Academic literature on the topic 'Women – Employment – Malawi'

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.

HIV testing is the entry point to the cascade of services within HIV care. Although Malawi has made positive strides in HIV testing, men are lagging at 65.5% while women are at 81.6%. This study explored the preferences of men on the avenues for HIV testing in Blantyre, Malawi. This was a descriptive qualitative study in the phenomenological tradition in seven public health facilities in Blantyre, Malawi, among men and health-care workers (HCWs). We conducted 20 in-depth interviews and held 14 focus group discussions among 113 men of varying HIV statuses. All our participants were purposively selected, and data were digitally recorded coded and managed through NVivo. Thematic analysis was guided by the differentiated service delivery model. Men reported a preference for formal and informal workplaces such as markets and other casual employment sites; social places like football pitches, bars, churches, and “bawo” spaces; and outreach services in the form of weekend door-to-door, mobile clinics, men-to-men group. The health facility was the least preferred avenue. The key to testing men for HIV is finding them where they are. Areas that can be leveraged in reaching men are outside the routine health system. Scaling up HIV testing among men will require targeting avenues and operations outside of the routine health system and leverage them to reach more men with services. This suggests that HIV testing and counseling (HTC) uptake among men may be increased if the services were provided at informal places.

Abstract Background: Hemophilia carriers report abnormal bleeding, even when factor VIII or IX levels are normal. Information comparing bleeding events between carriers and women with other inherited bleeding disorders is lacking. Purpose: The purpose of our study was to characterize bleeding in hemophilia carriers using the International Society on Thrombosis and Hemostasis Bleeding Assessment Tool (ISTH-BAT) and to compare it with bleeding in normal controls, women with Type 1 VWD and Type 3 VWD obligate carriers (OC). Method: This was a prospective, observational, cross-sectional study performed by members of GEHEP (Global Emerging HEmostasis Panel). Study participants were recruited from GEHEP members' clinics in North America (Kingston, Canada, Detroit and Philadelphia, USA), Europe (Malaga, Spain; Milan, Italy; Munich, Germany; Oslo, Norway) and South Africa (Johannesburg). Potential participants were identified through local patient databases and approached during clinic visits. All participants signed informed consent. Hemophilia carriers were defined by a documented FVIII or FIX mutation and/or by an appropriate family history (daughter of a man with hemophilia or mother of two sons with hemophilia or mother of one son with hemophilia with at least one other affected male relative). Demographic information was collected using a CRF and the ISTH-BAT was completed for each participant by study personnel. Existing ISTH-BAT data for women with Type 1 VWD, Type 3 VWD OC and age-matched female controls were used for comparison. Results: A total of 329 participants were included in this study; 168 hemophilia carriers, 83 women with Type 1 VWD, 32 Type 3 VWD OC and 46 female normal controls. Hemophilia carriers and normal controls were similar in age (40.1 vs 41.6, p=0.445). The mean overall ISTH-BAT bleeding score (BS) was significantly higher in carriers than in controls (5.7 vs 2.48, p<0.0001). Carriers reported significantly more bleeding in the categories of cutaneous, minor wounds, oral cavity bleeding, post-dental bleeding, surgical bleeding, menorrhagia, post-partum bleeding and other