Journal articles: 'Urban Malawi'

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Gondwe, Y. Zverev, M. "Growth of urban school children in Malawi." Annals of Human Biology 28, no. 4 (January 2001): 384–94. http://dx.doi.org/10.1080/03014460010013016.

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KALIPENI, EZEKIEL. "CONTAINED URBAN GROWTH IN POST-INDEPENDENCE MALAWI." East African Geographical Review 19, no. 2 (December 1997): 49–66. http://dx.doi.org/10.1080/00707961.1997.9756247.

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Zeleza Manda, Mtafu A. "Mchenga — urban poor housing fund in Malawi." Environment and Urbanization 19, no. 2 (October 2007): 337–59. http://dx.doi.org/10.1177/0956247807082818.

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McCRACKEN, JOHN. "BLANTYRE TRANSFORMED: CLASS, CONFLICT AND NATIONALISM IN URBAN MALAWI." Journal of African History 39, no. 2 (July 1998): 247–69. http://dx.doi.org/10.1017/s0021853797007093.

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There are good reasons why the remarkable outpouring of work on Southern African urban history that has taken place over the last twenty years has largely bypassed Malawi. To the overwhelmingly rural character of the Malawi economy must be added the weak impact of settler colonialism in the interwar period and hence the failure of Blantyre, one of the oldest colonial settlements in Central Africa, with a history going back to the foundation of the Blantyre mission in 1876, to develop as a substantial commercial centre. This feature was reinforced in turn by Sir Harry Johnston's decision, taken in 1891, to site the colonial capital at Zomba and by the construction in 1907 at Limbe, five miles from Blantyre, of the railway terminus for the protectorate.Urban development in Malawi was therefore not concentrated on a single dominant commercial and administrative centre, as was the case in neighbouring Tanganyika. Rather it was split between three equally impoverished settlements, containing small populations ranging in size in 1945 from approximately 4,600 in Blantyre and Zomba to 7,100 in Limbe. Far more Malawians, in consequence, experienced urban culture as labour migrants in Johannesburg or Salisbury, where an estimated 10,000 Malawians were living in 1938, than they did working at home.

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Brown, Donald. "The strengths and limitations of using hospital records to assess environmental health in Karonga, Malawi." Environment and Urbanization 32, no. 1 (July 18, 2019): 233–56. http://dx.doi.org/10.1177/0956247819860068.

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This paper explains the methods that were used to study environmental health problems in Karonga, a rapidly growing secondary urban centre in Malawi. The study used existing information from hospital records and consulted local health officials and academics on how best to use it. The aim was to position the hospital as a disease surveillance site by using its records to generate disaggregated health data at the intra-urban scale. This paper identifies the strengths and limitations of using hospital data to inform joint urban planning and public health interventions. It also provides a summary of the key findings, including a discussion of the implications for enhancing urban health intelligence and urban policy formulation in Malawi and other rapidly urbanizing countries. This paper is intended to show researchers how existing information in low-resource settings can be used to generate needed health data for urban populations, with a particular interest in secondary centres.

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Pratt, Michael, James F. Sallis, Kelli L. Cain, Terry L. Conway, Amparo Palacios-Lopez, Alberto Zezza, Chad Spoon, et al. "Physical activity and sedentary time in a rural adult population in Malawi compared with an age-matched US urban population." BMJ Open Sport & Exercise Medicine 6, no. 1 (October 2020): e000812. http://dx.doi.org/10.1136/bmjsem-2020-000812.

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ObjectivesThis study was designed to assess patterns of objectively measured physical activity (PA) and sedentary behaviour in a sample of adults in a rural setting from a low-income Sub-Saharan African country (Malawi). The patterns of PA and sedentary behaviour in Malawi were compared with US data collected and analysed using the same methodology.MethodsThe Malawi PA data were collected as part of a survey experiment on the measurement of agricultural labor conducted under the World Bank Living Standards Measurement Study program. ActiGraph accelerometers (model GT3X) were worn on the right hip in a household-based sample of 414 working-age adults (15–85 years).ResultsMean total and 95% CIs for PA by category in min/day for Malawi adults were: sedentary 387.6 (377.4–397.8), low-light 222.1 (214.7–229.5), high-light 136.3 (132.7–139.9), moderate 71.6 (68.8–74.5), vigorous 1.1 (0.5–1.8) and moderate-to-vigorous physical activity (MVPA) 72.8 (69.7–75.9). Mean of PA and sedentary behavior (min/day) summed across age and sex groups are compared between Malawi and US samples: sedentary behaviour, 387.6 vs 525.8 (p<0.001); low-light, 222.1 vs 217.0 (p=ns); high-light, 136.3 vs 45.6 (p<0.001); moderate, 71.6 vs 28.0 (p<0.001); vigorous, 1.1 vs 2.5 (p<0.001); MVPA, 72.8 vs 30.5 (p<0.001). Compared with the USA, Malawi participants averaged consistently less sedentary time/day and more minutes/day in all intensity levels of PA, except for low-light and vigorous PA.ConclusionOverall, levels of MVPA and high-light activity in adults in Malawi were substantially higher and sedentary time was substantially lower than those observed in US samples using near identical data collection, scoring and analysis.

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Breeveld, Richenel, Leon Hermans, and Siemen Veenstra. "Water operator partnerships and institutional capacity development for urban water supply." Water Policy 15, S2 (November 1, 2013): 165–82. http://dx.doi.org/10.2166/wp.2013.018.

