Sample records for kenya malawi nigeria
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The relation of female circumcision to sexual behavior in Kenya and Nigeria.
Mpofu, Sibonginkosi; Odimegwu, Clifford; De Wet, Nicole; Adedini, Sunday; Akinyemi, Joshua
2017-08-01
One of the reasons for the perpetuation of female circumcision is that it controls female sexuality. In this study, the authors examined the relationship between female circumcision and the sexual behavior of women in Kenya and Nigeria. Data on women who were aware of circumcision and were circumcised were extracted from the Kenya Demographic and Health Survey of 2008-09 as well as the Nigeria Demographic and Health Survey of 2008. The sample size was 7,344 for Kenya and 16,294 for Nigeria. The outcome variables were age at first intercourse and total lifetime number of sexual partners. The study hypothesis was that women who were circumcised were less likely to have initiated sex early and to have only one sex partner. Cox proportional hazards regression and Poisson regression were used to examine the relations of female circumcision and other selected variables to sexual behavior. No association was observed between female circumcision and the outcomes for sexual behavior of women in Kenya and Nigeria. The argument of sexual chastity is insufficient to sustain the perpetuation of female circumcision.
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2013-01-01
Background In endemic regions of sub-Saharan Africa, malaria during pregnancy (MiP) is a major preventable cause of maternal and infant morbidity and mortality. Current recommended MiP prevention and control includes intermittent preventive treatment (IPTp), distribution of insecticide-treated bed nets (ITNs) and appropriate case management. This article explores the social and cultural context to the uptake of these interventions at four sites across Africa. Methods A comparative qualitative study was conducted at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. Observations, which focused on behaviours linked to MiP prevention and treatment, were also undertaken at health facilities and in local communities. Results ITNs were generally recognized as important for malaria prevention. However, their availability and use differed across the sites. In Malawi and Kenya, ITNs were sought-after items, but there were complaints about availability. In central Ghana, women saved ITNs until the birth of the child and they were used seasonally in northern Ghana. In Kenya and central Ghana, pregnant women did not associate IPTp with malaria, whereas, in Malawi and northern Ghana, IPTp was linked to malaria, but not always with prevention. Although IPTp adherence was common at all sites, whether delivered with directly observed treatment or not, a few women did not comply with IPTp often citing previous side effects. Although generally viewed as positive, experiences of malaria testing varied across the four sites: treatment was sometimes administered in spite of a negative diagnosis in Ghana (observed) and Malawi (reported). Despite generally following the advice of healthcare staff, particularly in Kenya, personal experience, and the availability and accessibility of medication – including anti-malarials – influenced
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Tesfaye, Kindie; Jaleta, Moti; Jena, Pradyot; Mutenje, Munyaradzi
2015-02-01
Conservation agriculture (CA) is being promoted as an option for reducing soil degradation, conserving water, enhancing crop productivity, and maintaining yield stability. However, CA is a knowledge- and technology-intensive practice, and may not be feasible or may not perform better than conventional agriculture under all conditions and farming systems. Using high resolution (≈1 km(2)) biophysical and socioeconomic geospatial data, this study identified potential recommendation domains (RDs) for CA in Ethiopia, Kenya, and Malawi. The biophysical variables used were soil texture, surface slope, and rainfall while the socioeconomic variables were market access and human and livestock population densities. Based on feasibility and comparative performance of CA over conventional agriculture, the biophysical and socioeconomic factors were first used to classify cultivated areas into three biophysical and three socioeconomic potential domains, respectively. Combinations of biophysical and socioeconomic domains were then used to develop potential RDs for CA based on adoption potential within the cultivated areas. About 39, 12, and 5% of the cultivated areas showed high biophysical and socioeconomic potential while 50, 39, and 21% of the cultivated areas showed high biophysical and medium socioeconomic potential for CA in Malawi, Kenya, and Ethiopia, respectively. The results indicate considerable acreages of land with high CA adoption potential in the mixed crop-livestock systems of the studied countries. However, there are large differences among countries depending on biophysical and socio-economic conditions. The information generated in this study could be used for targeting CA and prioritizing CA-related agricultural research and investment priorities in the three countries.
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NASA Astrophysics Data System (ADS)
Tesfaye, Kindie; Jaleta, Moti; Jena, Pradyot; Mutenje, Munyaradzi
2015-02-01
Conservation agriculture (CA) is being promoted as an option for reducing soil degradation, conserving water, enhancing crop productivity, and maintaining yield stability. However, CA is a knowledge- and technology-intensive practice, and may not be feasible or may not perform better than conventional agriculture under all conditions and farming systems. Using high resolution (≈1 km2) biophysical and socioeconomic geospatial data, this study identified potential recommendation domains (RDs) for CA in Ethiopia, Kenya, and Malawi. The biophysical variables used were soil texture, surface slope, and rainfall while the socioeconomic variables were market access and human and livestock population densities. Based on feasibility and comparative performance of CA over conventional agriculture, the biophysical and socioeconomic factors were first used to classify cultivated areas into three biophysical and three socioeconomic potential domains, respectively. Combinations of biophysical and socioeconomic domains were then used to develop potential RDs for CA based on adoption potential within the cultivated areas. About 39, 12, and 5 % of the cultivated areas showed high biophysical and socioeconomic potential while 50, 39, and 21 % of the cultivated areas showed high biophysical and medium socioeconomic potential for CA in Malawi, Kenya, and Ethiopia, respectively. The results indicate considerable acreages of land with high CA adoption potential in the mixed crop-livestock systems of the studied countries. However, there are large differences among countries depending on biophysical and socio-economic conditions. The information generated in this study could be used for targeting CA and prioritizing CA-related agricultural research and investment priorities in the three countries.
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Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya
Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene
2016-01-01
ABSTRACT Background: The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Methods: Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. Results: In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (<25 years old) were significantly more likely to obtain their method from a drug shop or pharmacy than another type of facility. In both countries, family planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and
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Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya.
Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene
2016-12-23
The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (<25 years old) were significantly more likely to obtain their method from a drug shop or pharmacy than another type of facility. In both countries, family planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and drug shops in both countries indicate
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Nguyen, Kimberly H; Kress, Howard; Atuchukwu, Victor; Onotu, Dennis; Swaminathan, Mahesh; Ogbanufe, Obinna; Msungama, Wezi; Sumner, Steven A
2018-02-01
Understanding factors that are associated with disclosure of sexual violence (SV) is important for the delivery of health services as well as developing strategies for prevention and response. The Violence Against Children Surveys were conducted in Malawi and Nigeria. We examined the prevalence of SV, help-seeking behaviors, and factors associated with disclosure among girls and young women aged 13 to 24. The self-reported prevalence of SV was similar in Nigeria (26%) and Malawi (27%). Among females who experienced SV, approximately one third (37%) in Nigeria and one half (55%) in Malawi ever disclosed their experience of SV. Females in Nigeria were significantly more likely to disclose to their parents (31.8%) than females in Malawi (9.5%). The most common reason for nondisclosure in Nigeria was not feeling a need or desire to tell anyone (34.9%) and in Malawi was embarrassment (29.3%). Very close relationships with one or both parents were significantly associated with disclosure among Nigerian females (odds ratio [OR] = 5.5, 95% confidence interval [CI] = [2.1, 14.6]) but were inversely associated with disclosure among Malawian females (OR = 0.05, 95% CI = [0.01, 0.33]). Reasons for nondisclosure of SV and factors associated with disclosure among females differ in the African nations studied. The stigma associated with shame of SV may prevent females from disclosing and thus receiving necessary support and health, social, and other services. This study demonstrates a need to reduce barriers for disclosure to improve the delivery of health, social, and other response services across African nations, as well as to develop culturally appropriate strategies for its response.
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Winston, Jennifer; Calhoun, Lisa M; Corroon, Meghan; Guilkey, David; Speizer, Ilene
2018-01-05
The 2012 London Summit on Family Planning set ambitious goals to enable 120 million more women and adolescent girls to use modern contraceptives by 2020. The Urban Reproductive Health Initiative (URHI) was a Bill & Melinda Gates Foundation funded program designed to help contribute to these goals in urban areas in India, Kenya, Nigeria, and Senegal. URHI implemented a range of country-specific demand and supply side interventions, with supply interventions generally focused on improved service quality, provider training, outreach to patients, and commodity stock management. This study uses data collected by the Measurement, Learning & Evaluation (MLE) Project to examine the effectiveness of these supply-side interventions by considering URHI's influence on the number of family planning clients at health facilities over a four-year period in Kenya, Nigeria, and Senegal. The analysis used facility audits and provider surveys. Principal-components analysis was used to create country-specific program exposure variables for health facilities. Fixed-effects regression was used to determine whether family planning uptake increased at facilities with higher exposure. Outcomes of interest were the number of new family planning acceptors and the total number of family planning clients per reproductive health care provider in the last year. Higher program component scores were associated with an increase in new family planning acceptors per provider in Kenya (β = 18, 95% CI = 7-29), Nigeria (β = 14, 95% CI = 8-20), and Senegal (β = 7, 95% CI = 3-12). Higher scores were also associated with more family planning clients per provider in Kenya (β = 31, 95% CI = 7-56) and Nigeria (β = 26, 95% CI = 15-38), but not in Senegal. Supply-side interventions have increased the number of new family planning acceptors at facilities in urban Nigeria, Kenya, and Senegal and the overall number of clients in urban Nigeria and Kenya. While tailoring
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Eliah, Edson; Lewallen, Susan; Kalua, Khumbo; Courtright, Paul; Gichangi, Michael; Bassett, Ken
2014-01-01
This project examined the surgical productivity and attrition of non-physician cataract surgeons (NPCSs) in Tanzania, Malawi, and Kenya. Baseline (2008-9) data on training, support, and productivity (annual cataract surgery rate) were collected from officially trained NPCSs using mailed questionnaires followed by telephone interviews. Telephone interviews were used to collect follow-up data annually on productivity and semi-annually on attrition. A detailed telephone interview was conducted if a surgeon left his/her post. Data were entered into and analysed using STATA. Among the 135 NPCSs, 129 were enrolled in the study (Kenya 88, Tanzania 38, and Malawi 3) mean age 42 years; average time since completing training 6.6 years. Employment was in District 44%, Regional 24% or mission/ private 32% hospitals. Small incision cataract surgery was practiced by 38% of the NPCSs. The mean cataract surgery rate was 188/year, median 76 (range 0-1700). For 39 (31%) NPCSs their surgical rate was more than 200/year. Approximately 22% in Kenya and 25% in Tanzania had years where the cataract surgical rate was zero. About 11% of the surgeons had no support staff. High quality training is necessary but not sufficient to result in cataract surgical activity that meets population needs and maintains surgical skill. Needed are supporting institutions and staff, functioning equipment and programs to recruit and transport patients.
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McCauley, Mary; Madaj, Barbara; White, Sarah A; Dickinson, Fiona; Bar-Zev, Sarah; Aminu, Mamuda; Godia, Pamela; Mittal, Pratima; Zafar, Shamsa; van den Broek, Nynke
2018-01-01
For every woman who dies during pregnancy and childbirth, many more suffer ill-health, the burden of which is highest in low-resource settings. We sought to assess the extent and types of maternal morbidity. Descriptive observational cross-sectional study at primary-level and secondary-level healthcare facilities in India, Pakistan, Kenya and Malawi to assess physical, psychological and social morbidity during and after pregnancy. Sociodemographic factors, education, socioeconomic status (SES), quality of life, satisfaction with health, reported symptoms, clinical examination and laboratory investigations were assessed. Relationships between morbidity and maternal characteristics were investigated using multivariable logistic regression analysis. 11 454 women were assessed in India (2099), Malawi (2923), Kenya (3145), and Pakistan (3287). Almost 3 out of 4 women had ≥1 symptoms (73.5%), abnormalities on clinical examination (71.3%) or laboratory investigation (73.5%). In total, 36% of women had infectious morbidity of which 9.0% had an identified infectious disease (HIV, malaria, syphilis, chest infection or tuberculosis) and an additional 32.5% had signs of early infection. HIV-positive status was highest in Malawi (14.5%) as was malaria (10.4%). Overall, 47.9% of women were anaemic, 11.5% had other medical or obstetric conditions, 25.1% reported psychological morbidity and 36.6% reported social morbidity (domestic violence and/or substance misuse). Infectious morbidity was highest in Malawi (56.5%) and Kenya (40.4%), psychological and social morbidity was highest in Pakistan (47.3%, 60.2%). Maternal morbidity was not limited to a core at-risk group; only 1.2% had all four morbidities. The likelihood of medical or obstetric, psychological or social morbidity decreased with increased education; adjusted OR (95% CI) for each additional level of education ranged from 0.79 (0.75 to 0.83) for psychological morbidity to 0.91 (0.87 to 0.95) for infectious morbidity
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Rico, Emily; Fenn, Bridget; Abramsky, Tanya; Watts, Charlotte
2011-04-01
If effective interventions are to be used to address child mortality and malnutrition, then it is important that we understand the different pathways operating within the framework of child health. More attention needs to be given to understanding the contribution of social influences such as intimate partner violence (IPV). To investigate the relationship between maternal exposure to IPV and child mortality and malnutrition using data from five developing countries. Population data from Egypt, Honduras, Kenya, Malawi and Rwanda were analysed. Logistic regression analysis was used to generate odds ratios of the associations between several categories of maternal exposure to IPV since the age of 15 and three child outcomes: under-2-year-old (U2) mortality and moderate and severe stunting (<-2 Z-score height-for-age and <-3 Z-score height-for-age) in 6-59-month-old children. Analyses were adjusted for potential confounders, and the role of mediating factors was explored. The prevalence of physical and/or sexual IPV since the age of 15 years ranged from 15.5% (Honduras) to 46.2% (Kenya). For child stunting, prevalence ranged from 25.4% (Egypt) to 58.0% (Malawi) and for U2 mortality from 3.6% (Honduras) to 15.2% (Rwanda). In Kenya, maternal exposure to IPV was associated with higher U2 mortality (adjusted odds ratio (OR)=1.42, 95% CI 1.18 to 1.71) and child stunting (adjusted OR=1.36, 95% CI 1.16 to 1.61). In Malawi and Honduras, marginal associations were observed between IPV and severe stunting and U2 mortality, respectively, with strength of associations varying by type of violence. The relationship between IPV and U2 mortality and stunting in Kenya, Honduras and Malawi suggests that, in these countries, IPV plays a role in child malnutrition and mortality. This contributes to a growing body of evidence that broader public health benefits may be incurred if efforts to address IPV are incorporated into a wider range of maternal and child health programmes
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ERIC Educational Resources Information Center
Meyer, Rex
This report describes the activities of a UNESCO consultant who visited Kenya, Tanzania, Zambia and Malawi for the purpose of assisting local education agencies in the Biology Teaching Pilot Project. The consultant's report briefly summarizes the status of the School Science Project (SSP) in these East African countries. Also listed are the…
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Lencucha, Raphael; Reddy, Srikanth K; Labonte, Ronald; Drope, Jeffrey; Magati, Peter; Goma, Fastone; Zulu, Richard; Makoka, Donald
2018-04-01
Tobacco control norms have gained momentum over the past decade. To date 43 of 47 Sub-Saharan African countries are party to the Framework Convention on Tobacco Control (FCTC). The near universal adoption of the FCTC illustrates the increasing strength of these norms, although the level of commitment to implement the provisions varies widely. However, tobacco control is enmeshed in a web of international norms that has bearing on how governments implement and strengthen tobacco control measures. Given that economic arguments in favor of tobacco production remain a prominent barrier to tobacco control efforts, there is a continued need to examine how economic sectors frame and mobilize their policy commitments to tobacco production. This study explores the proposition that divergence of international norms fosters policy divergence within governments. This study was conducted in three African countries: Kenya, Malawi, and Zambia. These countries represent a continuum of tobacco control policy, whereby Kenya is one of the most advanced countries in Africa in this respect, whereas Malawi is one of the few countries that is not a party to the FCTC and has implemented few measures. We conducted 55 key informant interviews (Zambia = 23; Kenya = 17; Malawi = 15). Data analysis involved deductive coding of interview transcripts and notes to identify reference to international norms (i.e. commitments, agreements, institutions), coupled with an inductive analysis that sought to interpret the meaning participants ascribe to these norms. Our analysis suggests that commitments to tobacco control have yet to penetrate non-health sectors, who perceive tobacco control as largely in conflict with international economic norms. The reasons for this perceived conflict seems to include: (1) an entrenched and narrow conceptualization of economic development norms, (2) the power of economic interests to shape policy discourses, and (3) a structural divide between sectors in
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Repeat use of emergency contraceptive pills in urban Kenya and Nigeria.
Chin-Quee, Dawn; L'Engle, Kelly; Otterness, Conrad; Mercer, Sarah; Chen, Mario
2014-09-01
Little is known about the frequency and patterns of use of emergency contraceptive pills among women in urban Kenya and Nigeria. To recruit women who had used emergency contraceptive pills, individuals aged 18-49 were intercepted and interviewed at shopping venues in Nairobi, Kenya, and Lagos, Nigeria, in 2011. Information was collected on 539 Nairobi and 483 Lagos respondents' demographic and behavioral characteristics, attitudes toward the method, and frequency of use. Multinomial logistic regression analyses were used to identify associations between these characteristics and frequency of pill use. Eighteen percent of the women interviewed in Nairobi and 17% in Lagos had ever used emergency contraceptive pills. On average, these respondents had used the pills less than once per month, but greater use and acceptance were seen in Lagos. In multivariate analysis, women who had sex at least once in a typical week were generally more likely than others to have used the pills 2-5 times in the last six months, rather than once or never, or to have used them six or more times. Furthermore, Lagos respondents who said their main contraceptive method was the condom, the pill or injectable, or a natural method were generally less likely than those who did not report these methods to have used the emergency pills multiple times in the last six months. Repeated use of emergency contraceptive pills was not common in this sample.
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Bedford, K. Juliet A.; Sharkey, Alyssa B.
2014-01-01
We present qualitative research findings on care-seeking and treatment uptake for pneumonia, diarrhoea and malaria among children under 5 in Kenya, Nigeria and Niger. The study aimed to determine the barriers caregivers face in accessing treatment for these conditions; to identify local solutions that facilitate more timely access to treatment; and to present these findings as a platform from which to develop context-specific strategies to improve care-seeking for childhood illness. Kenya, Nigeria and Niger are three high burden countries with low rates of related treatment coverage, particularly in underserved areas. Data were collected in Homa Bay County in Nyanza Province, Kenya; in Kebbi and Cross River States, Nigeria; and in the Maradi and Tillabéri regions of Niger. Primary caregivers of children under 5 who did not regularly engage with health services or present their child at a health facility during illness episodes were purposively selected for interview. Data underwent rigorous thematic analysis. We organise the identified barriers and related solutions by theme: financial barriers; distance/location of health facilities; socio-cultural barriers and gender dynamics; knowledge and information barriers; and health facility deterrents. The relative importance of each differed by locality. Participant suggested solutions ranged from community-level actions to facility-level and more policy-oriented actions, plus actions to change underlying problems such as social perceptions and practices and gender dynamics. We discuss the feasibility and implications of these suggested solutions. Given the high burden of childhood morbidity and mortality due to pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger, this study provides important insights relating to demand-side barriers and locally proposed solutions. Significant advancements are possible when communities participate in both problem identification and resolution, and are engaged as important
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Okigbo, Chinelo C; Speizer, Ilene S; Corroon, Meghan; Gueye, Abdou
2015-07-22
Family planning (FP) researchers and policy makers have often overlooked the importance of involving men in couples' fertility choices and contraception, despite the fact that male involvement is a vital factor in sexual and reproductive health programming. This study aimed to assess whether men's exposure to FP demand-generation activities is associated with their reported use of modern contraceptive methods. We used evaluation data from the Measurement, Learning & Evaluation project for the Urban Reproductive Health Initiative (URHI) in select cities of three African countries (Kenya, Nigeria, and Senegal) collected in 2012/2013. A two-stage cluster sampling design was used to select a representative sample of men in the study sites. The sample for this study includes men aged 15-59 years who had no missing data on any of the key variables: 696 men in Kenya, 2311 in Nigeria, and 1613 in Senegal. We conducted descriptive analyses and multivariate logistic regression analyses to assess the associations of interest. All analyses were weighted to account for the study design and non-response rates using Stata version 13. The proportion of men who reported use of modern contraceptive methods was 58 % in Kenya, 43 % in Nigeria, and 27 % in Senegal. About 80 % were exposed to at least one URHI demand-generation activity in each country. Certain URHI demand-generation activities were significantly associated with men's reported use of modern contraception. In Kenya, those who participated in URHI-led community events had four times higher odds of reporting use of modern methods (aOR: 3.70; p < 0.05) while in Senegal, exposure to URHI-television programs (aOR: 1.40; p < 0.05) and having heard a religious leader speak favorably about FP (aOR: 1.72; p < 0.05) were associated with modern contraceptive method use. No such associations were observed in Nigeria. Study findings are important for informing future FP program activities that seek to engage men
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Speizer, Ilene S; Fotso, Jean Christophe; Davis, Joshua T; Saad, Abdulmumin; Otai, Jane
2013-11-01
To examine the timing and circumstances of first sex among urban female and male youth in Kenya, Nigeria, and Senegal. Recently collected data are used to examine youth sexual behaviors in Kenya, Nigeria, and Senegal. In each country, a large, representative sample of women (ages 15-49) and men (ages 15-59) was collected from multiple cities. Data from youth (ages 15-24) are used for the analyses of age at sexual initiation, whether first sex was premarital, and modern family planning use at first sex. Cox proportional hazard models and logistic regression analyses are performed to determine factors associated with these outcomes. Across all three countries, a greater percentage of male youth than female youth report initiating sex with a nonmarital partner. More educated youth are less likely to have initiated sex at each age. In Nigeria and Senegal, poor female youth report earlier first sex than wealthier female youth. In Kenya, richer female youth are more likely to have premarital first sex and to use contraception/condom at first sex than their poorer counterparts. Older age at first sex and youth who report that first sex was premarital are significantly more likely to use a method of contraception (including condom) at first sex. City-specific distinctions are found and discussed for each outcome. Programs seeking to reduce HIV and unintended pregnancy risk among urban youth need to undertake needs assessments to understand the local context that influences the timing and circumstances of first sex in each city/country-specific context. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
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Pell, Christopher; Meñaca, Arantza; Were, Florence; Afrah, Nana A.; Chatio, Samuel; Manda-Taylor, Lucinda; Hamel, Mary J.; Hodgson, Abraham; Tagbor, Harry; Kalilani, Linda; Ouma, Peter; Pool, Robert
2013-01-01
Background Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi) with varying levels of ANC attendance. Methods Data were collected as part of a programme of qualitative research investigating the social and cultural context of malaria in pregnancy. A range of methods was employed interviews, focus groups with diverse respondents and observations in local communities and health facilities. Results Across the sites, women attended ANC at least once. However, their descriptions of ANC were often vague. General ideas about pregnancy care – checking the foetus’ position or monitoring its progress – motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers. Women’s timing of ANC initiation was influenced by reproductive concerns and pregnancy uncertainties, particularly during the first trimester, and how ANC services responded to this uncertainty; age, parity and the associated implications for pregnancy disclosure; interactions with healthcare workers, particularly messages about timing of ANC; and the cost of ANC, including charges levied for ANC procedures – in spite of policies of free ANC – combined with ideas about the compulsory nature of follow-up appointments. Conclusion In these socially and culturally diverse sites, the findings suggest that ‘supply’ side factors have an important influence on ANC attendance: the design of ANC and particularly how ANC deals with the needs and concerns of women during the first trimester has implications for timing of initiation. PMID:23335973
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Chopra, Mickey; Doherty, Tanya; Mehatru, Saba; Tomlinson, Mark
2009-12-01
The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documenting progress over the last few years and determining the main challenges and constraints. Field teams conducted national-level interviews with key informants and visited a total of thirty-six facilities in twenty-one sites across the three countries--eighteen facilities in Malawi, eleven in Kenya and seven in Zambia. During these visits interviews were undertaken with key informants such as the district and facility management teams, programme coordinators and health workers. A rapid assessment of HIV and infant feeding counselling in Kenya, Malawi and Zambia, undertaken from February to May 2007. Infant feeding counselling has, until now, been given low priority within programmes aimed at prevention of MTCT (PMTCT) of HIV. This is manifest in the lack of resources - human, financial and time--for infant feeding counselling, leading to widespread misunderstanding of the HIV transmission risks from breast-feeding. It has also resulted in lack of space and time for proper counselling, poor support and supervision, and very weak monitoring and evaluation of infant feeding. Finally, there are very few examples of linkages with community-based infant feeding interventions. However, all three countries have started to revise their feeding policies and strategies and there are signs of increased resources. In order to sustain this momentum it will be necessary to continue the advocacy with the HIV community and stress the importance of child survival--not just minimization of HIV transmission - and hence the need for integrating MTCT
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ADULT EDUCATION IN AFRICA. CURRENT INFORMATION SOURCES, NUMBER 12.
ERIC Educational Resources Information Center
Syracuse Univ., NY. ERIC Clearinghouse on Adult Education.
TWENTY-THREE ABSTRACTS AND ANNOTATIONS OF RECENT (1962-67) PUBLICATIONS ON ADULT EDUCATION IN AFRICA ARE PROVIDED IN THIS BIBLIOGRAPHY. EDUCATIONAL NEEDS AND POLICIES AND SPECIFIC NATIONAL AND INSTITUTIONAL PROGRAMS IN ETHIOPIA, TANZANIA, KENYA, MALAWI, ZAMBIA, RHODESIA, AND NIGERIA ARE FEATURED, WITH COMMUNITY AND RURAL DEVELOPMENT, MANPOWER…
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Opportunities for Distance Education in the Commonwealth African Countries.
ERIC Educational Resources Information Center
INTELECON Research & Consultancy Ltd., Vancouver (British Columbia).
The geo-demographic, economic, and infrastructural makeup of 12 African countries (Botswana. Gambia, Kenya, Lesotho, Malawi, Nigeria, Sierra Leone, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe) were compared to determine the potential benefits to them of a Commonwealth of Learning (COL) distance education initiative. Data were collected on…
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van Rooyen, Heidi; Tulloch, Olivia; Mukoma, Wanjiru; Makusha, Tawanda; Chepuka, Lignet; Knight, Lucia C; Peck, Roger B; Lim, Jeanette M; Muturi, Nelly; Chirwa, Ellen; Taegtmeyer, Miriam
2015-01-01
HIV self-testing (HIVST) has the potential to increase uptake of HIV testing among untested populations in sub-Saharan Africa and is on the brink of scale-up. However, it is unclear to what extent HIVST would be supported by stakeholders, what policy frameworks are in place and how variations between contexts might influence country-preparedness for scale-up. This qualitative study assessed the perceptions of HIVST among stakeholders in three sub-Saharan countries. Fifty-four key informant interviews were conducted in Kenya (n=16), Malawi (n=26) and South Africa (n=12) with government policy makers, academics, activists, donors, procurement specialists, laboratory practitioners and health providers. A thematic analysis was conducted in each country and a common coding framework allowed for inter-country analysis to identify common and divergent themes across contexts. Respondents welcomed the idea of an accurate, easy-to-use, rapid HIV self-test which could increase testing across all populations. High-risk groups, such as men, Men who have sex with men (MSM), couples and young people in particular, could be targeted through a range of health facility and community-based distribution points. HIVST is already endorsed in Kenya, and political support for scale-up exists in South Africa and Malawi. However, several caveats remain. Further research, policy and ensuing guidelines should consider how to regulate, market and distribute HIVST, ensure quality assurance of tests and human rights, and critically, link testing to appropriate support and treatment services. Low literacy levels in some target groups would also need context-specific consideration before scale up. World Health Organization (WHO) policy and regulatory frameworks are needed to guide the process in those areas which are new or specific to self-testing. Stakeholders in three HIV endemic sub-Saharan countries felt that HIVST will be an important complement to existing community and facility
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ERIC Educational Resources Information Center
Swedish International Development Authority (SIDA).
This report summarizes the African Regional Seminar for Advanced Training in Systematic Curriculum Development and Evaluation that was held at Achimota, Ghana, July 14-August 15 1975. Attending the seminar were 67 participants from 12 African countries, including Cameroon, Gambia, Ghana, Kenya, Liberia, Malawi, Nigeria, Sierra Leone, Swaziland,…
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ERIC Educational Resources Information Center
Lewin, Keith M.; Sabates, Ricardo
2011-01-01
This paper explores patterns of growth in participation in six Anglophone and seven Francophone countries in SSA. The countries are Kenya, Malawi, Nigeria, Tanzania, Uganda, Zambia, Benin, Burkina Faso, Cameroon, Madagascar, Mali, Niger and Senegal. These countries all have large scale Universal Primary Education programmes and all have…
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Social Studies in African Education.
ERIC Educational Resources Information Center
Adeyemi, Michael B., Ed.
This collection of essays is organized into two sections: Section 1 deals with general issues in social studies, while Section 2 examines social studies education in Botswana, Ethiopia, Ghana, Kenya, Malawi, Namibia, Nigeria, Tanzania, and Zambia. Essays in Section One are: (1) "The Historical Context of Education in British Colonial…
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NASA Astrophysics Data System (ADS)
Vicarelli, M.; Giannini, A.; Osgood, D.
2009-12-01
In this study we explore the potential for re-insurance schemes built on regional climatic forecasts. We focus on micro-insurance contracts indexed on precipitation in 9 villages in Kenya, Tanzania (Eastern Africa) and Malawi (Southern Africa), and analyze the precipitation patterns and payouts resulting from El Niño Southern Oscillation (ENSO). The inability to manage future climate risk represents a “poverty trap” for several African regions. Weather shocks can potentially destabilize not only household, but also entire countries. Governments in drought-prone countries, donors and relief agencies are becoming aware of the importance to develop an ex-ante risk management framework for weather risk. Joint efforts to develop innovative mechanisms to spread and pool risk such as microinsurance and microcredit are currently being designed in several developing countries. While ENSO is an important component in modulating the rainfall regime in tropical Africa, the micro-insurance experiments currently under development to address drought risk among smallholder farmers in this region do not take into account ENSO monitoring or forecasting yet. ENSO forecasts could be integrated in the contracts and reinsurance schemes could be designed at the continental scale taking advantage of the different impact of ENSO on different regions. ENSO is associated to a bipolar precipitation pattern in Southern and Eastern Africa. La Niña years (i.e. Cold ENSO Episodes) are characterized by dry climate in Eastern Africa and wet climate in Southern Africa. During El Niño (or Warm Episode) the precipitation dipole is inverted, and Eastern Africa experiences increased probability for above normal rainfall (Halpert and Ropelewski, 1992, Journal of Climate). Our study represents the first exercise in trying to include ENSO forecasts in micro weather index insurance contract design. We analyzed the contracts payouts with respect to climate variability. In particular (i) we simulated
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Movement ecology of five Afrotropical waterfowl species from Malawi, Mali and Nigeria
Takekawa, John Y.; Heath, Shane R.; Iverson, S.R.L.; Gaidet, Nicolas; Cappelle, Julien; Dodman, Tim; Hagemeijer, Ward; Eldridge, William D.; Petrie, Scott A.; Yarris, Gregory S.; Manu, Shiiwua; Olsen, Glenn H.; Prosser, Diann J.; Spragens, Kyle A.; Douglas, David C.; Newman, Scott H.
2015-01-01
Habitat availability for Afrotropical waterbirds is highly dynamic with unpredictable rainfall patterns and ephemeral wetlands resulting in diverse movement strategies among different species. Movement strategies among waterfowl encompass resident, regional and intercontinental migrants, but little quantitative information exists on their specific movement patterns. We studied the movement ecology of five Afrotropical waterfowl species marked with satellite transmitters in Malawi, Mali and Nigeria. Resident species, including White-faced Whistling Ducks Dendrocygna viduata, Fulvous Whistling Ducks Dendrocygna bicolor and Spur-winged Geese Plectropterus gambensis, remained sedentary during the rainy season and only flew limited distances during other months. In contrast, Knob-billed Ducks Sarkidiornis melanotos made short regional movements >50 km in all months and showed little site fidelity to previously used habitats in subsequent years. Garganey Anas quequedula followed an intercontinental strategy and made long-distance jumps across the Sahara and Mediterranean to their Eurasian breeding grounds. Most species flew farthest during the dry season, as mean daily movements varied from 1.5 to 14.2 km and was greatest in the winter months (January-March). Total distance moved varied from 9.5 km for White-faced Whistling Ducks (October-December) to 45.6 km for Knob-billed Ducks (April-June). Nomadic behaviour by Knob-billed Ducks was evidenced by long exploratory flights, but small mean daily movements suggested that they were relying on previous experience. Improving our understanding of these movement strategies increases our ability to assess connectivity of wetland resources that support waterfowl throughout their annual cycle and focuses conservation efforts on their most important habitats.
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Stephenson, Rob; Winter, Amy; Elfstrom, Miriam
2013-01-01
Transactional sex, or the exchange of sex for material goods or money, is a risky sexual behavior that has been linked to HIV/AIDS and gender-based violence. Throughout sub-Saharan Africa, transactional sex remains a common practice, putting men and women at risk of HIV. However, little is known of how community environments shape men's participation in risky transactional sex. This analysis examines community-level influences on participation in risky transactional sex among sexually active men in three African countries (Malawi, Tanzania, and Nigeria). The analysis uses Demographic and Health Survey (DHS) data to examine the association between men's report of risky transactional sex and community characteristics including economic, gender norms, HIV behavior and knowledge, and demographic factors. The results show that men residing in communities with more female education and later age of first birth are less likely to report risky transactional sex, while men who live in communities where men report higher number of sexual partners are more likely to report risky transactional sex. While programmatic interventions should continue to improve women's status individually and relative to men, such efforts should be extended to recognize that many community and cultural influences also affect men's sexual behavior. Programs that understand, discuss, and challenge community factors that influence men's sexual behavior may be able to provide a more effective intervention resulting in opportunities for communities to initiate behavioral change.
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Biosystematics of Aedes (Neomelaniconion)
1989-06-01
Coast , Ghana, Nigeria, Central African Republic, Sudan, Ethiopia, Zaire, Uganda, Kenya, Rwanda, Zambia , Malawi, Mozambique, and South Africa. In...Rift Valley fever virus. A complete understanding of the natural history of this virus is not possible without better knowledge of these mosquitoes...have been isolated from species of Neomelaniconion (20). The virus that causes Rift Valley fever , an important disease of domestic animals and humans
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Funding and expenditure of a sample of community-based organizations in Kenya, Nigeria, and Zimbabwe
Krivelyova, Anya; Kakietek, Jakub; Connolly, Helen; Bonnel, Rene; Manteuffel, Brigitte; Rodriguez-García, Rosalía; N'Jie, N'Della; Berruti, Andres; Gregson, Simon; Agrawal, Ruchika
2013-01-01
Over the last decade, international donors, technical specialists, and governments have come to recognize the potential of community-based organizations (CBOs) in the fight against HIV/AIDS. Recent empirical studies suggest that community engagement, including the involvement of CBOs, adds value to the national response to HIV/AIDS. With the emerging evidence of the effectiveness of engaging communities in the fight against AIDS, it is crucial to understand the economic dimension of community engagement. This article provides an analysis of funding and expenditure data collected from CBOs in three African countries: Kenya, Nigeria, and Zimbabwe. It presents descriptive information regarding CBO funding and expenditure and examines the factors associated with the total amount of funds received and with the proportions of the funds allocated to programmatic activities and program management and administration. An average CBO in the sample received US$29,800 annually or about US$2480 per month. The highest percentage of CBO funding (37%) came from multilateral organizations. CBOs in the sample spent most of their funds (71%) on programmatic activities including provision of treatment, support, care, impact mitigation, and treatment services. PMID:23745626
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Krivelyova, Anya; Kakietek, Jakub; Connolly, Helen; Bonnel, Rene; Manteuffel, Brigitte; Rodriguez-García, Rosalía; N'Jie, N'Della; Berruti, Andres; Gregson, Simon; Agrawal, Ruchika
2013-01-01
Over the last decade, international donors, technical specialists, and governments have come to recognize the potential of community-based organizations (CBOs) in the fight against HIV/AIDS. Recent empirical studies suggest that community engagement, including the involvement of CBOs, adds value to the national response to HIV/AIDS. With the emerging evidence of the effectiveness of engaging communities in the fight against AIDS, it is crucial to understand the economic dimension of community engagement. This article provides an analysis of funding and expenditure data collected from CBOs in three African countries: Kenya, Nigeria, and Zimbabwe. It presents descriptive information regarding CBO funding and expenditure and examines the factors associated with the total amount of funds received and with the proportions of the funds allocated to programmatic activities and program management and administration. An average CBO in the sample received US$29,800 annually or about US$2480 per month. The highest percentage of CBO funding (37%) came from multilateral organizations. CBOs in the sample spent most of their funds (71%) on programmatic activities including provision of treatment, support, care, impact mitigation, and treatment services.