when compared with controls. Carriers were older than Type 1 VWD patients (40.1 vs 36.4 years, p=0.042). While women with Type 1 VWD had higher total ISTH-BAT BS (8.7 vs 5.7, p<0.0001) as well as higher scores for epistaxis, cutaneous bleeding, minor wounds, oral cavity bleeding and menorrhagia, hemophilia carriers had significantly higher scores for muscle hematomas and hemarthrosis. Carriers were younger than Type 3 VWD OC (40.1 vs 45.2 years, p = 0.02), had higher overall ISTH-BAT BS (5.7 vs 3.0, p=0.009) and reported more bleeding in the following categories: total score, epistaxis, hematuria, dental, muscle hematomas, hemarthrosis, and other. In fact, hemophilia carriers reported more musculoskeletal bleeding than all other groups. Importantly, given the concern about over-reporting of joint bleeds by hemophilia carriers because of familiarity with hemarthrosis in affected male relatives, no Type 3 VWD OC reported joint bleeds. See Table 1 for detailed results. Conclusion: In summary, our study showed that hemophilia carriers report significantly more bleeding by overall ISTH-BAT BS than age-matched female controls. Carriers experience both mucocutaneous bleeding as well as musculoskeletal bleeding. They score higher for mucocutaneous bleeding when compared with controls and when compared with Type 3 VWD OC. Overall Type 1 VWD patients experience more severe mucocutaneous bleeding than hemophilia carriers. However, hemophilia carriers report more musculoskeletal bleeding in the form of hemarthrosis and hematomas than all other groups. A comparison of overall ISTH-BAT BS between groups shows that bleeding in women with Type 1 VWD > hemophilia carriers > Type 3 VWD OC > controls. Additional research into the underlying pathophysiology of this abnormal bleeding is a critical next step in understanding and determining how to appropriately manage these patients. Disclosures Bidlingmaier: Novo Nordisk: Honoraria; Sobi: Honoraria; Pfizer: Honoraria; Biotest: Honoraria; Baxalta: Honoraria; Bayer: Honoraria; CSL Behring: Honoraria, Research Funding. Mingot-Castellano:Amgen: Consultancy; Pfizer: Consultancy; Novo Nordisk: Consultancy, Research Funding; Baxalta: Consultancy, Research Funding; Novartis: Consultancy; Bayer: Consultancy, Research Funding. Chitlur:Novo Nordisk: Consultancy; Baxalta: Honoraria; Bayer: Honoraria; Biogen-Idec: Honoraria; Pfizer: Honoraria. Fogarty:Bayer Healthcare: Membership on an entity's Board of Directors or advisory committees, Research Funding; Baxter/Baxalta: Membership on an entity's Board of Directors or advisory committees, Research Funding; Biogen: Membership on an entity's Board of Directors or advisory committees, Research Funding; Chugai: Membership on an entity's Board of Directors or advisory committees; CSL Behring: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees; Pfizer: Employment, Membership on an entity's Board of Directors or advisory committees, Research Funding; Spark Therapeutics: Research Funding. Cuker:T2 Biosystems: Research Funding; Genzyme: Consultancy; Biogen-Idec: Consultancy, Research Funding; Amgen: Consultancy; Stago: Consultancy. Mancuso:Bayer Healthcare: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Baxalta: Consultancy, Speakers Bureau; CSL Behring: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novo Nordisk: Consultancy, Speakers Bureau; Sobi/Biogen Idec: Consultancy, Speakers Bureau; Pfizer: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Kedrion: Consultancy. Holme:Baxalta, now part of Shire: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Investigator Clinical Studies. Mathew:Bayer: Employment. James:CSL Behring: Research Funding; Octapharma: Research Funding; Biogen: Consultancy; Basalt: Consultancy; Bayer: Research Funding.