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One way in which international water operator partnerships can contribute to capacity development is through the exchange of experiences with water institutions in different countries. This paper looks at a partnership between water operators in the Netherlands and Malawi to see to what extent institutional experiences in the Netherlands can contribute to capacity development of the Lilongwe Water Board in Malawi. For this, it combines insights from policy transfer, with a conceptual framework based on the Institutional Analysis and Development framework. Stylized game theoretic models are used to analyze in-depth the institutional (dis)incentives that contribute to improved performance for customers. Experiences in the Netherlands are analyzed by studying four specific action situations, such as asset management at drinking water company Vitens NV. Potential lessons are derived from this, which are evaluated for potential transfer to Malawi. The analysis suggests ways in which improved information gathering and data management can support allocation of investment and budgets for operation and maintenance. Furthermore, it suggests ways to increase the frequency of encounters between government and financing institutions and water utilities, as well as the use of a system of benchmarking to provide a platform for sharing best practices and to create competition.

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Dijk, Richard A. van. "Young puritan preachers in post-independence Malawi." Africa 62, no. 2 (April 1992): 159–81. http://dx.doi.org/10.2307/1160453.

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AbstractIn Blantyre, Malawi's main urban centre with a population of over 400,000, there are some thirty to forty young preachers who between them run fifteen or so organisations that constitute the Born Again movement. The organisations include ‘ministries’ and ‘fellowships’ as well as ‘churches’. The movement started c.1974. What is significant is that all the leaders were then teenagers; even today the second ‘generation’ of preachers are teenagers or in their early twenties. One theme dominates their message: vehement opposition to involvement in practices of a largely secretive or malevolent nature, witchcraft and ‘politics’ in particular. The young preachers assume these forces to be the basis of the power that elders wield in the villages or in urban townships. Yet in Blantyre, where political surveillance over everyday life is very marked, they have to be wary of challenging this older, powerful generation if they are to preserve the ‘intellectual space’ that religion offers them. The article ends by arguing that the theories which are used to explain urban Zionist Churches elsewhere in southern Africa are not relevant to the analysis of a Born Again movement run by successful young urbanites.

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Godlonton, Susan. "Employment Exposure: Employment and Wage Effects in Urban Malawi." Economic Development and Cultural Change 68, no. 2 (January 2020): 471–506. http://dx.doi.org/10.1086/700635.

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Riley, Liam, and Belinda Dodson. "Intersectional identities: Food, space and gender in urban Malawi." Agenda 30, no. 4 (October 2016): 53–61. http://dx.doi.org/10.1080/10130950.2017.1299970.

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Kamanga, Chimwemwe. "Who speaks Chibrazi, the urban contact vernacular of Malawi?" Language Matters 45, no. 2 (May 4, 2014): 257–75. http://dx.doi.org/10.1080/10228195.2014.910249.

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Zverev, Y. P. "Cultural and environmental pressure against left-hand preference in urban and semi-urban Malawi." Brain and Cognition 60, no. 3 (April 2006): 295–303. http://dx.doi.org/10.1016/j.bandc.2005.07.008.

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Brown, Donald. "Towards a comparative research agenda on in situ urbanisation and rural governance transformation." International Development Planning Review: Volume 43, Issue 3 43, no. 3 (June 1, 2021): 289–320. http://dx.doi.org/10.3828/idpr.2020.15.

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This article explores how rural settlements urbanise, and how rural governance transforms in the process. The question is motivated by the significant contribution that smaller urban centres are projected to make to the world’s future urban growth, the majority of which will occur in the global South. Many smaller centres are emerging through in situ urbanisation, wherein a rural settlement becomes urban. Given the importance of small town growth, the article proposes a comparative research agenda with the aim of exploring and comparing the institutional transformations occurring in ‘transitional spaces’, the governance complexities these transformations present and the consequences for establishing urban planning systems in historically rural settlements. The agenda is operationalised in sub-Saharan Africa through a case study of Karonga Town, an emerging urban centre in Malawi. The agenda draws on a varied body of case-study research on small town growth and rural transformation in sub-Saharan Africa generally and Malawi specifically. The agenda has the potential to make a significant contribution to the literature seeking to reveal the informality in different governance landscapes and the forms of urbanisation in which these landscapes are embedded in sub-Saharan Africa and beyond.

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Segal, Edwin S. "Projections of Internal Migration in Malawi: Implications for Development." Journal of Modern African Studies 23, no. 2 (June 1985): 315–29. http://dx.doi.org/10.1017/s0022278x00000197.

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Most of the world's developing nations are primarily rural and agricultural. Therefore, governments have tended to place a policy emphasis on development in those sectors, usually as a result of employing the relatively straightforward argument that they should focus on the needs of the largest proportion of the inhabitants. The movement of population is generally seen in the light of rural–urban migration, although there is some evidence and opinion that this is not per se as massive as usually estimated. In addition, Rakesh Mohan has developed an economic model that suggests a close linkage between the success of rural development policies and an expansion in urbanisation, based on the assumption that the former increase both demand for and awareness of urban goods and services, resulting in a greater propensity for people to move to those places where these resources are most readily availabe. Thus, the more it has to turn its attention to the urban consequences.

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Crumlish, Niall, Prince Samalani, Anthony Sefasi, Anthony Kinsella, Eadbhard O'Callaghan, and Harris Chilale. "Insight, psychopathology and global functioning in schizophrenia in urban Malawi." British Journal of Psychiatry 191, no. 3 (September 2007): 262–63. http://dx.doi.org/10.1192/bjp.bp.107.036673.