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GDP Matters: Cost Effectiveness of Cochlear Implantation and Deaf Education in Sub-Saharan Africa.
Emmett, Susan D; Tucci, Debara L; Smith, Magteld; Macharia, Isaac M; Ndegwa, Serah N; Nakku, Doreen; Mukara, Kaitesi B; Kaitesi, Mukara B; Ibekwe, Titus S; Mulwafu, Wakisa; Gong, Wenfeng; Francis, Howard W; Saunders, James E
2015-09-01
Cochlear implantation and deaf education are cost effective in Sub-Saharan Africa. Cost effectiveness of pediatric cochlear implantation has been well established in developed countries but is unknown in low resource settings, where access to the technology has traditionally been limited. With incidence of severe-to-profound congenital sensorineural hearing loss 5 to 6 times higher in low/middle-income countries than the United States and Europe, developing cost-effective management strategies in these settings is critical. Costs were obtained from experts in Nigeria, South Africa, Kenya, Rwanda, Uganda, and Malawi using known costs and published data, with estimation when necessary. A disability adjusted life years (DALY) model was applied using 3% discounting and 10-year length of analysis. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the WHO standard of cost-effectiveness ratio/gross domestic product per capita (CER/GDP) less than 3. Cochlear implantation was cost effective in South Africa and Nigeria, with CER/GDP of 1.03 and 2.05, respectively. Deaf education was cost effective in all countries investigated, with CER/GDP ranging from 0.55 to 1.56. The most influential factor in the sensitivity analysis was device cost, with the cost-effective threshold reached in all countries using discounted device costs that varied directly with GDP. Cochlear implantation and deaf education are equally cost effective in lower-middle and upper-middle income economies of Nigeria and South Africa. Device cost may have greater impact in the emerging economies of Kenya, Uganda, Rwanda, and Malawi.
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Speizer, Ilene S; Guilkey, David; Calhoun, Lisa M; Corroon, Meghan; O'Hara, Rick
2017-01-31
The adolescent (ages 15-19) and young adult (ages 20-24) years are a crucial time as many sexual and reproductive health (SRH) transitions take place in these years. The study of youth SRH transitions in sub-Saharan Africa is limited due to a paucity of longitudinal data needed to examine the timing and circumstances of these transitions. This paper uses recently collected longitudinal data from select urban areas in Kenya and Nigeria that include a large youth sample at baseline (2010/2011) and endline (2014). We control for unobserved heterogeneity in our modelling approach to correct for selectivity issues that are often ignored in similar types of analyses. We demonstrate that the transition patterns (i.e., sexual initiation, first marriage, and first pregnancy/birth) differ within and across the urban areas and countries studied. Urban Kenyan youth have more premarital sex and pregnancy than youth from the Nigerian cities. Further analyses demonstrate that more educated and wealthier youth transition later than their less educated and poorer counterparts. The findings from this study can be used to inform programs seeking to serve young people based on their varying reproductive health needs in different contexts over the adolescent and young adult years.
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Mensch, Barbara S.; Hewett, Paul C.; Gregory, Richard; Helleringer, Stephane
2008-01-01
This study investigates the reporting of premarital sex in rural southern Malawi. It summarizes the results of an interview-mode experiment conducted with unmarried young women aged 15–21 in which respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. In addition, biomarkers were collected for HIV and three STIs: gonorrhea, chlamydia, and trichomoniasis. Prior to collecting the biomarkers, nurses conducted a short face-to-face interview in which they repeated questions about sexual behavior. The study builds on earlier research among adolescents in Kenya where we first investigated the feasibility and effectiveness of ACASI. In both Malawi and Kenya, the mode of interviewing and questions about types of sexual partners affect the reporting of sexual activity. Yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode. When we ask about other partners as well as multiple lifetime partners, however, the reporting is consistently higher with ACASI, in many cases significantly so. The FTF mode produced more consistent reporting of sexual activity between the main interview and a subsequent interview. The association between infection status and reporting of sexual behavior is stronger in the FTF mode, although in both modes a number of young women who denied ever having sex test positive for STIs/HIV. PMID:19248718
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OUTLINE OF VOCATIONAL TRAINING IN MALAWI.
ERIC Educational Resources Information Center
Australian Dept. of Labour and National Service, Perth.
THE 1963 POPULATION OF MALAWI WAS 3,753,000. MALAWI'S ECONOMY IS BASED ON AGRICULTURE. PRIMARY EDUCATION COVERS 8 YEARS AND ENROLLS 98 PERCENT OF THE 380,000 PUPILS IN SCHOOL. TECHNICAL SCHOOLS INCLUDE TRADE- AND TECHNICIAN-ORIENTED PROGRAMS UNDER THE MINISTRY OF EDUCATION. A NEW UNIVERSITY OF MALAWI INCLUDES NO COURSES OF A TECHNICAL NATURE, BUT…
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Njelesani, Janet; Dacombe, Russell; Palmer, Tanith; Smith, Helen; Koudou, Benjamin; Bockarie, Moses; Bates, Imelda
2014-01-01
Background The lack of capacity in laboratory systems is a major barrier to achieving the aims of the London Declaration (2012) on neglected tropical diseases (NTDs). To counter this, capacity strengthening initiatives have been carried out in NTD laboratories worldwide. Many of these initiatives focus on individuals' skills or institutional processes and structures ignoring the crucial interactions between the laboratory and the wider national and international context. Furthermore, rigorous methods to assess these initiatives once they have been implemented are scarce. To address these gaps we developed a set of assessment and monitoring tools that can be used to determine the capacities required and achieved by laboratory systems at the individual, organizational, and national/international levels to support the control of NTDs. Methodology and principal findings We developed a set of qualitative and quantitative assessment and monitoring tools based on published evidence on optimal laboratory capacity. We implemented the tools with laboratory managers in Ghana, Malawi, Kenya, and Sri Lanka. Using the tools enabled us to identify strengths and gaps in the laboratory systems from the following perspectives: laboratory quality benchmarked against ISO 15189 standards, the potential for the laboratories to provide support to national and regional NTD control programmes, and the laboratory's position within relevant national and international networks and collaborations. Conclusion We have developed a set of mixed methods assessment and monitoring tools based on evidence derived from the components needed to strengthen the capacity of laboratory systems to control NTDs. Our tools help to systematically assess and monitor individual, organizational, and wider system level capacity of laboratory systems for NTD control and can be applied in different country contexts. PMID:24603407
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IMMUNISATION TRAINING NEEDS IN MALAWI.
Tsega, A Y; Hausi, H T; Steinglass, R; Chirwa, G Z
2014-09-01
The Malawi Ministry of Health (MOH) and its immunisation partners conducted a training needs assessment in May 2013 to assess the current status of immunisation training programmemes in health training institutions, to identify unmet training needs, and to recommend possible solutions for training of health workers on a regular basis. A cross-sectional, descriptive study. Health training institutions in Malawi, a developing country that does not regularly update its curricula to include new vaccines and management tools, nor train healthcare workers on a regular basis. Researchers interviewed Malawi's central immunisation manager, three zonal immunisation officers, six district officers, 12 health facility immunisation coordinators, and eight principals of training institutions. All health training institutions in Malawi include immunisation in their preservice training curricula. However, the curriculum is not regularly updated; thus, the graduates are not well equipped to provide quality services. In addition, the duration of the training curriculum is inadequate, and in-service training sessions for managers and service providers are conducted only on an ad hoc basis. All levels of Malawi's health system have not met sufficient training needs for providing immunisations, and the health training institutions teach their students with outdated materials. It is recommended that the training institutions update their training curricula regularly and the service providers are trained on a regular basis.
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Global leaf companies control the tobacco market in Malawi.
Otañez, Marty G; Mamudu, Hadii; Glantz, Stanton A
2007-08-01
To examine the influence of US-based tobacco leaf-buying companies, Universal Corporation and Alliance One International, on Malawi's economy and trade policy in 2000-6. Analyses of ethnographic data and tobacco industry documents. Universal Corporation and Alliance One International, through their subsidiary companies Limbe Leaf and Alliance One, respectively, in Malawi, control policy-making advisory groups and operate a tobacco cartel to influence Malawi's economic and trade sectors. Limbe Leaf's corporate secretary and lawyer is a member of several policy-making committees that advise the Malawi government on tobacco-related trade policy. The corporate representative's presence prevents other committee members from taking positions against the tobacco industry and ensures government policy that advances industry interests to obtain low-cost tobacco. The World Bank and Malawi's Anti-corruption Bureau report allegations of collusion between Limbe Leaf and Alliance One over prices at tobacco markets. Allegations of collusion between Limbe Leaf and Alliance One prompted Malawi President Bingu Mutharika in 2006 to warn the companies to end non-competitive practices or leave the country, but there was no meaningful follow-up action. Findings from interviews with small-scale tobacco traders in Malawi suggest that Universal and Alliance One International purchase smuggled raw tobacco from the neighbouring countries, Zambia and Mozambique, undermining growers' efforts to benefit from tobacco farming in Malawi. These actions restrict competition, depress tobacco prices for Malawi's farmers and contribute to poverty in Malawi, while keeping the country dependent on tobacco growing.
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Incidence of induced abortion in Malawi, 2015.
Polis, Chelsea B; Mhango, Chisale; Philbin, Jesse; Chimwaza, Wanangwa; Chipeta, Effie; Msusa, Ausbert
2017-01-01
In Malawi, abortion is legal only if performed to save a woman's life; other attempts to procure an abortion are punishable by 7-14 years imprisonment. Most induced abortions in Malawi are performed under unsafe conditions, contributing to Malawi's high maternal mortality ratio. Malawians are currently debating whether to provide additional exceptions under which an abortion may be legally obtained. An estimated 67,300 induced abortions occurred in Malawi in 2009 (equivalent to 23 abortions per 1,000 women aged 15-44), but changes since 2009, including dramatic increases in contraceptive prevalence, may have impacted abortion rates. We conducted a nationally representative survey of health facilities to estimate the number of cases of post-abortion care, as well as a survey of knowledgeable informants to estimate the probability of needing and obtaining post-abortion care following induced abortion. These data were combined with national population and fertility data to determine current estimates of induced abortion and unintended pregnancy in Malawi using the Abortion Incidence Complications Methodology. We estimate that approximately 141,044 (95% CI: 121,161-160,928) induced abortions occurred in Malawi in 2015, translating to a national rate of 38 abortions per 1,000 women aged 15-49 (95% CI: 32 to 43); which varied by geographical zone (range: 28-61). We estimate that 53% of pregnancies in Malawi are unintended, and that 30% of unintended pregnancies end in abortion. Given the challenges of estimating induced abortion, and the assumptions required for calculation, results should be viewed as approximate estimates, rather than exact measures. The estimated abortion rate in 2015 is higher than in 2009 (potentially due to methodological differences), but similar to recent estimates from nearby countries including Tanzania (36), Uganda (39), and regional estimates in Eastern and Southern Africa (34-35). Over half of pregnancies in Malawi are unintended. Our
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Projected changes in Malawi's growing season
NASA Astrophysics Data System (ADS)
Vizy, Edward K.; Cook, Kerry H.; Chimphamba, James; McCusker, Brent
2015-09-01
Regional climate model projections at 30-km resolution are used to predict future mid-century and late-century growing season changes over Malawi due to global warming under the Representative Concentration Pathway 8.5 business-as-usual emissions forcing scenario. Three different methods for estimating growing season characteristics are applied and evaluated. All three methods yield reasonable growing season length, onset, and demise date estimates over Malawi given the wide range of uncertainty of the observations. The projections indicate the likelihood for a shorter growing season in the future over Malawi south of 13.5°S. At mid-century the growing season length is predicted to be 20-40 % (20-55 days) shorter over the southernmost districts and 5-20 % (5-30 days) shorter over the central districts. By late-century the length is predicted to be 25-55 % (20-70 days) shorter with significant differences extending into northern Malawi. The shorter growing season is primarily associated with an earlier demise date, as no significant change in the onset date is predicted. Analysis of the regional circulation and horizontal moisture flux transport indicates that the earlier demise is associated with an intensification of the thermal low over the Kalahari Desert to the south and west of Malawi and an expansion of the mid-tropospheric Kalahari anticyclone over southern Africa. The stronger thermal low/anticyclone enhances the moisture flux divergence over Malawi suppressing the convective activity at the end of the wet season.
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Global leaf companies control the tobacco market in Malawi
Otañez, Marty G; Mamudu, Hadii; Glantz, Stanton A
2007-01-01
Objective To examine the influence of US‐based tobacco leaf‐buying companies, Universal Corporation and Alliance One International, on Malawi's economy and trade policy in 2000–6. Design Analyses of ethnographic data and tobacco industry documents. Results Universal Corporation and Alliance One International, through their subsidiary companies Limbe Leaf and Alliance One, respectively, in Malawi, control policy‐making advisory groups and operate a tobacco cartel to influence Malawi's economic and trade sectors. Limbe Leaf's corporate secretary and lawyer is a member of several policy‐making committees that advise the Malawi government on tobacco‐related trade policy. The corporate representative's presence prevents other committee members from taking positions against the tobacco industry and ensures government policy that advances industry interests to obtain low‐cost tobacco. The World Bank and Malawi's Anti‐corruption Bureau report allegations of collusion between Limbe Leaf and Alliance One over prices at tobacco markets. Allegations of collusion between Limbe Leaf and Alliance One prompted Malawi President Bingu Mutharika in 2006 to warn the companies to end non‐competitive practices or leave the country, but there was no meaningful follow‐up action. Findings from interviews with small‐scale tobacco traders in Malawi suggest that Universal and Alliance One International purchase smuggled raw tobacco from the neighbouring countries, Zambia and Mozambique, undermining growers' efforts to benefit from tobacco farming in Malawi. Conclusion These actions restrict competition, depress tobacco prices for Malawi's farmers and contribute to poverty in Malawi, while keeping the country dependent on tobacco growing. PMID:17652242
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Obanda, Vincent; Michuki, George; Jowers, Michael J; Rumberia, Cecilia; Mutinda, Mathew; Lwande, Olivia Wesula; Wangoru, Kihara; Kasiiti-Orengo, Jacquiline; Yongo, Moses; Angelone-Alasaad, Samer
2016-07-01
Following mass deaths of Laughing Doves (Streptopelia senegalensis) in different localities throughout Kenya, internal organs obtained during necropsy of two moribund birds were sampled and analyzed by next generation sequencing. We isolated the virulent strain of pigeon paramyxovirus type-1 (PPMV-1), PPMV1/Laughing Dove/Kenya/Isiolo/B2/2012, which had a characteristic fusion gene motif (110)GGRRQKRF(117). We obtained a partial full genome of 15,114 nucleotides. The phylogenetic relationship based on the fusion gene and genomic sequence grouped our isolate as class II genotype VI, a group of viruses commonly isolated from wild birds but potentially lethal to Chickens ( Gallus gallus domesticus ). The fusion gene isolate clustered with PPMV-I strains from pigeons (Columbidae) in Nigeria. The complete genome showed a basal and highly divergent lineage to American, European, and Asian strains, indicating a divergent evolutionary pathway. The isolated strain is highly virulent and apparently species-specific to Laughing Doves in Kenya. Risk of transmission of such a strain to poultry is potentially high whereas the cyclic epizootic in doves is a threat to conservation of wild Columbidae in Kenya.
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Incidence of induced abortion in Malawi, 2015
Mhango, Chisale; Philbin, Jesse; Chimwaza, Wanangwa; Chipeta, Effie; Msusa, Ausbert
2017-01-01
Background In Malawi, abortion is legal only if performed to save a woman’s life; other attempts to procure an abortion are punishable by 7–14 years imprisonment. Most induced abortions in Malawi are performed under unsafe conditions, contributing to Malawi’s high maternal mortality ratio. Malawians are currently debating whether to provide additional exceptions under which an abortion may be legally obtained. An estimated 67,300 induced abortions occurred in Malawi in 2009 (equivalent to 23 abortions per 1,000 women aged 15–44), but changes since 2009, including dramatic increases in contraceptive prevalence, may have impacted abortion rates. Methods We conducted a nationally representative survey of health facilities to estimate the number of cases of post-abortion care, as well as a survey of knowledgeable informants to estimate the probability of needing and obtaining post-abortion care following induced abortion. These data were combined with national population and fertility data to determine current estimates of induced abortion and unintended pregnancy in Malawi using the Abortion Incidence Complications Methodology. Results We estimate that approximately 141,044 (95% CI: 121,161–160,928) induced abortions occurred in Malawi in 2015, translating to a national rate of 38 abortions per 1,000 women aged 15–49 (95% CI: 32 to 43); which varied by geographical zone (range: 28–61). We estimate that 53% of pregnancies in Malawi are unintended, and that 30% of unintended pregnancies end in abortion. Given the challenges of estimating induced abortion, and the assumptions required for calculation, results should be viewed as approximate estimates, rather than exact measures. Conclusions The estimated abortion rate in 2015 is higher than in 2009 (potentially due to methodological differences), but similar to recent estimates from nearby countries including Tanzania (36), Uganda (39), and regional estimates in Eastern and Southern Africa (34–35). Over
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An economic perspective on Malawi's medical "brain drain".
Record, Richard; Mohiddin, Abdu
2006-12-18
The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding.Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production") of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance) to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. There is concern about the negative impacts of the medical "brain-drain". However a closer look at the evidence for and against the medical
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2014-01-01
Background There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students’ perspectives on specialization training in Malawi. Methods We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an “editing approach” to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. Results We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Conclusions Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country’s healthcare workforce and the needs of their
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Sawatsky, Adam P; Parekh, Natasha; Muula, Adamson S; Bui, Thuy
2014-01-06
There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students' perspectives on specialization training in Malawi. We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an "editing approach" to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country's healthcare workforce and the needs of their graduating medical students to be able to
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An economic perspective on Malawi's medical "brain drain"
Record, Richard; Mohiddin, Abdu
2006-01-01
Background The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. Discussion Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding. Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production") of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance) to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. Summary There is concern about the negative impacts of the medical "brain-drain". However a closer look at the evidence
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Feasey, Nicholas A; Everett, Dean; Faragher, E Brian; Roca-Feltrer, Arantxa; Kang'ombe, Arthur; Denis, Brigitte; Kerac, Marko; Molyneux, Elizabeth; Molyneux, Malcolm; Jahn, Andreas; Gordon, Melita A; Heyderman, Robert S
2015-01-01
Nontyphoidal Salmonellae (NTS) are responsible for a huge burden of bloodstream infection in Sub-Saharan African children. Recent reports of a decline in invasive NTS (iNTS) disease from Kenya and The Gambia have emphasised an association with malaria control. Following a similar decline in iNTS disease in Malawi, we have used 9 years of continuous longitudinal data to model the interrelationships between iNTS disease, malaria, HIV and malnutrition. Trends in monthly numbers of childhood iNTS disease presenting at Queen's Hospital, Blantyre, Malawi from 2002 to 2010 were reviewed in the context of longitudinal monthly data describing malaria slide-positivity among paediatric febrile admissions, paediatric HIV prevalence, nutritional rehabilitation unit admissions and monthly rainfall over the same 9 years, using structural equation models (SEM). Analysis of 3,105 iNTS episodes identified from 49,093 blood cultures, showed an 11.8% annual decline in iNTS (p < 0.001). SEM analysis produced a stable model with good fit, revealing direct and statistically significant seasonal effects of malaria and malnutrition on the prevalence of iNTS disease. When these data were smoothed to eliminate seasonal cyclic changes, these associations remained strong and there were additional significant effects of HIV prevalence. These data suggest that the overall decline in iNTS disease observed in Malawi is attributable to multiple public health interventions leading to reductions in malaria, HIV and acute malnutrition. Understanding the impacts of public health programmes on iNTS disease is essential to plan and evaluate interventions.
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Strides in Preservation of Malawi's Natural Stone
NASA Astrophysics Data System (ADS)
Kamanga, Tamara; Chisenga, Chikondi; Katonda, Vincent
2017-04-01
The geology of Malawi is broadly grouped into four main lithological units that is the Basement Complex, the Karoo Super group, Tertiary to Quaternary sedimentary deposits and the Chilwa Alkaline province. The basement complex rocks cover much of the country and range in age from late Precambrian to early Paleozoic. They have been affected by three major phases of deformation and metamorphism that is the Irumide, Ubendian and The Pan-African. These rocks comprise gneisses, granulites and schists with associated mafic, ultramafic, syenites and granite rocks. The Karoo System sedimentary rocks range in age from Permian to lower Jurassic and are mainly restricted to two areas in the extreme North and extreme Alkaline Province - late Jurassic to Cretaceous in age, preceded by upper Karoo Dolerite dyke swarms and basaltic lavas, have been intruded into the Basement Complex gneisses of southern Malawi. Malawi is endowed with different types of natural stone deposits most of which remain unexploited and explored. Over twenty quarry operators supply quarry stone for road and building construction in Malawi. Hundreds of artisanal workers continue to supply aggregate stones within and on the outskirts of urban areas. Ornamental stones and granitic dimension stones are also quarried, but in insignificant volumes. In Northern Malawi, there are several granite deposits including the Nyika, which is the largest single outcrop occupying approximately 260.5 km2 , Mtwalo Amazonite an opaque to translucent bluish -green variety of microcline feldspar that occurs in alkali granites and pegmatite, the Ilomba granite (sodalite) occurring in small areas within biotite; apatite, plagioclase and calcite. In the Center, there are the Dzalanyama granites, and the Sani granites. In the South, there are the Mangochi granites. Dolerite and gabbroic rocks spread across the country, treading as black granites. Malawi is also endowed with many deposits of marble. A variety of other igneous
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Risk Communication of Groundwater Quality in Northern Malawi, Africa
NASA Astrophysics Data System (ADS)
Holm, R.
2011-12-01
Malawi lies in Africa's Great Rift Valley. Its western border is defined by Lake Malawi, the third largest lake in Africa. Over 80% of Malawians live in rural areas and 90% of the labor force is associated with agriculture. More than half of the population lives below the poverty line. Area characteristics indicate a high likelihood of nitrate and total coliform in community drinking water. Infants exposed to high nitrate are at risk of developing methemoglobinemia. In addition, diarrheal diseases from unsafe drinking water are one of the top causes of mortality in children under five. Without sufficient and sustainable supplies of clean water, these challenges will continue to threaten Malawi's ability to overcome the devastating impact of diarrheal diseases on its population. Therefore, Malawi remains highly dependent on outside assistance and influence to reduce or eliminate the threat posed by unsafe drinking water. This research presents a literature review of nitrate and total coliform groundwater quality and a proposed risk communication plan for drinking water in northern Malawi.
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Identifying urban infrastructure multi-hazard risk in developing country contexts
NASA Astrophysics Data System (ADS)
Taylor, Faith; Malamud, Bruce; Millington, James
2017-04-01
This work presents a method to coarsely zone urban areas into different infrastructure typologies, from which physical vulnerability to a range of natural hazards and multi-hazard interactions can be estimated, particularly for developing country contexts where access to data can be a challenge. This work builds upon techniques developed for urban micrometeorology for classifying 12 urban typologies (Stewart and Oke, 2011) using Landsat 8 30 m × 30 m remote sensing imagery (Betchel et al., 2015). For each of these 12 urban typologies, we develop general rules about the presence, type and level of service of 10 broad categories of infrastructure (including buildings, roads, electricity and water), which we refer to as 'urban textures'. We have developed and applied this technique to five urban areas varying in size and structure across Africa: Nairobi (Kenya); Karonga (Malawi); Mzuzu (Malawi); Ibadan (Nigeria) and Cape Town (South Africa). For each urban area, a training dataset of 10 samples of each of the 12 urban texture classes is digitised using Google Earth imagery. A random forest classification is performed using SAGA GIS, resulting in a map of different urban typologies for each city. Based on >1200 georeferenced field photographs and expert interviews for Karonga (Malawi) and Nairobi (Kenya), generally applicable rules about the presence, type and level of service of 12 infrastructure types (the 'urban texture') are developed for each urban typology. For each urban texture, we are broadly reviewing how each infrastructure might be physically impacted by 21 different natural hazards and hazard interactions. This can aid local stakeholders such as emergency responders and urban planners to systematically identify how the infrastructure in different parts of an urban area might be affected differently during a natural disaster event.
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A strategic assessment of unsafe abortion in Malawi.
Jackson, Emily; Johnson, Brooke Ronald; Gebreselassie, Hailemichael; Kangaude, Godfrey D; Mhango, Chisale
2011-05-01
As part of efforts to achieve Millennium Development Goal 5--to reduce maternal mortality by 75% and achieve universal access to reproductive health by 2015--the Malawi Ministry of Health conducted a strategic assessment of unsafe abortion in Malawi. This paper describes the findings of the assessment, including a human rights-based review of Malawi's laws, policies and international agreements relating to sexual and reproductive health and data from 485 in-depth interviews about sexual and reproductive health, maternal mortality and unsafe abortion, conducted with Malawians from all parts of the country and social strata. Consensus recommendations to address the issue of unsafe abortion were developed by a broad base of local and international stakeholders during a national dissemination meeting. Malawi's restrictive abortion law, inaccessibility of safe abortion services, particularly for poor and young women, and lack of adequate family planning, youth-friendly and post-abortion care services were the most important barriers. The consensus reached was that to make abortion safe in Malawi, there were four areas for urgent action--abortion law reform; sexuality education and family planning; adolescent sexual and reproductive health services; and post-abortion care services. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
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Bello, Bamidele M; Fatusi, Adesegun O; Adepoju, Oluwatomi E; Maina, Beatrice W; Kabiru, Caroline W; Sommer, Marni; Mmari, Kristin
2017-10-01
This qualitative study assesses the cross-cultural and intergenerational reactions of young adolescents and parents to puberty in Ile-Ife, Nigeria, and Nairobi, Kenya. Sixty-six boys and girls (aged 11-13 years) and their parents participated in narrative interviews conducted in English or local languages in two urban poor settings in Ile-Ife and Nairobi. All interviews were recorded, transcribed, translated, and uploaded into Atlas.ti software for coding and analysis. Reactions of parents and adolescents to puberty were similar across both sites, with few exceptions. Adolescents' reactions to bodily changes varied from anxiety to pride. Adolescents generally tend to desire greater privacy; trying to hide their developing bodies from others. Most female adolescents emphasized breast development as compared with menstruation as the mark for pubertal initiation, while males emphasized voice changes. Among some ethnic groups in Nairobi, parents and adolescents view male circumcision as the hallmark of adolescence. Parents in both sites reported that with pubertal changes, adolescents tend to become arrogant and engaged in sexual relationships. Parents' reported responses to puberty include: educating adolescents on bodily changes; counseling on sexual relationships; and, provision of sanitary towels to females. Parents' responses are generally focused more on daughters. Approaches used by mothers in educating adolescents varied from the provision of factual information to fear/scare tactics. Compared with their own generation, parents perceive that their own children achieve pubertal development earlier, receive more puberty-related education from mothers, and are more exposed to and influenced by media and information technologies. Adolescents' responses to their pubertal bodily changes include anxiety, shame, and pride. Adolescents desire greater privacy. Parents' reactions were broadly supportive of their children's pubertal transition, but mothers' communication
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ERIC Educational Resources Information Center
Chazema, Jacqueline; O'Meara, James
2011-01-01
The establishment of formal teacher training systems is a relatively new innovation in some parts of Africa. Formal training of secondary teachers in Malawi commenced when the government of Malawi opened the University of Malawi in 1965. The contribution of Malawi's ruling parties to the development of teacher education in Malawi since then is an…
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Geostatistical modelling of household malaria in Malawi
NASA Astrophysics Data System (ADS)
Chirombo, J.; Lowe, R.; Kazembe, L.
2012-04-01
Malaria is one of the most important diseases in the world today, common in tropical and subtropical areas with sub-Saharan Africa being the region most burdened, including Malawi. This region has the right combination of biotic and abiotic components, including socioeconomic, climatic and environmental factors that sustain transmission of the disease. Differences in these conditions across the country consequently lead to spatial variation in risk of the disease. Analysis of nationwide survey data that takes into account this spatial variation is crucial in a resource constrained country like Malawi for targeted allocation of scare resources in the fight against malaria. Previous efforts to map malaria risk in Malawi have been based on limited data collected from small surveys. The Malaria Indicator Survey conducted in 2010 is the most comprehensive malaria survey carried out in Malawi and provides point referenced data for the study. The data has been shown to be spatially correlated. We use Bayesian logistic regression models with spatial correlation to model the relationship between malaria presence in children and covariates such as socioeconomic status of households and meteorological conditions. This spatial model is then used to assess how malaria varies spatially and a malaria risk map for Malawi is produced. By taking intervention measures into account, the developed model is used to assess whether they have an effect on the spatial distribution of the disease and Bayesian kriging is used to predict areas where malaria risk is more likely to increase. It is hoped that this study can help reveal areas that require more attention from the authorities in the continuing fight against malaria, particularly in children under the age of five.
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2007-03-01
abroad to assist targeted coun- tries—for example, in Kenya where key areas include economic and small business development, education, and public... culture .88 By sending Chinese teachers and exhibiting Chinese culture , the PRC at- tempted to influence the Ethiopian people directly. PRC political...performances, attracting an audience of 100,000 during a half-month tour of Kenya. The troupe not only acted as envoys of Chinese culture but also
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Menaca, Arantza; Pell, Christopher; Manda-Taylor, Lucinda; Chatio, Samuel; Afrah, Nana A; Were, Florence; Hodgson, Abraham; Ouma, Peter; Kalilani, Linda; Tagbor, Harry; Pool, Robert
2013-07-22
In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores and compares local understandings of MiP and their links with other pregnancy-related health problems. A comparative qualitative study was undertaken at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. MiP-related behaviours were also observed at health facilities and in local communities. Across the four sites, local malaria concepts overlapped with biomedically defined malaria. In terms of symptoms, at-risk groups, outcomes and aetiology of malaria during pregnancy, this overlap was however both site-specific and partial. Moreover, the local malaria concepts were not monolithic and their descriptions varied amongst respondents. The symptoms of pregnancy and malaria also overlapped but, for respondents, symptom severity was the distinguishing factor. Malaria was generally, though not universally, perceived as serious for pregnant women. Miscarriage was the most widely known outcome, and links with anaemia, low birth weight and congenital malaria were mentioned. Nonetheless, amongst many potential causes of miscarriage, malaria was not recognized as the most important, but rather interacted with other pregnancy-related problems. Given the overlap of common pregnancy problems with the symptoms of malaria, and the limited association of malaria with its main outcomes, a comprehensive antenatal care programme is the most appropriate strategy for the provision of health education, prevention and treatment for MiP. Variations in locally shared understandings of MiP must however be taken into account when designing and promoting Mi
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2013-01-01
Background In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores and compares local understandings of MiP and their links with other pregnancy-related health problems. Methods A comparative qualitative study was undertaken at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. MiP-related behaviours were also observed at health facilities and in local communities. Results Across the four sites, local malaria concepts overlapped with biomedically defined malaria. In terms of symptoms, at-risk groups, outcomes and aetiology of malaria during pregnancy, this overlap was however both site-specific and partial. Moreover, the local malaria concepts were not monolithic and their descriptions varied amongst respondents. The symptoms of pregnancy and malaria also overlapped but, for respondents, symptom severity was the distinguishing factor. Malaria was generally, though not universally, perceived as serious for pregnant women. Miscarriage was the most widely known outcome, and links with anaemia, low birth weight and congenital malaria were mentioned. Nonetheless, amongst many potential causes of miscarriage, malaria was not recognized as the most important, but rather interacted with other pregnancy-related problems. Conclusions Given the overlap of common pregnancy problems with the symptoms of malaria, and the limited association of malaria with its main outcomes, a comprehensive antenatal care programme is the most appropriate strategy for the provision of health education, prevention and treatment for MiP. Variations in locally shared understandings of MiP must however be taken into
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Human Melioidosis, Malawi, 2011
Katangwe, Thembi; Purcell, Janet; Bar-Zeev, Naor; Denis, Brigitte; Montgomery, Jacqui; Alaerts, Maaike; Heyderman, Robert Simon; Dance, David A.B.; Kennedy, Neil; Feasey, Nicholas
2013-01-01
A case of human melioidosis caused by a novel sequence type of Burkholderia pseudomallei occurred in a child in Malawi, southern Africa. A literature review showed that human cases reported from the continent have been increasing. PMID:23735189
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Schistosomiasis in Malawi: a systematic review.
Makaula, Peter; Sadalaki, John R; Muula, Adamson S; Kayuni, Sekeleghe; Jemu, Samuel; Bloch, Paul
2014-12-10
Schistosomiasis remains an important public health problem that undermines social and economic development in tropical regions of the world, mainly Sub-Saharan Africa. We are not aware of any systematic review of the literature of the epidemiology and transmission of schistosomiasis in Malawi since 1985. Therefore, we reviewed the current state of knowledge of schistosomiasis epidemiology and transmission in this country and identified knowledge gaps and relevant areas for future research and research governance. We conducted computer-aided literature searches of Medline, SCOPUS and Google Scholar using the keywords: "schistosomiasis", "Bilharzia", "Bulinus" and "Biomphalaria" in combination with "Malawi". These searches were supplemented by iterative reviews of reference lists for relevant publications in peer reviewed international scientific journals or other media. The recovered documents were reviewed for their year of publication, location of field or laboratory work, authorship characteristics, ethics review, funding sources as well as their findings regarding parasite and intermediate host species, environmental aspects, geographical distribution, seasonality of transmission, and infection prevalence and intensities. A total of 89 documents satisfied the inclusion criteria and were reviewed. Of these, 76 were published in international scientific journals, 68 were peer reviewed and 54 were original research studies. Most of the documents addressed urinary schistosomiasis and about two thirds of them dealt with the definitive host. Few documents addressed the parasites and the intermediate hosts. While urinary schistosomiasis occurs in most parts of Malawi, intestinal schistosomiasis mainly occurs in the central and southern highlands, Likoma Island and Lower Shire. Studies in selected communities estimated prevalence rates of up to 94.9% for Schistosoma haematobium and up to 67.0% for Schistosoma mansoni with considerable geographical variation. The main
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Positively essential: traditional birth attendants in Malawi.
Stronge, Shirley
2011-06-01
One of the biggest challenges for healthcare professionals working in developing countries is the lack of trained personnel to carry out much needed health care provision. Shirley Stronge worked as a nurse/midwife tutor in a rural area in the north of Malawi. Millennium Development Goals four and five have focused our attention on the care required by mothers and newborns. Shirley has chosen to reflect on the role of Traditional Birth Attendants in the north of Malawi and their positive impact on maternity services in this area.
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Physiotherapy in Malawi - a step in the right direction.
Fielder, S; Mpezeni, S; Benjamin, L; Cary, I
2013-09-01
Physiotherapists in Malawi are in short supply and the demand for this service is increasing. This profession is instrumental in the rehabilitation of patients following accident and disease. Early input from a physiotherapist can be life changing; for example, timely physiotherapy could prevent a patient from becoming wheelchair-bound for life. This article explores the role of physiotherapists, in the context of what they do, the medical conditions that benefit from physiotherapy and the services available in Malawi. The clinical focus will be on orthopaedic, musculoskeletal and neurological conditions, since those are the specialties of the authors. With the start of the physiotherapy degree programme at the College of Medicine, University of Malawi, huge steps have been taken to address this neglected profession.
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Influences on Children's Human Capital in Rural Malawi: Three Essays
ERIC Educational Resources Information Center
Appiah-Yeboah, Shirley Afua
2013-01-01
The circumstances that characterize poor, rural communities in Malawi suggest that children's health-wealth gradient can vary from other settings. This dissertation begins with a description of the methods used to create a household wealth variable using assets data in the Malawi Longitudinal Study of Families and Health project. By using a fixed…
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Women’s perspectives on quality of maternal health care services in Malawi
Machira, Kennedy; Palamuleni, Martin
2018-01-01
Despite promotion by many stakeholders to improve maternal health outcome in many developing countries including Malawi, many analysts agree that the utmost success in maternal health will arise if maternal health care services are an unparallel led source for women’s health care solutions for any problem related to childbirth. Health advocates worldwide claim that even though maternal services are provided, women’s utilization of such services has not been ascertained. The objective of this study was to explore women’s perspectives on the quality of health care service delivery in Malawi. This article therefore investigates women’s perspectives on the quality of maternal health care services in Malawi. We used six focus group discussions in six health facilities that were selected across Malawi. We found that erratic availability of medical resources and unethical practices among health workers adversely affected quality of maternal health care service delivery. We concluded that the expensive routine operational audits of medical resources and service delivery across health facilities are imperative if women’s health outcomes are to be enhanced in Malawi. PMID:29386917
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Bartonella Species in Bats (Chiroptera) and Bat Flies (Nycteribiidae) from Nigeria, West Africa
Baneth, Gad; Mitchell, Mark; Mumcuoglu, Kosta Y.; Gutiérrez, Ricardo; Harrus, Shimon
2014-01-01
Abstract Previous and ongoing studies have incriminated bats as reservoirs of several emerging and re-emerging zoonoses. Most of these studies, however, have focused on viral agents and neglected important bacterial pathogens. To date, there has been no report investigating the prevalence of Bartonella spp. in bats and bat flies from Nigeria, despite the fact that bats are used as food and for cultural ritual purposes by some ethnic groups in Nigeria. To elucidate the role of bats as reservoirs of bartonellae, we screened by molecular methods 148 bats and 34 bat flies, Diptera:Hippoboscoidea:Nycteribiidae (Cyclopodia greeffi) from Nigeria for Bartonella spp. Overall, Bartonella spp. DNA was detected in 76 out of 148 (51.4%) bat blood samples tested and 10 out of 24 (41.7%) bat flies tested by qPCR targeting the 16S–23S internal transcribed spacer (ITS) locus. Bartonella was isolated from 23 of 148 (15.5%) bat blood samples, and the isolates were genetically characterized. Prevalence of Bartonella spp. culture-positive samples ranged from 0% to 45.5% among five bat species. Micropterus spp. bats had a significantly higher relative risk of 3.45 for being culture positive compared to Eidolon helvum, Epomophorus spp., Rhinolophus spp., and Chaerephon nigeriae. Bartonella spp. detected in this study fall into three distinct clusters along with other Bartonella spp. isolated from bats and bat flies from Kenya and Ghana, respectively. The isolation of Bartonella spp. in 10.0–45.5% of four out of five bat species screened in this study indicates a widespread infection in bat population in Nigeria. Further investigation is warranted to determine the role of these bacteria as a cause of human and animal diseases in Nigeria. PMID:25229701
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Bartonella species in bats (Chiroptera) and bat flies (Nycteribiidae) from Nigeria, West Africa.