Abstract Background Women in low and middle-income countries (LMICs) do not have equal access to resources, such as education, employment, or healthcare compared to men. We sought to explore health disparities and associations between gender prioritization, sociocultural factors, and household decision-making in Central Malawi. Methods From June–August 2017, a cross-sectional study with 200 participants was conducted in Central Malawi. We evaluated respondents’ access to care, prioritization within households, decision-making power, and gender equity which was measured using the Gender-Equitable Men (GEM) scale. Relationships between these outcomes and sociodemographic factors were analyzed using multivariable mixed-effect logistic regression. Results We found that women were less likely than men to secure community-sourced healthcare financial aid (68.6% vs. 88.8%, p < 0.001) and more likely to underutilize necessary healthcare (37.2% vs. 22.4%, p = 0.02). Both men and women revealed low GEM scores, indicating adherence to traditional gender norms, though women were significantly less equitable (W:16.77 vs. M:17.65, p = 0.03). Being a woman (Odds Ratio (OR) 0.41, 95% confidence interval (CI) 0.21–0.78) and prioritizing a woman as a decision-maker for large purchases (OR 0.38, CI 0.15–0.93) were independently associated with a lower likelihood of prioritizing women for medical treatment and being a member of the Chewa tribal group (OR 3.87, CI 1.83–8.18) and prioritizing women for education (OR 4.13, CI 2.13–8.01) was associated with a higher odds. Conclusion Women report greater barriers to healthcare and adhere to more traditional gender roles than men in this Central Malawian population. Women contribute to their own gender’s barriers to care and economic empowerment alone is not enough to correct for these socially constructed roles. We found that education and matriarchal societies may protect against gender disparities. Overall, internal and external gender discrimination contribute to a woman’s disproportionate lack of access to care.

Domestic workers - who sweep, swab, wash, cook, take care of the children and look after the elderly – yet, are invisible. According to the International Labour Organization (ILO), "A domestic worker is someone who carries out household work in a private household in return for wages." The poor and marginalized women are now joining the growing force of domestic workers in Malawian towns and villages. In this backdrop, this research work aims at understanding the socioeconomic background of women domestic workers and problems faced by them in Mangochi District in Malawi. This particular region was selected for research as it has a large number of women domestic workers due to seasonal employment in Salt and Fishing sectors. 100 women domestic workers were selected as sample through Purposive Sampling method and the required data were collected from them by using a semi structured interview schedule designed for this purpose. The study results show that the poor economic condition of family drives the women to opt for domestic work and they are exploited by the employers in many forms. They possess a very low status both in the workplace as well as in the society. They work for a paltry sum and are at the mercy of their keepers without any rights. The study emphasizes the need for a comprehensive policy and legislations to control the exploitation of women in unorganized workforce. Domestic Work should be declared as a profession and as such all the rights and privileges as applicable to all other workers are made available to them. Establishing Self help groups in their area and giving training in income generating activities will certainly go a long way to empower them.

Abstract Background Male partners are rarely present during PMTCT (Prevention-Mother-To-Child-Transmission) services in Sub-Saharan Africa (SSA). Male involvement is increasingly recognised as an important element of women’s access to care. This study aims to identify the socio-demographic characteristics, HIV-Knowledge, Attitude and Practice (KAP) among women accompanied and not accompanied by their male partners. Methods We included pregnant women enrolled in PMTCT programme between August 2018 and November 2019 in the Southern Region of Malawi. Eligible women were aged 18 years or older, living with a male partner, enrolled for the first time in one of the four selected facilities. We provided a KAP survey to women and their partners attending the facilities. Our primary objective was to assess and analyse the proportion of women who were accompanied by their partner at least once. We applied descriptive statistics and logistic regressions to study the association between being accompanied and explanatory variables. Results We enrolled 128 HIV-positive women: 82 (64.1%) were accompanied by their male partners and 46 (35.9%) were alone. In the multivariable model, women’s unemployment and owning a means of transport are negatively associated with male attendance (respectively adjusted OR 0.32 [95% CI, 0.11–0.82] and 0.23 [95% CI, 0.07–0.77]), whereas, in the univariable model, high women’s level of knowledge of HIV is positively associated with male attendance (OR 2.17 [95% CI, 1.03–4.58]). Level of attitude and practice toward HIV were not significantly associated to our study variable. Conclusions Our study shows a high male attendance in Malawi compared to other studies performed in SSA. This study highlights that women’s level of knowledge on HIV and their economic condition (employment and owning a means of transport) affects male attendance. Moreover, the study points out that gender power relationships and stringent gender norms play a crucial role thus they should be considered to enhance male involvement.