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SummaryInsight, psychopathology and functioning are related in schizophrenia, but it is unclear whether insight relates independently to functioning after controlling for psychopathology. Equally, any such relationship may vary culturally. We investigated the relationship between insight, psychopathology and functioning in 60 patients with schizophrenia in Mzuzu, a town in Malawi. After controlling for psychopathology, functioning was associated with the ‘symptom relabelling’ dimension of insight (P=0.01). This preliminary finding suggests that symptom-focused psychoeducation might be appropriate for African patients with schizophrenia.

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Nwanyanwu, Okey, Daniel Nyangulu, and Felix Salaniponi. "Persistent Cough in Patients Using an Urban Chest Clinic in Malawi." Tropical Doctor 26, no. 4 (October 1996): 165–67. http://dx.doi.org/10.1177/004947559602600408.

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In many sub-Saharan African countries, tuberculosis (TB) cases have been increasing steadily since 1985. In Malawi, they have increased by 38% from 1990 to 1993, and extrapulmonary TB increased by 79%. Among 385 patients with a history of persistent cough presumed to be TB, 360 (94%) initially consented to be tested for both HIV and TB. Of these, 301 completed testing and 95% returned for their test results. Among test completers ( n = 301), 280 (93%) were found to be HIV-infected. Seropositivity rates were similar for males and females, and higher for urban dwellers than for rural dwellers (94% versus 79%). TB was found in only 48 (16%) patients. Among TB patients, 33 (77%) were HIV positive. This study suggests that TB may not be the main cause of persistent cough among persons using urban chest clinics in Malawi; HIV without sputum positive TB appears to be a major contributor. Clinicians in areas of high HIV prevalence should therefore suspect other HIV-related infections in a patient with persistent cough and in whom TB has been ruled out.

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Newell, Jonathan. "‘A Moment of Truth’? The Church and Political Change in Malawi, 1992." Journal of Modern African Studies 33, no. 2 (June 1995): 243–62. http://dx.doi.org/10.1017/s0022278x00021054.

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The immediate origins of the democratic elections held in Malawi in 1994, which brought to an end over 30 years of political dominance by President Kamuzu Banda and the Malawi Congress Party (MCP), lie in the unprecedented events which shook the entire nation in 1992. Although that turbulent year was characterised by industrial action, serious urban riots, student demonstrations, the emergence of new domestic political groupings, and the Government's agreement to hold a national referendum on the future of the one-party system in the country, in retrospect perhaps what was most remarkable about these developments was that they were sparked off by the Catholic Church, and that their momentum was sustained at crucial stages by other Christian denominations in Malawi.1

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Afolabi, Rotimi Felix, and Martin Enock Palamuleni. "Multilevel analysis of unhealthy bodyweight among women in Malawi: Does urbanisation matter?" PLOS ONE 16, no. 3 (March 29, 2021): e0249289. http://dx.doi.org/10.1371/journal.pone.0249289.

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Background Underweight and overweight constitute unhealthy bodyweight and their coexistence is symptomatic of the dual burden of malnutrition (DBM) of high public health concern in many sub-Saharan Africa countries. Little is known about DBM and its correlates in Malawi, a country undergoing urbanisation. The study examined net effects of urban residence on unhealthy weights amidst individual- and community-level factors among women in Malawi. Methods Data on 7231 women aged 15–49 years nested within 850 communities extracted from 2015–16 Malawi Demographic and Health Survey were analysed. Women’s weight status measured by body mass index, operationally categorised as underweight, normal and overweight, was the outcome variable while urban-rural residence was the main explanatory variable. Multilevel multinomial logistic regression analysis was employed at 5% significant level; the relative-risk ratio (RR) and its 95% confidence interval (CI) were presented. Results Urban residents had a significantly higher prevalence of overweight than rural (36.4% vs. 17.2%; p< 0.001) but a -non-significant lower prevalence of underweight (6.2% vs. 7.4%; p = 0.423). Having adjusted for both individual- and community-level covariates, compared to rural, living in urban (aRR = 1.25; CI: 1.02–1.53) accounted for about 25% higher risk of being overweight relative to normal weight. Higher education attainment, being married and belonging to Chewa, Lomwe or Mang’anja ethnic group significantly reduced the risk of being underweight but heightened the risk of being overweight. Being older and living in wealthier households respectively accounted for about 3- and 2-times higher likelihood of being overweight, while breastfeeding (aRR = 0.65; CI: 0.55–0.76) was protective against overweight. Living in communities with higher poverty and higher education levels reduced and increased the risk of being overweight, respectively. Evidence of community’s variability in unhealthy weights was observed in that 11.1% and 3.0% respectively of the variance in the likelihood of being overweight and underweight occurred across communities. Conclusions The study demonstrated association between urban residence and women overweight. Other important associated factors of overweight included breastfeeding, community education- and poverty-level, while education attainment, marital status and ethnicity were associated with the dual unhealthy weight. Thus, both individual- and community-level characteristics are important considerations for policy makers in designing interventions to address DBM in Malawi.

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Kalua, Amos. "Urban Residential Building Energy Consumption by End-Use in Malawi." Buildings 10, no. 2 (February 18, 2020): 31. http://dx.doi.org/10.3390/buildings10020031.