Kamani, Joshua; Baneth, Gad; Mitchell, Mark; Mumcuoglu, Kosta Y; Gutiérrez, Ricardo; Harrus, Shimon
2014-09-01
Previous and ongoing studies have incriminated bats as reservoirs of several emerging and re-emerging zoonoses. Most of these studies, however, have focused on viral agents and neglected important bacterial pathogens. To date, there has been no report investigating the prevalence of Bartonella spp. in bats and bat flies from Nigeria, despite the fact that bats are used as food and for cultural ritual purposes by some ethnic groups in Nigeria. To elucidate the role of bats as reservoirs of bartonellae, we screened by molecular methods 148 bats and 34 bat flies, Diptera:Hippoboscoidea:Nycteribiidae (Cyclopodia greeffi) from Nigeria for Bartonella spp. Overall, Bartonella spp. DNA was detected in 76 out of 148 (51.4%) bat blood samples tested and 10 out of 24 (41.7%) bat flies tested by qPCR targeting the 16S-23S internal transcribed spacer (ITS) locus. Bartonella was isolated from 23 of 148 (15.5%) bat blood samples, and the isolates were genetically characterized. Prevalence of Bartonella spp. culture-positive samples ranged from 0% to 45.5% among five bat species. Micropterus spp. bats had a significantly higher relative risk of 3.45 for being culture positive compared to Eidolon helvum, Epomophorus spp., Rhinolophus spp., and Chaerephon nigeriae. Bartonella spp. detected in this study fall into three distinct clusters along with other Bartonella spp. isolated from bats and bat flies from Kenya and Ghana, respectively. The isolation of Bartonella spp. in 10.0-45.5% of four out of five bat species screened in this study indicates a widespread infection in bat population in Nigeria. Further investigation is warranted to determine the role of these bacteria as a cause of human and animal diseases in Nigeria.
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AIDS epidemic in Malawi: shaking cultural foundations.
Chirwa, I
1993-05-01
Many young men and women in Malawi are infected with HIV and dying from AIDS. The head of the Malawi AIDS Control Program estimates that as many as 10% of all adults in the country may be infected with HIV, with the rate being higher in urban areas. While more than 90% of the population is now aware of the existence of AIDS and its dangers, changes in behavior have not taken place and HIV continues to spread. Early campaigns attempted to generate condom use through peer educators among bar girls, truck drivers, and STD patients. Many men state, however, that they prefer to have sex without condoms because it is more exciting. Others cite alcohol consumption, ignorance of the dangers of HIV infection, and/or a fear of suggesting mistrust in a partner as reasons for not using condoms. Many women also find it difficult to negotiate condom use among reluctant men. Making condoms readily accessible and giving them a positive image may help increase their rate of use; the opposition of some religious groups must be thwarted and the distribution system needs to be improved to realize these ends. Condoms are provided to Malawi free of charge by the US Agency of International Development. Supplies are then either distributed free through health centers and bars or sold in shops. The failure of free condoms to be readily available in rural areas where 90% of the population resides, however, poses concern. Finally, training programs, counseling, anonymous HIV testing centers, and peer educators are among some of the interventions being made against AIDS in Malawi.
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2016-08-10
Lilongwe is the capital city of Malawi. Like many cities in Africa, it has seen phenomenal growth in the last 50 years. In 1966 the population was about 19,000; in 1987 the census counted 223,000 inhabitants; and in 2015 1,080,000 residents called Lilongwe home. . The Landsat image was acquired 27 August 1984, and the ASTER image on 31 July 2015. The images cover an area of 20 by 33 km, and are located at 14 degrees south, 33.8 degrees east. http://photojournal.jpl.nasa.gov/catalog/?IDNumber=pia20804
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Adeloye, Davies
2012-12-01
Road traffic injuries (RTIs) and attendant fatalities on Nigerian roads have been on an increasing trend over the past three decades. Mortality from RTIs in Nigeria is estimated to be 162 deaths/100,000 population. This study aims to compare and identify best prehospital trauma care practices in Nigeria and some other African countries where prehospital services operate. A review of secondary data, grey literature, and pertinent published articles using a conceptual framework to assess: (1) policies; (2) structures; (3) first responders; (4) communication facilities; (5) transport and ambulance facilities, and (6) roadside emergency trauma units. There is no national prehospital trauma care system (PTCS) in Nigeria. The lack of a national emergency health policy is a factor in this absence. The Nigerian Federal Road Safety Corps (FRSC) mainly has been responsible for prehospital services. South Africa, Zambia, Kenya, and Ghana have improved prehospital services in Africa. Commercial drivers, laypersons, military, police, a centrally controlled communication network, and government ambulance services are feasible delivery models that can be incorporated into the Nigerian prehospital system. Prehospital trauma services have been useful in reducing morbidities and mortalities from traffic injuries, and appropriate implementation of this study's recommendations may reduce this burden in Nigeria.
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IWRM and poverty reduction in Malawi: A socio-economic analysis
NASA Astrophysics Data System (ADS)
Mulwafu, Wapulumuka O.; Msosa, Hendrina K.
Like most other countries in the SADC region, Malawi has swiftly endorsed the United Nations Millennium Development Goals. In the water sector, these principles are reflected in the National Water Policy (2004) and in the Malawi Poverty Reduction Strategy Paper (PRSP) (2002) which emphasize three key aspects. First, the articulation of a vision and policy objectives that address development and management of water for productive purposes, conservation and poverty reduction. Second, the recognition of international and regional conventions and agreements on water resources to which Malawi is a signatory, thereby promoting global partnership for development. Third, the provision of mechanisms for monitoring, assessment and development related to watershed management, conservation and the mitigation of floods and droughts. Both the Malawi Poverty Reduction Strategy Paper and the National Water Policy seek to reduce poverty by increasing access to water for domestic and productive purposes. In particular, the MPRSP will focus on constructing and rehabilitating water facilities, extend water supply capacity, promote community-based management and improve water resources conservation and management. In this paper, we examine the challenges of implementing these goals against the background of various institutional reforms in the water sector. We argue that although Malawi has come up with very clear strategies and guidelines for promoting MDGs, a combination of human and financial resources, bedevil the successful implementation of these ideas. In addition, the strategies do not articulate water as a medium for poverty alleviation in a holistic manner. The paper further demonstrates ways in which the promotion of IWRM can facilitate in reducing poverty.
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The cost-effectiveness of rotavirus vaccination in Malawi.
Berry, Stephen A; Johns, Benjamin; Shih, Chuck; Berry, Andrea A; Walker, Damian G
2010-09-01
Rotarix (GlaxoSmithKline), a newly licensed rotavirus vaccine requiring 2 doses, may have the potential to save hundreds of thousands of lives in Africa. Nations such as Malawi, where Rotarix is currently under phase III investigation, may nevertheless face difficult economic choices in considering vaccine adoption. The cost-effectiveness of implementing a Rotarix vaccine program in Malawi was estimated using published estimates of rotavirus burden, vaccine efficacy, and health care utilization and costs. With 49.5% vaccine efficacy, a Rotarix program could avert 2582 deaths annually. With GAVI Alliance cofinancing, adoption of Rotarix would be associated with a cost of $5.07 per disability-adjusted life-year averted. With market pricing, Rotarix would be associated with a base case cost of $74.73 per disability-adjusted life-year averted. Key variables influencing results were vaccine efficacy, under-2 rotavirus mortality, and program cost of administering each dose. Adopting Rotarix would likely be highly cost-effective for Malawi, particularly with GAVI support. This finding holds true across uncertainty ranges for key variables, including efficacy, for which data are becoming available.
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Tobacco growing and the sustainable development goals, Malawi
Bialous, Stella Aguinaga; Munthali, Spy; Max, Wendy
2017-01-01
Abstract Negative impacts of tobacco result from human consumption and from tobacco-growing activities, most of which now occur in low- and middle-income countries. Malawi is the world’s largest producer of burley tobacco and its population is affected by the negative consequences of both tobacco consumption and production. In countries like Malawi, tobacco control refers to control of the tobacco supply chain, rather than control of consumption. We review the impact of tobacco cultivation, using Malawi as an example, to illustrate the economic, environmental, health and social issues faced by low- and middle-income countries that still produce significant tobacco crops. We place these issues in the context of the sustainable development goals (SDGs), particularly 3a which calls on all governments to strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control. Other goals address the negative effects that tobacco cultivation has on development. The SDGs offer an opportunity for low- and middle-income countries that are dependent on tobacco production and that are not yet parties to the Convention, to reconsider joining the FCTC. PMID:28479637
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Odera, Joab Otieno; Odera, Elizabeth; Githang’a, Jessie; Walong, Edwin Oloo; Li, Fang; Xiong, Zhaohui; Chen, Xiaoxin Luke
2017-01-01
Kenya belongs to a high incidence region known as Africa’s esophageal cancer (EC) corridor. It has one of the highest incidence rates of EC worldwide, but research on EC in Kenya has gone highly unnoticed. EC in Kenya is unique in its high percentage of young cases (< 30 years of age). In this review, we show the current status of EC in the country. We mainly focus on significant risk factors such as alcohol drinking, genetic factors, malnutrition and hot food/drink. Future directions in the study and prevention of EC in Kenya are also discussed. PMID:29082268
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Lüdecke, Tina; Schrenk, Friedemann; Thiemeyer, Heinrich; Kullmer, Ottmar; Bromage, Timothy G; Sandrock, Oliver; Fiebig, Jens; Mulch, Andreas
2016-01-01
The development of East African savannas is crucial for the origin and evolution of early hominins. These ecosystems, however, vary widely in their fraction of woody cover and today range from closed woodland to open grassland savanna. Here, we present the first Plio-Pleistocene long-term carbon isotope (δ(13)C) record from pedogenic carbonate and Suidae teeth in the southern East African Rift (EAR). These δ(13)C data from the Chiwondo and Chitimwe Beds (Karonga Basin, Northern Malawi) represent a southern hemisphere record in the EAR, a key region for reconstructing vegetation patterns in today's Zambezian Savanna, and permit correlation with data on the evolution and migration of early hominins in today's Somali-Masai Endemic Zone. The sediments along the northwestern shore of Lake Malawi contain fossils attributed to Homo rudolfensis and Paranthropus boisei. The associated hominin localities (Uraha, Malema) are situated between the well-known hominin bearing sites of the Somali-Masai Endemic Zone in the Eastern Rift and the Highveld Grassland in southern Africa, and fill an important geographical gap for hominin research. Persistent δ(13)C values around -9‰ from pedogenic carbonate and suid enamel covering the last ∼4.3 Ma indicate a C3-dominated closed environment with regional patches of C4-grasslands in the Karonga Basin. The overall fraction of woody cover of 60-70% reflects significantly higher canopy density in the Malawi Rift than the Eastern Rift through time. The discrepancy between the two savanna types originated in the Late Pliocene, when the Somali-Masai ecosystem started to show increasing evidence for open, C4-dominated landscapes. Based on the Malawi δ(13)C data, the evolution of savanna ecosystems in Eastern Africa followed different patterns along the north-south extent of the EAR. The appearance of C4-grasses is considered a driver of evolutionary faunal shifts, but despite the difference of ecosystem evolution in the north, similar
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Babalola, Stella
2014-02-01
Many pregnant women in Africa who access professional antenatal care do not receive all the WHO-recommended components of care. Using Demographic and Health Survey (DHS) data from Kenya, Malawi and Nigeria, this study assesses the relationship of education level with the quality of antenatal care received and highlights how the number of antenatal visits mediates this relationship. The results show that a large proportion of the effect of education level on quality of care is direct, while only a small portion is mediated through the number of antenatal visits. Efforts to improve pregnancy outcomes for under-privileged women should focus on removing structural barriers to access, strengthening the technical and interpersonal skills of providers, and addressing providers' biases and discriminatory practices towards these women. Such efforts should also seek to empower underprivileged women to insist on quality antenatal care by explaining what to expect during an antenatal visit.
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Remarkable rates of lightning strike mortality in Malawi.
Mulder, Monique Borgerhoff; Msalu, Lameck; Caro, Tim; Salerno, Jonathan
2012-01-01
Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area.
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Availability and affordability of antimalarial and antibiotic medicines in Malawi
Khuluza, Felix
2017-01-01
Background Availability and affordability of medicines are key determinants of universal health coverage, yet achieving them presents a major challenge especially in low-income countries. We here present an analysis of availability and prices of antimalarial and antibiotic medicines in public, faith-based and private health facilities in Malawi. Medicines are provided free of charge in the public health care system of Malawi. In contrast, facilities of the Christian Health Association of Malawi (CHAM) usually charge their patients for medicines, as do private for-profit facilities. Methods As part of a study on medicine quality, samples of six antimalarial and six antibiotic medicines were collected in 31 health facilities in four districts of southern Malawi. These included 15 public facilities (i.e. health centres, district hospitals and central hospitals), eight CHAM and eight private facilities. Random selection was used in choosing the included health facilities. The availability of medicines was recorded, including the number of units which could be collected of each medicine, as well as the prices of medicines which were charged in CHAM and private facilities. These data were analyzed using the standard methodology developed by the World Health Organization (WHO) and Health Action International (HAI). Results Availability of the antimalarials artemether/lumefantrine and sulfadoxine/pyrimethamine, which are provided with financial support from international donors, was high in public and CHAM facilities (93% and 100%, respectively). However, availability of antibiotics was much lower (e.g. 40% availability of amoxicillin tablets/capsules in public health centres). Medicine prices were lower than reported from many other countries. The median price ratio (MPR) to a wholesale international procurement price was 2.8 in CHAM facilities and even lower in the private sector (MPR 2.3). Nevertheless, for 10 of the 12 investigated medicines the cost for one course of
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2016-01-01
Kenya currently does not produce any hydrocarbons, although the country has the potential to become an oil producer most likely after 2020. Over the past few years, several commercial oil discoveries have been made in Kenya, but the country faces obstacles that have caused production delays. Negotiations over a joint export pipeline route with its neighbor Uganda is in flux, while sustained low oil prices have slowed down exploration drilling activity in Kenya.
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Socially disempowered women as the key to addressing change in Malawi: how do they do it?
Macintyre, Linda M; Rankin, Sally; Pinderhughes, Howard; Waters, Catherine M; Schell, Ellen; Fiedler, Rachel
2013-01-01
Malawi women are in the ironic juxtaposition of being socially disempowered while, at the same time, thought to hold the key to shaping an effective community response to the HIV crisis. Based on this juxtaposition, a descriptive, qualitative study was conducted in Malawi and the United States where 26 participants from nongovernmental organizations (NGOs) and community-based organizations (CBOs) discussed the roles of Malawi women. Interviews were audiotaped, transcribed, and analyzed. We identified an improvement in women's economic status as the strongest factor in reducing gender inequities. Through providing stipends for rural Malawi women, one NGO created unintended changes in gender roles.
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Sources of Social Capital for Malawi People Living With HIV
Rankin, Sally H.; Jong, SoSon; Matovu, Schola; Youmans, Sharon; Lindgren, Teri
2016-01-01
With one of the highest rates of poverty and HIV in the world, Malawi faith-based organizations (FBOs), non-governmental organizations (NGOs), and community-based organizations (CBOs) are expected to provide tangible and emotional support to people living with HIV (PLWH). Using Lin’s social capital theoretical approach, we examine the perspective of PLWH regarding the adequacy of support responses. Forty-six rural Malawi HIV+ adults provided interviews that were recorded digitally, translated, and transcribed by Malawi research assistants. Atlas.ti was used to organize the data and to aid in the analytic process. Participants expressed disappointment in the lack of resources that could be accessed through the FBOs although their expectations may have been unrealistic. Outcomes from accessing and mobilizing the FBO network were negative in terms of stigmatization by FBO leaders and members, whereas outcomes related to CBOs and NGOs were generally positive in terms of empowerment through HIV information and attendance at support groups. PMID:28462349
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Remarkable Rates of Lightning Strike Mortality in Malawi
Borgerhoff Mulder, Monique; Msalu, Lameck; Caro, Tim; Salerno, Jonathan
2012-01-01
Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area. PMID:22253708
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Cundale, Katie; Wroe, Emily; Matanje-Mwagomba, Beatrice L; Muula, Adamson S; Gupta, Neil; Berman, Josh; Kasomekera, Noel; Masiye, Jones
2017-06-01
Noncommunicable diseases and injuries (NCDIs) account for nearly 70% of deaths worldwide, with an estimated 75% of these deaths occurring in low- and middle-income countries. Globally, the burden of disease from noncommunicable diseases (NCDs) is most often caused by the "big 4," namely: diabetes, cardiovascular diseases, cancer, and chronic lung diseases. However, in Malawi, these 4 conditions account for only 29% of the NCDI disease burden. The Malawi National NCDI Poverty Commission was launched in November 2016 and will describe and evaluate the current NCDI situation in Malawi, with a focus on the poorest populations. The National Commission will investigate which NCDIs cause the biggest burden, which are more present in the young, and which interventions are available to avert death and disability from NCDIs in Malawi, particularly among the poorest segments of the population. The evidence gained through the work of this Commission will help inform research, policy, and programme interventions, all through an advocacy lens, as we strive to address the impact of NCDIs among all populations in Malawi.
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NASA Astrophysics Data System (ADS)
Le Gall, B.; Rolet, J.; Gernigon, L.; Ebinger, C.; Gloaguen, R.
2003-04-01
The southern tip zone of the Kenya Rift on the eastern branch of the East African System is usually thought to occur in the so-called North Tanzanian Divergence. In this region, the narrow (50 km-wide) axial graben of southern Kenya splays southwards, via a major EW-trending volcanic lineament, into a 200 km-wide broad rifted zone with three separate arms of normal faulting and tilted fault blocks (Eyasi, Manyara and Pangani arms from W to E). Remote sensing analysis from Central Tanzania demonstrates that rift morphology exists over an area lying 400 km beyond the southern termination of the Kenya Rift. The most prominent rift structures are observed in the Kilombero region and consist of a 100 km-wide range of uplifted basement blocks fringed to the west by an E-facing half-graben inferred to reach depths of 6-8 km from aeromagnetic dataset. Physiographic features (fault scarps), and river drainage anomalies suggest that the present-day rift pattern in the Kilombero extensional province principally results from Recent/Neogene deformation. That assumption is also supported by the seismogenic character of a number of faults. The Kilombero half-graben is superimposed upon an earlier rift system, Karoo in age, which is totally overprinted and is only evidenced from its sedimentary infill. On the other hand, the nature and thickness of the inferred Neogene synrift section is still unknown. The Kilombero rifted zone is assumed to connect northwards into the central rift arm (Manyara) of the South Kenya Rift via a seismically active transverse fault zone that follows ductile fabrics within the Mozambican crystalline basement. The proposed rift model implies that incipient rifting propagates hroughout the cold and strong crust/lithosphere of Central Tanzania along Proterozoic (N140=B0E) basement weakness zones and earlier Karoo (NS)rift structures. A second belt of Recent-active linked fault/basins also extends further East from the Pangani rift arm to the offshore
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Nigeria`s Escravos gas project starts up
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nwokoma, M.
Nigeria`s Escravos gas project, Delta state, officially began late last year. The project -- 6,650 b/d of LPG and 1,740 b/d of condensate from 165 MMscfd of gas -- is the first attempt to rid Nigeria of incessant flares that have lit the Delta skies. Operator Chevron Nigeria Ltd. believes that the Escravos project will enable the joint venture to utilize a significant portion of the gas reserves, thus reducing gas flaring. The paper describes the background of the project, the gas fields, transport pipeline, process design, construction, and start-up.
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National health research system in Malawi: dead, moribund, tepid or flourishing?
Kirigia, Joses Muthuri; Kathyola, Damson D; Muula, Adamson S; Ota, Martin Matthew Okechukwu
2015-03-31
Several instruments at both the global and regional levels to which countries in the WHO African Region are party call for action by governments to strengthen national health research systems (NHRS). This paper debates the extent to which Malawi has fulfilled this commitment. Some research literature has characterized African research - and by implication NHRS - as moribund. In our view, the Malawi government, with partner support, has made effort to strengthen the capacities of individuals and institutions that generate scientific knowledge. This is reflected in the Malawi national NHRS index (MNSR4HI) of 51%, which is within the 50%-69% range, and thus, it should be characterized as tepid with significant potential to flourish. Governance of research for health (R4H) has improved with the promulgation of the Malawi Science and Technology Act in 2003. However, lack of an explicit R4H policy, a strategic plan and a national R4H management forum undermines the government's effectiveness in overseeing the operation of the NHRS. The mean index of 'governance of R4H' sub-functions was 67%, implying that research governance is tepid. Malawi has a national health research focal point, an R4H program, and four public and 11 private universities. The average index of 'creating and sustaining resources' sub-functions was 48.6%, meaning that R4H human and infrastructural resources can be considered to be in a moribund state. The average index of 'producing and using research' sub-functions of 50.4% implies that production and utilization of research findings in policy development and public health practice can best be described as tepid. Efforts need to be intensified to boost national research productivity. Over the five financial years 2011-2016 the government plans to spend 0.26% of its total health budget on R4H. The mean index of 'financing' sub-functions of 23.6% is within the range of 1-49%, which is considered moribund. A functional NHRS is a prerequisite for the
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Atmospheric Science Data Center
2013-04-15
article title: Smoke over Nigeria and the Gulf of Guinea ... document extensive smoke from fires burning throughout Nigeria and north central Africa on January 31, 2003. At left are natural-color ... the dark-colored Aïr Mountains), through forested Nigeria, and beyond the Niger Delta to the Gulf of Guinea and the open ocean. ...
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Lake Malawi cichlid evolution along a benthic/limnetic axis.
Hulsey, C D; Roberts, R J; Loh, Y-H E; Rupp, M F; Streelman, J T
2013-07-01
Divergence along a benthic to limnetic habitat axis is ubiquitous in aquatic systems. However, this type of habitat divergence has largely been examined in low diversity, high latitude lake systems. In this study, we examined the importance of benthic and limnetic divergence within the incredibly species-rich radiation of Lake Malawi cichlid fishes. Using novel phylogenetic reconstructions, we provided a series of hypotheses regarding the evolutionary relationships among 24 benthic and limnetic species that suggests divergence along this axis has occurred multiple times within Lake Malawi cichlids. Because pectoral fin morphology is often associated with divergence along this habitat axis in other fish groups, we investigated divergence in pectoral fin muscles in these benthic and limnetic cichlid species. We showed that the eight pectoral fin muscles and fin area generally tended to evolve in a tightly correlated manner in the Lake Malawi cichlids. Additionally, we found that larger pectoral fin muscles are strongly associated with the independent evolution of the benthic feeding habit across this group of fish. Evolutionary specialization along a benthic/limnetic axis has occurred multiple times within this tropical lake radiation and has produced repeated convergent matching between exploitation of water column habitats and locomotory morphology.
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Traditional birth attendants in Malawi.
Smit, J J
1994-06-01
Traditional Birth Attendants (TBAs) and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 per cent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal--"Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country. The Ministry of Health is responsible for the training and control of Traditional Birth Attendants and in 1976 opened a register in order to list all those trained. In early 1978 a training course for selected TBAs was conducted at the Kamuzu Central Hospital, Lilongwe and from 1982 the training programme evolved into a national training programme for TBAs. By February 1987, a total of 841 Traditional birth Attendants had been trained and the programme is still continuing.
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First Responders and Prehospital Care for Road Traffic Injuries in Malawi.
Chokotho, Linda; Mulwafu, Wakisa; Singini, Isaac; Njalale, Yasin; Maliwichi-Senganimalunje, Limbika; Jacobsen, Kathryn H
2017-02-01
Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi. In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes. All governmental and nongovernmental first response organizations identified by key informants were contacted, and a checklist was used to identify the services they offer. Access to professional prehospital care in Malawi is almost nonexistent, aside from a few city fire departments and private ambulance services. Rapid transportation to a hospital is usually the primary goal of roadside care because of limited first aid knowledge and a lack of access to basic safety equipment. The key informants recommended: expanding community-based first aid training; emphasizing umunthu (shared humanity) to inspire bystander involvement in roadside care; empowering local leaders to coordinate on-site responses; improving emergency communication systems; equipping traffic police with road safety gear; and expanding access to ambulance services. Prehospital care in Malawi would be improved by the creation of a formal network of community leaders, police, commercial drivers, and other lay volunteers who are trained in basic first aid and are equipped to respond to crash sites to provide roadside care to trauma patients and prepare them for safe transport to hospitals. Chokotho L , Mulwafu W , Singini I , Njalale Y , Maliwichi-Senganimalunje L , Jacobsen KH . First responders and prehospital care for road traffic injuries in Malawi. Prehosp Disaster Med. 2017;32(1):14-19.
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1985-07-01
Kenya's 1st census, in 1948, counted 5.8 million people, the 1979 census counted 15.3 million, and the government estimates the 1984 population at 19.4 million. Development planning began in 1966; the current 5-year plan (1984-1988) stresses manpower, capital, and land development, mainly in the West. The government considers population growth an obstacle to meeting educational, health, housing, food, and employment needs. Kenya's high 4% growth rate results from a high birth rate and a declining death rate. The government intends to reduce population growth to 3.3% by 1988 by 1) informing Kenyans of the benefits of small families and 2) making family planning services easily available, especially in rural areas. Life expectancy is currently 52.9 years and infant mortality is 82/1000. Most health problems relate to childbearing, communicable diseases, malnutrition, and poor sanitation. The current development plan strives to expand services in 1) staff training, information, and education, 2) monitoring and evaluation, 3) contraceptive delivery, and 4) increasing family planning acceptors. Kenyan women desire 7 children and usually have 8. The government is trying to improve the status of women through education and employment, with the expectation of reducing fertility levels. Abortion for contraceptive purposes is illegal; sterilization and contraceptives are available. Neither emigration nor immigration are significant in Kenya. 90% of the people live on 20% of the land. Urban growth is increasing too rapidly and the government's policies to correct the population distribution inequity include 1) urban development, mainly in Western Kenya; 2) encouraging agricultural development; 3) development of export-oriented, resource based, and labor intensive industries; 4) funding development sites outside of Nairobi and Mombasa; 5) stimulating growth in undeveloped areas; 6) improving roads, rails, and ports; and 7) providing adequate water, housing, and energy.
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Deep Sequencing Reveals a Divergent Ugandan cassava brown streak virus Isolate from Malawi
Winter, Stephan; Mukasa, Settumba; Tairo, Fred; Sseruwagi, Peter; Ndunguru, Joseph; Duffy, Siobain
2017-01-01
ABSTRACT Illumina sequencing of RNA from a cassava cutting from northern Malawi produced a genome of Ugandan cassava brown streak virus (UCBSV-MW-NB7_2013). Sequence comparisons revealed stronger similarity to an isolate from nearby Tanzania (93.4% pairwise nucleotide identity) than to those previously reported from Malawi (86.9 to 87.0%). PMID:28818908
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Improving cold chain systems: Challenges and solutions.
Ashok, Ashvin; Brison, Michael; LeTallec, Yann
2017-04-19
While a number of new vaccines have been rolled out across the developing world (with more vaccines in the pipeline), cold chain systems are struggling to efficiently support national immunization programs in ensuring the availability of safe and potent vaccines. This article reflects on the Clinton Health Access Initiative, Inc. (CHAI) experience working since 2010 with national immunization programs and partners to improve vaccines cold chains in 10 countries-Ethiopia, Nigeria, Kenya, Malawi, Tanzania, Uganda, Cameroon, Mozambique, Lesotho and India - to identify the root causes and solutions for three common issues limiting cold chain performance. Key recommendations include: Collectively, the solutions detailed in this article chart a path to substantially improving the performance of the cold chain. Combined with an enabling global and in-country environment, it is possible to eliminate cold chain issues as a substantial barrier to effective and full immunization coverage over the next few years. Copyright © 2017. Published by Elsevier Ltd.
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Hounton, Sennen; Winfrey, William; Barros, Aluisio J. D.; Askew, Ian
2015-01-01
Background The first 12 months following childbirth are a period when a subsequent pregnancy holds the greatest risk for mother and baby, but also when there are numerous contacts with the healthcare system for postnatal care for mother and baby (immunisation, nutrition, etc.). The benefits and importance of postpartum family planning are well documented. They include a reduction in risk of miscarriage, as well as mitigation of (or protection against) low birth weight, neonatal and maternal death, preterm birth, and anaemia. Objectives The objectives of this paper are to assess patterns and trends in the use of postpartum family planning at the country level, to determine whether postpartum family planning is associated with birth interval and parity, and to identify the health services most closely associated with postpartum family planning after adjusting for socio-economic characteristics. Design Data were used from Demographic and Health Surveys that contain a reproductive calendar, carried out within the last 10 years, from Ethiopia, Malawi, and Nigeria. All women for whom the calendar was completed and who gave birth between 57 and 60 months prior to data collection were included in the analysis. For each of the births, we merged the reproductive calendar with the birth record into a survey for each country reflecting the previous 60 months. The definition of the postpartum period in this paper is based on a period of 3 months postpartum. We used this definition to assess early adoption of postpartum family planning. We assessed variations in postpartum family planning according to demographic and socio-economic variables, as well as its association with various contact opportunities with the health system [antenatal care (ANC), childbirth in facilities, immunisation, etc.]. We did simple descriptive analysis with tabular, graphic, and ‘equiplot’ displays and a logistic regression controlling for important background characteristics. Results Overall
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Hounton, Sennen; Winfrey, William; Barros, Aluisio J D; Askew, Ian
2015-01-01
The first 12 months following childbirth are a period when a subsequent pregnancy holds the greatest risk for mother and baby, but also when there are numerous contacts with the healthcare system for postnatal care for mother and baby (immunisation, nutrition, etc.). The benefits and importance of postpartum family planning are well documented. They include a reduction in risk of miscarriage, as well as mitigation of (or protection against) low birth weight, neonatal and maternal death, preterm birth, and anaemia. The objectives of this paper are to assess patterns and trends in the use of postpartum family planning at the country level, to determine whether postpartum family planning is associated with birth interval and parity, and to identify the health services most closely associated with postpartum family planning after adjusting for socio-economic characteristics. Data were used from Demographic and Health Surveys that contain a reproductive calendar, carried out within the last 10 years, from Ethiopia, Malawi, and Nigeria. All women for whom the calendar was completed and who gave birth between 57 and 60 months prior to data collection were included in the analysis. For each of the births, we merged the reproductive calendar with the birth record into a survey for each country reflecting the previous 60 months. The definition of the postpartum period in this paper is based on a period of 3 months postpartum. We used this definition to assess early adoption of postpartum family planning. We assessed variations in postpartum family planning according to demographic and socio-economic variables, as well as its association with various contact opportunities with the health system [antenatal care (ANC), childbirth in facilities, immunisation, etc.]. We did simple descriptive analysis with tabular, graphic, and 'equiplot' displays and a logistic regression controlling for important background characteristics. Overall, variation in postpartum use of modern
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Study on the feasibility of provision of distance learning programmes in surgery to Malawi.
Mains, Edward A A; Blackmur, James P; Dewhurst, David; Ward, Ross M; Garden, O James; Wigmore, Stephen J
2011-12-01
Medical educational opportunities and resources are considerably limited in the developing world. The expansion of computing and Internet access means that there exists a potential to provide education to students through distance learning programmes. This study investigated the feasibility of providing distance learning course in surgery in Malawi. The study investigated the user requirements, technical requirements and Internet connections in two teaching hospitals in Malawi. In addition the appropriateness of current course material from the Edinburgh Surgical Sciences Qualification to Malawi trainees was assessed. The study found a high degree of interest from Malawian trainees in distance learning. The provision of basic science modules such as anatomy and physiology and the ability to access journals were considered highly desirable. The current ESSQ course would require extensive re-modelling to make it suitable to an African trainee's requirements. Internet speeds remain slow and access is currently expensive. There is considerable interest in distance learning programmes in Malawi but access to them is limited partly because of slow and expensive Internet access. Understanding the needs of trainees in countries such as Malawi will allow better direction of educational aid and resources to support surgical training. Copyright © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Lupafya, Phindile Chitsulo; Mwagomba, Beatrice L. Matanje; Hosig, Kathy; Maseko, Lucy M.; Chimbali, Henry
2016-01-01
Malawi is a Sub-Saharan African country experiencing the epidemiological transition from predominantly infectious to noncommunicable diseases (NCDs) with dramatically increasing prevalence of lifestyle-related diseases such as obesity, hypertension, and diabetes. Malawi's 2011-2016 Health Sector Strategic Plan included NCDs, and an NCD Control…
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Perl, Rebecca; Murukutla, Nandita; Occleston, Jessica; Bayly, Megan; Lien, Mego; Wakefield, Melanie; Mullin, Sandra
2015-11-01
This study examined whether adaptation of existing antitobacco television and radio advertisements (ads) from high-income countries is a viable tobacco control strategy for Africa. 1078 male and female adult smokers and non-smokers, aged 18-40 years, from major and smaller urban locations in Kenya, Nigeria and Senegal, were recruited into groups using locally appropriate convenience sampling methods and stratified by smoking status, gender, age and socioeconomic status. Eligibility criteria included age, smoking status and literacy. Each participant rated five radio and five TV antismoking ads on five-point scales, which were later aggregated into measures of perceived effectiveness, potential behaviour change and antitobacco industry sentiment/support for government actions. For radio ads across all three countries, two health harms-focused ads-Coughing Child followed by Suffering-had the highest odds of a positive rating on the Perceived Effectiveness measure among smokers and non-smokers. For television ads, the strong graphic ad Baby Alive tended to be rated most positively across the majority of measures by all subgroups. This first systematic study of tobacco control advertisements in Africa is consistent with findings from other countries, suggesting that graphic health-harms ads developed and used in other countries could also be effective in African countries. This implies that adaptation would be a successful approach in Africa, where scarce resources for tobacco control communications can be focused on advertising dissemination, saving programmes from the cost, time and technical expertise required for development of new materials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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NASA Technical Reports Server (NTRS)
2008-01-01
If you live in Europe and buy roses, there is a good chance that they were grown in Kenya specifically, in one of the colossal greenhouses that blot out the once wild shores of Lake Naivasha, 90km north-west of Nairobi. Some 25% of Europe's cut flowers come from Kenya. After a tentative start in the 1980s the industry is now the country's third-largest foreign-currency earner, bringing in $120m a year. But the recent violence in Kenya is having a major impact on the flower growers. A local trade union says 3,000 of the 30,000 workers employed in Naivasha's flower farms have abandoned their jobs. Kenya emerged as a flower power when Israel scaled down its own industry. It has since lost business to neighboring Ethiopia, which offers tax breaks and better security, but Naivasha's perfect intensity of sunlight and days of near-constant length should keep it on top. The ASTER image was acquired February 2, 2008, covers an area of 25 x 26.6 km, and is located near 0.8 degrees south latitude, 36.4 degrees east longitude. The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate. -
Farmer Experience of Pluralistic Agricultural Extension, Malawi
ERIC Educational Resources Information Center
Chowa, Clodina; Garforth, Chris; Cardey, Sarah
2013-01-01
Purpose: Malawi's current extension policy supports pluralism and advocates responsiveness to farmer demand. We investigate whether smallholder farmers' experience supports the assumption that access to multiple service providers leads to extension and advisory services that respond to the needs of farmers. Design/methodology/approach: Within a…
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Abongomera, George; Chiwaula, Levison; Revill, Paul; Mabugu, Travor; Tumwesige, Edward; Nkhata, Misheck; Cataldo, Fabian; van Oosterhout, J; Colebunders, Robert; Chan, Adrienne K; Kityo, Cissy; Gilks, Charles; Hakim, James; Seeley, Janet; Gibb, Diana M; Ford, Deborah
2018-01-01
The Lablite project captured information on access to antiretroviral therapy (ART) at larger health facilities ('hubs') and lower-level health facilities ('spokes') in Phalombe district, Malawi and in Kalungu district, Uganda. We conducted a cross-sectional survey among patients who had transferred to a spoke after treatment initiation (Malawi, n=54; Uganda, n=33), patients who initiated treatment at a spoke (Malawi, n=50; Uganda, n=44) and patients receiving treatment at a hub (Malawi, n=44; Uganda, n=46). In Malawi, 47% of patients mapped to the two lowest wealth quintiles (Q1-Q2); patients at spokes were poorer than at a hub (57% vs 23% in Q1-Q2; p<0.001). In Uganda, 7% of patients mapped to Q1-Q2; patients at the rural spoke were poorer than at the two peri-urban facilities (15% vs 4% in Q1-Q2; p<0.001). The median travel time one way to a current ART facility was 60 min (IQR 30-120) in Malawi and 30 min (IQR 20-60) in Uganda. Patients who had transferred to the spokes reported a median reduction in travel time of 90 min in Malawi and 30 min in Uganda, with reductions in distance and food costs. Decentralizing ART improves access to treatment. Community-level access to treatment should be considered to further minimize costs and time. © The Author(s) 2018. Published by Oxford University Press Royal Society of Tropical Medicine and Hygiene.