Malaria in pregnancy poses a serious public health issues especially in developing countries. This study was to determine the Prevalence and risk factors of Malaria among Pregnant women attending antenatal clinic in Aboh Mbaise General Hospital. A total of 284 pregnant women participated in this study. A structured interviewer-administered questionnaire was used to obtain some socio-demographic characteristics of patients. Thick and thin films were made from blood collected from each pregnant woman. The films were stained using the gold standard staining technique, Giemsa staining for detecting malaria parasites in blood. Data generated was analyzed using SPSS 23.0 statistical package. A p-value<0.05 was considered significant.The prevalence of malaria parasite among the pregnant women in Aboh Mbaise was 70.8%. Plasmodium falciparum was the only specie of malaria parasite found in this study. The age group 15 – 25 years, illiterates, unemployed and single patients had the highest prevalence of malaria positive (MP) patients of 81(28.5%), 80(28.2%), 140(49.3%) and 53(18.7%) respectively. Primigravidae had the highest frequency of MP patients of 109(38.4%) followed by multigravidae 92(32.4%) but there was no statistical significance (p>0.05). Malaria prevalence followed the trend of 1st trimester 80(28.2%) to 2nd trimester 66(23.2%) to 3rd trimester 45(15.8%) in that order but the differences were not statistically significant (p>0.05). The lowest frequency occurred in the month of February 9(3.2%) while the highest frequency occurred in the month of July 62(21.8%) but the difference was not statistically significant (p>0.05). Patients who had bushes around their compound, and who didn’t use mosquito bed net (MBN) and insecticide treated nets (ITNs); those patients surrounded by mosquito breeding sites and who didn’t use Intermittent Preventive Treatment (IPT) were significantly associated with malaria parasite infection (p< 0.05). The prevalence of malaria parasite among the pregnant women in was 70.8%. Lack of education and employment; and risk factors like non-compliance to use of ITNs/MBN; and non-usage of IPT during pregnancy, presence of mosquito breeding sites and bushes around the premises of the study participants were risk factors contributing to prevalence of malaria among pregnant women in Aboh Mbaise General Hospital in Imo State.

Women representation in management positions is described as a fundamental human right and an important means of fair democratic representation. This study intended to investigate the factors determining women upward mobility and their promotion to management positions. Included as variables were traditional gender roles, access to education and lack of mentoring and role models. The study followed the qualitative approach using snowball sampling and conducting semi structured interviews with ten Controlling Officers from different ministries and department of the Malawi Public Service to find out whether the variables under investigation indeed affect women upward mobility. Empirical evidence shows that traditional gender roles e.g. being mothers affect women upward mobility. Similarly, limited access to education is another factor that limits women access to managerial positions. Lack of mentoring and role models, especially where there are already few women at the top also affects women’s upward mobility. The study recommended that Malawi government should help women get scholarships that provide for their children. Furthermore, the government should provide flexible working hours especially for mothers. Women themselves should meet for a cup of tea where they can empower each other on the most important aspects of their job as chief executives; that is delivering a speech, making presentations and forming networks.

This study sought to explore gender issues affecting management promotions in Malawi's health care services, utilising both qualitative and quantitative techniques in data collection and analysis. Promotion patterns were compared and contrasted for male and female managers. The study was based on the assumptions that • both men and women were aware of experiences that affected their promotion opportunities • promotion patterns showed fewer variations than did cultural, social and gender factors • male prejudices were maintained which oppressed women's promotions • increased decision-making power lowered stress about professional growth and development The findings supported the first two assumptions, but not the last two. The findings suggested that males and females encountered similar experiences concerning managerial promotions in Malawi's health care services. Factors that enhanced management successes for both males and females included management orientation and mentorship. Unclear promotion policies and procedures hindered management promotions. Information derived from this research could enable policy-makers to establish an environment that increases supportive networks and interactions between male and female managers in Malawi. Furthermore, to ensure equal opportunities in the health care services management, monitoring strategies by Malawi's Ministry of Gender, the Department of Human Resources Management and Development, and the Ministry of Health and Population need to be established and implemented.
Health Studies
D.Litt. et Phil. (Health Studies)