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Buildings account for about 40% of the global energy consumption and this energy demand is projected to continue growing over the next few decades. Residential buildings are responsible for over 60% of this consumption pattern with commercial buildings being responsible for the remainder. While residential building energy consumption constitutes about 20% of the total consumption in the developed world, it constitutes up to more than 50% in the sub-Sahara African region. The growing consumption of energy has raised concerns over the impacts on the environment, supply difficulties, and depletion of resources. In efforts toward addressing these concerns, the need for effective management of energy resources and adequate planning for energy infrastructure cannot be overemphasized within the building industry in general and the residential building sector in particular. Toward this end, it is necessary to ensure that high quality and high-resolution information on the consumption of energy in buildings is made available. Unfortunately, in many countries within the sub-Sahara African region, building energy consumption information is hardly ever readily available. This study seeks to make a contribution toward this facet of the literature at the greater regional level in general and particularly, in Malawi, a country located in the southern part of Africa. With a grounding in the context of urban residential buildings, the study identifies the key energy end-uses, investigates the proportional mixes of the end-uses and the energy sources and, finally, establishes the periodical per capita energy consumption amounts for the end-uses and the typical residential building unit.

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Kalua, Amos. "Envelope Thermal Design Optimization for Urban Residential Buildings in Malawi." Buildings 6, no. 2 (April 13, 2016): 13. http://dx.doi.org/10.3390/buildings6020013.

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Riley, Liam. "Operation Dongosolo and the Geographies of Urban Poverty in Malawi." Journal of Southern African Studies 40, no. 3 (May 4, 2014): 443–58. http://dx.doi.org/10.1080/03057070.2014.913425.

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Shacham, Enbal, Rebecca Thornton, Susan Godlonton, Ryan Murphy, and Jake Gilliland. "Geospatial analysis of condom availability and accessibility in urban Malawi." International Journal of STD & AIDS 27, no. 1 (February 13, 2015): 44–50. http://dx.doi.org/10.1177/0956462415571373.

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Lewis, Joseph M., Michael Abouyannis, Grace Katha, Mulinda Nyirenda, Grace Chatsika, Nicholas A. Feasey, and Jamie Rylance. "Population Incidence and Mortality of Sepsis in an Urban African Setting, 2013–2016." Clinical Infectious Diseases 71, no. 10 (November 14, 2019): 2547–52. http://dx.doi.org/10.1093/cid/ciz1119.

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Abstract Background Sepsis is an important cause of mortality globally, although population incidence estimates from low-income settings, including sub-Saharan Africa, are absent. We aimed to estimate sepsis incidence burden using routinely available data from a large urban hospital in Malawi. Methods We linked routine-care databases at Queen Elizabeth Central Hospital, Blantyre, Malawi, to provide admission and discharge data for 217 149 adults from 2013–2016. Using a definition of sepsis based on systemic inflammatory response syndrome criteria and Blantyre census population data, we calculated population incidence estimates of sepsis and severe sepsis and used negative binomial regression to assess for trends over time. Missing data were multiply imputed with chained equations. Results We estimate that the incidence rate of emergency department–attending sepsis and severe sepsis in adults was 1772 per 100 000 person-years (95% confidence interval [CI], 1754–1789) and 303 per 100 000 person-years (95% CI, 295–310), respectively, between 2013 and 2016, with a year-on-year decrease in incidence. In-hospital mortality for patients admitted to the hospital with sepsis and severe sepsis was 23.7% (95% CI, 22.7–24.7%) and 28.1% (95% CI, 26.1 – 30.0%), respectively, with no clear change over time. Conclusions Sepsis incidence is higher in Blantyre, Malawi, than in high-income settings, from where the majority of sepsis incidence data are derived. Worldwide sepsis burden is likely to be underestimated, and data from low-income countries are needed to inform the public health response.

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EPSTEIN, MARC J., and KRISTI YUTHAS. "RURAL MICROFINANCE AND CLIENT RETENTION: EVIDENCE FROM MALAWI." Journal of Developmental Entrepreneurship 18, no. 01 (March 2013): 1350006. http://dx.doi.org/10.1142/s1084946713500064.

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Microfinance institutions (MFIs) have largely focused on urban markets, leaving the rural poor underserved. The high costs of serving rural markets has often been identified as the key impediment to serving these markets, resulting in saturation and heavy competition in urban markets while poor rural clients remain unserved. In this paper, we provide evidence from a sample of over 10,000 microfinance loans in Malawi, that the cost argument has an important flaw. Results show that client retention, a critical aspect of financial sustainability, is significantly higher in rural markets. In addition to being a key financial indicator in an industry where annual client exit rates can exceed 50 percent, client retention is also a key measure of social impact. By operating in rural markets, MFIs may be able to increase both social impact and financial performance.

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Zverev, Y. P., and M. Mipando. "Cultural and environmental influences on footedness: Cross-sectional study in urban and semi-urban Malawi." Brain and Cognition 65, no. 2 (November 2007): 177–83. http://dx.doi.org/10.1016/j.bandc.2007.07.008.

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Chilunga, Felix P., Crispin Musicha, Terence Tafatatha, Steffen Geis, Moffat J. Nyirenda, Amelia C. Crampin, and Alison J. Price. "Investigating associations between rural-to-urban migration and cardiometabolic disease in Malawi: a population-level study." International Journal of Epidemiology 48, no. 6 (October 11, 2019): 1850–62. http://dx.doi.org/10.1093/ije/dyz198.