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Spatial quantile regression using INLA with applications to childhood overweight in Malawi.
Mtambo, Owen P L; Masangwi, Salule J; Kazembe, Lawrence N M
2015-04-01
Analyses of childhood overweight have mainly used mean regression. However, using quantile regression is more appropriate as it provides flexibility to analyse the determinants of overweight corresponding to quantiles of interest. The main objective of this study was to fit a Bayesian additive quantile regression model with structured spatial effects for childhood overweight in Malawi using the 2010 Malawi DHS data. Inference was fully Bayesian using R-INLA package. The significant determinants of childhood overweight ranged from socio-demographic factors such as type of residence to child and maternal factors such as child age and maternal BMI. We observed significant positive structured spatial effects on childhood overweight in some districts of Malawi. We recommended that the childhood malnutrition policy makers should consider timely interventions based on risk factors as identified in this paper including spatial targets of interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Lessons from the recent rise in use of female sterilization in Malawi.
Jacobstein, Roy
2013-03-01
Although female sterilization is the most widely used modern contraceptive method in the world, most family planning programs in Africa have had difficulty providing it. Malawi, however, despite daunting constraints, has made female sterilization widely and equitably accessible, thereby increasing method choice and helping its citizens better meet their reproductive intentions. Ten percent of currently married Malawian women of reproductive age rely on female sterilization for contraceptive protection, compared with less than 2 percent across Africa, and demand to limit births now exceeds demand to space births. Malawi's female sterilization prevalence surpasses that of some high-resource countries. Key service-delivery factors enabling this achievement include supportive policies, strong public-private partnerships, and mobile services delivered at no cost by dedicated providers. Challenges remain, but Malawi's achievement offers lessons for other countries with low availability of female sterilization and similar resource constraints. © 2013 The Population Council, Inc.
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Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.
Zafar, Shamsa; Jean-Baptiste, Rachel; Rahman, Atif; Neilson, James P; van den Broek, Nynke R
2015-01-01
For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective) and psychological morbidities in two different low-income countries. Cross sectional study with assessment of morbidity in early pregnancy (34%), late pregnancy (35%) and the postnatal period (31%) among 3459 women from two rural communities in Pakistan (1727) and Malawi (1732). Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity. One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective). Both infective (Pakistan) and non-infective morbidity (Pakistan and Malawi) was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon (<10%). There were marked differences in psychological morbidity: 26.9% of women in Pakistan 2.6% in Malawi had an Edinburgh Postnatal Depression Score (EPDS) > 9. Complications during a previous pregnancy, infective morbidity (p <0.001), intra or postpartum haemorrhage (p <0.02) were associated with psychological morbidity in both settings. Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust
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"Can Anything Good Come Out of This Mouth?" Female Experiences of Disability in Malawi
ERIC Educational Resources Information Center
Braathen, Stine Hellum; Kvam, Marit Hoem
2008-01-01
The aim of this article is to give an overview of the daily life stories of 23 women with disabilities in Malawi. The stories were gained through qualitative interviews that covered aspects of being a woman and living with a disability in Malawi. Recent studies from countries in southern Africa have documented how people with disabilities…
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Malaria research in Malawi from 1984 to 2016: a literature review and bibliometric analysis.
Mwendera, Chikondi A; de Jager, Christiaan; Longwe, Herbert; Hongoro, Charles; Mutero, Clifford M; Phiri, Kamija S
2017-06-12
Malaria research can play a vital role in addressing the malaria burden in Malawi. An organized approach in addressing malaria in Malawi started in 1984 by the establishment of the first National Malaria Control Programme and research was recognized to be significant. This study aimed to assess the type and amount of malaria research conducted in Malawi from 1984 to 2016 and its related source of funding. A systematic literature search was conducted in the Medline/PubMed database for Malawian publications and approved malaria studies from two Ethical Committees were examined. Bibliometric analysis was utilized to capture the affiliations of first and senior/last authors, funding acknowledgements, while titles, abstracts and accessed full text were examined for research type. A total of 483 publications and 165 approved studies were analysed. Clinical and basic research in the fields of malaria in pregnancy 105 (21.5%), severe malaria 97 (20.1%) and vector and/or agent dynamics 69 (14.3%) dominated in the publications while morbidity 33 (20%), severe malaria 28 (17%) and Health Policy and Systems Research 24 (14.5%) dominated in the approved studies. In the publications, 146 (30%) first authors and 100 (21%) senior authors, and 88 (53.3%) principal investigators in approved studies were affiliated to Malawian-based institutions. Most researchers were affiliated to the Malawi-Liverpool Wellcome Trust, College of Medicine, Blantyre Malaria Project, Ministry of Health, and Malaria Alert Centre. The major malaria research funders were the National Institute for Health/USA, Wellcome Trust and the US Agency for International Development. Only three (2.5%) out of 118 journals publishing research on malaria in Malawi were from Africa and the Malaria Journal, with 76 (15.7%) publications, published most of the research from Malawi, followed by the American Journal of Tropical Medicine and Hygiene with 57 (11.8%) in comparison to only 13 (2.7%) published in the local Malawi
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Kenya: Current Conditions and the Challenges Ahead
2010-10-06
Peoples Party of Kenya Trumpet 1 NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit Basket (Mavuno) 1 Kenya...Meru 6%, other African 15%, Asian, European, and Arab 1% Religions: Protestant 45%, Roman Catholic 33%, indigenous beliefs 10%, Muslim 10
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Health promotion and risk reduction in Malawi, Africa, village women.
Gennaro, S; Thyangathyanga, D; Kershbaumer, R; Thompson, J
2001-01-01
A train-the-trainer intervention was evaluated in which village leaders in Malawi, Africa, taught other villagers how to improve their health. Health knowledge and reported health practices were compared before and after the educational intervention in 15 villages in Chimutu, Malawi, Africa. Surveys were completed by trained data gatherers in the village setting. All men and women of childbearing age who were present in the village when data collection occurred were asked to participate. There were 187 participants in the preintervention survey and 175 participants in the postintervention survey. Seventy-six village women were trained, using low literacy techniques, to provide content on health promotion and risk reduction in pregnancy. Over 20,000 persons have received at least one health teaching session from the village trainers. The intervention resulted in reported changes in prenatal and postpartum care and in more births occurring in the hospital or clinic. Some positive nutritional changes were reported, although few changes in beliefs about use of herbal medicines or about the use of witchcraft were reported. A train-the-trainer approach is a sustainable intervention that appears to have positive benefits on the health of village women living in Malawi, Africa.
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Sheikh, Mohamed A; Makokha, Frederick; Hussein, Abdullahi M; Mohamed, Gedi; Mach, Ondrej; Humayun, Kabir; Okiror, Samuel; Abrar, Leila; Nasibov, Orkhan; Burton, John; Unshur, Ahmed; Wannemuehler, Kathleen; Estivariz, Concepcion F
2014-03-21
Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, circulation of indigenous wild poliovirus (WPV) has continued without interruption in only three countries: Afghanistan, Nigeria, and Pakistan. During April-December 2013, a polio outbreak caused by WPV type 1 (WPV1) of Nigerian origin resulted in 217 cases in or near the Horn of Africa, including 194 cases in Somalia, 14 cases in Kenya, and nine cases in Ethiopia (all cases were reported as of March 10, 2014). During December 14-18, 2013, Kenya conducted the first-ever campaign providing inactivated poliovirus vaccine (IPV) together with oral poliovirus vaccine (OPV) as part of its outbreak response. The campaign targeted 126,000 children aged ≤59 months who resided in Somali refugee camps and surrounding communities near the Kenya-Somalia border, where most WPV1 cases had been reported, with the aim of increasing population immunity levels to ensure interruption of any residual WPV transmission and prevent spread from potential new importations. A campaign evaluation and vaccination coverage survey demonstrated that combined administration of IPV and OPV in a mass campaign is feasible and can achieve coverage >90%, although combined IPV and OPV campaigns come at a higher cost than OPV-only campaigns and require particular attention to vaccinator training and supervision. Future operational studies could assess the impact on population immunity and the cost-effectiveness of combined IPV and OPV campaigns to accelerate interruption of poliovirus transmission during polio outbreaks and in certain areas in which WPV circulation is endemic.
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Kenya: Current Conditions and the Challenges Ahead
2010-02-04
Kenya Tree 1 PPK Peoples Party of Kenya Trumpet 1 NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit...Luhya 14%, Luo 13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1% Religions: Protestant 45%, Roman
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NASA Astrophysics Data System (ADS)
Mariita, N. O.; Tadesse, K.; Keller, G. R.
2003-12-01
The East African rift (EAR) is a Tertiary-Miocene system that extends from the Middle East, through East Africa, to Mozambique in southern Africa. Much of the present information is from the Ethiopian and Kenyan parts of the rift. Several characteristics of the EAR such as rift-related volcanism, faulting and topographic relief being exposed make it attractive for studying continental rift processes. Structural complexities reflected in the geometries of grabens and half-grabens, the existence of transverse fault zones and accommodation zones, and the influence of pre-existing geologic structures have been documented. In particular, the EAR traverses the Anza graben and related structures near the Kenya/Ethiopian border. The Anza graben is one in a series of Cretaceous-Paleogene failed rifts that trend across Central Africa from Nigeria through Chad to Sudan and Kenya with an overall northwest-southeast trend. In spite of a number of recent studies, we do not understand the interaction of these two rift systems. In both Ethiopia and Kenya, the rift segments share some broad similarities in timing and are related in a geographic sense. For example, volcanism appears to have generally preceded or in some cases have been contemporaneous with major rift faulting. Although, these segments are distinct entities, each with its own tectonic and magmatic evolution, and they do connect in the region crossed by the Anza graben and related structures. In our present study, we are using a combination of recently collected seismic, gravity and remote sensing data to increase our understanding of these two segments of the EAR. We hope that by analysing the satellite data, the variety and differences in the volume of magmatic products extruded along in southern Ethiopia and northern Kenya will be identified. The geometry of structures (in particular, those causing the gravity axial high) will be modelled to study the impact of the older Anza graben structural trends with the
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Deforestation in Mwanza District, Malawi, from 1981 to 1992 as determined from Landsat MSS imagery
Andrew T. Hudak; Carol A. Wessman
2000-01-01
Malawi is critically short of fuelwood, the primary energy source for its poverty-stricken populace. Deforestation from 1981 to 1992 in Mwanza District in southern Malawi was assessed using Normalized Difference Vegetation Index (NDVI) values calculated from multitemporal Landsat Multispectral Scanner (MSS) images. A control site, where vegetation change was assumed to...
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Ali, Zipporah
2016-01-01
In Kenya, cancers as a disease group rank third as a cause of death after infectious and cardiovascular diseases. It is estimated that the annual incidence of cancer is about 37,000 new cases with an annual mortality of 28,000 cases (Kenya National Cancer Control Strategy 2010). The incidence of non-communicable diseases accounts for more than 50% of total hospital admissions and over 55% of hospital deaths (Kenya National Strategy for the Prevention and Control of Non Communicable Diseases 2015-2020). The prevalence of HIV is 6.8 (KIAS 2014). Most of these patients will benefit from palliative care services, hence the need to integrate palliative care services in the public healthcare system. The process of integrating palliative care in public hospitals involved advocacy both at the national level and at the institutional level, training of healthcare professionals, and setting up services within the hospitals that we worked with. Technical support was provided to each individual institution as needed. Eleven provincial hospitals across the country have now integrated palliative care services (Palliative Care Units) and are now centres of excellence. Over 220 healthcare providers have been trained, and approximately, over 30,000 patients have benefited from these services. Oral morphine is now available in the hospital palliative care units. As a success of the pilot project, Kenya Hospices and Palliative Care Association (KEHPCA) is now working with the Ministry of Health Kenya to integrate palliative care services in 30 other county hospitals across the country, thus ensuring more availability and access to more patients. Other developing countries can learn from Kenya's successful experience.
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The difficulties of conducting maternal death reviews in Malawi.
Kongnyuy, Eugene J; van den Broek, Nynke
2008-09-11
Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. SWOT (strengths, weaknesses, opportunities and threats) analysis of the process of maternal death review during a workshop in Malawi. Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.
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ERIC Educational Resources Information Center
Kalanda, Boniface Francis
2010-01-01
Malawi is one of the countries with a youthful population. Youths are susceptible to various social-economic pressures that put their well being into jeopardy. One of the issues that affect youth is early drop out of school, drug abuse and contracting sexually transmitted diseases including HIV. To address these issues, the Malawi Government…
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Bearing the Cost: An Examination of the Gendered Impacts of Water Policy Reform in Malawi
ERIC Educational Resources Information Center
Marra, Simona
2008-01-01
Water insecurity is one of the most pressing issues currently faced by Malawi. The consequences of these issues are borne significantly by women, who are most directly involved with water provision and use, particularly at the household level. Since the mid-1990s, Malawi has undertaken a process of water policy reform. Reflective of international…
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Otañez, M G; Muggli, M E; Hurt, R D; Glantz, S A
2006-01-01
Objectives To examine British American Tobacco and other tobacco industry support of the Eliminating Child Labour in Tobacco Growing Foundation. Design Analyses of internal tobacco industry documents and ethnographic data. Results British American Tobacco co‐founded the Eliminating Child Labour in Tobacco Growing Foundation (ECLT) in October 2000 and launched its pilot project in Malawi. ECLT's initial projects were budgeted at US$2.3 million over four years. Labour unions and leaf dealers, through ECLT funds, have undertook modest efforts such as building schools, planting trees, and constructing shallow wells to address the use of child labour in tobacco farming. In stark contrast, the tobacco companies receive nearly US$40 million over four years in economic benefit through the use of unpaid child labour in Malawi during the same time. BAT's efforts to combat child labour in Malawi through ECLT was developed to support the company's “corporate social responsibility agenda” rather than accepting responsibility for taking meaningful steps to eradicate child labour in the Malawi tobacco sector. Conclusion In Malawi, transnational tobacco companies are using child labour projects to enhance corporate reputations and distract public attention from how they profit from low wages and cheap tobacco. PMID:16728754
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Herbalism and divination in southern Malawi.
Morris, B
1986-01-01
Although contemporary anthropological studies of African medical systems have indicated their pluralistic and complex nature, many studies still suggest a stark contrast between folk and cosmopolitan medicine, implying that ethnomedicine is primarily concerned with mystical causation. The present paper outlines ethnomedical practices in southern Malawi, stressing the distinctiveness of herbalists and diviners, and the important role of herbal remedies in the empirical treatment of all illnesses.
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How are health professionals earning their living in Malawi?
Muula, Adamson S; Maseko, Fresier C
2006-01-01
Background The migration of health professionals from southern Africa to developed nations is negatively affecting the delivery of health care services in the source countries. Oftentimes however, it is the reasons for the out-migration that have been described in the literature. The work and domestic situations of those health professionals continuing to serve in their posts have not been adequately studied. Methods The present study utilized a qualitative data collection and analysis method. This was achieved through focus group discussions and in-depth interviews with health professionals and administrators to determine the challenges they face and the coping systems they resort to and the perceptions towards those coping methods. Results Health professionals identified the following as some of the challenges there faced: inequitable and poor remuneration, overwhelming responsibilities with limited resources, lack of a stimulating work environment, inadequate supervision, poor access to continued professionals training, limited career progression, lack of transparent recruitment and discriminatory remuneration. When asked what kept them still working in Malawi when the pressures to emigrate were there, the following were some of the ways the health professionals mentioned as useful for earning extra income to support their families: working in rural areas where life was perceived to be cheaper, working closer to home village so as to run farms, stealing drugs from health facilities, having more than one job, running small to medium scale businesses. Health professionals would also minimize expenditure by missing meals and walking to work. Conclusion Many health professionals in Malawi experience overly challenging environments. In order to survive some are involved in ethically and legally questionable activities such as receiving "gifts" from patients and pilfering drugs. The efforts by the Malawi government and the international community to retain health
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Baseline Trachoma Mapping in Malawi with the Global Trachoma Mapping Project (GTMP).
Kalua, Khumbo; Phiri, Menard; Kumwenda, Isaac; Masika, Michael; Pavluck, Alexandre L; Willis, Rebecca; Mpyet, Caleb; Lewallen, Susan; Courtright, Paul; Solomon, Anthony W
2015-01-01
To determine the prevalence of trachoma in all suspected endemic districts in Malawi. A population-based survey conducted in 16 evaluation units from 12 suspected endemic districts in Malawi (population 6,390,517), using the standardized Global Trachoma Mapping Project (GTMP) protocol. A 2-stage cluster-random sampling design selected 30 households from each of 30 clusters per evaluation unit; all residents aged 1 year and older in selected households were examined for evidence of follicular trachoma (TF), intense trachomatous inflammation (TI), and trachomatous trichiasis (TT). Four of the 16 evaluation units were found to be endemic for trachoma, with a prevalence range of 10.0-13.5% for TF and 0.2-0.6% for TT. Nine evaluation units had a TF prevalence between 5.0% and 9.9% while three evaluation units had a TF prevalence <5.0%. The prevalence rates of active trachoma in Malawi were not uniform among suspected endemic evaluation units, with rates higher than the World Health Organization (WHO) threshold for implementation of community-based control measures (TF ≥ 10.0%) in only 4 of the 16 evaluation units. Trachoma remains a disease of public health importance in some parts of Malawi and adjoining (unmapped) districts should be prioritized for mapping. According to the survey, an additional 3,169,362 people require intervention to reduce active disease and 1557 trichiasis surgeries are needed to reduce the prevalence of TT below WHO recommended thresholds.
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Task sharing within a managed clinical network to improve child health in Malawi.
O'Hare, Bernadette; Phiri, Ajib; Lang, Hans-Joerg; Friesen, Hanny; Kennedy, Neil; Kawaza, Kondwani; Jana, Collins E; Chirambo, George; Mulwafu, Wakisa; Heikens, Geert T; Mipando, Mwapatsa
2015-07-21
Eighty per cent of Malawi's 8 million children live in rural areas, and there is an extensive tiered health system infrastructure from village health clinics to district hospitals which refers patients to one of the four central hospitals. The clinics and district hospitals are staffed by nurses, non-physician clinicians and recently qualified doctors. There are 16 paediatric specialists working in two of the four central hospitals which serve the urban population as well as accepting referrals from district hospitals. In order to provide expert paediatric care as close to home as possible, we describe our plan to task share within a managed clinical network and our hypothesis that this will improve paediatric care and child health. Managed clinical networks have been found to improve equity of care in rural districts and to ensure that the correct care is provided as close to home as possible. A network for paediatric care in Malawi with mentoring of non-physician clinicians based in a district hospital by paediatricians based at the central hospitals will establish and sustain clinical referral pathways in both directions. Ultimately, the plan envisages four managed paediatric clinical networks, each radiating from one of Malawi's four central hospitals and covering the entire country. This model of task sharing within four hub-and-spoke networks may facilitate wider dissemination of scarce expertise and improve child healthcare in Malawi close to the child's home. Funding has been secured to train sufficient personnel to staff all central and district hospitals in Malawi with teams of paediatric specialists in the central hospitals and specialist non-physician clinicians in each government district hospital. The hypothesis will be tested using a natural experiment model. Data routinely collected by the Ministry of Health will be corroborated at the district. This will include case fatality rates for common childhood illness, perinatal mortality and process
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Obura, D O
2001-12-01
The Kenya coast is bathed by the northward-flowing warm waters of the East Africa Coastal Current, located between latitudes 1 and 5 degrees S. With a narrow continental shelf, the coastal marine environments are dominated by coral reefs, seagrass beds and mangroves, with large expanses of sandy substrates where river inputs from Kenya's two largest rivers, the Tana and Athi rivers, prevent the growth of coral reefs. The northern part of the coast is seasonally influenced by upwelling waters of the Somali Current, resulting in lower water temperatures for part of the year. The coast is made up of raised Pleistocene reefs on coastal plains and hills of sedimentary origin, which support native habitats dominated by scrub bush and remnant pockets of the forests that used to cover East Africa and the Congo basin. The marine environment is characterized by warm tropical conditions varying at the surface between 25 degrees C and 31 degrees C during the year, stable salinity regimes, and moderately high nutrient levels from terrestrial runoff and groundwater. The semi-diurnal tidal regime varies from 1.5 to 4 m amplitude from neap to spring tides, creating extensive intertidal platform and rocky-shore communities exposed twice-daily during low tides. Fringing reef crests dominate the whole southern coast and parts of the northern coast towards Somalia, forming a natural barrier to the wave energy from the ocean. Coral reefs form the dominant ecosystem along the majority of the Kenya coast, creating habitats for seagrasses and mangroves in the lagoons and creeks protected by the reef crests. Kenya's marine environment faces a number of threats from the growing coastal human population estimated at just under three million in 2000. Extraction of fish and other resources from the narrow continental shelf, coral reef and mangrove ecosystems increases each year with inadequate monitoring and management structures to protect the resource bases. Coastal development in urban and
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ERIC Educational Resources Information Center
Sookrajh, Reshma; McCloud, Salanjira
2009-01-01
We review spaces of contest in the formulation and implementation of the Religious Education curriculum through an exploration of the understandings regarding the dual-mode Religious Education (RE) curriculum policy for secondary schools in Malawi. Six leaders of nationally organised faith communities in Malawi were interviewed about their…
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Health spending, illicit financial flows and tax incentives in Malawi.
O'Hare, B; Curtis, M
2014-12-01
This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.
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Stoves or Sugar? Willingness to Adopt Improved Cookstoves in Malawi
Jagger, Pamela; Jumbe, Charles
2016-01-01
Malawi has set a target of adoption of two million improved cookstoves (ICS) by 2020. Meeting this objective requires knowledge about determinants of adoption, particularly in rural areas where the cost of traditional cooking technologies and fuels are non-monetary, and where people have limited capacity to purchase an ICS. We conducted a discrete choice experiment with 383 households in rural Malawi asking them if they would chose a locally made ICS or a package of sugar and salt of roughly equal value. Six months later, we assessed adoption and stove use patterns. Sixty-six percent of households chose the ICS. We find that having a larger share of crop residues in household fuel supply, awareness of the environmental impacts of woodfuel reliance, time the primary cook devotes to collecting fuelwood, and peer effects at the village-level increase the odds of choosing the ICS. Having a large labor supply for fuelwood collection and experience with a non-traditional cooking technology decreased the odds of choosing the ICS. In a rapid assessment six months after stoves were distributed, we found 80% of households were still using the ICS, but not exclusively. Our findings suggest considerable potential for wide-scale adoption of ICS in Malawi. PMID:27346912
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Building a knowledge translation platform in Malawi to support evidence-informed health policy.
Berman, Joshua; Mitambo, Collins; Matanje-Mwagomba, Beatrice; Khan, Shiraz; Kachimanga, Chiyembekezo; Wroe, Emily; Mwape, Lonia; van Oosterhout, Joep J; Chindebvu, Getrude; van Schoor, Vanessa; Puchalski Ritchie, Lisa M; Panisset, Ulysses; Kathyola, Damson
2015-12-08
With the support of the World Health Organization's Evidence-Informed Policy Network, knowledge translation platforms have been developed throughout Africa, the Americas, Eastern Europe, and Asia to further evidence-informed national health policy. In this commentary, we discuss the approaches, activities and early lessons learned from the development of a Knowledge Translation Platform in Malawi (KTPMalawi). Through ongoing leadership, as well as financial and administrative support, the Malawi Ministry of Health has strongly signalled its intention to utilize a knowledge translation platform methodology to support evidence-informed national health policy. A unique partnership between Dignitas International, a medical and research non-governmental organization, and the Malawi Ministry of Health, has established KTPMalawi to engage national-level policymakers, researchers and implementers in a coordinated approach to the generation and utilization of health-sector research. Utilizing a methodology developed and tested by knowledge translation platforms across Africa, a stakeholder mapping exercise and initial capacity building workshops were undertaken and a multidisciplinary Steering Committee was formed. This Steering Committee prioritized the development of two initial Communities of Practice to (1) improve data utilization in the pharmaceutical supply chain and (2) improve the screening and treatment of hypertension within HIV-infected populations. Each Community of Practice's mandate is to gather and synthesize the best available global and local evidence and produce evidence briefs for policy that have been used as the primary input into structured deliberative dialogues. While a lack of sustained initial funding slowed its early development, KTPMalawi has greatly benefited from extensive technical support and mentorship by an existing network of global knowledge translation platforms. With the continued support of the Malawi Ministry of Health and the
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Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan
Zafar, Shamsa; Jean-Baptiste, Rachel; Rahman, Atif; Neilson, James P.; van den Broek, Nynke R.
2015-01-01
Background For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective) and psychological morbidities in two different low-income countries. Methods Cross sectional study with assessment of morbidity in early pregnancy (34%), late pregnancy (35%) and the postnatal period (31%) among 3459 women from two rural communities in Pakistan (1727) and Malawi (1732). Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity. Results One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective). Both infective (Pakistan) and non-infective morbidity (Pakistan and Malawi) was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon (<10%). There were marked differences in psychological morbidity: 26.9% of women in Pakistan 2.6% in Malawi had an Edinburgh Postnatal Depression Score (EPDS) > 9. Complications during a previous pregnancy, infective morbidity (p <0.001), intra or postpartum haemorrhage (p <0.02) were associated with psychological morbidity in both settings. Conclusions Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests
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Male circumcision and HIV infection among sexually active men in Malawi.
Mutombo, Namuunda; Maina, Beatrice; Jamali, Monica
2015-10-13
The HIV epidemic remains a major health challenge all over the world. In 2013, an estimated 35million people were living with HIV globally. Male circumcision is increasingly being adopted as a method of HIV prevention. WHO and UNAIDS have advised that male circumcision be added to current HIV interventions. Malawi is one of the countries hardest hit by HIV/AIDS with a prevalence rate of 11 % and male circumcision prevalence of 21.6 % in 2010. Prior to 2011, traditional male circumcision in Malawi was the dominant form of male circumcision, mainly for cultural and religious reasons. This paper looks at male circumcision as a prevention method against HIV by examining the relationship between male circumcision and HIV status among Malawian men. The data used were collected as part of the 2010 Malawi Demographic and Health Survey. The methodology used in the 2010 MDHS has been comprehensively described by the National Statistical Office of Malawi and ICF Macro. Our analysis is based on men aged 15-54 years who were tested for HIV and responded to questions on circumcision during the survey. Sixty one percent of the 7175 men interviewed in the MDHS, qualified for this analysis. The sample was weighted to ensure representativeness. Frequencies, cross-tabulations, univariate and multivariate logistic regressions were conducted. Differences in the prevalence of HIV infection among circumcised and uncircumcised men were determined with Chi-squared tests. There is no significant difference in HIV prevalence between circumcised (12 %) and uncircumcised men (10 %). Among circumcised men, age and number of lifetime partners are the dominant correlates of HIV status. Additionally, circumcised men who have had ritual sex are two times more likely (OR = 2.399) to be HIV+ compared to circumcised men who have never had ritual sex. This study has demonstrated that traditional male circumcision was not associated with HIV infection in pre-2010 Malawi. Among circumcised men, age and
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Factors associated with cholera in Kenya, 2008-2013
Cowman, Gretchen; Otipo, Shikanga; Njeru, Ian; Achia, Thomas; Thirumurthy, Harsha; Bartram, Jamie; Kioko, Jackson
2017-01-01
Introduction Kenya experienced widespread cholera outbreaks in 1997-1999 and 2007-2010. The re-emergence of cholera in Kenya in 2015 indicates that cholera remains a public health threat. Understanding past outbreaks is important for preventing future outbreaks. This study investigated the relationship between cholera occurrence in Kenya and various environmental and demographic factors related to water, sanitation, socio-economic status, education, urbanization and availability of health facilities during the time period 2008-2013. Methods The primary outcome analyzed was the number of cholera cases at the district level, obtained from the Kenya Ministry of Health's national cholera surveillance records. Values of independent variables were obtained from the 2009 Kenya Population and Housing Census and other national surveys. The data were analyzed using a zero-inflated negative binomial regression model. Results Multivariate analysis indicated that the risk of cholera was associated with open defecation, use of unimproved water sources, poverty headcount ratio and the number of health facilities per 100,000 population (p < 0.05). No statistically significant association was found between cholera occurrence and education, percentage of population living in urban areas or population density. Conclusion The Sustainable Development Goals and Kenya's blueprint for development, Kenya Vision 2030, call for access to sanitation facilities and clean water for all by 2030. Kenya has made important economic strides in recent years but continues to be affected by diseases like cholera that are associated with low socio-economic status. Further expansion of access to sanitation facilities and clean water is necessary for preventing cholera in Kenya. PMID:29515719
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Factors associated with cholera in Kenya, 2008-2013.
Cowman, Gretchen; Otipo, Shikanga; Njeru, Ian; Achia, Thomas; Thirumurthy, Harsha; Bartram, Jamie; Kioko, Jackson
2017-01-01
Kenya experienced widespread cholera outbreaks in 1997-1999 and 2007-2010. The re-emergence of cholera in Kenya in 2015 indicates that cholera remains a public health threat. Understanding past outbreaks is important for preventing future outbreaks. This study investigated the relationship between cholera occurrence in Kenya and various environmental and demographic factors related to water, sanitation, socio-economic status, education, urbanization and availability of health facilities during the time period 2008-2013. The primary outcome analyzed was the number of cholera cases at the district level, obtained from the Kenya Ministry of Health's national cholera surveillance records. Values of independent variables were obtained from the 2009 Kenya Population and Housing Census and other national surveys. The data were analyzed using a zero-inflated negative binomial regression model. Multivariate analysis indicated that the risk of cholera was associated with open defecation, use of unimproved water sources, poverty headcount ratio and the number of health facilities per 100,000 population (p < 0.05). No statistically significant association was found between cholera occurrence and education, percentage of population living in urban areas or population density. The Sustainable Development Goals and Kenya's blueprint for development, Kenya Vision 2030 , call for access to sanitation facilities and clean water for all by 2030. Kenya has made important economic strides in recent years but continues to be affected by diseases like cholera that are associated with low socio-economic status. Further expansion of access to sanitation facilities and clean water is necessary for preventing cholera in Kenya.
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Moderating the Demand for Primary Education in Malawi.
ERIC Educational Resources Information Center
Minnis, John R.
1997-01-01
Against the backdrop of declining performance, political transition, and the increasingly dominant role of donor agencies in educational decision making, this paper questions the feasibility and sustainability of educational expansion in Malawi. Three critical features of the Malawian political economy (land scarcity, declining wage economy, and…
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Comparative study of general public owl knowledge in Costa Rica, Central America and Malawi, Africa
Paula A. Enriquez; Heimo Mikkola
1997-01-01
The public knowledge of owls in Central America and Africa was compared based on 162 interviews in Costa Rica and 147 in Malawi. General knowledge of owls included: species, common names, habitats, food, and calls, and was quite similar in both study areas. In Malawi, more than 90 percent of the respondents connected owls with bad luck, witchcraft, and death. In Costa...
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Marital Aspirations, Sexual Behaviors, and HIV/AIDS in Rural Malawi
Clark, Shelley; Poulin, Michelle; Kohler, Hans-Peter
2009-01-01
We explore how marital aspirations are related to the sexual behaviors of adolescents and young adults in Malawi, where HIV/AIDS prevalence among adults exceeds 10%. We also consider whether the specter of AIDS is shaping ideals about marriage. By combining survey data (N = 1,087) and in-depth interviews (N = 133) with young Malawians from the Malawi Diffusion and Ideational Change Project, we show that looking for and finding a suitable spouse are linked to sexual behaviors and, thus, HIV risks. Moreover, concerns about contracting HIV are closely tied to the ideal characteristics of a future spouse. Our findings draw long-overdue attention to the importance of marital aspirations in understanding adolescent sexual behaviors and risks in the era of AIDS. PMID:20161389
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ERIC Educational Resources Information Center
Useem, Michael; Chipande, Graham
1991-01-01
To identify general principles of implementing a system of evaluation, the experience of Malawi in building a national system for agriculture is described. Applying principles of both centralization and decentralization and principles of trial and error has helped translate theories of evaluation into practice in Malawi. (SLD)
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ERIC Educational Resources Information Center
Mtika, Peter; Gates, Peter
2010-01-01
This article is mainly concerned with the capability of trainee teachers to implement learner-centred practice at one of the teacher education institutions in Malawi. The notion of learner-centred education has assumed a positive policy position for teaching and learning in both primary and secondary sectors not only in Malawi, but also in the…
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Peterson, Erin N; Cline, Maggie E; Moore, Emily C; Roberts, Natalie B; Roberts, Reade B
2017-06-01
East African cichlids display extensive variation in sex determination systems. The species Astatotilapia calliptera is one of the few cichlids that reside both in Lake Malawi and in surrounding waterways. A. calliptera is of interest in evolutionary studies as a putative immediate outgroup species for the Lake Malawi species flock and possibly as a prototype ancestor-like species for the radiation. Here, we use linkage mapping to test association of sex in A. calliptera with loci that have been previously associated with genetic sex determination in East African cichlid species. We identify a male heterogametic XY system segregating at linkage group (LG) 7 in an A. calliptera line that originated from Lake Malawi, at a locus previously shown to act as an XY sex determination system in multiple species of Lake Malawi cichlids. Significant association of genetic markers and sex produce a broad genetic interval of approximately 26 megabases (Mb) using the Nile tilapia genome to orient markers; however, we note that the marker with the strongest association with sex is near a gene that acts as a master sex determiner in other fish species. We demonstrate that alleles of the marker are perfectly associated with sex in Metriaclima mbenjii, a species from the rock-dwelling clade of Lake Malawi. While we do not rule out the possibility of other sex determination loci in A. calliptera, this study provides a foundation for fine mapping of the cichlid sex determination gene on LG7 and evolutionary context regarding the origin and persistence of the LG7 XY across diverse, rapidly evolving lineages.
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NASA Astrophysics Data System (ADS)
Peterson, Erin N.; Cline, Maggie E.; Moore, Emily C.; Roberts, Natalie B.; Roberts, Reade B.
2017-06-01
East African cichlids display extensive variation in sex determination systems. The species Astatotilapia calliptera is one of the few cichlids that reside both in Lake Malawi and in surrounding waterways. A. calliptera is of interest in evolutionary studies as a putative immediate outgroup species for the Lake Malawi species flock and possibly as a prototype ancestor-like species for the radiation. Here, we use linkage mapping to test association of sex in A. calliptera with loci that have been previously associated with genetic sex determination in East African cichlid species. We identify a male heterogametic XY system segregating at linkage group (LG) 7 in an A. calliptera line that originated from Lake Malawi, at a locus previously shown to act as an XY sex determination system in multiple species of Lake Malawi cichlids. Significant association of genetic markers and sex produce a broad genetic interval of approximately 26 megabases (Mb) using the Nile tilapia genome to orient markers; however, we note that the marker with the strongest association with sex is near a gene that acts as a master sex determiner in other fish species. We demonstrate that alleles of the marker are perfectly associated with sex in Metriaclima mbenjii, a species from the rock-dwelling clade of Lake Malawi. While we do not rule out the possibility of other sex determination loci in A. calliptera, this study provides a foundation for fine mapping of the cichlid sex determination gene on LG7 and evolutionary context regarding the origin and persistence of the LG7 XY across diverse, rapidly evolving lineages.