Qualitative and quantitative research designs were employed to assess the influence of religion on gender equality and women empowerment in Mulanje district in Malawi. Qualitative data was collected using semi-structured questionnaires through interview with 18 key informants who were sampled by judgmental sampling and 4 FGDs with men and women belonging to different religions who were sampled by stratified random sampling. Quantitative data was collected using a self administered questionnaire to 130 participants sampled by stratified random sampling. Quantitative data was analyzed by using SPSS computer program version 16.0 in order to reach to a valid conclusion. The analysis of the data involved descriptive statistics. For qualitative data, themes were induced from the interview with key informants and FGD. Findings have revealed positive religious teachings and beliefs that have empowered women and promoted equality between men and women. Nevertheless, the study has also revealed that discriminatory religious teachings and attitudes are a reality in religious institutions and these have influenced not only the way women are treated in religious institutions but also the way women look at themselves. In light of the findings, recommendations have been made to the government of Malawi, religious institutions, religious leaders and CSOs to take appropriate actions to promote gender equality and women empowerment in Mulanje district.
Development Studies
M.A. (Development Studies)

Fertility level and labour force participation of women in selected countries Abstract The objective of this thesis is to analyze the position of women in the family and in the labour market in selected countries representing different models of family policy. More countries were selected within some models in connection with the specific features related to these states. The analyzed countries are the Czech Republic, Finland, France, Germany, Italy, the Netherlands, Portugal, Sweden and the United Kingdom. Thesis focuses on comparing the position of countries with regard to the fertility level and female employment, to the conditions for the reconciliation of work and family life and to the attitudes and opinions of respondents concerning issues of gender equality, equal opportunities and mothers' employment. The first part presents the changes in the position of women and in family behaviour that took place in the 20th century and factors that influence fertility and labour force participation of women. The second part deals with analysis of fertility, female employment and the relationship between them and also deals with the comparative analysis of the conditions for reconciliation of work and family life. Subsequently, on the basis of data from the survey European Values Study and Eurobarometer,...

This is a research proposal of a PhD study under the Department of Gender Studies, Faculty of Arts and Social Sciences, University of Malaya, Malaysia. In broader perspective, the proposal covers the issue of women's empowerment through the rapid employment of poor women in the ready-made garment industries in Bangladesh. The proposal has been written as the requirement for the PhD students at the University of Malaya. The writing contains fundamental components of a research proposal: study background, problem statement, research objectives, significance of the research, literature review on concepts and theoretical framework, research methodology, and a gantt chart showing the research's time schedule. The study will follow a qualitative research method including in-depth interview, focus group discussion, and factory visit as data collection tools. This chapter will be a useful guideline to the students and researchers who are interested in qualitative research approach in this particular field.