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Abstract Background The extent to which rural-to-urban migration affects risk for cardiometabolic diseases (CMD) in Africa is not well understood. We investigated prevalence and risk for obesity, diabetes, hypertension and precursor conditions by migration status. Methods In a cross-sectional survey in Malawi (February 2013–March 2017), 13 903 rural, 9929 rural-to-urban migrant and 6741 urban residents (≥18 years old) participated. We interviewed participants, measured blood pressure and collected anthropometric data and fasting blood samples to estimate population prevalences and odds ratios, using negative binomial regression, for CMD, by migration status. In a sub-cohort of 131 rural–urban siblings-sets, migration-associated CMD risk was explored using conditional Poisson regression. Results In rural, rural-to-urban migrant and urban residents, prevalence estimates were; 8.9, 20.9 and 15.2% in men and 25.4, 43.9 and 39.3% in women for overweight/obesity; 1.4, 2.9 and 1.9% in men and 1.5, 2.8 and 1.7% in women for diabetes; and 13.4, 18.8 and 12.2% in men and 13.7, 15.8 and 10.2% in women for hypertension. Rural-to-urban migrants had the greatest risk for hypertension (adjusted relative risk for men 1.18; 95% confidence interval 1.04–1.34 and women 1.17: 95% confidence interval 1.05–1.29) and were the most screened, diagnosed and treated for CMD, compared with urban residents. Within sibling sets, rural-to-urban migrant siblings had a higher risk for overweight and pre-hypertension, with no evidence for differences by duration of stay. Conclusions Rural-to-urban migration is associated with increased CMD risk in Malawi. In a poor country experiencing rapid urbanization, interventions for the prevention and management of CMD, which reach migrant populations, are needed.

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Mzumara, Grace W., Marlen Chawani, Melody Sakala, Lily Mwandira, Elias Phiri, Edith Milanzi, Mphatso Dennis Phiri, et al. "The health policy response to COVID-19 in Malawi." BMJ Global Health 6, no. 5 (May 2021): e006035. http://dx.doi.org/10.1136/bmjgh-2021-006035.

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Malawi declared a state of national disaster due to the COVID-19 pandemic on 20th March 2020 and registered its first confirmed coronavirus case on the 2 April 2020. The aim of this paper was to document policy decisions made in response to the COVID-19 pandemic from January to August 2020. We reviewed policy documents from the Public Health Institute of Malawi, the Malawi Gazette, the Malawi Ministry of Health and Population and the University of Oxford Coronavirus Government Response Tracker. We found that the Malawi response to the COVID-19 pandemic was multisectoral and implemented through 15 focused working groups termed clusters. Each cluster was charged with providing policy direction in their own area of focus. All clusters then fed into one central committee for major decisions and reporting to head of state. Key policies identified during the review include international travel ban, school closures at all levels, cancellation of public events, decongesting workplaces and public transport, and mandatory face coverings and a testing policy covering symptomatic people. Supportive interventions included risk communication and community engagement in multiple languages and over a variety of mediums, efforts to improve access to water, sanitation, nutrition and unconditional social-cash transfers for poor urban and rural households.

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Chibwana, Marah G., Khuzwayo C. Jere, Raphael Kamng'ona, Jonathan Mandolo, Vincent Katunga-Phiri, Dumizulu Tembo, Ndaona Mitole, et al. "High SARS-CoV-2 seroprevalence in health care workers but relatively low numbers of deaths in urban Malawi." Wellcome Open Research 5 (August 25, 2020): 199. http://dx.doi.org/10.12688/wellcomeopenres.16188.1.

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Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

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Chibwana, Marah G., Khuzwayo C. Jere, Raphael Kamng'ona, Jonathan Mandolo, Vincent Katunga-Phiri, Dumizulu Tembo, Ndaona Mitole, et al. "High SARS-CoV-2 seroprevalence in health care workers but relatively low numbers of deaths in urban Malawi." Wellcome Open Research 5 (December 18, 2020): 199. http://dx.doi.org/10.12688/wellcomeopenres.16188.2.

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Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

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Andersson, Agnes. "Maize remittances, smallholder livelihoods and maize consumption in Malawi." Journal of Modern African Studies 49, no. 1 (February 11, 2011): 1–25. http://dx.doi.org/10.1017/s0022278x10000637.

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ABSTRACTThis article explores the phenomenon of in-kind remittances of maize and its implications for rural household livelihoods and food consumption. Interviews with a sample of 391 households in eight villages in Malawi are used to substantiate the discussion. Explanations for in-kind remittances are sought in the micro-level interaction between the formal market realm, informalised exchange systems and the household. Remittances are not connected to lower commercialisation levels, suggesting that the explanation for remittances should be sought in the production and consumption patterns of the households. Remittances function as an important redistributive mechanism for food across space. The role of smallholder food production for urban livelihoods as well as the subsistence responsibilities of rural households are underestimated if agrarian household level linkages from rural to urban areas are not recognised in national production and consumption surveys and among policy makers.

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Tione, Sarah E., and Stein T. Holden. "Urban proximity, demand for land and land shadow prices in Malawi." Land Use Policy 94 (May 2020): 104509. http://dx.doi.org/10.1016/j.landusepol.2020.104509.