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Lupafya, Phindile Chitsulo; Mwagomba, Beatrice L Matanje; Hosig, Kathy; Maseko, Lucy M; Chimbali, Henry
2016-04-01
Malawi is a Sub-Saharan African country experiencing the epidemiological transition from predominantly infectious to noncommunicable diseases (NCDs) with dramatically increasing prevalence of lifestyle-related diseases such as obesity, hypertension, and diabetes. Malawi's 2011-2016 Health Sector Strategic Plan included NCDs, and an NCD Control Program was established with subsequent development of a National Action Plan for prevention and management of NCDs launched in 2013. The current study was designed to identify gaps in implementation of NCD control program policies and action plan strategies by describing current efforts toward prevention and management of NCDs in Malawi with emphasis on challenges and opportunities. Semistructured questionnaires were used to collect quantitative and qualitative data from Malawi Ministry of Health personnel (senior officers, service providers, health education officers, and nutritionists) in 10 health districts and 3 central hospitals. Frequencies were generated for quantitative data. Qualitative data were used to generate themes and most common responses. Results showed that current services focus on facility-based NCD screening and clinical services rather than active screening, prevention, and community awareness and outreach, although respondents emphasized the importance of prevention, lifestyle education, and community outreach. Respondents indicated inadequate resources for NCD services including financial capital, human resources, equipment and supplies, and transportation. While Malawi has begun to address NCDs, policy and practice implications include (a) better integration of services within the existing infrastructure with emphasis on capacity building; (b) greater implementation of planned NCD activities; (c) a stronger, more comprehensive data management system; and (d) innovative funding solutions. © 2015 Society for Public Health Education.
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Van Der Tak, J
1986-06-01
In Kenya, women still average about 8 children each, but the average family size desired by ever-married women dropped by 1 child, from 7.2 to 6.2, between 1978-84. The percentage of currently married women using contraception more than doubled, from 7 to 17%. These are highlights of trends revealed by comparison of the recently released results of the Kenya Contraceptive Prevalence Survey of 1984 with the Kenya Fertility Survey of 1977-78. The latest trends in Kenya's fertility and family planning can be expected to be of worldwide interest in view of the country's record high population growth rate of 4.2% a year. Estimated at 21 million in 1986, the population of Kenya is projected by the UN to quadruple to 83 million by 2025 and could reach as high as 116 million by 2100, according to the World Bank. Among the reasons cited for the failure of Kenya's government family planning program, established in 1968, are bureaucratic snarls, shortages of supplies and trained personnel, and short business hours and long waits in clinics that are not always easily accessible in rural areas. These problems are now being dealt with, but there remains the obstacle of a persistent desire for large families among the population. Over 80% of the 6581 women aged 15-49 interviewed in the 1984 survey knew of at least 1 contraceptive method. The survey report terms the more than doubling of current contraceptive use between 1978-84 as a major success for the family planning program. Yet, the 1984 level is low. Also, the contraceptive mix shifted toward less effective methods. Among currently married women using contraception, the proportion using modern methods was down from 61% in 1978 to 52% in 1984, with oral contraceptive (OC) use dropping from 29 to 19% of the total and rhythm increasing from 16 to 25%. Fertility change was negligible. There was a slight increase in children ever born among women 45-49 from 7.9-8.2 per woman, along with a small decrease in the current total
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Menstruation and School Absenteeism: Evidence from Rural Malawi
ERIC Educational Resources Information Center
Grant, Monica; Lloyd, Cynthia; Mensch, Barbara
2013-01-01
The provision of toilets and menstrual supplies appears to be a promising strategy to promote adolescent girls' school attendance and performance in less developed countries. In this article, we use the first round of the Malawi Schooling and Adolescent Survey (MSAS) to examine the individual- and school-level factors associated with…
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Newborn survival in Malawi: a decade of change and future implications.
Zimba, Evelyn; Kinney, Mary V; Kachale, Fannie; Waltensperger, Karen Z; Blencowe, Hannah; Colbourn, Tim; George, Joby; Mwansambo, Charles; Joshua, Martias; Chanza, Harriet; Nyasulu, Dorothy; Mlava, Grace; Gamache, Nathalie; Kazembe, Abigail; Lawn, Joy E
2012-07-01
Malawi is one of two low-income sub-Saharan African countries on track to meet the Millennium Development Goal (MDG 4) for child survival despite high fertility and HIV and low health worker density. With neonatal deaths becoming an increasing proportion of under-five deaths, addressing newborn survival is critical for achieving MDG 4. We examine change for newborn survival in the decade 2000-10, analysing mortality and coverage indicators whilst considering other contextual factors. We assess national and donor funding, as well as policy and programme change for newborn survival using standard analyses and tools being applied as part of a multi-country analysis. Compared with the 1990s, progress towards MDG 4 and 5 accelerated considerably from 2000 to 2010. Malawi's neonatal mortality rate (NMR) reduced slower than annual reductions in mortality for children 1-59 months and maternal mortality (NMR reduced 3.5% annually). Yet, the NMR reduced at greater pace than the regional and global averages. A significant increase in facility births and other health system changes, including increased human resources, likely contributed to this decline. High level attention for maternal health and associated comprehensive policy change has provided a platform for a small group of technical and programme experts to link in high impact interventions for newborn survival. The initial entry point for newborn care in Malawi was mainly through facility initiatives, such as Kangaroo Mother Care. This transitioned to an integrated and comprehensive approach at community and facility level through the Community-Based Maternal and Newborn Care package, now being implemented in 17 of 28 districts. Addressing quality gaps, especially for care at birth in facilities, and including newborn interventions in child health programmes, will be critical to the future agenda of newborn survival in Malawi.
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Doherty, Jane; Kirigia, Doris; Okoli, Chijioke; Chuma, Jane; Ezumah, N; Ichoku, Hyacinth; Hanson, Kara; McIntyre, Diane
2018-01-01
ABSTRACT Background: The global focus on promoting Universal Health Coverage has drawn attention to the need to increase public domestic funding for health care in low- and middle-income countries. Objectives: This article examines whether increased tax revenue in the three territories of Kenya, Lagos State (Nigeria) and South Africa was accompanied by improved resource allocation to their public health sectors, and explores the reasons underlying the observed trends. Methods: Three case studies were conducted by different research teams using a common mixed methods approach. Quantitative data were extracted from official government financial reports and used to describe trends in general tax revenue, total government expenditure and government spending on the health sector and other sectors in the first decade of this century. Twenty-seven key informant interviews with officials in Ministries of Health and Finance were used to explore the contextual factors, actors and processes accounting for the observed trends. A thematic content analysis allowed this qualitative information to be compared and contrasted between territories. Findings: Increased tax revenue led to absolute increases in public health spending in all three territories, but not necessarily in real per capita terms. However, in each of the territories, the percentage of the government budget allocated to health declined for much of the period under review. Factors contributing to this trend include: inter-sectoral competition in priority setting; the extent of fiscal federalism; the Ministry of Finance’s perception of the health sector’s absorptive capacity; weak investment cases made by the Ministry of Health; and weak parliamentary and civil society involvement. Conclusion: Despite dramatic improvements in tax revenue collection, fiscal space for health in the three territories did not improve. Ministries of Health must strengthen their ability to motivate for larger allocations from
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Doherty, Jane; Kirigia, Doris; Okoli, Chijioke; Chuma, Jane; Ezumah, N; Ichoku, Hyacinth; Hanson, Kara; McIntyre, Diane
2018-01-01
The global focus on promoting Universal Health Coverage has drawn attention to the need to increase public domestic funding for health care in low- and middle-income countries. This article examines whether increased tax revenue in the three territories of Kenya, Lagos State (Nigeria) and South Africa was accompanied by improved resource allocation to their public health sectors, and explores the reasons underlying the observed trends. Three case studies were conducted by different research teams using a common mixed methods approach. Quantitative data were extracted from official government financial reports and used to describe trends in general tax revenue, total government expenditure and government spending on the health sector and other sectors in the first decade of this century. Twenty-seven key informant interviews with officials in Ministries of Health and Finance were used to explore the contextual factors, actors and processes accounting for the observed trends. A thematic content analysis allowed this qualitative information to be compared and contrasted between territories. Increased tax revenue led to absolute increases in public health spending in all three territories, but not necessarily in real per capita terms. However, in each of the territories, the percentage of the government budget allocated to health declined for much of the period under review. Factors contributing to this trend include: inter-sectoral competition in priority setting; the extent of fiscal federalism; the Ministry of Finance's perception of the health sector's absorptive capacity; weak investment cases made by the Ministry of Health; and weak parliamentary and civil society involvement. Despite dramatic improvements in tax revenue collection, fiscal space for health in the three territories did not improve. Ministries of Health must strengthen their ability to motivate for larger allocations from government revenue through demonstrating improved performance and the
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NASA Astrophysics Data System (ADS)
Glasson, George E.; Frykholm, Jeffrey A.; Mhango, Ndalapa A.; Phiri, Absalom D.
2006-07-01
The purpose of this 2-year study was to investigate Malawian teacher educators' perspectives and dispositions toward teaching about ecological sustainability issues in Malawi, a developing country in sub-Sahara Africa. This study was embedded in a larger theoretical framework of investigating earth systems science through the understanding of nature-knowledge-culture systems from local, place-based perspectives. Specifically, we were interested in learning more about eco-justice issues that are related to environmental degradation in Malawi and the potential role of inquiry-oriented pedagogies in addressing these issues. In a science methods course, the African educators' views on deforestation and teaching about ecological sustainability were explored within the context of the local environment and culture. Teachers participated in inquiry pedagogies designed to promote the sharing of perspectives related to the connections between culture and ecological degradation. Strategies encouraging dialogue and reflection included role-playing, class discussions, curriculum development activities, teaching experiences with children, and field trips to a nature preserve. Data were analyzed from postcolonial and critical pedagogy of place theoretical perspectives to better understand the hybridization of viewpoints influenced by both Western and indigenous science and the political hegemonies that impact sustainable living in Malawi. Findings suggested that the colonial legacy of Malawi continues to impact the ecological sustainability issue of deforestation. Inquiry-oriented pedagogies and connections to indigenous science were embraced by the Malawian educators as a means to involve children in investigation, decision making, and ownership of critical environmental issues.
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Estimated burden of fungal infections in Kenya.
Guto, John Abuga; Bii, Christine C; Denning, David W
2016-08-31
Kenya is a developing country with a high rate of tuberculosis (TB) and a moderate HIV infection burden. No estimate of the burden of fungal diseases in Kenya is published. We used specific populations at risk and fungal infection frequencies from the literature to estimate national incidence or prevalence of serious fungal infections. Used sources were: 2010 WHO TB statistics, Kenya Acquired Immunodeficiency Syndrome (AIDS) Epidemic Update 2012, Kenya Facts and figures 2012, Kenya Demographic and Health Survey 2008-2009. Of Kenya's population of ~40 million, 43% are under 15 years old and approximately 594,660 Kenyan women get >4 episodes Candida vulvovaginitis annually (2,988/100,000). The HIV/AIDS population at risk of opportunistic infections (OI) is 480,000 and the OI estimates include 306,000 patients with oral thrush (768/100,000), 114,000 with oesophageal candidiasis (286/100,000), 11,900 with cryptococcal meningitis (29/100,000) and 17,000 patients with Pneumocystis pneumonia (42/100,000). Chronic pulmonary aspergillosis following TB has a prevalence of 10,848 cases (32/100,000). The adult asthma prevalence is 3.1% and assuming 2.5% have allergic bronchopulmonary aspergillosis then 17,696 (44/100,000) are affected. Invasive aspergillosis, candidaemia and Candida peritonitis are probably uncommon. Tinea capitis infects 9.6% of children in Kenya, while fungal keratitis and otomycoses are difficult to estimate. At any one time, about 7% of the Kenyan population suffers from a significant fungal infection, with recurrent vaginitis and tinea capitis accounting for 82% of the infections. These estimates require further epidemiological studies for validation.
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A Seasonal Air Transport Climatology for Kenya
NASA Technical Reports Server (NTRS)
Gatebe, C. K.; Tyson, P. D.; Annegarn, H.; Piketh, S.; Helas, G.
1998-01-01
A climatology of air transport to and from Kenya has been developed using kinematic trajectory modeling. Significant months for trajectory analysis have been determined from a classification of synoptic circulation fields. Five-point back and forward trajectory clusters to and from Kenya reveal that the transport corridors to Kenya are clearly bounded and well defined. Air reaching the country originates mainly from the Saharan region and northwestern Indian Ocean of the Arabian Sea in the northern hemisphere and from the Madagascan region of the Indian Ocean in the southern hemisphere. Transport from each of these source regions show distinctive annual cycles related to the northeasterly Asian monsoon and the southeasterly trade wind maximum over Kenya in May. The Saharan transport in the lower troposphere is at a maximum when the subtropical high over northern Africa is strongly developed in the boreal winter. Air reaching Kenya between 700 and 500 hPa is mainly from Sahara and northwest India Ocean flows in the months of January and March, which gives way to southwest Indian Ocean flow in May and November. In contrast, air reaching Kenya at 400 hPa is mainly from southwest Indian Ocean in January and March, which is replaced by Saharan transport in May and November. Transport of air from Kenya is invariant, both spatially and temporally, in the tropical easterlies to the Congo Basin and Atlantic Ocean in comparison to the transport to the country. Recirculation of air has also been observed, but on a limited and often local scale and not to the extent reported in southern Africa.
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Health systems challenges in cervical cancer prevention program in Malawi.
Maseko, Fresier C; Chirwa, Maureen L; Muula, Adamson S
2015-01-01
Cervical cancer remains the leading cause of cancer death among women in sub-Saharan Africa. In Malawi, very few women have undergone screening and the incidence of cervical cancer is on the increase as is the case in most developing countries. We aimed at exploring and documenting health system gaps responsible for the poor performance of the cervical cancer prevention program in Malawi. The study was carried out in 14 randomly selected districts of the 29 districts of Malawi. All cervical cancer service providers in these districts were invited to participate. Two semi-structured questionnaires were used, one for the district cervical cancer coordinators and the other for the service providers. The themes of both questionnaires were based on World Health Organization (WHO) health system frameworks. A checklist was also developed to audit medical supplies and equipment in the cervical cancer screening facilities. The two questionnaires together with the medical supplies and equipment checklist were piloted in Chikwawa district before being used as data collection tools in the study. Quantitative data were analyzed using STATA and qualitative in NVIVO. Forty-one service providers from 21 health facilities and 9 district coordinators participated in the study. Our findings show numerous health system challenges mainly in areas of health workforce and essential medical products and technologies. Seven out of the 21 health facilities provided both screening and treatment. RESULTS showed challenges in the management of the cervical cancer program at district level; inadequate service providers who are poorly supervised; lack of basic equipment and stock-outs of basic medical supplies in some health facilities; and inadequate funding of the program. In most of the health facilities, services providers were not aware of the policy which govern their work and that they did not have standards and guidelines for cervical cancer screening and treatment. Numerous health
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Distance to Care, Facility Delivery and Early Neonatal Mortality in Malawi and Zambia
Lohela, Terhi J.; Campbell, Oona M. R.; Gabrysch, Sabine
2012-01-01
Background Globally, approximately 3 million babies die annually within their first month. Access to adequate care at birth is needed to reduce newborn as well as maternal deaths. We explore the influence of distance to delivery care and of level of care on early neonatal mortality in rural Zambia and Malawi, the influence of distance (and level of care) on facility delivery, and the influence of facility delivery on early neonatal mortality. Methods and Findings National Health Facility Censuses were used to classify the level of obstetric care for 1131 Zambian and 446 Malawian delivery facilities. Straight-line distances to facilities were calculated for 3771 newborns in the 2007 Zambia DHS and 8842 newborns in the 2004 Malawi DHS. There was no association between distance to care and early neonatal mortality in Malawi (OR 0.97, 95%CI 0.58–1.60), while in Zambia, further distance (per 10 km) was associated with lower mortality (OR 0.55, 95%CI 0.35–0.87). The level of care provided in the closest facility showed no association with early neonatal mortality in either Malawi (OR 1.02, 95%CI 0.90–1.16) or Zambia (OR 1.02, 95%CI 0.82–1.26). In both countries, distance to care was strongly associated with facility use for delivery (Malawi: OR 0.35 per 10km, 95%CI 0.26–0.46). All results are adjusted for available confounders. Early neonatal mortality did not differ by frequency of facility delivery in the community. Conclusions While better geographic access and higher level of care were associated with more frequent facility delivery, there was no association with lower early neonatal mortality. This could be due to low quality of care for newborns at health facilities, but differential underreporting of early neonatal deaths in the DHS is an alternative explanation. Improved data sources are needed to monitor progress in the provision of obstetric and newborn care and its impact on mortality. PMID:23300599
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Patterns of intimate partner violence: a study of female victims in Malawi.
Bazargan-Hejazi, Shahrzad; Medeiros, Sarah; Mohammadi, Reza; Lin, Johnny; Dalal, Koustuv
2013-01-01
The term "intimate partner violence" (IPV) encompasses physical, sexual and psychological violence, or any combination of these acts, and globally is the most common type of violence against women. This study aims to examine the lifetime prevalence of different types of intimate partner violence (IPV) among Malawi women ages 15 to 49, and its association with age, education, and living in rural versus urban areas. Data was obtained from a cross-sectional study of data as part of the 2004 Malawi Demographic and Health Survey. Women were eligible for the study if they met the following criteria: 1) lived in one of the 15,041 households randomly selected from 522 rural and urban clusters located in 10 large districts of Malawi; 2) were married or cohabitating; and 3) were between the ages of 15 and 49 years. Consenting, eligible women responded to a comprehensive questionnaire covering demographic factors, health issues, as well as items related to physical, emotional and sexual IPV. To assess bivariate associations, chi-squared tests and multivariate logistic regressions were conducted. Among the 8291 respondents, 13% reported emotional violence; 20% reported being pushed, shaken, slapped or punched; 3% reported experiencing severe violence, such as being strangled or burned, threatened with a knife, gun or with another weapon; and 13% reported sexual violence. Data showed women ages 15 to 19 were significantly less likely to report emotional IPV, women ages 25 to 29 were significantly more likely to report being pushed or shaken, slapped or punched (OR 1.35; CI: 1.05-1.73), and women ages 30 to 34 were significantly more likely to report sexual IPV, compared to women ages 45 to 49 (OR 1.40; CI: 1.03-1.90). Finally, women who had no ability to read were less likely to report sexual IPV than their counterparts who could read a full sentence (OR 0.76; CI: 0.66-0.87). The prevalence of different types of IPV in Malawi appears slightly lower than that reported for other
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Patterns of Intimate Partner Violence: a study of female victims in Malawi
Bazargan-Hejazi, Shahrzad; Medeiros, Sarah; Mohammadi, Reza; Lin, Johnny; Dalal, Koustuv
2013-01-01
Abstract: Background: The term “intimate partner violence” (IPV) encompasses physical, sexual and psychological violence, or any combination of these acts, and globally is the most common type of violence against women. This study aims to examine the lifetime prevalence of different types of intimate partner violence (IPV) among Malawi women ages 15 to 49, and its association with age, education, and living in rural versus urban areas. Methods: Data was obtained from a cross-sectional study of data as part of the 2004 Malawi Demographic and Health Survey. Women were eligible for the study if they met the following criteria: 1) lived in one of the 15,041 households randomly selected from 522 rural and urban clusters located in 10 large districts of Malawi; 2) were married or cohabitating; and 3) were between the ages of 15 and 49 years. Consenting, eligible women responded to a comprehensive questionnaire covering demographic factors, health issues, as well as items related to physical, emotional and sexual IPV. To assess bivariate associations, chi-squared tests and multivariate logistic regressions were conducted. Results: Among the 8291 respondents, 13% reported emotional violence; 20% reported being pushed, shaken, slapped or punched; 3% reported experiencing severe violence, such as being strangled or burned, threatened with a knife, gun or with another weapon; and 13% reported sexual violence. Data showed women ages 15 to 19 were significantly less likely to report emotional IPV, women ages 25 to 29 were significantly more likely to report being pushed or shaken, slapped or punched (OR 1.35; CI: 1.05-1.73), and women ages 30 to 34 were significantly more likely to report sexual IPV, compared to women ages 45 to 49 (OR 1.40; CI: 1.03-1.90). Finally, women who had no ability to read were less likely to report sexual IPV than their counterparts who could read a full sentence (OR 0.76; CI: 0.66-0.87). Conclusions: The prevalence of different types of IPV in
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Anticipation and response: pandemic influenza in Malawi, 2009
Sambala, Evanson Z.; Manderson, Lenore
2017-01-01
ABSTRACT Background: In 2006, Malawi developed a national influenza plan to mitigate, prevent and manage the burden of infection should an outbreak occur. In 2009, it translated its contingency plan to respond to the unfolding influenza pandemic. However, little is known of how Malawi translated its national influenza plan into response actions, or the success of these responses. Objective: To investigate how Malawi translated its preparedness plan and so broaden our understanding of the outcomes of the responses. Methods: We draw on data from 22 in-depth interviews with government policymakers and people working at a policy level in various non-governmental organisations, conducted to assess the level of preparedness and the challenges of translating this. Results: Through a number of public health initiatives, authorities developed communication strategies, strengthened influenza surveillance activities and updated overall goals in pandemic training and education. However, without influenza drills, exercises and simulations to test the plan, activating the pandemic plan, including coordinating and deploying generic infection control measures, was problematic. Responses during the pandemic were at times ‘weak and clumsy’ and failed to mirror the activities and processes highlighted in the preparedness plan. Conclusions: Participants stressed that in order to achieve a coordinated and successful response to mitigate and prevent the further transmission of pandemic influenza, good preparation was critical. The key elements which they identified as relevant for a rapid response included effective communications, robust evidence-based decision-making, strong and reliable surveillance systems and flexible public health responses. To effectively articulate a viable trajectory of pandemic responses, the potential value of simulation exercises could be given more consideration as a mean of sustaining good levels of preparedness and responses against future pandemics
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HIV/AIDS and time allocation in rural Malawi
Bignami-Van Assche, Simona; Van Assche, Ari; Anglewicz, Philip; Fleming, Peter; van de Ruit, Catherine
2012-01-01
AIDS-related morbidity and mortality are expected to have a large economic impact in rural Malawi, because they reduce the time that adults can spend on production for subsistence and on income-generating activities. However, households may compensate for production losses by reallocating tasks among household members. The data demands for measuring these effects are high, limiting the amount of empirical evidence. In this paper, we utilize a unique combination of qualitative and quantitative data, including biomarkers for HIV, collected by the 2004 Malawi Diffusion and Ideational Change Project, to analyze the association between AIDS-related morbidity and mortality, and time allocation decisions in rural Malawian households. We find that AIDS-related morbidity and mortality have important economic effects on women’s time, whereas men’s time is unresponsive to the same shocks. Most notably, AIDS is shown to induce diversification of income sources, with women (but not men) reallocating their time, generally from work-intensive (typically farming and heavy chores) to cash-generating tasks (such as casual labor). PMID:22639544
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Kenya's Maligned African Press: A Reassessment.
ERIC Educational Resources Information Center
Scotton, James F.
Kenya's dozen or more newspapers and 50 news sheets edited and published by Africans in the turbulent 1945-52 preindependence period were condemned as irresponsible, inflammatory, antiwhite, and seditious by the Kenya colonial government, and this characterization has been accepted by many scholars and journalists, including Africans. There is…
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Hosseinipour, Mina; Nelson, Julie A E; Trapence, Clement; Rutstein, Sarah E; Kasende, Florence; Kayoyo, Virginia; Kaunda-Khangamwa, Blessings; Compliment, Kara; Stanley, Christopher; Cataldo, Fabian; van Lettow, Monique; Rosenberg, Nora E; Tweya, Hannock; Gugsa, Salem; Sampathkumar, Veena; Schouten, Erik; Eliya, Michael; Chimbwandira, Frank; Chiwaula, Levison; Kapito-Tembo, Atupele; Phiri, Sam
2017-06-01
In 2011, Malawi launched Option B+, a program of universal antiretroviral therapy (ART) treatment for pregnant and lactating women to optimize maternal health and prevent pediatric HIV infection. For optimal outcomes, women need to achieve HIVRNA suppression. We report 6-month HIVRNA suppression and HIV drug resistance in the PURE study. PURE study was a cluster-randomized controlled trial evaluating 3 strategies for promoting uptake and retention; arm 1: Standard of Care, arm 2: Facility Peer Support, and arm 3: Community Peer support. Pregnant and breastfeeding mothers were enrolled and followed according to Malawi ART guidelines. Dried blood spots for HIVRNA testing were collected at 6 months. Samples with ART failure (HIVRNA ≥1000 copies/ml) had resistance testing. We calculated odds ratios for ART failure using generalized estimating equations with a logit link and binomial distribution. We enrolled 1269 women across 21 sites in Southern and Central Malawi. Most enrolled while pregnant (86%) and were WHO stage 1 (95%). At 6 months, 950/1269 (75%) were retained; 833/950 (88%) had HIVRNA testing conducted, and 699/833 (84%) were suppressed. Among those with HIVRNA ≥1000 copies/ml with successful amplification (N = 55, 41% of all viral loads > 1000 copies/ml), confirmed HIV resistance was found in 35% (19/55), primarily to the nonnucleoside reverse transcriptase inhibitor class of drugs. ART failure was associated with treatment default but not study arm, age, WHO stage, or breastfeeding status. Virologic suppression at 6 months was <90% target, but the observed confirmed resistance rates suggest that adherence support should be the primary approach for early failure in option B+.
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NASA Astrophysics Data System (ADS)
Mbano, Nellie
2003-01-01
The use of the 'Cognitive Acceleration through Science Education' (CASE) intervention programme was explored in Malawi to see if the critical period for cognitive transition from concrete operations to formal operations at 12-14 years of age actually exists. The older pupils (16-17 years of age) in secondary school classes in Malawi made similar cognitive gains to younger English pupils after being taught CASE for 2 years. This was taken to suggest that the critical period does not exist. However, in Malawi, girls, who are on average a year younger than boys in the same class, and older boys, had lower academic achievement than younger boys. Explanations for this age and gender interaction are explored.
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NASA Astrophysics Data System (ADS)
Klug, M.; Cissell, J.; Grossman, M.
2017-12-01
Malawi has become increasingly prone to landslides in the past few decades. This can be attributed to the terrain, types of soil and vegetation, increased human interference, and heavy flooding after long periods of drought. In addition to the floods and droughts, landslides cause extra stress to farmlands, thus exacerbating the current food security crisis in the country. It can be difficult to pinpoint just how many people are affected by landslides in Malawi because landslides often occur in rural areas or are grouped with other disasters, such as floods or earthquakes. This project created a Landslide Susceptibility Map to assess landslide-prone areas in Malawi using variables such as slope, distance to roads, distance to streams, soil type, and precipitation. These variables were derived using imagery from Landsat 8 Operational Land Imager (OLI), Shuttle Radar Topography Mission Version 3 (SRTM-v3), Global Precipitation Measurement (GPM), and Tropical Rainfall Measuring Mission (TRMM) satellites. Furthermore, this project created a Landslide Exposure Map to estimate how much of the local population lives in susceptible areas by intersecting population data with the Landslide Susceptibility Map. Additionally, an assessment of GPM and TRMM precipitation measurements was generated to better understand the reliability of both measurements for landslide monitoring. Finally, this project updated NASA SERVIR's Global Landslide Catalog (GLC) for Malawi by using WorldView data from Google Earth and Landsat 8 OLI. These end products were used by NASA SERVIR and the Regional Centre for Mapping of Resources for Development (RCMRD) for aiding in disaster management throughout Malawi.
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ERIC Educational Resources Information Center
Mzuza, Maureen Kapute; Yudong, Yang; Kapute, Fanuel
2014-01-01
Factors that cause poor examination passing rates and high dropout rates among primary school girls in Malawi were analysed. First hand data was collected by conducting a survey in all the three regions of Malawi. The respondents to the questionnaire were girls (402) who are repeating the last class in primary schools (Standard 8), primary school…
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Umar, Shuaibu; Shinkafi, Saadatu Haruna; Hudu, Shuaibu Abdullahi; Neela, Vasanthakumari; Suresh, Kumar; Nordin, Syafinaz Amin; Malina, Osman
Schistosomiasis is the major source of morbidity in Sub-Saharan Africa and Asia. It is estimated that 207 million people are infected, of which 97% are in Africa. The aim of this study was the determining of prevalence as well as the phylogeny of S. haematobium among school children in Argungu Emirate, Kebbi State Nigeria. A total of 325 urine samples was collected from school children between 7 to 14 years. S. heamatobium eggs was examined under dissecting microscope and DNA was extracted from urine sample and COX1 gene was amplified by nested PCR. The PCR products were purified, sequenced and analysed. This study showed a prevalence of 32.09%, with male pupils having the highest prevalence. S. haematobium infections in children who fetch water in the river have 24 times higher risk of being infected while those who bath in the river have 158 times higher risk of being infected. Our sequences were phylogenetically related to S. haematobium isolate U82266 from Kenya and consistence with the predominant species in Africa. This was the first S. haematobium and S. mansoni co-infection reported in Nigeria. S. haematobium infection is prevalent among school age and significantly associated with water contact.
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Harries, Anthony D; Ford, Nathan; Jahn, Andreas; Schouten, Erik J; Libamba, Edwin; Chimbwandira, Frank; Maher, Dermot
2016-09-06
The scale-up of antiretroviral therapy (ART) in Malawi was based on a public health approach adapted to its resource-poor setting, with principles and practices borrowed from the successful tuberculosis control framework. From 2004 to 2015, the number of new patients started on ART increased from about 3000 to over 820,000. Despite being a small country, Malawi has made a significant contribution to the 15 million people globally on ART and has also contributed policy and service delivery innovations that have supported international guidelines and scale up in other countries. The first set of global guidelines for scaling up ART released by the World Health Organization (WHO) in 2002 focused on providing clinical guidance. In Malawi, the ART guidelines adopted from the outset a more operational and programmatic approach with recommendations on health systems and services that were needed to deliver HIV treatment to affected populations. Seven years after the start of national scale-up, Malawi launched a new strategy offering all HIV-infected pregnant women lifelong ART regardless of the CD4-cell count, named Option B+. This strategy was subsequently incorporated into a WHO programmatic guide in 2012 and WHO ART guidelines in 2013, and has since then been adopted by the majority of countries worldwide. In conclusion, the Malawi experience of ART scale-up has become a blueprint for a public health response to HIV and has informed international efforts to end the AIDS epidemic by 2030.
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Organic sedimentation in modern lacustrine systems: A case study from Lake Malawi, East Africa
Ellis, Geoffrey S.; Barry J. Katz,; Christopher A. Scholz,; Peter K. Swart,
2015-01-01
This study examines the relationship between depositional environment and sedimentary organic geochemistry in Lake Malawi, East Africa, and evaluates the relative significance of the various processes that control sedimentary organic matter (OM) in lacustrine systems. Total organic carbon (TOC) concentrations in recent sediments from Lake Malawi range from 0.01 to 8.80 wt% and average 2.83 wt% for surface sediments and 2.35 wt% for shallow core sediments. Hydrogen index (HI) values as determined by Rock-Eval pyrolysis range from 0 to 756 mg HC g−1 TOC and average 205 mg HC g−1 TOC for surface sediments and 228 mg HC g−1 TOC for shallow core samples. On average, variations in primary productivity throughout the lake may account for ~33% of the TOC content in Lake Malawi sediments (as much as 1 wt% TOC), and have little or no impact on sedimentary HI values. Similarly, ~33% to 66% of the variation in TOC content in Lake Malawi sediments appears to be controlled by anoxic preservation of OM (~1–2 wt% TOC), although some component of the water depth–TOC relationship may be due to physical sediment transport processes. Furthermore, anoxic preservation has a minimal effect on HI values in Lake Malawi sediments. Dilution of OM by inorganic sediment may account for ~16% of variability in TOC content in Lake Malawi sediments (~0.5 wt% TOC). The effect of inputs of terrestrial sediment on the organic character of surface sediments in these lakes is highly variable, and appears to be more closely related to the local depositional environment than the regional flux of terrestrial OM. Total nitrogen and TOC content in surface sediments collected throughout the lake are found to be highly correlated (r2 = 0.95), indicating a well-homogenized source of OM to the lake bottom. The recurring suspension and deposition of terrestrial sediment may account for significant amounts of OM deposited in offshore regions of the lake. This process effectively separates denser
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Unemployed Youth: Alternative Approaches to an African Crisis.
ERIC Educational Resources Information Center
Livingstone, Ian
1989-01-01
This article draws on the findings of seven country studies of youth employment programs in Africa (Botswana, Somalia, Zambia, Malawi, Kenya, Ethiopia, and Mauritius). Considered are public service/public works programs, agricultural development, employable skills development and vocationalization of education, and national youth services. (SK)
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Adult Literacy Policy and Performance in Malawi: An Analysis.
ERIC Educational Resources Information Center
Bhola, H. S.
In Malawi, adult literacy deserves immediate attention in order to promote health, family planning, and productivity. While policy commitment for adult literacy promotion has not been lacking, intensified action has been. In 1979 the government accepted the Unesco Mission Report to undertake a functional literacy program on the successful…
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Thermal care of newborns: drying and bathing practices in Malawi and Bangladesh
Khan, Shane M; Kim, Eunsoo Timothy; Singh, Kavita; Amouzou, Agbessi; Carvajal-Aguirre, Liliana
2018-01-01
Background Thermal care of newborns is one of the recommended strategies to reduce hypothermia, which contributes to neonatal morbidity and mortality. However, data on these two topics have not been collected at the national level in many surveys. In this study, we examine two elements of thermal care: drying and delayed bathing of newborns after birth with the objectives of examining how two countries collected such data and then looking at various associations of these outcomes with key characteristics. Further, we examine the data for potential data quality issues as this is one of the first times that such data are available at the national level. Methods We use data from two nationally-representative household surveys: the Malawi Multiple Indicator Cluster Survey 2014 and the Bangladesh Demographic and Health Survey 2014. We conduct descriptive analysis of the prevalence of these two newborn practices by various socio-demographic, economic and health indicators. Results Our results indicate high levels of immediate drying/drying within 1 hour in Malawi (87%). In Bangladesh, 84% were dried within the first 10 minutes of birth. Bathing practices varied in the two settings; in Malawi, only 26% were bathed after 24 hours but in Bangladesh, 87% were bathed after the same period. While in Bangladesh there were few newborns who were never bathed (less than 5%), in Malawi, over 10% were never bathed. Newborns delivered by a skilled provider tended to have better thermal care than those delivered by unskilled providers. Conclusion These findings reveal gaps in coverage of thermal care and indicate the need to further develop the role of unskilled providers who can give unspecialized care as a means to improve thermal care for newborns. Further work to harmonize data collection methods on these topics is needed to ensure comparable data across countries. PMID:29862028
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Arbovirus Prevalence in Mosquitoes, Kenya
Sutherland, Laura J.; Muiruri, Samuel; Muchiri, Eric M.; Gray, Laurie R.; Zimmerman, Peter A.; Hise, Amy G.; King, Charles H.
2011-01-01
Few studies have investigated the many mosquito species that harbor arboviruses in Kenya. During the 2006–2007 Rift Valley fever outbreak in North Eastern Province, Kenya, exophilic mosquitoes were collected from homesteads within 2 affected areas: Gumarey (rural) and Sogan-Godud (urban). Mosquitoes (n = 920) were pooled by trap location and tested for Rift Valley fever virus and West Nile virus. The most common mosquitoes trapped belonged to the genus Culex (75%). Of 105 mosquito pools tested, 22% were positive for Rift Valley fever virus, 18% were positive for West Nile virus, and 3% were positive for both. Estimated mosquito minimum infection rates did not differ between locations. Our data demonstrate the local abundance of mosquitoes that could propagate arboviral infections in Kenya and the high prevalence of vector arbovirus positivity during a Rift Valley fever outbreak. PMID:21291594
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Policy perspectives on post pandemic influenza vaccination in Ghana and Malawi.
Sambala, Evanson Z; Manderson, Lenore
2017-02-28
In the late 1990s, in the context of renewed concerns of an influenza pandemic, countries such as Ghana and Malawi established plans for the deployment of vaccines and vaccination strategies. A new pandemic was declared in mid-June 2009, and by April 2011, Ghana and Malawi vaccinated 10% of the population. We examine the public health policy perspectives on vaccination as a means to prevent the spread of infection under post pandemic conditions. In-depth interviews were conducted with 46 policymakers (Ghana, n = 24; Malawi, n = 22), identified through snowballing sampling. Interviews were supplemented by field notes and the analysis of policy documents. The use of vaccination to interrupt the pandemic influenza was affected by delays in the procurement, delivery and administration of vaccines, suboptimal vaccination coverage, refusals to be vaccinated, and the politics behind vaccination strategies. More generally, rolling-out of vaccination after the transmission of the influenza virus had abated was influenced by policymakers' own financial incentives, and government and foreign policy conditionality on vaccination. This led to confusion about targeting and coverage, with many policymakers justifying that the vaccination of 10% of the population would establish herd immunity and so reduce future risk. Ghana succeeded in vaccinating 2.3 million of the select groups (100% coverage), while Malawi, despite recourse to force, succeeded only in vaccinating 1.15 million (74% coverage of select groups). For most policymakers, vaccination coverage was perceived as successful, despite that vaccination delays and coverage would not have prevented infection when influenza was at its peak. While the vaccination strategy was problematic and implemented too late to reduce the effects of the 2009 epidemic, policy makers supported the overall goal of pandemic influenza vaccination to interrupt infection. In this context, there was strong support for governments engaging
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NASA Astrophysics Data System (ADS)
Galford, G. L.; Fiske, G. J.; Sedano, F.; Michelson, H.