Gender equality and information and communication technology are important in the achievement of the Millennium Development Goals (MDGs) in policy, planning, and practice. The 2000 Millennium Declaration of the United Nations (UN) formed an international agreement among member states to work toward the reduction of poverty and its effects by 2015 through eight Millennium Development Goals: 1. Eradicate extreme poverty and hunger 2. Achieve universal primary education 3. Promote gender equality and the empowerment of women 4. Reduce child and maternal mortality 5. Improve maternal health care 6. Combat HIV and AIDS, malaria, and other major diseases 7. Ensure environmental sustainability 8. Develop global partnership for development Progress toward gender equality and the empowerment of women is one goal that is important to achieving the others. Poverty, hunger, illiteracy, environmental threats, HIV and AIDS, and other health threats disproportionately affect the lives of women and their dependent children. Gender-sensitive ICT applications to education, health care, and local economies have helped communities progress toward the MDGs. ICT applications facilitate rural health-care workers’ access to medical expertise through phones and the Internet. Teachers expand learning resources through the Internet and satellite services, providing a greater knowledge base for learners. Small entrepreneurs with ICT access and training move their local business into world markets. ICT diffusion into world communication systems has been pervasive. Even some of the poorest economies in Africa show the fastest cell-phone growth, though Internet access and landline numbers are still low (International Telecommunications Union [ITU], 2003b). ICT access or a lack of it impacts participation, voice, and decision making in local, regional, and international communities. ICTs impact the systems that move or inhibit MDG progress. UN secretary general Kofi Annan explained the role of the MDGs in global affairs: Millennium Development Goals are too important to fail. For the international political system, they are the fulcrum on which development policy is based. For the billion-plus people living in extreme poverty, they represent the means to a productive life. For everyone on Earth, they are a linchpin to the quest for a more secure and peaceful world. (UN, 2005, p. 28) Annan also stressed the critical need for partnerships to facilitate technology training to enable information exchange and analysis (UN, 2005). ICT facilitates sharing lessons of success and failure, and progress evaluation of work in all the MDG target areas. Targets and indicators measuring progress were selected for all the MDGs. Gender equality and women’s empowerment are critical to the achievement of each other goal. Inadequate access to the basic human needs of clean water, food, education, health services, and environmental sustainability and the support of global partnership impacts great numbers of women. Therefore, the targets and indicators for Goal 3 address females in education, employment, and political participation. Progress toward the Goal 3 target to eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015, will be measured by the following indicators. • Ratio of girls to boys in primary, secondary, and tertiary education • Ratio of literate females to males who are 15- to 24-year-olds • Share of women in wage employment in the nonagricultural sector • Proportion of seats held by women in national parliaments (World Bank, 2003) Education is positively related to improved maternal and infant health, economic empowerment, and political participation (United Nations Development Program [UNDP], 2004; World Bank, 2003). Education systems in developing countries are beginning to offer or seek ways to provide ICT training as a basic skill and knowledge base. Proactive policy for gender equality in ICT access has not always accompanied the unprecedented ICT growth trend. Many civil-society representatives to the World Summit on the Information Society (WSIS) argue for ICT access to be considered a basic human right (Girard & Ó Soichrú, 2004; UN, 1948). ICT capability is considered a basic skill for education curriculum at tertiary, secondary, and even primary levels in developed regions. In developing regions, ICT access and capability are more limited but are still tightly woven into economic communication systems. ICTs minimize time and geography barriers. Two thirds of the world’s poor and illiterate are women (World Bank, 2003). Infant and maternal health are in chronic crisis for poor women. Where poverty is highest, HIV and AIDS are the largest and fastest growing health threat. Ninety-five percent of people living with HIV and AIDS are in developing countries, partly because of poor dissemination of information and medical treatment. Women are more vulnerable to infection than men. Culturally reinforced sexual practices have led to higher rates of HIV infection for women. Gender equality and the empowerment of women, starting with education, can help fight the spread of HIV, AIDS, and other major diseases. ICT can enhance health education through schools (World Bank). Some ICT developers, practitioners, and distributors have identified ways to incorporate gender inclusiveness into their policies and practice for problem-solving ICT applications toward each MDG target area. Yet ICT research, development, education, training, applications, and businesses remain male-dominated fields, with only the lesser skilled and salaried ICT labor force approaching gender equality. Successful integration of gender equality and ICT development policy has contributed to MDG progress through several projects in the developing regions. Notable examples are the South-African-based SchoolNet Africa and Bangladesh-based Grameen Bank Village Pay Phone. Both projects benefit from international public-private partnerships. These and similar models suggest the value and importance of linking gender equality and empowerment with global partnership for development, particularly in ICT. This article reports on developing efforts to coordinate the achievement of the MDGs with policy, plans, and practice for gender equality beyond the universal educational target, and with the expansion of ICT access and participation for women and men. The article examines the background and trends of MDG 3, to promote gender equality and the empowerment of women, with particular consideration of MDG 8, to develop global partnership for development, in ICT access and participation.