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Mpakati-Gama, Effiness C., Andrew Brown, and Brian Sloan. "Embodied energy and carbon analysis of urban residential buildings in Malawi." International Journal of Construction Management 16, no. 1 (December 2, 2015): 1–12. http://dx.doi.org/10.1080/15623599.2015.1110274.

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Rutstein, S. E., L. B. Brown, A. K. Biddle, S. B. Wheeler, G. Kamanga, P. Mmodzi, N. Nyirenda, et al. "Cost-effectiveness of provider-based HIV partner notification in urban Malawi." Health Policy and Planning 29, no. 1 (January 15, 2013): 115–26. http://dx.doi.org/10.1093/heapol/czs140.

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Amberbir, Alemayehu, Victor Singano, Alfred Matengeni, Zahra Ismail, Gift Kawalazira, Adrienne K. Chan, Sumeet D. Sodhi, and Joep J. van Oosterhout. "Dyslipidemia among rural and urban HIV patients in south-east Malawi." PLOS ONE 13, no. 5 (May 21, 2018): e0197728. http://dx.doi.org/10.1371/journal.pone.0197728.

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Simmons, D., G. Barbour, J. Congleton, J. Levy, P. Meacher, H. Saul, and T. Sowerby. "Blood pressure and salt intake in Malawi: an urban rural study." Journal of Epidemiology & Community Health 40, no. 2 (June 1, 1986): 188–92. http://dx.doi.org/10.1136/jech.40.2.188.

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Holm, Rochelle H., Alinafe Kamangira, Mavuto Tembo, Victor Kasulo, Hastings Kandaya, Peter Gijs Van Enk, and Alex Velzeboer. "Sanitation service delivery in smaller urban areas (Mzuzu and Karonga, Malawi)." Environment and Urbanization 30, no. 2 (April 3, 2018): 597–612. http://dx.doi.org/10.1177/0956247818766495.

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This paper assesses the provision of sanitation services in two urban areas in northern Malawi, both with populations under 150,000, to determine the potential for private sector enterprises to contribute to longer-term self-reliance as part of the overall sanitation situation. The paper shows that most households in the two study areas use pit latrines and remain unserved with regard to both faecal sludge management and solid waste removal. Local governments have been unable to offer adequate coverage of sanitation services, and community-based organizations are doing very little that is relevant to the issue. This gap offers a viable business opportunity for private sanitation service providers. Of these two urban areas, Karonga Town has no formal private sector services, but Mzuzu City has pit emptying and solid waste collection services, plus some small-scale manufacturers of pre-made pit latrine slabs. The paper explores these activities, considering their accessibility to low-income customers. It closes with suggestions regarding the potential for building on what is currently available.

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Kita, Stern Mwakalimi. "Urban vulnerability, disaster risk reduction and resettlement in Mzuzu city, Malawi." International Journal of Disaster Risk Reduction 22 (June 2017): 158–66. http://dx.doi.org/10.1016/j.ijdrr.2017.03.010.

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Kayange, Albert K. M. Y. "Contradicting Learning Environments between Rural and Urban: The Case of Malawi." Journal of Information Technologies and Lifelong Learning 3, no. 1 (December 31, 2020): 170–76. http://dx.doi.org/10.20533/jitll.2633.7681.2020.0023.

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Gondwe, James, Mtafu Zeleza A. Manda, and Dominic Kamlomo. "Discriminatory land use planning and flood risk management in Karonga Town, Malawi." Journal of Human Sciences 14, no. 4 (October 30, 2017): 3343. http://dx.doi.org/10.14687/jhs.v14i4.4706.

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This study examines how discriminatory land use planning predisposes the low income residents to flood disaster risks in Karonga town, Malawi. Using a qualitative research design, in-depth interviews were conducted with ten government and non government institutions engaged in land use planning and disaster risk management and traditional leaders. The study showed that theoretical aims of land use planning to improve the living environment remain partial and in certain cases exacerbate risks posed by floods because the planning tool divides the urban landscape into formal and informal spaces. Such separation which coincided with incomes levels forced the marginalised and urban poor to occupy flood-prone areas While literature on flood control promotes an integrated approach to flood risk management, land use planning practice is singled out as a regulatory measure which ironically not only fails to meet the needs, but also increases vulnerability to flood risks, of the urban poor residents. The study further revealed that land use planning has failed to reduce flood disaster risks in informal spaces because it is not compatible with the needs of the urban poor.

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BRODISH, PAUL HENRY. "AN ASSOCIATION BETWEEN ETHNIC DIVERSITY AND HIV PREVALENCE IN SUB-SAHARAN AFRICA." Journal of Biosocial Science 45, no. 6 (January 10, 2013): 853–62. http://dx.doi.org/10.1017/s002193201200082x.

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SummaryThis paper investigates whether ethnic diversity at the Demographic and Health Surveys (DHS) cluster level predicts HIV serostatus in three sub-Saharan African countries (Kenya, Malawi and Zambia), using DHS household survey and HIV biomarker data for men and women aged 15–59 collected since 2006. The analysis relates a binary dependent variable (HIV positive serostatus) and a weighted aggregate predictor variable representing the number of different ethnic groups within a DHS Statistical Enumeration Area (SEA) or cluster, which roughly corresponds to a neighbourhood. Multilevel logistic regression is used to predict HIV prevalence within each SEA, controlling for known demographic, social and behavioural predictors of HIV serostatus. The key finding was that the cluster-level ethnic diversity measure was a significant predictor of HIV serostatus in Malawi and Zambia but not in Kenya. Additional results reflected the heterogeneity of the epidemics: male gender, marriage (Kenya), number of extramarital partners in the past year (Kenya and Malawi, but probably confounded with younger age) and Muslim religion (Zambia) were associated with lower odds of positive HIV serostatus. Condom use at last intercourse (a spurious result probably reflecting endogeneity), STD in the past year, number of lifetime sexual partners, age (Malawi and Zambia), education (Zambia), urban residence (Malawi and Zambia) and employment (Kenya and Malawi) were associated with higher odds of positive serostatus. Future studies might continue to employ multilevel models and incorporate additional, more robust, controls for individual behavioural risk factors and for higher-level social and economic factors, in order to verify and further clarify the association between neighbourhood ethnic diversity and HIV serostatus.