2016-12-01
Agriculture in sub-Saharan Africa is characterized by smallholder production and low yields ( 1 ton ha-1 year-1 since records began in 1961) for staple food crops such as maize (Zea mays). Many years of low-input farming have depleted much of the region's agricultural land of critical soil carbon and nitrogen, further reducing yield potentials. Malawi is a 98,000 km2 subtropical nation with a short rainy season from November to May, with most rainfall occurring between December and mid-April. This short growing season supports the cultivation of one primary crop, maize. In Malawi, many smallholder farmers face annual nutrient deficits as nutrients removed as grain harvest and residues are beyond replenishment levels. As a result, Malawi has had stagnant maize yields averaging 1.2 ton ha-1 year-1 for decades. After multiple years of drought and widespread hunger in the early 2000s, Malawi introduced an agricultural input support program (fertilizer and seed subsidy) in time for the 2006 harvest that was designed to restore soil nutrients, improve maize production, and decrease dependence on food aid. Malawi's subsidy program targets 50-67% of smallholder farmers who cultivate half a hectare or less, yet collectively supply 80% of the country's maize. The country has achieved significant increases in crop yields (now 2 tons/ha/year) and, as our analysis shows, benefited from a new resilience against drought. We utilized Landsat time series to determine cropland extent from 2000-present and identify areas of marginal and/or intermittent production. We found a strong latitudinal gradient of precipitation variability from north to south in CHIRPS data. We used the precipitation variability to normalize trends in a productivity proxy derived from MODIS EVI. After normalization of productivity to precipitation variability, we found significant productivity trends correlated to subsidy distribution. This work was conducted with Google's Earth Engine, a cloud-based platform
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Changing times? Gender roles and relationships in maternal, newborn and child health in Malawi.
Manda-Taylor, Lucinda; Mwale, Daniel; Phiri, Tamara; Walsh, Aisling; Matthews, Anne; Brugha, Ruairi; Mwapasa, Victor; Byrne, Elaine
2017-09-25
For years, Malawi remained at the bottom of league tables on maternal, neonatal and child health. Although maternal mortality ratios have reduced and significant progress has been made in reducing neonatal morality, many challenges in achieving universal access to maternal, newborn and child health care still exist in Malawi. In Malawi, there is still minimal, though increasing, male involvement in ANC/PMTCT/MNCH services, but little understanding of why this is the case. The aim of this paper is to explore the role and involvement of men in MNCH services, as part of the broader understanding of those community system factors. This paper draws on the qualitative data collected in two districts in Malawi to explore the role and involvement of men across the MNCH continuum of care, with a focus on understanding the community systems barriers and enablers to male involvement. A total of 85 IDIs and 20 FGDs were conducted from August 2014 to January 2015. Semi-structure interview guides were used to guide the discussion and a thematic analysis approach was used for data analysis. Policy changes and community and health care provider initiatives stimulated men to get involved in the health of their female partners and children. The informal bylaws, the health care provider strategies and NGO initiatives created an enabling environment to support ANC and delivery service utilisation in Malawi. However, traditional gender roles in the home and the male 'unfriendly' health facility environments still present challenges to male involvement. Traditional notions of men as decision makers and socio-cultural views on maternal health present challenges to male involvement in MNCH programs. Health care provider initiatives need to be sensitive and mindful of gender roles and relations by, for example, creating gender inclusive programs and spaces that aim at reducing perceptions of barriers to male involvement in MNCH services so that programs and spaces that are aimed at
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Gender and socio-cultural determinants of delay to diagnosis of TB in Bangladesh, India and Malawi.
Gosoniu, G D; Ganapathy, S; Kemp, J; Auer, C; Somma, D; Karim, F; Weiss, M G
2008-07-01
Tuberculosis (TB) control programmes in Bangladesh, India and Malawi. To compare the interval from symptom onset to diagnosis of TB for men and women, and to assess socio-cultural and gender-related features of illness explaining diagnostic delay. Semi-structured Explanatory Model Interview Catalogue (EMIC) interviews were administered to 100 or more patients at each site, assessing categories of distress, perceived causes and help seeking. Based on time from initial symptoms to diagnosis of TB, patients were classified with problem delay (>90 days), timely diagnosis (< or =30 days) or moderate delay. EMIC interview data were analysed to explain problem delay. The median interval from symptom onset to diagnosis was longest in India and shortest in Malawi. With adjustment for confounding, female sex (Bangladesh), and status of married woman (India) and housewife (Malawi) were associated with problem delay. Prominent non-specific symptoms--chest pain (Bangladesh) and breathlessness (Malawi)--were also significant. Cough in India, widely associated with TB, was associated with timely diagnosis. Sanitation as a perceived cause linked to poor urban conditions was associated with delayed diagnosis in India. Specific prior help seeking with circuitous referral patterns was identified. The study identified gender- and illness-related features of diagnostic delay. Further research distinguishing patient and provider delay is needed.
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HIV and mental illness in Malawi and the neuropsychiatric sequelae of efavirenz.
Drury, Andrew; Gleadow-Ware, Selena; Gilfillan, Sheila; Ahrens, Jen
2018-03-01
Little is published about mental disorders in Malawi, specifically in relation to Human Immunodeficiency Virus (HIV) and it's treatment. Efavirenz is a medication commonly used as part of triple therapy for HIV treatment. Indeed, in 2013, Malawi introduced 5A with Efavirenz as part of it's 1st line treatment for HIV. There exists some literature documenting known psychiatric side effects of Efavirenz, which include anxiety, mood changes, nightmares, psychosis and suicidal ideation. Little is known about what features are most common in the presentation and what factors in the patient and drug which may make this reaction more likely. The aim of this commentary is to review the association between HIV and psychiatric disorder, and consider the neuropsychiatric side-effects of Efavirenz. An evaluative literature review was completed by means of multiple electronic database search as well as an additional manual search to obtain published works identified through the electronic search. Search terms used were: Efavirenz, Acquired Immunodeficiency Syndrome, Africa, Antiretroviral Therapy, Developing Countries, Malawi, Mental Disorders, Public Health, and Psychiatry. This is an important area of study, as potentially large numbers of individuals with HIV are being placed on Efavirenz as first line treatment, yet 60% may experience some form of neuropsychiatric side effects.
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Mungwira, Randy G; Nyangulu, Wongani; Misiri, James; Iphani, Steven; Ng'ong'ola, Ruby; Chirambo, Chawanangwa M; Masiye, Francis; Mfutso-Bengo, Joseph
2015-12-02
This paper discusses the contentious issue of reuse of stored biological samples and data obtained from research participants in past clinical research to answer future ethical and scientifically valid research questions. Many countries have regulations and guidelines that guide the use and exportation of stored biological samples and data. However, there are variations in regulations and guidelines governing the reuse of stored biological samples and data in Sub-Saharan Africa including Malawi. The current research ethics regulations and guidelines in Malawi do not allow indefinite storage and reuse of biological samples and data for future unspecified research. This comes even though the country has managed to answer pertinent research questions using stored biological samples and data. We acknowledge the limited technical expertise and equipment unavailable in Malawi that necessitates exportation of biological samples and data and the genuine concern raised by the regulatory authorities about the possible exploitation of biological samples and data by researchers. We also acknowledge that Malawi does not have bio-banks for storing biological samples and data for future research purposes. This creates room for possible exploitation of biological samples and data collected from research participants in primary research projects in Malawi. However, research ethics committees require completion and approval of material transfer agreements and data transfer agreements for biological samples and data collected for research purposes respectively and this requirement may partly address the concern raised by the regulatory authorities. Our concern though is that there is no such requirement for biological samples and data collected from patients for clinical or diagnostic purposes. In conclusion, we propose developing a medical data and material transfer agreement for biological samples and data collected from patients for clinical or diagnostic purposes in both public
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-04
... poverty reduction. The Act requires the Millennium Challenge Corporation (MCC) to take a number of steps... its people; and (b) considering the opportunity to reduce poverty and generate economic growth in the... India Indonesia Iraq Kenya Kiribati Kyrgyz Republic Lao PDR Lesotho Liberia Malawi Mauritania Micronesia...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-07
... programs that advance the progress of such countries to achieve lasting economic growth and poverty [[Page...) investments in its people; and (b) considering the opportunity to reduce poverty and generate economic growth...; Ghana, Guinea, Haiti, Honduras, India, Kenya, Kyrgyz Republic, Lao PDR, Lesotho, Liberia, Malawi, Mali...
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Kenya: Current Conditions and the Challenges Ahead
2010-12-09
Tree 1 PPK Peoples Party of Kenya Trumpet 1 NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit Basket...15%, Asian, European, and Arab 1% Religions: Protestant 45%, Roman Catholic 33%, indigenous beliefs 10%, Muslim 10%, other 2% Languages: English
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Supporting the development of a health benefits package in Malawi
Revill, Paul; Manthalu, Gerald; McGuire, Finn; Nkhoma, Dominic; Rollinger, Alexandra; Sculpher, Mark; Claxton, Karl
2018-01-01
Malawi, like many low-income and middle-income countries, has used health benefits packages (HBPs) to allocate scarce resources to key healthcare interventions. With no widely accepted method for their development, HBPs often promise more than can be delivered, given available resources. An analytical framework is developed to guide the design of HBPs that can identify the potential value of including and implementing different interventions. It provides a basis for informing meaningful discussions between governments, donors and other stakeholders around the trade-offs implicit in package design. Metrics of value, founded on an understanding of the health opportunity costs of the choices faced, are used to quantify the scale of the potential net health impact (net disability adjusted life years averted) or the amount of additional healthcare resources that would be required to deliver similar net health impacts with existing interventions (the financial value to the healthcare system). The framework can be applied to answer key questions around, for example: the appropriate scale of the HBP; which interventions represent ‘best buys’ and should be prioritised; where investments in scaling up interventions and health system strengthening should be made; whether the package should be expanded; costs of the conditionalities of donor funding and how objectives beyond improving population health can be considered. This is illustrated using data from Malawi. The framework was successfully applied to inform the HBP in Malawi, as a core component of the country’s Health Sector Strategic Plan II 2017–2022. PMID:29662689
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Sex, Money, and Premarital Relationships in Southern Malawi
Poulin, Miss Michelle J.
2009-01-01
In this paper, I argue two main points: (1), the purpose of money exchange in premarital, sexual partnerships in rural Malawi extends beyond the alleviation of female partners’ economic constraints, and (2), by elucidating this broader purpose, it becomes possible to recognize where women exert control over their own sexual selves. These findings come from field observations and a rich set of in-depth interviews (N=54), bolstered on occasion by survey data, conducted with young women and men, aged 15 to 24 years, in the Balaka district in the southern region of the country. My research demonstrates that, contrary to typical expectations, money and gift transfers in sexual partnerships are part and parcel of the courting practices of young Malawian women and men. Transfers are as much about the expression of love and commitment as they are about meeting the financial “needs” of women or the acquisition of sex for men. Using narrative information to shed light on the semiotics of the sex-money link, these findings from Malawi offer a new perspective that broadens usual interpretations of “transactional” sex, the understanding of which is critical in fighting AIDS. PMID:17764797
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Nakagomi, Toyoko; Nakagomi, Osamu; Dove, Winifred; Doan, Yen Hai; Witte, Desiree; Ngwira, Bagrey; Todd, Stacy; Steele, A Duncan; Neuzil, Kathleen M; Cunliffe, Nigel A
2014-01-01
The human, G1P[8] rotavirus vaccine (Rotarix) significantly reduced severe rotavirus gastroenteritis episodes in a clinical trial in South Africa and Malawi, but vaccine efficacy was lower in Malawi (49.5%) than reported in South Africa (76.9%) and elsewhere. The aim of this study was to examine the molecular relationships of circulating wild-type rotaviruses detected during the clinical trial in Malawi to RIX4414 (the strain contained in Rotarix) and to common human rotavirus strains. Of 88 rotavirus-positive, diarrhoeal stool specimens, 43 rotaviruses exhibited identifiable RNA migration patterns when examined by polyacrylamide gel electrophoresis. The genes encoding VP7, VP4, VP6 and NSP4 of 5 representative strains possessing genotypes G12P[6], G1P[8], G9P[8], and G8P[4] were sequenced. While their VP7 (G) and VP4 (P) genotype designations were confirmed, the VP6 (I) and NSP4 (E) genotypes were either I1E1 or I2E2, indicating that they were of human rotavirus origin. RNA-RNA hybridization using 21 culture-adapted strains showed that Malawian rotaviruses had a genomic RNA constellation common to either the Wa-like or DS-1 like human rotaviruses. Overall, the Malawi strains appear similar in their genetic make-up to rotaviruses described in countries where vaccine efficacy is greater, suggesting that the lower efficacy in Malawi is unlikely to be explained by the diversity of circulating strains. PMID:22520123
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Girls' Attitudes towards Science in Kenya
ERIC Educational Resources Information Center
Chetcuti, Deborah A.; Kioko, Beriter
2012-01-01
This study investigated girls' attitudes towards science in Kenya. It was carried out with 120 girls from four secondary schools in the Eastern province of Kenya. These were an urban single-sex (SS) and co-educational (Co-Ed) school and a rural SS and Co-Ed school. Different schools were chosen in order to explore whether there are any differences…
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Okoroji, C.E.I.
1982-09-01
A public consensus has developed on the need for national energy policies and better planning in the utilization of energy resources in Nigeria. A look at Nigeria's energy future is timely as a period of rapid technological growth and industrial development begins. At the present time, Nigeria exports a relatively high percentage (92%) of the petroleum produced annually. In addition, about 95% of all produced natural gas is flared. Only a relatively minor fraction of the coal produced is used and the rest exported to West African countries. Water power in Nigeria is not yet fully developed. Although the depositsmore » of uranium and oil sand may be substantial, the reserves are not currently known. The proportions in which mineral fuels are used are not related to their relative abundance. Based on present production rates, domestic reserves of petroleum will last 20 years, those of natural gas 63 years, and those of coal 1503 years. Nigeria is not currently and is not likely to become self-sufficient in terms of energy requirements. During the past decade, Nigeria's population has increased by 28.4%. Of vital concern for the immediate future in Nigeria are the demands on energy consumption and mineral resources resulting from increasing population pressure.« less
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The Impact of Out-Migration on the Nursing Workforce in Kenya
Gross, Jessica M; Rogers, Martha F; Teplinskiy, Ilya; Oywer, Elizabeth; Wambua, David; Kamenju, Andrew; Arudo, John; Riley, Patricia L; Higgins, Melinda; Rakuom, Chris; Kiriinya, Rose; Waudo, Agnes
2011-01-01
Objective To examine the impact of out-migration on Kenya's nursing workforce. Study Setting This study analyzed deidentified nursing data from the Kenya Health Workforce Informatics System, collected by the Nursing Council of Kenya and the Department of Nursing in the Ministry of Medical Services. Study Design We analyzed trends in Kenya's nursing workforce from 1999 to 2007, including supply, deployment, and intent to out-migrate, measured by requests for verification of credentials from destination countries. Principle Findings From 1999 to 2007, 6 percent of Kenya's nursing workforce of 41,367 nurses applied to out-migrate. Eighty-five percent of applicants were registered or B.Sc.N. prepared nurses, 49 percent applied within 10 years of their initial registration as a nurse, and 82 percent of first-time applications were for the United States or United Kingdom. For every 4.5 nurses that Kenya adds to its nursing workforce through training, 1 nurse from the workforce applies to out-migrate, potentially reducing by 22 percent Kenya's ability to increase its nursing workforce through training. Conclusions Nurse out-migration depletes Kenya's nursing workforce of its most highly educated nurses, reduces the percentage of younger nurses in an aging nursing stock, decreases Kenya's ability to increase its nursing workforce through training, and represents a substantial economic loss to the country. PMID:21413982
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Village registers for vital registration in rural Malawi.
Singogo, E; Kanike, E; van Lettow, M; Cataldo, F; Zachariah, R; Bissell, K; Harries, A D
2013-08-01
Paper-based village registers were introduced 5 years ago in Malawi as a tool to measure vital statistics of births and deaths at the population level. However, usage, completeness and accuracy of their content have never been formally evaluated. In Traditional Authority Mwambo, Zomba district, Malawi, we assessed 280 of the 325 village registers with respect to (i) characteristics of village headmen who used village registers, (ii) use and content of village registers, and (iii) whether village registers provided accurate information on births and deaths. All village headpersons used registers. There were 185 (66%) registers that were regarded as 95% completed, and according to the registers, there were 115 840 people living in the villages in the catchment area. In 2011, there were 1753 births recorded in village registers, while 6397 births were recorded in health centre registers in the same catchment area. For the same year, 199 deaths were recorded in village registers, giving crude death rates per 100 000 population of 189 for males and 153 for females. These could not be compared with death rates in health centre registers due to poor and inconsistent recording in these registers, but they were compared with death rates obtained from the 2010 Malawi Demographic Health Survey that reported 880 and 840 per 100 000 for males and females, respectively. In conclusion, this study shows that village registers are a potential source for vital statistics. However, considerable inputs are needed to improve accuracy of births and deaths, and there are no functional systems for the collation and analysis of data at the traditional authority level. Innovative ways to address these challenges are discussed, including the use of solar-powered electronic village registers and mobile phones, connected with each other and the health facilities and the District Commissioner's office through the cellular network and wireless coverage. © 2013 John Wiley & Sons Ltd.
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Cholera outbreaks in Malawi in 1998-2012: social and cultural challenges in prevention and control.
Msyamboza, Kelias Phiri; Kagoli, Mathew; M'bang'ombe, Maurice; Chipeta, Sikhona; Masuku, Humphrey Dzanjo
2014-06-11
Cholera still remains a significant cause of morbidity and mortality in developing countries, although comprehensive surveillance data to inform policy and strategies are scarce. A desk review of the national cholera database and zonal and districts reports was conducted. Interviews were conducted with district health management teams, health workers, and participants in communities in six districts affected by cholera in 2011/2012 to obtain data on water, sanitation, and sociocultural issues. From 1998 to 2012, cholera outbreaks occurred every year in Malawi, with the highest number of cases and deaths reported in 2001/2002 (33,546 cases, 968 deaths; case fatality rate [CFR] 2.3%). In 2011/2012, cholera outbreak was widespread in the southern region, affecting 10 out of 13 districts, where 1,806 cases and 38 deaths (CFR 2.1%) were reported. Unsafe water sources, lack of maintenance of broken boreholes, frequent breakdown of piped water supply, low coverage of pit latrines (range 40%-60%), lack of hand washing facilities (< 5%), salty borehole water, fishermen staying on Lake Chilwa, cross-border Malawi-Mozambique disease spread, and sociocultural issues were some of the causes of the persistent cholera outbreaks in Malawi. Despite improvements in safe drinking water and sanitation, cholera is still a major public health problem. Introduction of a community-led total sanitation approach, use of social and cultural information in community mobilization strategies, and introduction of an oral cholera vaccine could help to eliminate cholera in Malawi.
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Assessing the Impact of Early Learning Programs in Africa
ERIC Educational Resources Information Center
Gove, Amber; Brunette, Tracy; Bulat, Jennae; Carrol, Bidemi; Henny, Catherine; Macon, Wykia; Nderu, Evangeline; Sitabkhan, Yasmin
2017-01-01
We present results from early learning programs in six African countries: Ethiopia, Kenya, Liberia, Malawi, Tanzania, and Uganda. In partnership with ministries of education, RTI International has worked within government systems to support the design and deployment of locally contextualized materials, training, and assessment tools, with the goal…
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Survey of Basic Education in Eastern Africa. UNESCO/UNICEF Co-Operation Programme.
ERIC Educational Resources Information Center
United Nations Educational, Scientific, and Cultural Organization, Nairobi (Kenya). Regional Office of Science and Technology for Africa.
A survey of basic education in 13 Eastern African countries (Madagascar, Burundi, Comores, Ethiopia, Mauritius, Botswana, Kenya, Lesotho, Swaziland, Tanzania, Zambia, Malawi, and Somalia) covers basic education programs and UNICEF's supporting role. Basic education is seen as a concept evolved in the region, involving formal school systems and…
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ERIC Educational Resources Information Center
Okanga, Anne Asiko; Ogur, John Okoth; Arudo, John
2017-01-01
Kenya has seen a paradigm shift in nursing education sector recording high rates of enrolment of students to training while their performance in Nursing Council of Kenya (NCK) examination remained variable and unpredictable. This study evaluated performance of BSc nursing students in NCK examinations by examining institutional characteristics in…
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7 CFR 319.56-45 - Shelled garden peas from Kenya.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 5 2010-01-01 2010-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United States from Kenya only under the following conditions and in accordance with all other applicable...
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Kenya: Current Conditions and the Challenges Ahead
2009-05-14
Traditional African Banjo 1 MGPK Mazingira Greens Party of Kenya Tree 1 PPK Peoples Party of Kenya Trumpet 1 NLP National Labour Party Bull (Ndume) 1...Ethnic Divisions: Kikuyu 22%, Luhya 14%, Luo 13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1
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The Antlion Project with School Pupils in Zomba, Malawi
ERIC Educational Resources Information Center
Young, Simon
2013-01-01
This article presents an account of a practical outdoor science project using the larvae of antlions with year 5 and 6 (age 10-11) pupils from Sir Harry Johnston International Primary School in Zomba, Malawi. Aim: To conduct a science project outdoors using scientific enquiry and knowledge in a typical African school environment and to see whether…
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Criteria for clinical audit of women friendly care and providers' perception in Malawi
Kongnyuy, Eugene J; van den Broek, Nynke
2008-01-01
Background There are two dimensions of quality of maternity care, namely quality of health outcomes and quality as perceived by clients. The feasibility of using clinical audit to assess and improve the quality of maternity care as perceived by women was studied in Malawi. Objective We sought to (a) establish standards for women friendly care and (b) explore attitudinal barriers which could impede the proper implementation of clinical audit. Methods We used evidence from Malawi national guidelines and World Health Organisation manuals to establish local standards for women friendly care in three districts. We equally conducted a survey of health care providers to explore their attitudes towards criterion based audit. Results The standards addressed different aspects of care given to women in maternity units, namely (i) reception, (ii) attitudes towards women, (iii) respect for culture, (iv) respect for women, (v) waiting time, (vi) enabling environment, (vii) provision of information, (viii) individualised care, (ix) provision of skilled attendance at birth and emergency obstetric care, (x) confidentiality, and (xi) proper management of patient information. The health providers in Malawi generally held a favourable attitude towards clinical audit: 100.0% (54/54) agreed that criterion based audit will improve the quality of care and 92.6% believed that clinical audit is a good educational tool. However, there are concerns that criterion based audit would create a feeling of blame among providers (35.2%), and that manager would use clinical audit to identify and punish providers who fail to meet standards (27.8%). Conclusion Developing standards of maternity care that are acceptable to, and valued by, women requires consideration of both the research evidence and cultural values. Clinical audit is acceptable to health professionals in Malawi although there are concerns about its negative implications to the providers. PMID:18647388
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Criteria for clinical audit of women friendly care and providers' perception in Malawi.
Kongnyuy, Eugene J; van den Broek, Nynke
2008-07-22
There are two dimensions of quality of maternity care, namely quality of health outcomes and quality as perceived by clients. The feasibility of using clinical audit to assess and improve the quality of maternity care as perceived by women was studied in Malawi. We sought to (a) establish standards for women friendly care and (b) explore attitudinal barriers which could impede the proper implementation of clinical audit. We used evidence from Malawi national guidelines and World Health Organisation manuals to establish local standards for women friendly care in three districts. We equally conducted a survey of health care providers to explore their attitudes towards criterion based audit. The standards addressed different aspects of care given to women in maternity units, namely (i) reception, (ii) attitudes towards women, (iii) respect for culture, (iv) respect for women, (v) waiting time, (vi) enabling environment, (vii) provision of information, (viii) individualised care, (ix) provision of skilled attendance at birth and emergency obstetric care, (x) confidentiality, and (xi) proper management of patient information. The health providers in Malawi generally held a favourable attitude towards clinical audit: 100.0% (54/54) agreed that criterion based audit will improve the quality of care and 92.6% believed that clinical audit is a good educational tool. However, there are concerns that criterion based audit would create a feeling of blame among providers (35.2%), and that manager would use clinical audit to identify and punish providers who fail to meet standards (27.8%). Developing standards of maternity care that are acceptable to, and valued by, women requires consideration of both the research evidence and cultural values. Clinical audit is acceptable to health professionals in Malawi although there are concerns about its negative implications to the providers.
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Adolescent Experience of Menstruation in Rural Kenya.
Secor-Turner, Molly; Schmitz, Kaitlin; Benson, Kristen
2016-01-01
Although menstruation is a universal experience, girls in resource-poor areas face unique challenges related to menstruation management. In Kenya, girls miss nearly 3.5 million learning days per month because of limited access to sanitary products and lack of adequate sanitation. Global priorities to address gender inequality-especially related to education-often do not consider the impact of poverty on gendered experiences, such as menstruation. The aim of the study was to describe the experiences of menstruation from the perspective of adolescent girls living in rural Kenya. Data for this qualitative study were collected through 29 individual interviews with adolescent girls and separate field observations. Descriptive content analysis was used to identify themes reflective of the data from the individual interviews and field notes. Four themes were developed to summarize the data: (a) receiving information about menstruation, (b) experiences of menstruation, (c) menstrual hygiene practices, and (d) social norms and the meaning of menstruation. Findings from this study describe the impact of menstruation on the lives of adolescent girls in rural Kenya. Menstrual hygiene management and its associated challenges may impact girls' academic continuity. Experiences of menstruation also reinforce gender inequality and further marginalize girls in low-income, rural areas of Kenya. Consideration of menstruation is critical to promote health and academic continuity for girls in rural Kenya.
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Environmental risk factors for oesophageal cancer in Malawi: A case-control study.
Mlombe, Y B; Rosenberg, N E; Wolf, L L; Dzamalala, C P; Chalulu, K; Chisi, J; Shaheen, N J; Hosseinipour, M C; Shores, C G
2015-09-01
There is a high burden of oesophageal cancer in Malawi with dismal outcomes. It is not known whether environmental factors are associated with oesophageal cancer. Without knowing this critical information, prevention interventions are not possible. The purpose of this analysis was to explore environmental factors associated with oesophageal cancer in the Malawian context. A hospital-based case-control study of the association between environmental risk factors and oesophageal cancer was conducted at Kamuzu Central Hospital in Lilongwe, Malawi and Queen Elizabeth Central Hospital in Blantyre, Malawi. Ninety-six persons with squamous cell carcinoma and 180 controls were enrolled and analyzed. These two groups were compared for a range of environmental risk factors, using logistic regression models. Unadjusted and adjusted odds ratios and 95% confidence intervals (CI) were calculated. Firewood cooking, cigarette smoking, and use of white maize flour all had strong associations with squamous cell carcinoma of the oesophagus, with adjusted odds ratios of 12.6 (95% CI: 4.2-37.7), 5.4 (95% CI: 2.0-15.2) and 6.6 (95% CI: 2.3-19.3), respectively. Several modifiable risk factors were found to be strongly associated with squamous cell carcinoma. Research is needed to confirm these associations and then determine how to intervene on these modifiable risk factors in the Malawian context.
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Measuring Institutions: Indicators of Political and Property Rights in Malawi
ERIC Educational Resources Information Center
Fedderke, Johannes; Garlick, Julia
2012-01-01
This paper constructs a new set of institutional indicators for Malawi. We develop indicators of political rights, of freehold, traditional (communitarian) and intellectual property rights, based on the Malawian legislative framework. In exploring the association between our rights measures and a range of indicators of socio-economic development,…
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Nakagomi, Toyoko; Nakagomi, Osamu; Dove, Winifred; Doan, Yen Hai; Witte, Desiree; Ngwira, Bagrey; Todd, Stacy; Duncan Steele, A; Neuzil, Kathleen M; Cunliffe, Nigel A
2012-04-27
The human, G1P[8] rotavirus vaccine (Rotarix™) significantly reduced severe rotavirus gastroenteritis episodes in a clinical trial in South Africa and Malawi, but vaccine efficacy was lower in Malawi (49.5%) than reported in South Africa (76.9%) and elsewhere. The aim of this study was to examine the molecular relationships of circulating wild-type rotaviruses detected during the clinical trial in Malawi to RIX4414 (the strain contained in Rotarix™) and to common human rotavirus strains. Of 88 rotavirus-positive, diarrhoeal stool specimens, 43 rotaviruses exhibited identifiable RNA migration patterns when examined by polyacrylamide gel electrophoresis. The genes encoding VP7, VP4, VP6 and NSP4 of 5 representative strains possessing genotypes G12P[6], G1P[8], G9P[8], and G8P[4] were sequenced. While their VP7 (G) and VP4 (P) genotype designations were confirmed, the VP6 (I) and NSP4 (E) genotypes were either I1E1 or I2E2, indicating that they were of human rotavirus origin. RNA-RNA hybridization using 21 culture-adapted strains showed that Malawian rotaviruses had a genomic RNA constellation common to either the Wa-like or the DS-1 like human rotaviruses. Overall, the Malawi strains appear similar in their genetic make-up to rotaviruses described in countries where vaccine efficacy is greater, suggesting that the lower efficacy in Malawi is unlikely to be explained by the diversity of circulating strains. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Area Handbook Series Kenya, A Country Study,
1983-06-01
has included the provision of free seed, interest-free credit to permit purchase of pesticides and to secure tractor plowing, and a number of increases...Hanover, New Hampshire: AUFS, 1980. Caplan, Basil . "Kenya’s Pragmatism Pays Off," Banker [London], 129, No. 3, March 1979, 29-32. Carroll, Jane. "Kenya
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Child Sexual Abuse in Tanzania and Kenya
ERIC Educational Resources Information Center
Lalor, Kevin
2004-01-01
Objective: Most research on child abuse in Tanzania and Kenya is unpublished in the international literature. The purpose of this paper is to examine the various commentaries and reports extant, toward an overview of the nature and frequency of child sexual abuse in Tanzania and Kenya. Methods: Contacts were made with academics, government…
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Temporal and spatial characteristics of annual and seasonal rainfall in Malawi
NASA Astrophysics Data System (ADS)
Ngongondo, Cosmo; Xu, Chong-Yu; Gottschalk, Lars; Tallaksen, Lena M.; Alemaw, Berhanu
2010-05-01
An understanding of the temporal and spatial characteristics of rainfall is central to water resources planning and management. However, such information is often limited in many developing countries like Malawi. In an effort to bridge the information gap, this study examined the temporal and spatial charecteristics of rainfall in Malawi. Rainfall readings from 42 stations across Malawi from 1960 to 2006 were analysed at monthly, annual and seasonal scales. The Malawian rainfall season lasts from November to April. The data were firstly subjected to quality checks through the cumulative deviations test and the Standard Normal Homogeinity Test (SNHT). Monthly distribution in a typical year, called heterogeneity, was investigated using the Precipitation Concentration Index (PCI). Further, normalized precipitation anomaly series of annual rainfall series (AR) and the PCI (APCI) were used to test for interannual rainfall variability. Spatial variability was characterised by fitting the Spatial Correlation function (SCF). The nonparametric Mann-Kendall statistic was used to investigate the temporal trends of the various rainfall variables. The results showed that 40 of the stations passed both data quality tests. For the two stations that failed, the data were adjusted using nearby stations. Annual and seasonal rainfall were found to be characterised by high spatial variation. The country mean annual rainfall was 1095 mm with mean interannual variability of 26%. The highland areas to the north and southeast of the country exhibited the highest rainfall and lowest interannual variability. Lowest rainfall coupled with high interannual variability was found in the Lower Shire basin, in the southern part of Malawi. This simillarity is the pattern of annual and seasonal rainfall should be expected because all stations had over 90% of their observed annual rainfall in the six month period between November and April. Monthly rainfall was found to be highly variable both
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Bergmann, Julie N; Legins, Kenneth; Sint, Tin Tin; Snidal, Sarah; Amor, Yanis Ben; McCord, Gordon C
2017-03-01
This paper provides the first estimates of impact and cost-effectiveness for integrated HIV and nutrition service delivery in sub-Saharan Africa. HIV and undernutrition are synergistic co-epidemics impacting millions of children throughout the region. To alleviate this co-epidemic, UNICEF supported small-scale pilot programs in Malawi and Mozambique that integrated HIV and nutrition service delivery. We use trends from integration sites and comparison sites to estimate the number of lives saved, infections averted and/or undernutrition cases cured due to programmatic activities, and to estimate cost-effectiveness. Results suggest that Malawi's program had a cost-effectiveness of $11-29/DALY, while Mozambique's was $16-59/DALY. Some components were more effective than others ($1-4/DALY for Malawi's Male motivators vs. $179/DALY for Mozambique's One stop shops). These results suggest that integrating HIV and nutrition programming leads to a positive impact on health outcomes and should motivate additional work to evaluate impact and determine cost-effectiveness using an appropriate research design.
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Resources for controlling tuberculosis in Malawi.
Harries, A. D.; Kwanjana, J. H.; Hargreaves, N. J.; Van Gorkom, J.; Salaniponi, F. M.
2001-01-01
OBJECTIVE: To document resources for controlling tuberculosis (TB) in Malawi. METHODS: We performed a countrywide study of all 43 hospitals (3 central, 22 district and 18 mission) which register and treat patients with TB. To collect data for 1998 on the TB-related workload, diagnostic facilities, programme staff and treatment facilities, we used laboratory, radiographic and TB registers, conducted interviews and visited hospital facilities. FINDINGS: The data show that in 1998, 88,257 TB suspects/patients contributed approximately 230,000 sputum specimens for smear microscopy, 55,667 chest X-rays were performed and 23,285 patients were registered for TB treatment. There were 86 trained laboratory personnel, 44 radiographers and 83 TB programme staff. Of these, about 40% had periods of illness during 1998. Approximately 20% of the microscopes and X-ray machines were broken. Some 16% of the hospital beds were designated for TB patients in special wards, but even so, the occupancy of beds in TB wards exceeded 100%. Although stocks of anti-TB drugs were good, there was a shortage of full-time TB ward nurses and 50% of district hospitals conducted no TB ward rounds. In general, there was a shortage of facilities for managing associated HIV-related disease; central hospitals, in particular, were underresourced. CONCLUSION: Malawi needs better planning to utilize its manpower and should consider cross-training hospital personnel. The equipment needs regular maintenance, and more attention should be paid to HIV-related illness. The policies of decentralizing resources to the periphery and increasing diagnostic and case-holding resources for central hospitals should be continued. PMID:11357212
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Evaluation and costs of different haemoglobin methods for use in district hospitals in Malawi
Medina Lara, A; Mundy, C; Kandulu, J; Chisuwo, L; Bates, I
2005-01-01
Aims: To evaluate the characteristics of manual haemoglobin methods in use in Malawi and provide evidence for the Ministry of Health in Malawi to enable them to choose a suitable method for district hospitals. Methods: Criteria on accuracy, clinical usefulness, user friendliness, speed, training time, and economic costs were determined by local health professionals and used to compare six different manual haemoglobin methods. These were introduced sequentially into use in a district hospital in Malawi alongside the reference method. Results: HemoCue was the optimal method based on most of the outcome measures but was also the most expensive (US$0.75/test). DHT meter and Jenway colorimeter were the second choice because they were cheaper (US$0.20–0.35/test), but they were not as accurate or user friendly as HemoCue. Conclusions: The process for choosing appropriate laboratory methods is complex and very little guidance is available for health managers in poorer countries. This paper describes the development and testing of a practical model for gathering evidence about test efficiency that could be adapted for use in other resource poor settings. PMID:15623483
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NASA Astrophysics Data System (ADS)
Accardo, N. J.; Shillington, D. J.; Scholz, C. A.; McCartney, T.; Ebinger, C. J.; Gaherty, J. B.; Nyblade, A.; Eatmon, A.; Chindandali, P. R. N.; Kamihanda, G.; Ferdinand, R.; Salima, J.; Mruma, A. H.
