religion, among others, has a direct application in subjects in which cultural and social contents are the key elements and in political decisions that manage the urban spaces and communities. The search of these questions and the variety the objects presented imposed in the analysis scope a broader geographical horizon, determining, almost immediately, which urban cores would worth a deeper look. Cochin, Colombo, Malacca, Santhome of Mylapore and Macao are the objects that, forming themselves as an urban network with variants, better articulate the different regional frameworks in which there are the Asian urban networks where the Portuguese influence was exercised. The variety also defined the strategy of analysis. To each case corresponds a morphological study of the urban programs and mesh, focused on how, on which conditions, by who and when the city was thought and built, and how from these matrices it evolved. Then, in the cases that required it, an analysis of the Portuguese interference in the surrounding territory is made. Alongside this process, history is drawn on an operational basis, which, like the text, is a tool for the interpretation and knowledge consolidation. Finally, a confrontational reading between the objects aims to expose the types, the mechanisms of action, and the particularities that led the urban design, and the level of involvement in the territories. In brief, it informs the process of urbanistic definition, which opens the discussion to two areas that are closely linked to it: the urbanistics culture and heritage, both producers and products of processes.