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Prynn, Josephine E., Louis Banda, Alemayehu Amberbir, Alison J. Price, Ndoliwe Kayuni, Shabbar Jaffar, Amelia C. Crampin, Liam Smeeth, and Moffat Nyirenda. "Dietary sodium intake in urban and rural Malawi, and directions for future interventions." American Journal of Clinical Nutrition 108, no. 3 (June 30, 2018): 587–93. http://dx.doi.org/10.1093/ajcn/nqy125.

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ABSTRACT Background High dietary sodium intake is a major risk factor for hypertension. Data on population sodium intake are scanty in sub-Saharan Africa, despite a high hypertension prevalence in most countries. Objective We aimed to determine daily sodium intake in urban and rural communities in Malawi. Design In an observational cross-sectional survey, data were collected on estimated household-level per capita sodium intake, based on how long participants reported that a defined quantity of plain salt lasts in a household. In a subset of 2078 participants, 24-h urinary sodium was estimated from a morning spot urine sample. Results Of 29,074 participants, 52.8% of rural and 50.1% of urban individuals lived in households with an estimated per capita plain salt consumption >5 g/d. Of participants with urinary sodium data, 90.8% of rural and 95.9% of urban participants had estimated 24-h urinary sodium >2 g/d; there was no correlation between household per capita salt intake and estimated 24-h urinary sodium excretion. Younger adults were more likely to have high urinary sodium and to eat food prepared outside the home than were those over the age of 60 y. Households with a member with previously diagnosed hypertension had reduced odds (OR: 0.59; 95% CI: 0.51, 0.68) of per capita household plain salt intake >5 g/d, compared with those where hypertension was undiagnosed. Conclusions Sodium consumption exceeds the recommended amounts for most of the population in rural and urban Malawi. Population-level interventions for sodium intake reduction with a wide focus are needed, targeting both sources outside the home as well as home cooking. This trial was registered at clinicaltrials.gov as NCT03422185.

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Schade, Alexander Thomas, Foster Mbowuwa, Paul Chidothi, Peter MacPherson, Simon Matthew Graham, Claude Martin, William James Harrison, and Linda Chokotho. "Epidemiology of fractures and their treatment in Malawi: Results of a multicentre prospective registry study to guide orthopaedic care planning." PLOS ONE 16, no. 8 (August 4, 2021): e0255052. http://dx.doi.org/10.1371/journal.pone.0255052.

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Importance Injuries cause 30% more deaths than HIV, TB and malaria combined, and a prospective fracture care registry was established to investigate the fracture burden and treatment in Malawi to inform evidence-based improvements. Objective To use the analysis of prospectively-collected fracture data to develop evidence-based strategies to improve fracture care in Malawi and other similar settings. Design Multicentre prospective registry study. Setting Two large referral centres and two district hospitals in Malawi. Participants All patients with a fracture (confirmed by radiographs)—including patients with multiple fractures—were eligible to be included in the registry. Exposure All fractures that presented to two urban central and two rural district hospitals in Malawi over a 3.5-year period (September 2016 to March 2020). Main outcome(s) and measure(s) Demographics, characteristics of injuries, and treatment outcomes were collected on all eligible participants. Results Between September 2016 and March 2020, 23,734 patients were enrolled with a median age of 15 years (interquartile range: 10–35 years); 68.7% were male. The most common injuries were radius/ulna fractures (n = 8,682, 36.8%), tibia/fibula fractures (n = 4,036, 17.0%), humerus fractures (n = 3,527, 14.9%) and femoral fractures (n = 2,355, 9.9%). The majority of fractures (n = 21,729, 91.6%) were treated by orthopaedic clinical officers; 88% (20,885/2,849) of fractures were treated non-operatively, and 62.7% were treated and sent home on the same day. Open fractures (OR:53.19, CI:39.68–72.09), distal femoral fractures (OR:2.59, CI:1.78–3.78), patella (OR:10.31, CI:7.04–15.07), supracondylar humeral fractures (OR:3.10, CI:2.38–4.05), ankle fractures (OR:2.97, CI:2.26–3.92) and tibial plateau fractures (OR:2.08, CI:1.47–2.95) were more likely to be treated operatively compared to distal radius fractures. Conclusions and relevance The current model of fracture care in Malawi is such that trained orthopaedic surgeons manage fractures operatively in urban referral centres whereas orthopaedic clinical officers mainly manage fractures non-operatively in both district and referral centres. We recommend that orthopaedic surgeons should supervise orthopaedic clinical officers to manage non operative injuries in central and district hospitals. There is need for further studies to assess the clinical and patient reported outcomes of these fracture cases, managed both operatively and non-operatively.