2016-12-01
Current models of continental rifting increasingly point to the important role of weakening mechanisms like the addition of magmatic products in overcoming the disparity between the magnitude of tectonic forces available for rifting and the forces required to break strong, cold lithosphere. However, many rifts have limited volcanism. To understand the controls on rifting in magma-poor systems, we conduct 3D first arrival time tomography from active-source wide-angle refraction data collected in the Malawi Rift to constrain crustal structure along and across the rift. The Malawi Rift represents a weakly extended rift system located within the southernmost portion of the EARS. The only surface magmatism present occurs within the Rungwe Volcanic Province (RVP) located at the northern termination of the Malawi Rift. We utilize active-source data collected in Lake Malawi as a part of SEGMeNT (Study of Extension and maGmatism in Malawi aNd Tanzania). Over 86,000 unique air gun shots were recorded on an array of 33 offshore "lake" bottom seismometers and 55 onshore seismometers. The resulting ray-coverage encompasses the entire northern section of the Malawi Rift spanning the North and Central basins of Lake Malawi, portions of the surround plateaus, as well as the RVP. First arrivals are picked for all shot-receiver pairs with sufficient signal-to-noise ratio and included in a 3D first-arrival tomography model. Direct arrivals (Ps and Pg) and reflections (PmP) are observed on the majority of instruments, with clear arrivals observed to offsets >220 km. Data and preliminary models indicate variations in fault structure and overall sediment thickness between and within rift basins. The North Basin is characterized by a series of synthetic intrabasin faults and sediments thickening to the east along the Livingstone border fault. The Central Basin is characterized by sediments thickening to the west along the Nkhata border fault in the south near Usisya, Malawi and then
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The HIV and AIDS Tribunal of Kenya
2016-01-01
Abstract Established under Section 25 of the HIV Prevention and Control Act of 2006, the HIV and AIDS Tribunal of Kenya is the only HIV-specific statutory body in the world with the mandate to adjudicate cases relating to violations of HIV-related human rights. Yet, very limited research has been done on this tribunal. Based on findings from a desk research and semi-structured interviews of key informants conducted in Kenya, this article analyzes the composition, mandate, procedures, practice, and cases of the tribunal with the aim to appreciate its contribution to the advancement of human rights in the context of HIV. It concludes that, after a sluggish start, the HIV and AIDS Tribunal of Kenya is now keeping its promise to advance the human rights of people living with and affected by HIV in Kenya, notably through addressing barriers to access to justice, swift ruling, and purposeful application of the law. The article, however, highlights various challenges still affecting the tribunal and its effectiveness, and cautions about the replication of this model in other jurisdictions without a full appraisal. PMID:27781008
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Developing a Nursing Database System in Kenya
Riley, Patricia L; Vindigni, Stephen M; Arudo, John; Waudo, Agnes N; Kamenju, Andrew; Ngoya, Japheth; Oywer, Elizabeth O; Rakuom, Chris P; Salmon, Marla E; Kelley, Maureen; Rogers, Martha; St Louis, Michael E; Marum, Lawrence H
2007-01-01
Objective To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Principal Findings Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya's most qualified. Conclusions The Kenya nursing database is a first step toward facilitating evidence-based decision making in HRH. This database is unique to developing countries in sub-Saharan Africa. Establishing an electronic workforce database requires long-term investment and sustained support by national and global stakeholders. PMID:17489921
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ERIC Educational Resources Information Center
Seidenfeld, David; Prencipe, Leah; Handa, Sudhanshu; Hawkinson, Laura
2015-01-01
Little research has been conducted on unconditional cash transfers (UCTs) despite their growing prevalence in Africa, including South Africa, Zambia, Zimbabwe, Kenya, Malawi, Lesotho, and Uganda. In this study, researchers implemented a randomized control trial with over 2,500 households to investigate the impact of Africa's child grant program on…
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Variations in Reading Achievement across 14 Southern African School Systems: Which Factors Matter?
ERIC Educational Resources Information Center
Hungi, Njora; Thuku, Florence W.
2010-01-01
In this study the authors employed a multilevel analysis procedure in order to examine the pupil and school levels factors that contributed to variation in reading achievement among Grade 6 primary school pupils in 14 southern African school systems (Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa,…
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NASA Astrophysics Data System (ADS)
Chasukwa Mwalwenje, Yvonne; Chasukwa, Steria
2015-04-01
Malawi is popularly known as the Warm Heart of Africa. Malawi has a total land area of 45,747 sq. miles. Of the total area, 80 % is covered by fresh water from Lake Malawi and other rivers. The country boasts that it holds large amounts of fresh water and has the third largest lake in Africa. Ironically, the number of households with reliable water access is low (Water Aid, 2014, UNDP, Human Development Report 2008). Regardless of signs of economic development, water security still remains a challenge in the Warm Heart of Africa. The problem with access to water prompted the Government of Malawi to introduce a National Water Policy in 1994 with the vision of 'Water and Sanitation for All'. Since then, other water access interventions have impacted on the ability to manage water sustainably. Over the past few years, more inclusive and diversified interventions have been put in place to reverse the situation. For instance, the government of Malawi has taken action to increase the number of water tanks in schools (UNICEF 2005). Several stakeholders' support the government in their role provides policy direction and coordinate management of the water sector. The outlined National Water and Sanitation Policy strategies includes promoting water conservation and catchment protection; incorporating local governments and communities in planning, development and management of water supplies and sanitation services; rehabilitating the existing infrastructure; creating an enabling environment for public-private partnerships in water supply and sanitation activities; undertaking rehabilitation and reduction of unaccounted-for-water of existing urban, peri-urban, as a priority; promoting economic incentives and opportunities to encourage the participation of small-scale water and sanitation service providers; and promoting water recycling and re-use. Despite of all these interventions, Malawi still continues to face significant challenges with issues of access and quality of
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Health Selection, Migration, and HIV Infection in Malawi.
Anglewicz, Philip; VanLandingham, Mark; Manda-Taylor, Lucinda; Kohler, Hans-Peter
2018-04-27
Despite its importance in studies of migrant health, selectivity of migrants-also known as migration health selection-has seldom been examined in sub-Saharan Africa (SSA). This neglect is problematic because several features of the context in which migration occurs in SSA-very high levels of HIV, in particular-differ from contextual features in regions that have been studied more thoroughly. To address this important gap, we use longitudinal panel data from Malawi to examine whether migrants differ from nonmigrants in pre-migration health, assessed via SF-12 measures of mental and physical health. In addition to overall health selection, we focus on three more-specific factors that may affect the relationship between migration and health: (1) whether migration health selection differs by destination (rural-rural, rural-town, and rural-urban), (2) whether HIV infection moderates the relationship between migration and health, and (3) whether circular migrants differ in pre-migration health status. We find evidence of the healthy migrant phenomenon in Malawi, where physically healthier individuals are more likely to move. This relationship varies by migration destination, with healthier rural migrants moving to urban and other rural areas. We also find interactions between HIV-infected status and health: HIV-infected women moving to cities are physically healthier than their nonmigrant counterparts.
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The Rebellion of Enlisted Personnel and Democratization in Malawi
2011-12-01
presidentialism” in Africa )3 to push for free and fair democratic elections. D. METHODS AND SOURCES For this research, process tracing was conducted to...3 Michael Bratton and Nicolas van de Walle, Democratic Experiments in Africa : Regime Transitions in Comparative Perspective...Nandini Patel, “Political Parties: Development and Change in Malawi,” Electoral Institute of Southern Africa Research Report 21 (Johannesburg: EISA
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Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume
2013-05-28
To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. A cross-sectional survey. Malawi The study used a sample of 6395 women aged 15-49 years from the 2010 Malawi Health and Demographic Surveys. Individual HIV status: positive or not. Findings from the Pearson χ(2) and χ(2) Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15-24) never married or in union and living in rural areas. In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25-49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30-49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment.
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Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe
Mwenge, Lawrence; Sande, Linda; Mangenah, Collin; Ahmed, Nurilign; Kanema, Sarah; d’Elbée, Marc; Sibanda, Euphemia; Kalua, Thokozani; Ncube, Gertrude; Johnson, Cheryl C.; Hatzold, Karin; Cowan, Frances M.; Corbett, Elizabeth L.; Ayles, Helen; Maheswaran, Hendramoorthy
2017-01-01
Background Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. We sought to explore the costs of providing these services across three southern African countries with high HIV burden. Methods Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for the health facilities were extracted to estimate the costs per individual tested and costs per HIV-positive individual identified. Costs are presented in 2016 US dollars. Sensitivity analysis explored key drivers of costs. Results Health facilities were testing on average 2290 individuals annually, albeit with wide variations. The mean cost per individual tested was US$5.03.9 in Malawi, US$4.24 in Zambia and US$8.79 in Zimbabwe. The mean cost per HIV-positive individual identified was US$79.58, US$73.63 and US$178.92 in Malawi, Zambia and Zimbabwe respectively. Both cost estimates were sensitive to scale of testing, facility staffing levels and the costs of HIV test kits. Conclusions Health facility based HIV testing remains an essential service to meet HIV universal access goals. The low costs and potential for economies of scale suggests an opportunity for further scale-up. However low uptake in many settings suggests that demand creation or alternative testing models may be needed to achieve economies of scale and reach populations less willing to attend facility based services. PMID:29036171
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Kasambala Donga, Trust; Meadow, Richard
2018-06-22
Sugarcane is one of the most valuable crops in the world. Native and exotic Lepidopteran stemborers significantly limit sugarcane production. However, the identity and genetic diversity of stemborers infesting sugarcane in Malawi is unknown. The main objectives for this study were to identify and determine genetic diversity in stemborers infesting sugarcane in Malawi. We conducted field surveys between June 2016 and March 2017 in the Lower Shire Valley district of Chikwawa and Nsanje, southern Malawi. Molecular identification was based amplification the partial cytochrome oxidase subunit I (COI) gene region. Phylogenetic trees for sequences were generated and published GenBank accessions for each species were constructed. We found that Malawi Busseola fusca (Lepidoptera: Noctuidae) specimens belonged to clade II, Spodoptera frugiperda sp. 1 (Lepidoptera: Noctuidae) and Chilo partellus (Lepidoptera: Crambidae) were infesting sugarcane. Interspecific divergence ranged from 8.7% to 15.3%. Intraspecific divergence was highest for B. fusca , 3.6%. There were eight haplotypes for B. fusca , three for S. frugiperda and three for C. partellus . The importance of accurate species identification and genetic diversity on stemborer management is presented.
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Hypertension in Sub-Saharan Africa: Cross-Sectional Surveys in Four Rural and Urban Communities
Hendriks, Marleen E.; Wit, Ferdinand W. N. M.; Roos, Marijke T. L.; Brewster, Lizzy M.; Akande, Tanimola M.; de Beer, Ingrid H.; Mfinanga, Sayoki G.; Kahwa, Amos M.; Gatongi, Peter; Van Rooy, Gert; Janssens, Wendy; Lammers, Judith; Kramer, Berber; Bonfrer, Igna; Gaeb, Esegiel; van der Gaag, Jacques; Rinke de Wit, Tobias F.; Lange, Joep M. A.; Schultsz, Constance
2012-01-01
Background Cardiovascular disease (CVD) is the leading cause of adult mortality in low-income countries but data on the prevalence of cardiovascular risk factors such as hypertension are scarce, especially in sub-Saharan Africa (SSA). This study aims to assess the prevalence of hypertension and determinants of blood pressure in four SSA populations in rural Nigeria and Kenya, and urban Namibia and Tanzania. Methods and Findings We performed four cross-sectional household surveys in Kwara State, Nigeria; Nandi district, Kenya; Dar es Salaam, Tanzania and Greater Windhoek, Namibia, between 2009–2011. Representative population-based samples were drawn in Nigeria and Namibia. The Kenya and Tanzania study populations consisted of specific target groups. Within a final sample size of 5,500 households, 9,857 non-pregnant adults were eligible for analysis on hypertension. Of those, 7,568 respondents ≥18 years were included. The primary outcome measure was the prevalence of hypertension in each of the populations under study. The age-standardized prevalence of hypertension was 19.3% (95%CI:17.3–21.3) in rural Nigeria, 21.4% (19.8–23.0) in rural Kenya, 23.7% (21.3–26.2) in urban Tanzania, and 38.0% (35.9–40.1) in urban Namibia. In individuals with hypertension, the proportion of grade 2 (≥160/100 mmHg) or grade 3 hypertension (≥180/110 mmHg) ranged from 29.2% (Namibia) to 43.3% (Nigeria). Control of hypertension ranged from 2.6% in Kenya to 17.8% in Namibia. Obesity prevalence (BMI ≥30) ranged from 6.1% (Nigeria) to 17.4% (Tanzania) and together with age and gender, BMI independently predicted blood pressure level in all study populations. Diabetes prevalence ranged from 2.1% (Namibia) to 3.7% (Tanzania). Conclusion Hypertension was the most frequently observed risk factor for CVD in both urban and rural communities in SSA and will contribute to the growing burden of CVD in SSA. Low levels of control of hypertension are alarming. Strengthening of health
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Theobald, Sally; Nhlema-Simwaka, Bertha
2008-09-01
The case for research to promote equity in health in resource poor contexts such as Malawi is compelling. In Malawi, nearly half of all the people with tuberculosis cannot afford to access free tuberculosis services. In this scenario, there is a clear need to understand the multiple barriers poor women and men face in accessing services and pilot interventions to address these in a way that engages policy makers, practitioners and communities. This paper provides a critical reflection on our experience as applied social researchers working at the REACH (Research for Equity and Community Health) Trust in Malawi. Our work largely uses qualitative research methodologies as a tool for applied social research to explore the equity dimensions of health services in the country. We argue that a key strength of qualitative research methods and analysis is the ability to bring the perceptions and experiences of marginalised groups to policy makers and practitioners. The focus of this paper is two-fold. The first focus lies in synthesising the opportunities and challenges we have encountered in promoting the use of applied social research, and in particular qualitative research methods, on TB and HIV in Malawi. The second focus is on documenting and reflecting on our experiences of using applied social research to promote gender equity in TB/HIV policy and practice in Malawi. In this paper, we reflect on the strategic frameworks we have used in the Malawian context to try and bring the voices of poor women and men to policy makers and practitioners and hence intensify the research to policy and practice interface.
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Makoka, Donald; Masibo, Peninah Kinya
2015-08-22
Maternal education is strongly associated with young child nutrition outcomes. However, the threshold of the level of maternal education that reduces the level of undernutrition in children is not well established. This paper investigates the level of threshold of maternal education that influences child nutrition outcomes using Demographic and Health Survey data from Malawi (2010), Tanzania (2009-10) and Zimbabwe (2005-06). The total number of children (weighted sample) was 4,563 in Malawi; 4,821 children in Tanzania; and 3,473 children in Zimbabwe Demographic and Health Surveys. Using three measures of child nutritional status: stunting, wasting and underweight, we employ a survey logistic regression to analyse the influence of various levels of maternal education on child nutrition outcomes. In Malawi, 45% of the children were stunted, 42% in Tanzania and 33% in Zimbabwe. There were 12% children underweight in Malawi and Zimbabwe and 16% in Tanzania.The level of wasting was 6% of children in Malawi, 5% in Tanzania and 4% in Zimbabwe. Stunting was significantly (p values < 0.0001) associated with mother's educational level in all the three countries. Higher levels of maternal education reduced the odds of child stunting, underweight and wasting in the three countries. The maternal threshold for stunting is more than ten years of schooling. Wasting and underweight have lower threshold levels. These results imply that the free primary education in the three African countries may not be sufficient and policies to keep girls in school beyond primary school hold more promise of addressing child undernutrition.
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Intergenerational transfers in the era of HIV/AIDS: Evidence from rural Malawi.
Kohler, Iliana V; Kohler, Hans-Peter; Anglewicz, Philip; Behrman, Jere R
2012-12-13
Intergenerational transfer patterns in sub-Saharan Africa are poorly understood, despite the alleged importance of support networks to ameliorate the complex implications of the HIV/AIDS epidemic for families. There is a considerable need for research on intergenerational support networks and transfers to better understand the mechanisms through which extended families cope with the HIV/AIDS epidemic and potentially alleviate some of its consequences in sub-Saharan Africa, and to comprehend how transfers respond-or not-to perceptions about own and other family members' health. Using the 2008 round of the Malawi Longitudinal Study of Families and Health (MLSFH), we estimate the age patterns and the multiple directions of financial and non-financial transfer flows in rural Malawi-from prime-aged respondents to their elderly parents and adult children age 15 and up. We also estimate the social, demographic and economic correlates of financial and non-financial transfers of financial intergenerational transfers in this context. Our findings are that: (1) intergenerational financial and non-financial transfers are widespread and a key characteristic of family relationships in rural Malawi; (2) downward and upward transfers are importantly constrained and determined by the availability of transfer partners (parents or adult children); (3) financial net transfers are strongly age-patterned and the middle generations are net-providers of transfers; (4) non-financial transfers are based on mutual assistance rather than reallocation of resources; and (5) intergenerational transfers are generally not related to health status, including HIV positive status.
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ERIC Educational Resources Information Center
Olembo, Jotham Ombisi
1986-01-01
This article focuses on the financing of education in Kenya. It reviews government, parental, community, and international efforts aimed at improving education during a period of economic austerity. (JDH)
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Identification of Cichlid Fishes from Lake Malawi Using Computer Vision
Joo, Deokjin; Kwan, Ye-seul; Song, Jongwoo; Pinho, Catarina; Hey, Jody; Won, Yong-Jin
2013-01-01
Background The explosively radiating evolution of cichlid fishes of Lake Malawi has yielded an amazing number of haplochromine species estimated as many as 500 to 800 with a surprising degree of diversity not only in color and stripe pattern but also in the shape of jaw and body among them. As these morphological diversities have been a central subject of adaptive speciation and taxonomic classification, such high diversity could serve as a foundation for automation of species identification of cichlids. Methodology/Principal Finding Here we demonstrate a method for automatic classification of the Lake Malawi cichlids based on computer vision and geometric morphometrics. For this end we developed a pipeline that integrates multiple image processing tools to automatically extract informative features of color and stripe patterns from a large set of photographic images of wild cichlids. The extracted information was evaluated by statistical classifiers Support Vector Machine and Random Forests. Both classifiers performed better when body shape information was added to the feature of color and stripe. Besides the coloration and stripe pattern, body shape variables boosted the accuracy of classification by about 10%. The programs were able to classify 594 live cichlid individuals belonging to 12 different classes (species and sexes) with an average accuracy of 78%, contrasting to a mere 42% success rate by human eyes. The variables that contributed most to the accuracy were body height and the hue of the most frequent color. Conclusions Computer vision showed a notable performance in extracting information from the color and stripe patterns of Lake Malawi cichlids although the information was not enough for errorless species identification. Our results indicate that there appears an unavoidable difficulty in automatic species identification of cichlid fishes, which may arise from short divergence times and gene flow between closely related species. PMID:24204918
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Bacterial meningitis and Haemophilus influenzae type b conjugate vaccine, Malawi.
McCormick, David W; Molyneux, Elizabeth M
2011-04-01
A retrospective database review showed that Haemophilus influenzae type b conjugate vaccine decreased the annual number of cases of H. influenzae type b meningitis in children in Blantyre, Malawi. Among young bacterial meningitis patients, HIV prevalence was high (36.7% during 1997-2009), and pneumococcus was the most common etiologic agent (57% in 2009).
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Barriers to pilot mobile teleophthalmology in a rural hospital in Southern Malawi.
Pérez, Guillermo Martínez; Swart, Wayne; Munyenyembe, Jimmy Kondwani; Saranchuk, Peter
2014-01-01
Malawi has one of the highest HIV prevalences in Sub-Saharan Africa. The rate of eligible HIV-infected people being initiated on antiretroviral therapy (ART) and retained in HIV-care is currently far from adequate. Consequently, many people continue present with advanced immunosuppression at public health facilities, often with undiagnosed opportunistic infections (OIs). In this context, mHealth was the innovation chosen to assist Eye Clinical Officers in early diagnosis of HIV-related diseases having eye manifestations in a rural hospital in Thyolo, Southern Malawi. The mTeleophthalmology program began in October 2013, but was stopped prematurely due to organizational and technological barriers that compromised its feasibility. Sharing these barriers might be useful to inform the design of similar innovations in other resource-limited settings with a high HIV prevalence and a dearth of eye specialists with capacity to diagnose HIV-related retinopathies.
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Instructional Supervision in Public Secondary Schools in Kenya
ERIC Educational Resources Information Center
Wanzare, Zachariah
2012-01-01
This article reports some findings of study regarding practices and procedures of internal instructional supervision in public secondary schools in Kenya. The findings are part of a large-scale project undertaken in Kenya to determine the perceptions of headteachers, teachers and senior government education officers regarding the practices of…
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ERIC Educational Resources Information Center
Northern Iowa Univ., Cedar Falls. Geographic Alliance of Iowa.
This lesson plans project provides information and classroom-ready lesson plans about Nigeria. These lesson plans can stand alone or be used in conjunction with one another. They have been correlated to coincide with the standards set forth in Geography for Life. Following background information "Why Study Nigeria?" (A. Shields), lesson…
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Nyirenda, Deborah; Makawa, Tamara Chipasula; Chapita, Greyson; Mdalla, Chisomo; Nkolokosa, Mzati; O'byrne, Thomasena; Heyderman, Robert; Desmond, Nicola
2018-02-01
Radio is an effective source of health information in many resource poor countries. In Malawi, 53% of households own radios however few radio programmes in Malawi focus on health issues in the context of medical research. An interactive health-talk radio programme ' Umoyo nkukambirana' was introduced by Malawi-Liverpool-Wellcome Trust Clinical Research Programme on a national radio station. The aim was to increase awareness of health and medical research, and improve engagement between researchers, healthcare workers and the public. The content and presentation were developed through participatory community consultations. Focus Group Discussions were conducted with established Radio Listening Clubs whilst quantitative data was collected using toll free FrontlineSMS to explore national response. A total of 277 to 695 SMS (Median: 477) were received per theme. The majority of SMS were received from men (64%) and mainly from rural areas (54%). The programme improved knowledge of medical research, health and dispelled misconceptions. This study suggests that the radio may be an effective means of increasing the exposure of men to health information in resource poor settings.
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An Evaluation of the Role of Sensory Drive in the Evolution of Lake Malawi Cichlid Fishes
Smith, Adam R.; van Staaden, Moira J.; Carleton, Karen L.
2012-01-01
Although the cichlids of Lake Malawi are an important model system for the study of sensory evolution and sexual selection, the evolutionary processes linking these two phenomena remain unclear. Prior works have proposed that evolutionary divergence is driven by sensory drive, particularly as it applies to the visual system. While evidence suggests that sensory drive has played a role in the speciation of Lake Victoria cichlids, the findings from several lines of research on cichlids of Lake Malawi are not consistent with the primary tenets of this hypothesis. More specifically, three observations make the sensory drive model implausible in Malawi: (i) a lack of environmental constraint due to a broad and intense ambient light spectrum in species rich littoral habitats, (ii) pronounced variation in receiver sensory characteristics, and (iii) pronounced variability in male courtship signal characteristics. In the following work, we synthesize the results from recent studies to draw attention to the importance of sensory variation in cichlid evolution and speciation, and we suggest possible avenues of future research. PMID:22779029
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THE TEACHING OF GEO SCIENCE IN MALAWI SECONDARY SCHOOLS: The case of the Solar System and beyond
NASA Astrophysics Data System (ADS)
Chasukwa Mwalwenje, Yvonne; Chasukwa, Fidel
2016-04-01
Malawi secondary school curriculum has been offering Geo sciences Education since the dawn of independence from the British rule in 1964. Qualified primary and secondary school teachers are responsible for the teaching of Geo sciences. The assumption is that trained teachers are more likely to produce successful students thus making geoscience a successful subject. To make the subject more relevant and captivating to stakeholders, the government revised Geo science curriculum and incorporated other topics. Among additional topic was the solar system that was covered in great detail in secondary school. The solar system is a Geo science concept taught in Geography curriculum from primary school for 8 years and in secondary school for 4 years. Despite the solar system being one of the traditional topics in Malawi school curriculum and Government's effort to revise the curriculum in the interest of learners and improving the pass rate, number of students conversant with the topic has been failing sharply over the years. The disparity between the input in terms of effort to improve familiarity with solar system among learners and the outcomes is of great concern and worth hard investigation to inform education policy and curriculum revision decisions. Based on empirical data collected through qualitative research design, the paper establishes that regardless of imploring such interventions, there are still indicators that students continue to fail in solar system related subjects. Malawi National Examination report (2015) reveals that Geography at Malawi School Certificate Examinations pass rate has been going down ranging from 69.49 to 60.78 per cent from 2009 to 2014. The report advances that lack of instruction materials across the schools have contributed to deteriorating knowledge in solar system education. For instance, the school may have no simple models such as globes that clarify the shape of the earth better. As such, the teacher may improvise by getting an
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Bacterial Meningitis and Haemophilus influenzae Type b Conjugate Vaccine, Malawi
Molyneux, Elizabeth M.
2011-01-01
A retrospective database review showed that Haemophilus influenzae type b conjugate vaccine decreased the annual number of cases of H. influenzae type b meningitis in children in Blantyre, Malawi. Among young bacterial meningitis patients, HIV prevalence was high (36.7% during 1997–2009), and pneumococcus was the most common etiologic agent (57% in 2009). PMID:21470461
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Agriculture and development in Africa: the case of Kenya.
Hyden, G
1987-01-01
The Government of Kenya has successfully developed macroeconomic policies that overcome constraints in the domestic and international environments and have a relatively well-functioning public sector. At present, the major challenge facing Kenya concerns the ability of the government to improve agricultural productivity given the weakness of its research services and peasant resistance to development. The response to the 1984 drought indicates that the Government of Kenya has the formal structures in place to deal with emergencies, yet the absence of reliable statistics on grain production, marketing, and on-farm storage led to serious miscalculations of the severity of the drought. Government of Kenya has been reluctant to experiment with institutional forms that reduce the opportunity for direct political control, especially over agricultural marketing. Privatization of the grain trade or the establishment of cooperatively owned local dairies has been proposed but rejected as too risky. New policies and concerted action, at both the government and community levels, tend to be in response to threat or hardship rather than a result of a dynamic strategy. Given this tendency to avoid experimentation with alternative political forms, socioeconomic development in Kenya may be limited in the years ahead.
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ERIC Educational Resources Information Center
Mlangeni, Angstone Noel J. Thembachako; Chiotha, Sosten Staphael
2015-01-01
A study was conducted to investigate factors that affect students' poor performance in physical science examinations at Malawi School Certificate of Education and Junior Certificate of Education levels in Community day secondary schools (CDSS) in Lilongwe Rural West Education District in Malawi. Students' performance was collected from schools'…
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Human resources requirements for highly active antiretroviral therapy scale-up in Malawi.
Muula, Adamson S; Chipeta, John; Siziya, Seter; Rudatsikira, Emmanuel; Mataya, Ronald H; Kataika, Edward
2007-12-19
Twelve percent of the adult population in Malawi is estimated to be HIV infected. About 15% to 20% of these are in need of life saving antiretroviral therapy. The country has a public sector-led antiretroviral treatment program both in the private and public health sectors. Estimation of the clinical human resources needs is required to inform the planning and distribution of health professionals. We obtained data on the total number of patients on highly active antiretroviral treatment program from the Malawi National AIDS Commission and Ministry of Health, HIV Unit, and the number of registered health professionals from the relevant regulatory bodies. We also estimated number of health professionals required to deliver highly active antiretroviral therapy (HAART) using estimates of human resources from the literature. We also obtained data from the Ministry of Health on the actual number of nurses, clinical officers and medical doctors providing services in HAART clinics. We then made comparisons between the human resources situation on the ground and the theoretical estimates based on explicit assumptions. There were 610 clinicians (396 clinical officers and 214 physicians), 44 pharmacists and 98 pharmacy technicians and 7264 nurses registered in Malawi. At the end of March 2007 there were 85 clinical officer and physician full-time equivalents (FTEs) and 91 nurse FTEs providing HAART to 95,674 patients. The human resources used for the delivery of HAART comprised 13.9% of all clinical officers and physicians and 1.1% of all nurses. Using the estimated numbers of health professionals from the literature required 15.7-31.4% of all physicians and clinical officers, 66.5-199.3% of all pharmacists and pharmacy technicians and 2.6 to 9.2% of all the available nurses. To provide HAART to all the 170,000 HIV infected persons estimated as clinically eligible would require 4.7% to 16.4% of the total number of nurses, 118.1% to 354.2% of all the available pharmacists and
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Newberry, Laura; Kennedy, Neil; Greene, Elizabeth A
2016-06-01
Malawi has a high burden of paediatric cardiac disease but a limited number of health providers familiar with these chronic diseases. Given the rising number of Malawian postgraduate paediatric trainees at the University of Malawi College of Medicine, we sought to remedy this lack of basic cardiology training with a long-distance, module-based curriculum that could be utilised independently, as needed, with on-site teaching. We also wished to evaluate the initial modules for utility and improvement in knowledge and confidence in each topic. After an initial site visit to determine curriculum needs, online modules with interactive evaluations and quizzes were developed by a paediatric cardiologist in the United States, in collaboration with paediatric registrar training directors in Malawi. This online interactive curriculum was followed by several site visits to Malawi, by the United States-based paediatric cardiologist, to provide bedside teaching, case-based discussions and hands-on skill training in cardiac ultrasound and electrocardiogram interpretation. Evaluation of the curriculum model included post-module quizzes on cardiac topics as well as registrar self-assessments regarding confidence in content areas. The average post-module quiz score was 93.6%. Repeat testing with the same questions four months later yielded an average score of 78%, with a range from 60 to 100%. Pre- and post-module registrar self-assessment regarding confidence in content areas showed a substantial gain in knowledge and confidence mean. In their qualitative feedback, registrars noted that the modules were helpful in studying for their certifying examinations, and all four of the registrars sitting Part I of their Malawian and South African paediatric certifying examinations passed. Our innovative hybrid approach, combining online educational modules with in-person teaching visits, is a useful approach in expanding paediatric cardiology subspecialty education in Malawi.
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2008-02-29
If you live in Europe and buy roses, the chance is good that they were grown in Kenya -- specifically, in one of the colossal greenhouses that blot out the once wild shores of Lake Naivasha, 90km north-west of Nairobi. Image from NASA Terra satellite.
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Early childhood development: the role of community based childcare centres in Malawi.
Munthali, Alister C; Mvula, Peter M; Silo, Lois
2014-01-01
Somatic changes including growth and development of the brain of a human being occur very early in life. Programmes that enhance early childhood development (ECD) therefore should be part of the national agenda. Cognizant of this fact, the Malawi Government together with development partners facilitated the establishment of community-based child care centres (CBCCs) which are owned and managed by community members. This study was aimed at understanding how CBCCs operated and their core functions. Using information from databases kept by the District Social Welfare Officers from all the 28 districts in Malawi, coupled with snowballing, all functioning CBCCs were enumerated. A questionnaire was administered to the head of the CBCC or a care giver. Highly trained Research Assistants also carried our observations of the structures around the centres and the activities that actually happened. Data was analysed using a Statistical Package for Social Sciences. Communities provide structures, support for care givers, food, utensils, labour and play materials for the children in CBCCs. The first ECD centre was established in 1966 but the real surge in establishing these happened towards the end of the 1990s and by 2007 there were 5,665 CBCCs in Malawi caring for 407,468 children aged between 3 and 5 years. CBCCs were established to provide pre-primary school learning, and in some cases provide special care to orphans and other vulnerable. Despite the fact that most CBCC premises and structures fell short of the standards laid down by the CBCC profile, the activities and services provided were mostly to the book. Children were provided with nutritious foods and subjected to play that stimulated their cognitive and mental development. Despite the fact that some members of the community do not realize the value of the CBCCs, the existence of these institutions is an opportunity for the community to take care of their children communally, a task that has become imperative as a
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Educating Handicapped Young People in Eastern and Southern Africa in 1981-83.
ERIC Educational Resources Information Center
Ross, D. H.
This publication compiles the findings and conclusions of the 3-year first phase (1980-83) of the Unesco Sub-regional Project for Special Education in Eastern and Southern Africa. It presents the state of the art of special education and prospects for future development in Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mauritius, Seychelles, Somalia,…
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Institutional Challenges to Viable Civil-Military Relations in Malawi
2008-03-01
teacher who was responsible for discipline and physical education and was the most feared teacher at every institution. In short, Banda successfully...of guidance is particularly evident in the higher education program of the armed forces. The Malawi Defense Force, in 2007, established a Centre for...has lost respect, due to what he termed childish and irresponsible, with opposition MPs and their leaders who use abusive language while transacting
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What can health care professionals in the United Kingdom learn from Malawi?
Neville, Ron; Neville, Jemma
2009-01-01
Debate on how resource-rich countries and their health care professionals should help the plight of sub-Saharan Africa appears locked in a mind-set dominated by gloomy statistics and one-way monetary aid. Having established a project to link primary care clinics based on two-way sharing of education rather than one-way aid, our United Kingdom colleagues often ask us: "But what can we learn from Malawi?" A recent fact-finding visit to Malawi helped us clarify some aspects of health care that may be of relevance to health care professionals in the developed world, including the United Kingdom. This commentary article is focused on encouraging debate and discussion as to how we might wish to re-think our relationship with colleagues in other health care environments and consider how we can work together on a theme of two-way shared learning rather than one-way aid. PMID:19327137
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Moral maps and medical imaginaries: clinical tourism at Malawi's College of Medicine.
Wendland, Claire L
2012-01-01
At an understaffed and underresourced urban African training hospital, Malawian medical students learn to be doctors while foreign medical students, visiting Malawi as clinical tourists on short-term electives, learn about “global health.” Scientific ideas circulate fast there; clinical tourists circulate readily from outside to Malawi but not the reverse; medical technologies circulate slowly, erratically, and sometimes not at all. Medicine's uneven globalization is on full display. I extend scholarship on moral imaginations and medical imaginaries to propose that students map these wards variously as places in which—or from which—they seek a better medicine. Clinical tourists, enacting their own moral maps, also become representatives of medicine “out there”: points on the maps of others. Ethnographic data show that for Malawians, clinical tourists are colleagues, foils against whom they construct ideas about a superior and distinctly Malawian medicine and visions of possible alternative futures for themselves.
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Barriers to pilot mobile teleophthalmology in a rural hospital in Southern Malawi
Pérez, Guillermo Martínez; Swart, Wayne; Munyenyembe, Jimmy Kondwani; Saranchuk, Peter
2014-01-01
Introduction Malawi has one of the highest HIV prevalences in Sub-Saharan Africa. The rate of eligible HIV-infected people being initiated on antiretroviral therapy (ART) and retained in HIV-care is currently far from adequate. Consequently, many people continue present with advanced immunosuppression at public health facilities, often with undiagnosed opportunistic infections (OIs). Methods In this context, mHealth was the innovation chosen to assist Eye Clinical Officers in early diagnosis of HIV-related diseases having eye manifestations in a rural hospital in Thyolo, Southern Malawi. Results The mTeleophthalmology program began in October 2013, but was stopped prematurely due to organizational and technological barriers that compromised its feasibility. Conclusion Sharing these barriers might be useful to inform the design of similar innovations in other resource-limited settings with a high HIV prevalence and a dearth of eye specialists with capacity to diagnose HIV-related retinopathies. PMID:25767656
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Tougher, Sarah; Hanson, Kara; Goodman, Catherine
2017-04-25
The private sector supplies anti-malarial treatment for large proportions of patients in sub-Saharan Africa. Following the large-scale piloting of the Affordable Medicines Facility-malaria (AMFm) from 2010 to 2011, a private sector co-payment mechanism (CPM) provided continuation of private sector subsidies for quality-assured artemisinin combination therapies (QAACT). This article analyses for the first time the extent to which improvements in private sector QAACT supply and distribution observed during the AMFm were maintained or intensified during continuation of the CPM through 2015 in Kenya, Madagascar, Nigeria, Tanzania and Uganda using repeat cross-sectional outlet survey data. QAACT market share in all five countries increased during the AMFm period (p < 0.001). According to the data from the last ACTwatch survey round, in all study countries except Madagascar, AMFm levels of private sector QAACT availability were maintained or improved. In 2014/15, private sector QAACT availability was greater than 70% in Nigeria (84.3%), Kenya (70.5%), Tanzania (83.0%) and Uganda (77.1%), but only 11.2% in Madagascar. QAACT market share was maintained or improved post-AMFm in Nigeria, Tanzania and Uganda, but statistically significant declines were observed in Kenya and Madagascar. In 2014/5, QAACT market share was highest in Kenya and Uganda (48.2 and 47.5%, respectively) followed by Tanzania (39.2%), Nigeria (35.0%), and Madagascar (7.0%). Four of the five countries experienced significant decreases in median QAACT price during the AMFm period. Private sector QAACT prices were maintained or further reduced in Tanzania, Nigeria and Uganda, but prices increased significantly in Kenya and Madagascar. SP prices were consistently lower than those of QAACT in the AMFm period, with the exception of Kenya and Tanzania in 2011, where they were equal. In 2014/5 QAACT remained two to three times more expensive than the most popular non-artemisinin therapy in all countries except
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Kidane, Teklay; Chirwa, Geoffrey; Tesfaye, Neghist; Prescott, Marta R; Scotney, Soleine T; Valle, Moussa; Abebe, Sintayehu; Tambuli, Adija; Malewezi, Bridget; Mohammed, Tahir; Kobayashi, Emily; Wootton, Emily; Wong, Renee; Dosani, Rahima; Subramaniam, Hamsa; Joseph, Jessica; Yavuz, Elif; Apple, Aliza; Le Tallec, Yann; Kang’ethe, Alice
2016-01-01
Understanding post-launch demand for new vaccines can help countries maximize the benefits of immunization programmes. In particular, low- and middle-income countries (LMICs) should ensure adequate resource planning with regards to stock consumption and service delivery for new vaccines, whereas global suppliers must produce enough vaccines to meet demand. If a country underestimates the number of children seeking vaccination, a stock-out of commodities will create missed opportunities for saving lives. We describe the post-launch demand for the first dose of pneumococcal conjugate vaccine (PCV1) in Ethiopia and Malawi and the first dose of rotavirus vaccine (Rota1) in Malawi, with focus on the new birth cohort and the ‘backlog cohort’, comprised of older children who are still eligible for vaccination at the time of launch. PCV1 and Rota1 uptake were compared with the demand for the first dose of pentavalent vaccine (Penta1), a routine immunization that targets the same age group and immunization schedule. In the first year, the total demand for PCV1 was 37% greater than that of Penta1 in Ethiopia and 59% greater in Malawi. In the first 6 months, the demand of Rota1 was only 5.9% greater than Penta1 demand in Malawi. Over the first three post-introduction months, 70.7% of PCV1 demand in Ethiopia and 71.5% of demand in Malawi came from children in the backlog cohort, whereas only 28.0% of Rota1 demand in Malawi was from the backlog cohort. The composition of demand was impacted by time elapsed since vaccine introduction and age restrictions. Evidence suggests that countries’ plans should account for the impact of backlog demand, especially in the first 3 months post-introduction. LMICs should request for higher stock volumes when compared with routine needs, plan social mobilization activities to reach the backlog cohort and allocate human resources and cold chain capacity to accommodate high demand following vaccine introduction. PMID:26856361
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Africa and Applied Linguistics.