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Soares, Ana Luiza G., Louis Banda, Alemayehu Amberbir, Shabbar Jaffar, Crispin Musicha, Alison Price, Moffat J. Nyirenda, Debbie A. Lawlor, and Amelia Crampin. "Sex and area differences in the association between adiposity and lipid profile in Malawi." BMJ Global Health 4, no. 5 (September 2019): e001542. http://dx.doi.org/10.1136/bmjgh-2019-001542.

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BackgroundEvidence from high-income countries shows that higher adiposity results in an adverse lipid profile, but it is unclear whether this association is similar in Sub-Saharan African (SSA) populations. This study aimed to assess the association between total and central adiposity measures and lipid profile in Malawi, exploring differences by sex and area of residence (rural/urban).MethodsIn this cross-sectional study, data from 12 096 rural and 12 847 urban Malawian residents were used. The associations of body mass index (BMI) and waist to hip ratio (WHR) with fasting lipids (total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and triglycerides (TG)) were assessed by area and sex.ResultsAfter adjusting for potential confounders, higher BMI and WHR were linearly associated with increased TC, LDL-C and TG and reduced HDL-C. BMI was more strongly related to fasting lipids than was WHR. The associations of adiposity with adverse lipid profile were stronger in rural compared with urban residents. For instance, one SD increase in BMI was associated with 0.23 mmol/L (95% CI 0.19 to 0.26) increase in TC in rural women and 0.13 mmol/L (95% CI 0.11 to 0.15) in urban women. Sex differences in the associations between adiposity and lipids were less evident.ConclusionsThe consistent associations observed of higher adiposity with adverse lipid profiles in men and women living in rural and urban areas of Malawi highlight the emerging adverse cardio-metabolic epidemic in this poor population. Our findings underline the potential utility of BMI in estimating cardiovascular risk and highlight the need for greater investment to understand the long-term health outcomes of obesity and adverse lipid profiles and the extent to which lifestyle changes and treatments effectively prevent and modify adverse cardio-metabolic outcomes.

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Machira, Kennedy, and Martin Palamulen. "Rural–urban differences in the use of postnatal care services in Malawi." Journal of Egyptian Public Health Association 92, no. 1 (March 1, 2017): 1–10. http://dx.doi.org/10.21608/epx.2017.7003.

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Machira, Kennedy, and Martin Palamulen. "Rural–urban differences in the use of postnatal care services in Malawi." Journal of Egyptian Public Health Association 92, no. 1 (March 1, 2017): 1–10. http://dx.doi.org/10.21608/epx.2018.6645.

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Mussa, Richard. "Rural–urban differences in parental spending on children's primary education in Malawi." Development Southern Africa 30, no. 6 (December 2013): 789–811. http://dx.doi.org/10.1080/0376835x.2013.859066.

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Moyo, Philani. "Urban appropriation and transformation: bicycle taxi and handcart operators in Mzuzu, Malawi." Review of African Political Economy 40, no. 136 (June 2013): 336–38. http://dx.doi.org/10.1080/03056244.2013.797769.

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Refstie, Hilde, and Cathrine Brun. "Voicing noise: Political agency and the trialectics of participation in urban Malawi." Geoforum 74 (August 2016): 136–46. http://dx.doi.org/10.1016/j.geoforum.2016.05.012.

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Madise, Nyovani Janet, and Mabel Mpoma. "Child Malnutrition and Feeding Practices in Malawi." Food and Nutrition Bulletin 18, no. 2 (January 1997): 1–14. http://dx.doi.org/10.1177/156482659701800205.

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The 1992 Malawi and Demographic Health Survey data are used to assess the association between breast-feeding practices, socio-economic and morbidity variables, and the nutritional status of children under the age of five years using multilevel models. About 27% of under-five children in Malawi are underweight, and nearly 50% are stunted. The results of this study suggest that socio-economicfactors, morbidity, and inappropriate feeding practices are some of the factors associated with malnutrition in Malawi. High socio-economic status, as measured by urban residence, the presence of modern amenities, and some maternal education, is associated with better nutritional status, whereas morbidity within two weeks before the survey is associated with low weight-for-age Z scores. Breast-feeding is almost universal and is carried on for about 21 months, but the introduction of complementary food starts much too early; only 3% of Malawian children under the age of 4 months are exclusively breastfed. Children aged 12 months or older who were still breastfeeding at the time of the survey were of lower nutritional status than those who had stopped breastfeeding. The analysis also showed a significant intra-family correlation of weight-for-age Z scores of children of the same family of about 39%.

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Makwiza, Chikondi, and Heinz Erasmus Jacobs. "Assessing the impact of property size on residential water use for selected neighbourhoods in Lilongwe, Malawi." Journal of Water, Sanitation and Hygiene for Development 6, no. 2 (May 31, 2016): 242–51. http://dx.doi.org/10.2166/washdev.2016.014.

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Malawi has one of the highest urbanisation rates in Africa, with an urban housing approach that favours large residential plot sizes. The impact of plot size on residential water use was evaluated by examining water use records, obtained for the period between January 2009 and December 2014, for formal residential properties in the city of Lilongwe. Water use increased with plot size in line with other reported research, but the dataset contained a considerable proportion of large plots, which were also associated with higher residential water use than presented in similar studies. The findings of this study point to the need for collaboration between water managers and urban planners to promote increased access of urban water supplies by appropriately managing future residential plot sizes.

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Journal articles on the topic 'Urban Malawi'

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