ERIC Educational Resources Information Center
Makoni, Sinfree, Ed.; Meinhof, Ulrike H., Ed.
2003-01-01
This collection of articles includes: "Introducing Applied Linguistics in Africa" (Sinfree Makoni and Ulrike H. Meinhof); "Language Ideology and Politics: A Critical Appraisal of French as Second Official Language in Nigeria" (Tope Omoniyi); "The Democratisation of Indigenous Languages: The Case of Malawi" (Themba…
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Documenting human rights violations against sex workers in Kenya.
Lukera, MaryFrances
2007-12-01
The human rights of sex workers are an increasing concern for prominent women's rights organizations such as the Federation of Women Lawyers (FIDA). As FIDA-Kenya's MaryFrances Lukera writes, documenting human rights abuses against sex workers is critical to responding to Kenya's HIV epidemic.
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Kenya: The December 2007 Elections and the Challenges Ahead
2008-02-15
Trumpet 1 NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit Basket (Mavuno) 1 KENDA Kenya National...13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1% Religions: Protestant 45%, Roman Catholic 33
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Living with disabled children in Malawi: Challenges and rewards
Barlindhaug, Grete; Umar, Eric; Wazakili, Margaret
2016-01-01
Background Rehabilitation personnel need to be sensitive to the cultural aspects that constitute the environment of a disabled child’s family life. Objectives The aim of this study was to gain insight on how families experience parenting of disabled children and how the families experience the support provided by the rehabilitation system in Malawi. Method An anthropological field study combining interviews and observations was conducted in a rural district of Malawi in 2011. Permission was granted to follow four families, and this study presents the stories of two families, whose children have severe disabilities. We used phenomenological and narrative analyses to make sense of the stories. Results The findings indicate that families with disabled children invest time and emphasise care for their disabled children. They feel enriched by their experience despite challenging situations with little support from the rehabilitation services. High standards of care demonstrating positive and moral attitudes have earned these families respect in their communities. Storytelling has created an opportunity for the families to understand and interpret their challenging situation with inherent contextual meaning. Conclusion This study shows that families with disabled children draw on cultural and structural strengths that rehabilitation professionals should be aware of in their support to mothers and other caregivers of children with disabilities. PMID:28730057
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Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume
2013-01-01
Objectives To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. Design A cross-sectional survey. Setting Malawi Participants The study used a sample of 6395 women aged 15–49 years from the 2010 Malawi Health and Demographic Surveys. Interventions N/A Primary and secondary outcome measures Individual HIV status: positive or not. Results Findings from the Pearson χ2 and χ2 Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15–24) never married or in union and living in rural areas. Conclusions In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25–49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30–49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment. PMID:23793677
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Exploration gaps exist in Nigeria`s prolific delta
DOE Office of Scientific and Technical Information (OSTI.GOV)
Thomas, D.
The Niger delta region of the Republic of Nigeria is Africa`s largest oil producing area. It is clear that Nigeria will continue to contribute significantly to world petroleum production well into the 21st century: with increases in recoverable oil reserves in the Niger delta onshore and offshore; the promising potential of the Niger delta deepwater region; and a lesser but not insignificant contribution from the unexplored onshore Benue trough, part of the mid-African rift system, which has already proved to hold substantial oil reserves in the Doba basin of neighboring Chad. This is the first of five parts on Nigeria`smore » oil and gas potential. The later articles deal with Niger delta oil reserves and production, Niger delta gas reserves, the delta`s deepwater region, and the Benue trough and onshore cretaceous rift basins. This article deals with the geologic setting of the Niger delta-Benue trough region, the synrift deposits, marine sedimentation, margin evolution, geologic strata and reservoirs, reservoir character, structure and traps, hydrocarbon types, geotemperatures, and source rock quality.« less
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ARE LITERACY SKILLS ASSOCIATED WITH YOUNG ADULTS’ HEALTH IN AFRICA? EVIDENCE FROM MALAWI
Smith-Greenaway, Emily
2014-01-01
This study investigates whether literacy skills are a distinct dimension of education that influences young adults’ health in the southeast African context of Malawi. It uses new data from Tsogolo la Thanzi, a study of young adults in southern Malawi, to achieve three aims. The first is descriptive: to demonstrate a direct assessment for measuring literacy in a population-based survey, and show that it captures variability in skills among young adults, including those with comparable levels of educational attainment. The second aim is to identify whether literacy influences young adults’ health—net of their educational attainment and other confounding factors. Multivariate analyses reveal that literacy is associated with two measures of physical health: self-rated health and prolonged sickness. Because literacy is a key determinant of health, the third aim is to provide insight into how to measure it: can commonly used indirect approaches to estimating literacy (e.g., based on educational attainment or self-reports), accurately capture its prevalence and relationship with health? In a second set of analyses, bivariate results show whether, and the extent to which, indirect measures of literacy overestimate literacy’s prevalence, and multivariate models assess whether indirect estimates of literacy capture its relationship with health. The findings support future efforts to incorporate literacy assessments into population surveys to accurately estimate literacy’s prevalence and health benefits, particularly in contexts like Malawi where access to high-quality schools remains limited. PMID:25164414
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Facilitating factors and barriers to malaria research utilization for policy development in Malawi.
Mwendera, Chikondi A; de Jager, Christiaan; Longwe, Herbert; Phiri, Kamija; Hongoro, Charles; Mutero, Clifford M
2016-10-19
Research on various determinants of health is key in providing evidence for policy development, thereby leading to successful interventions. Utilization of research is an intricate process requiring an understanding of contextual factors. The study was conducted to assess enhancing factors and barriers of research utilization for malaria policy development in Malawi. Qualitative research approach was used through in-depth interviews with 39 key informants that included malaria researchers, policy makers, programme managers, and key stakeholders. Purposive sampling and snowballing techniques were used in identifying key informants. Interview transcripts were entered in QSR Nvivo 11 software for coding and analysis. Respondents identified global efforts as key in advancing knowledge translation, while local political will has been conducive for research utilization. Other factors were availability of research, availability of diverse local researchers and stakeholders supporting knowledge translation. While barriers included: lack of platforms for researcher-public engagement, politics, researchers' lack of communication skills, lack of research collaborations, funder driven research, unknown World Health Organization policy position, and the lack of a malaria research repository. Overall, the study identified facilitating factors to malaria research utilization for policy development in Malawi. These factors need to be systematically coordinated to address the identified barriers and improve on malaria research utilization in policy development. Malaria research can be key in the implementation of evidence-based interventions to reduce the malaria burden and assist in the paradigm shift from malaria control to elimination in Malawi.
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Kenya: The December 2007 Elections and the Challenges Ahead
2008-09-17
NLP National Labour Party Bull (Ndume) 1 KADDU Kenya African Democratic Development Union Fruit Basket (Mavuno) 1 KENDA Kenya National Democratic...Ethnic Divisions: Kikuyu 22%, Luhya 14%, Luo 13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1% Religions
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Nyirenda, Deborah; Makawa, Tamara Chipasula; Chapita, Greyson; Mdalla, Chisomo; Nkolokosa, Mzati; O’byrne, Thomasena; Heyderman, Robert; Desmond, Nicola
2016-01-01
Radio is an effective source of health information in many resource poor countries. In Malawi, 53% of households own radios however few radio programmes in Malawi focus on health issues in the context of medical research. An interactive health-talk radio programme ‘Umoyo nkukambirana’ was introduced by Malawi-Liverpool-Wellcome Trust Clinical Research Programme on a national radio station. The aim was to increase awareness of health and medical research, and improve engagement between researchers, healthcare workers and the public. The content and presentation were developed through participatory community consultations. Focus Group Discussions were conducted with established Radio Listening Clubs whilst quantitative data was collected using toll free FrontlineSMS to explore national response. A total of 277 to 695 SMS (Median: 477) were received per theme. The majority of SMS were received from men (64%) and mainly from rural areas (54%). The programme improved knowledge of medical research, health and dispelled misconceptions. This study suggests that the radio may be an effective means of increasing the exposure of men to health information in resource poor settings. PMID:27365364
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Liotta, Giuseppe; Chimbwandira, Frank; Wouters, Kristien; Nielsen-Saines, Karin; Jere, Haswell; Mancinelli, Sandro; Ceffa, Susanna; Erba, Fulvio; Palombi, Leonardo; Marazzi, Maria Cristina
2016-01-01
Combination antiretroviral therapy has been shown to reduce HIV transmission and incident infections. In recent years, Malawi has significantly increased the number of individuals on combination antiretroviral drugs through more inclusive treatment policies. Using a retrospective observational cohort design, records with HIV test results were reviewed for pregnant women attending a referral hospital in Malawi over a 5-year period, with viral load measurements recorded. HIV prevalence over time was determined, and results correlated with population viral load. A total of 11 052 women were included in this analysis, with 440 (4.1%) HIV infections identified. HIV prevalence rates in pregnant women in Malawi halved from 6.4% to 3.0% over 5 years. Mean viral loads of adult patients decreased from 120 000 copies/mL to less than 20 000 copies/mL. Results suggest that community viral load has an effect on HIV incidence rates in the population, which in turn correlates with reduced HIV prevalence rates in pregnant women. © The Author(s) 2015.
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Developments in Space Research in Nigeria
NASA Astrophysics Data System (ADS)
Oke, O.
Nigeria s desire to venture into space technology was first made known to ECA OAU member countries at an inter-governmental meeting in Addis Ababa 1976 The Nigerian space research is highly rated in Africa in terms of reputation and scientific results The National Space Research and Development Agency NASRDA Nigeria s space research coordinating body has taken a more active role to help Nigeria s space research community to succeed internationally The paper presents recent examples of Nigeria s successes in space and its detailed applications in areas such as remote sensing meteorology communication and Information Technology and many more It gave an analysis of the statistics of Nigerian born space scientists working in the other space-faring nations The analysis have been used to develop a model for increasing Nigerian scientist s involvement in the development of space research in Nigeria It concluded with some thoughts on the current and future of Nigeria s space borne scientific experiments policies and programs
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Developments in Space Research in Nigeria
NASA Astrophysics Data System (ADS)
Oke, O.
2006-08-01
Nigeria's desire to venture into space technology was first made known to ECA/ OAU member countries at an inter-governmental meeting in Addis Ababa, 1976. The Nigerian space research is highly rated in Africa in terms of reputation and scientific results. The National Space Research and Development Agency (NASRDA), Nigeria's space research coordinating body; has taken a more active role to help Nigeria's space research community to succeed internationally. The paper presents recent examples of Nigeria's successes in space and its detailed applications in areas such as remote sensing, meteorology, communication and Information Technology. and many more. It gave an analysis of the statistics of Nigerian born space scientists working in the other space-faring nations. The analysis have been used to develop a model for increasing Nigerian scientist's involvement in the development of space research in Nigeria. It concluded with some thoughts on the current and future of Nigeria's space borne scientific experiments, policies and programs.
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Capturing Complexities of Relationship-Level Family Planning Trajectories in Malawi.
Furnas, Hannah E
2016-09-01
In a transitioning fertility climate, preferences and decisions surrounding family planning are constantly in flux. Malawi provides an ideal case study of family planning complexities as fertility preferences are flexible, the relationship context is unstable, and childbearing begins early. I use intensive longitudinal data from Tsogolo la Thanzi-a research project in Malawi that follows young adults in romantic partnerships through the course of their relationship. I examine two questions: (1) What are the typical patterns of family planning as young adults transition through a relationship? (2) How are family planning trajectories related to individual and relationship-level characteristics? I use sequence analysis to order family planning across time and to contextualize it within each relationship. I generate and cluster the family planning trajectories and find six distinct groups of young adults who engage in family planning in similar ways. I find that family planning is complex, dynamic, and unique to each relationship. I argue that (a) family planning research should use the relationship as the unit of analysis and (b) family planning behaviors and preferences should be sequenced over time for a better understanding of key concepts, such as unmet need. © 2016 The Population Council, Inc.
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Capturing Complexities of Relationship-Level Family Planning Trajectories in Malawi
Furnas, Hannah E.
2017-01-01
In a transitioning fertility climate, preferences and decisions surrounding family planning are constantly in flux. Malawi provides an ideal case study of family planning complexities as fertility preferences are flexible, the relationship context is unstable, and childbearing begins early. I use intensive longitudinal data from Tsogolo la Thanzi—a research project in Malawi that follows young adults in romantic partnerships through the course of their relationship and allows me to ask two questions: (1) What are the typical patterns of family planning as young adults transition through a relationship? (2) How are family planning trajectories related to individual and relationship-level characteristics? I use sequence analysis to order family planning across time and to contextualize it within each relationship. I generate and cluster the family planning trajectories and find six distinct groups of young adults who engage in family planning in similar ways. I find that family planning is complex, dynamic, and unique to each relationship. I argue that (a) family planning research should use the relationship as the unit of analysis and (b) family planning behaviors and preferences should be sequenced over time for a better understanding of key concepts, such as unmet need. PMID:27517867
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Moral competence among nurses in Malawi: A concept analysis approach.
Maluwa, Veronica Mary; Gwaza, Elizabeth; Sakala, Betty; Kapito, Esnath; Mwale, Ruth; Haruzivishe, Clara; Chirwa, Ellen
2018-01-01
Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Analysis of moral competence concept was done using Walker and Avant's strategy of concept analysis. Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi.
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Scaling Up Integrated Community Case Management of Childhood Illness: Update from Malawi
Nsona, Humphreys; Mtimuni, Angella; Daelmans, Bernadette; Callaghan-Koru, Jennifer A.; Gilroy, Kate; Mgalula, Leslie; Kachule, Timothy; Zamasiya, Texas
2012-01-01
The Government of Malawi (GoM) initiated activities to deliver treatment of common childhood illnesses (suspected pneumonia, fever/suspected malaria, and diarrhea) in the community in 2008. The service providers are Health Surveillance Assistants (HSAs), and they are posted nationwide to serve communities at a ratio of 1 to 1,000 population. The GoM targeted the establishment of 3,452 village health clinics (VHCs) in hard-to-reach areas by 2011. By September of 2011, 3,296 HSAs had received training in integrated case management of childhood illness, and 2,709 VHCs were functional. An assessment has shown that HSAs are able to treat sick children with quality similar to the quality provided in fixed facilities. Monitoring data also suggest that communities are using the sick child services. We summarize factors that have facilitated the scale up of integrated community case management of children in Malawi and address challenges, such as ensuring a steady supply of medicines and supportive supervision. PMID:23136278
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Cohort Profile: The Malawi Longitudinal Study of Families and Health (MLSFH).
Kohler, Hans-Peter; Watkins, Susan C; Behrman, Jere R; Anglewicz, Philip; Kohler, Iliana V; Thornton, Rebecca L; Mkandawire, James; Honde, Hastings; Hawara, Augustine; Chilima, Ben; Bandawe, Chiwoza; Mwapasa, Victor; Fleming, Peter; Kalilani-Phiri, Linda
2015-04-01
The Malawi Longitudinal Study of Families and Health (MLSFH) is one of very few long-standing, publicly available longitudinal cohort studies in a sub-Saharan African (SSA) context. It provides a rare record of more than a decade of demographic, socioeconomic and health conditions in one of the world's poorest countries. The MLSFH was initially established in 1998 to study social network influences on fertility behaviours and HIV risk perceptions, and over time the focus of the study expanded to include health, sexual behaviours, intergenerational relations and family/household dynamics. The currently available data include MLSFH rounds collected in 1998, 2001, 2004, 2006, 2008, 2010 and 2012 for up to 4000 individuals, providing information about socioeconomic and demographic characteristics, sexual behaviours, marriage, household/family structure, risk perceptions, social networks and social capital, intergenerational relations, HIV/AIDS and other dimensions of health. The MLSFH public use data can be requested on the project website: http://www.malawi.pop.upenn.edu/. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
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7 CFR 319.56-54 - French beans and runner beans from Kenya.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 7 Agriculture 5 2014-01-01 2014-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under the...
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7 CFR 319.56-54 - French beans and runner beans from Kenya.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 7 Agriculture 5 2012-01-01 2012-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under the...
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7 CFR 319.56-54 - French beans and runner beans from Kenya.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 7 Agriculture 5 2013-01-01 2013-01-01 false French beans and runner beans from Kenya. 319.56-54... § 319.56-54 French beans and runner beans from Kenya. French beans (Phaseolus vulgaris L.) and runner beans (Phaseolus coccineus L.) may be imported into the United States from Kenya only under the...
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Developmental Idealism and Cultural Models of the Family in Malawi
Pierotti, Rachael S.; Young-DeMarco, Linda; Watkins, Susan
2014-01-01
This paper examines the extent to which developmental idealism has been disseminated in Malawi. Developmental idealism is a set of beliefs and values about development and the relationships between development and family structures and behavior. Developmental idealism states that attributes of societies and families defined as modern are better than attributes defined as traditional, that modern societies help produce modern families, that modern families facilitate the achievement of modern societies, and that the future will bring family change in the direction of modernity. Previous research has demonstrated that knowledge of developmental idealism is widespread in many places around the world, but provides little systematic data about it in sub-Saharan Africa or how knowledge of it is associated with certain demographic characteristics in that region. In this paper, we address this issue by examining whether ordinary people in two settings in Malawi, a sub-Saharan African country, have received and understood messages that are intended to associate development with certain types of family forms and family behaviors. We then examine associations between demographic characteristics and developmental idealism to investigate possible mechanisms linking global discourse about development to the grassroots. We analyze data collected in face-to-face surveys from two samples of Malawian men in 2009 and 2010, one rural, the other in a low-to-medium income neighborhood of a city. Our analysis of these survey data shows considerable evidence that many developmental idealism beliefs have been spread in that country and that education has positive effects on beliefs in the association between development and family attributes. We also find higher levels of developmental idealism awareness in the urban sample than we do in the rural sample, but once dissimilarities in education and wealth between the two samples are controlled, awareness levels no longer differed between
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Globalisation and Higher Education Funding Policy Shifts in Kenya
ERIC Educational Resources Information Center
Wangenge-Ouma, Gerald
2008-01-01
This paper identifies, examines and discusses higher education funding policy shifts that have taken place in Kenya. The paper argues that even though Kenya's higher education funding policy shifts, from free higher education to cost-sharing, and privatisation and commercialisation, are (to a greater extent) products of the country's encounter…
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Kenya: The December 2007 Elections and the Challenges Ahead
2008-04-04
Peoples Democratic Party Traditional African Banjo 1 MGPK Mazingira Greens Party of Kenya Tree 1 PPK Peoples Party of Kenya Trumpet 1 NLP National Labour...Kikuyu 22%, Luhya 14%, Luo 13%, Kalenjin 12%, Kamba 11%, Kisii 6%, Meru 6%, other African 15%, Asian, European, and Arab 1% Religions: Protestant 45
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Aha Malawi! Envisioning Field Experiences That Nurture Cultural Competencies for Preservice Teachers
ERIC Educational Resources Information Center
Talbot, Patricia A.
2011-01-01
This theoretical study uses the context of the writer's personal encounters in Malawi, Africa, to propose a conceptual model for creating diverse field experiences based on best practices in critical pedagogy, service learning, and the underpinnings of transformational learning theory, for the purpose of increasing the probability of meaningful…
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Eckerle, Michelle; Crouse, Heather L; Chiume, Msandeni; Phiri, Ajib; Kazembe, Peter N; Friesen, Hanny; Mvalo, Tisungane; Rus, Marideth C; Fitzgerald, Elizabeth F; McKenney, Allyson; Hoffman, Irving F; Coe, Megan; Mkandawire, Beatrice M; Schubert, Charles
2017-01-01
To achieve sustained reductions in child mortality in low- and middle-income countries, increased local capacity is necessary. One approach to capacity building is support offered via partnerships with institutions in high-income countries. However, lack of cooperation between institutions can create barriers to successful implementation of programs and may inadvertently weaken the health system they are striving to improve. A coordinated approach is necessary. Three U.S.-based institutions have separately supported various aspects of pediatric care at Kamuzu Central Hospital (KCH), the main government referral hospital in the central region of Malawi, for several years. Within each institution's experience, common themes were recognized, which required attention in order to sustain improvements in care. Each recognized that support of clinical care is a necessary cornerstone before initiating educational or training efforts. In particular, the support of emergency and acute care is paramount in order to decrease in-hospital mortality. Through the combined efforts of Malawian partners and the US-based institutions, the pediatric mortality rate has decreased from >10 to <4% since 2011, yet critical gaps remain. To achieve further improvements, representatives with expertise in pediatric emergency medicine (PEM) from each US-based institution hypothesized that coordinated efforts would be most effective, decrease duplication, improve communication, and ensure that investments in education and training are aligned with local priorities. Together with local stakeholders, the three US-based partners created a multi-institutional partnership, Pediatric Alliance for Child Health Improvement in Malawi at Kamuzu Central Hospital and Environs (PACHIMAKE). Representatives from each institution gathered in Malawi late 2016 and sought input and support from local partners at all levels to prioritize interventions, which could be collectively undertaken by this consortium. Long
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ERIC Educational Resources Information Center
Sedere, Upali M.
2005-01-01
This paper outlines the issues relating to teacher education and teacher supply in Malawi. Malawi has a severe shortage of teachers. Over the years, particularly since EFA the student numbers has gone up yet the teacher supply has not followed the increased student numbers. This paper outlines the broader picture as a basis for further…
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Wilson, Lynda Law; Somerall, D'Ann; Theus, Lisa; Rankin, Sally; Ngoma, Catherine; Chimwaza, Angela
2014-05-01
This article describes participant outcomes of an interprofessional collaboration between health professionals and faculty in Malawi, Zambia, and the United States (US). One strategy critical for improving global health and addressing Millennium Development goals is promotion of interprofessional education and collaboration. Program participants included 25 health professionals from Malawi and Zambia, and 19 faculty/health professionals from Alabama and California. African Fellows participated in a 2 week workshop on Interprofessional Education in Alabama followed by 2 weeks working on individual goals with faculty collaborators/mentors. The US Fellows also spent 2 weeks visiting their counterparts in Malawi and Zambia to develop plans for sustainable partnerships. Program evaluations demonstrated participants' satisfaction with the program and indicated that the program promoted interprofessional and cross-cultural understanding; fostered development of long-term sustainable partnerships between health professionals and educators in Zambia and the US; and created increased awareness and use of resources for global health education. © 2014.
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Kenya's Plans for Its Children.
ERIC Educational Resources Information Center
Chege, Nancy
1995-01-01
This article looks into the reasons behind Kenya's rapidly declining fertility rates over the last decade. Examines such factors as economic conditions, Westernization, contraceptive use, and formal education programs. (LZ)
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Job satisfaction and retention of health-care providers in Afghanistan and Malawi.
Fogarty, Linda; Kim, Young Mi; Juon, Hee-Soon; Tappis, Hannah; Noh, Jin Won; Zainullah, Partamin; Rozario, Aleisha
2014-02-17
This study describes job satisfaction and intention to stay on the job among primary health-care providers in countries with distinctly different human resources crises, Afghanistan and Malawi. Using a cross-sectional design, we enrolled 87 health-care providers in 32 primary health-care facilities in Afghanistan and 360 providers in 10 regional hospitals in Malawi. The study questionnaire was used to assess job satisfaction, intention to stay on the job and five features of the workplace environment: resources, performance recognition, financial compensation, training opportunities and safety. Descriptive analyses, exploratory factor analyses for scale development, bivariate correlation analyses and bivariate and multiple linear regression analyses were conducted. The multivariate model for Afghanistan, with demographic, background and work environment variables, explained 23.9% of variance in job satisfaction (F(9,73) = 5.08; P < 0.01). However, none of the work environment variables were significantly related to job satisfaction. The multivariate model for intention to stay for Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P < 0.01). Those with high scores for recognition were more likely to have higher intention to stay (β = 0.328, P < 0.05). However, being paid an appropriate salary was negatively related to intent to stay (β = -0.326, P < 0.01). For Malawi, the overall model explained only 9.8% of variance in job satisfaction (F(8,332) = 4.19; P < 0.01) and 9.1% of variance in intention to stay (F(10,330) = 3.57; P < 0.01). The construction of concepts of health-care worker satisfaction and intention to stay on the job are highly dependent on the local context. Although health-care workers in both Afghanistan and Malawi reported satisfaction with their jobs, the predictors of satisfaction, and the extent to which those predictors explained variations in job satisfaction and intention to stay on the
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Job satisfaction and retention of health-care providers in Afghanistan and Malawi
2014-01-01
Background This study describes job satisfaction and intention to stay on the job among primary health-care providers in countries with distinctly different human resources crises, Afghanistan and Malawi. Methods Using a cross-sectional design, we enrolled 87 health-care providers in 32 primary health-care facilities in Afghanistan and 360 providers in 10 regional hospitals in Malawi. The study questionnaire was used to assess job satisfaction, intention to stay on the job and five features of the workplace environment: resources, performance recognition, financial compensation, training opportunities and safety. Descriptive analyses, exploratory factor analyses for scale development, bivariate correlation analyses and bivariate and multiple linear regression analyses were conducted. Results The multivariate model for Afghanistan, with demographic, background and work environment variables, explained 23.9% of variance in job satisfaction (F(9,73) = 5.08; P < 0.01). However, none of the work environment variables were significantly related to job satisfaction. The multivariate model for intention to stay for Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P < 0.01). Those with high scores for recognition were more likely to have higher intention to stay (β = 0.328, P < 0.05). However, being paid an appropriate salary was negatively related to intent to stay (β = -0.326, P < 0.01). For Malawi, the overall model explained only 9.8% of variance in job satisfaction (F(8,332) = 4.19; P < 0.01) and 9.1% of variance in intention to stay (F(10,330) = 3.57; P < 0.01). Conclusions The construction of concepts of health-care worker satisfaction and intention to stay on the job are highly dependent on the local context. Although health-care workers in both Afghanistan and Malawi reported satisfaction with their jobs, the predictors of satisfaction, and the extent to which those predictors explained variations in job
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Barden-O'Fallon, Janine
2017-05-08
Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. Results show that FBOs are less likely to offer FP services than other managing authorities (p < 0.05). For example, 69% of FBOs in Kenya offer FP services compared to 97% of public facilities and 83% of other private facilities. Offering long-acting or permanent methods in faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). Results from this analysis indicate that there is room for improvement in
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ERIC Educational Resources Information Center
Odokara, Elijah O.
Focusing on eastern Nigeria, these studies describe educational planning to combat anomia (uncertainty and despair) in war-ravaged rural areas; the role of the University of Nigeria in social action, womens education, young farmers' clubs, and other activities aimed at postwar reconstruction; a proposal for improving family life education for…
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The estimated incidence of induced abortion in Kenya: a cross-sectional study.
Mohamed, Shukri F; Izugbara, Chimaraoke; Moore, Ann M; Mutua, Michael; Kimani-Murage, Elizabeth W; Ziraba, Abdhalah K; Bankole, Akinrinola; Singh, Susheela D; Egesa, Caroline
2015-08-21
The recently promulgated 2010 constitution of Kenya permits abortion when the life or health of the woman is in danger. Yet broad uncertainty remains about the interpretation of the law. Unsafe abortion remains a leading cause of maternal morbidity and mortality in Kenya. The current study aimed to determine the incidence of induced abortion in Kenya in 2012. The incidence of induced abortion in Kenya in 2012 was estimated using the Abortion Incidence Complications Methodology (AICM) along with the Prospective Morbidity Survey (PMS). Data were collected through three surveys, (i) Health Facilities Survey (HFS), (ii) Prospective Morbidity Survey (PMS), and (iii) Health Professionals Survey (HPS). A total of 328 facilities participated in the HFS, 326 participated in the PMS, and 124 key informants participated in the HPS. Abortion numbers, rates, ratios and unintended pregnancy rates were calculated for Kenya as a whole and for five geographical regions. In 2012, an estimated 464,000 induced abortions occurred in Kenya. This translates into an abortion rate of 48 per 1,000 women aged 15-49, and an abortion ratio of 30 per 100 live births. About 120,000 women received care for complications of induced abortion in health facilities. About half (49%) of all pregnancies in Kenya were unintended and 41% of unintended pregnancies ended in an abortion. This study provides the first nationally-representative estimates of the incidence of induced abortion in Kenya. An urgent need exists for improving facilities' capacity to provide safe abortion care to the fullest extent of the law. All efforts should be made to address underlying factors to reduce risk of unsafe abortion.
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The Information Age and Information Development.
ERIC Educational Resources Information Center
Hughes, Graeme C.; And Others
1991-01-01
This theme issue includes eight articles that discuss the information age, the impact of information technology, and the role of libraries. Highlights include libraries in Brazil, Indonesia, and Nigeria; the Universal Availability of Publications (UAP) program; community literacy; database development in Malawi; and the Regional Energy Resources…
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Nigeria Country Analysis Brief
2016-01-01
Nigeria is currently the largest oil producer in Africa and was the world's fourth-largest exporter of LNG in 2015. Nigeria's oil production is hampered by instability and supply disruptions, while its natural gas sector is restricted by the lack of infrastructure to commercialize natural gas that is currently flared (burned off).
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Barriers to Participation in Adult Literacy Programs in Kenya
ERIC Educational Resources Information Center
Muiru, John; Mukuria, Gathogo
2005-01-01
To compete internationally, adapt to new technologies, and attain higher levels of efficiency and productivity, a country needs a highly literate populace. However, in Kenya, literacy stands at less than 65% of the population. With such a low rate of literacy, most development is hampered. In order for Kenya to make progress in political, social,…
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Reflecting on the Challenges of Applied Theatre in Kenya
ERIC Educational Resources Information Center
Okuto, Maxwel; Smith, Bobby
2017-01-01
In this article the authors draw on their own experience and research in applied theatre in Kenya in order to reflect on challenges currently facing practitioners working in the country. In order to outline the range of challenges faced by practitioners, issues related to the wider landscapes of government and politics in Kenya are explored,…
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Kobayashi, Miwako; Mwandama, Dyson; Nsona, Humphreys; Namuyinga, Ruth J.; Shah, Monica P.; Bauleni, Andrew; Vanden Eng, Jodi; Rowe, Alexander K.; Mathanga, Don P.; Steinhardt, Laura C.
2017-01-01
Pneumonia and diarrhea are leading causes of child deaths in Malawi. Guidelines to manage childhood illnesses in resource-poor settings exist, but studies have reported low health-care worker (HCW) adherence to guidelines. We conducted a health facility survey from January to March 2015 to assess HCW management of pneumonia and diarrhea in children < 5 years of age in southern Malawi, and to determine factors associated with case management quality. Descriptive statistics and multivariable logistic regression models examined patient, HCW, and health facility factors associated with recommended pneumonia and diarrhea management, using Malawi's national guidelines as the gold standard. Of 694 surveyed children 2–59 months of age at 95 health facilities, 132 (19.0%) met survey criteria for pneumonia; HCWs gave recommended antibiotic treatment to 90 (68.2%). Of 723 children < 5 years of age, 222 (30.7%) had uncomplicated diarrhea; HCWs provided recommended treatment to 94 (42.3%). In multivariable analyses, caregivers' spontaneous report of children's symptoms was associated with recommended treatment of both pneumonia (odds ratio [OR]: 2.8, 95% confidence interval [CI]: 1.2–6.8, P = 0.023) and diarrhea (OR: 24.2, 95% CI: 6.0–97.0, P < 0001). Malaria diagnosis was negatively associated with recommended treatment (OR for pneumonia: 0.5, 95% CI: 0.2–1.0, P = 0.046; OR for diarrhea: 0.3, 95% CI: 0.1–0.6, P = 0.003). To improve quality of care, children should be assessed systematically, even when malaria is suspected. Renewed efforts to invigorate such a systematic approach, including HCW training, regular follow-up supervision, and monitoring HCW performance, are needed in Malawi. PMID:28500813
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Kobayashi, Miwako; Mwandama, Dyson; Nsona, Humphreys; Namuyinga, Ruth J; Shah, Monica P; Bauleni, Andrew; Vanden Eng, Jodi Vanden; Rowe, Alexander K; Mathanga, Don P; Steinhardt, Laura C
2017-05-01
Pneumonia and diarrhea are leading causes of child deaths in Malawi. Guidelines to manage childhood illnesses in resource-poor settings exist, but studies have reported low health-care worker (HCW) adherence to guidelines. We conducted a health facility survey from January to March 2015 to assess HCW management of pneumonia and diarrhea in children < 5 years of age in southern Malawi, and to determine factors associated with case management quality. Descriptive statistics and multivariable logistic regression models examined patient, HCW, and health facility factors associated with recommended pneumonia and diarrhea management, using Malawi's national guidelines as the gold standard. Of 694 surveyed children 2-59 months of age at 95 health facilities, 132 (19.0%) met survey criteria for pneumonia; HCWs gave recommended antibiotic treatment to 90 (68.2%). Of 723 children < 5 years of age, 222 (30.7%) had uncomplicated diarrhea; HCWs provided recommended treatment to 94 (42.3%). In multivariable analyses, caregivers' spontaneous report of children's symptoms was associated with recommended treatment of both pneumonia (odds ratio [OR]: 2.8, 95% confidence interval [CI]: 1.2-6.8, P = 0.023) and diarrhea (OR: 24.2, 95% CI: 6.0-97.0, P < 0001). Malaria diagnosis was negatively associated with recommended treatment (OR for pneumonia: 0.5, 95% CI: 0.2-1.0, P = 0.046; OR for diarrhea: 0.3, 95% CI: 0.1-0.6, P = 0.003). To improve quality of care, children should be assessed systematically, even when malaria is suspected. Renewed efforts to invigorate such a systematic approach, including HCW training, regular follow-up supervision, and monitoring HCW performance, are needed in Malawi.
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Forests and competing land uses in Kenya
NASA Astrophysics Data System (ADS)
Allaway, James; Cox, Pamela M. J.
1989-03-01
Indigenous forests in Kenya, as in other developing countries, are under heavy pressure from competing agricultural land uses and from unsustainable cutting. The problem in Kenya is compounded by high population growth rates and an agriculturally based economy, which, even with efforts to control birth rates and industrialize, will persist into the next century. Both ecological and economic consequences of these pressures need to be considered in land-use decision making for land and forest management to be effective. This paper presents one way to combine ecological and economic considerations. The status of principal forest areas in Kenya is summarized and competing land uses compared on the basis of ecological functions and economic analysis. Replacement uses do not match the ecological functions of forest, although established stands of tree crops (forest plantations, fuel wood, tea) can have roughly comparable effects on soil and water resources. Indigenous forests have high, although difficult to estimate, economic benefits from tourism and protection of downstream agricultural productivity. Economic returns from competing land uses range widely, with tea having the highest and fuel wood plantations having returns comparable to some annual crops and dairying. Consideration of ecological and economic factors together suggests some trade-offs for improving land allocation decisions and several management opportunities for increasing benefits or reducing costs from particular land uses. The evaluation also suggests a general strategy for forest land management in Kenya.
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Informal alcohol in Malawi: stakeholder perceptions and policy recommendations.
Limaye, Rupali J; Rutkow, Lainie; Rimal, Rajiv N; Jernigan, David H
2014-02-01
Through the eyes of those involved in the alcohol policy-making process in Malawi, we explored the role of informal (non-commercial) alcohol in rural communities, its harmful effects, and implications for appropriate national policy. Harms included early drinking initiation, violence, and sexual risk exposure. Informants suggested that policy should address informal alcohol's content, selling times, and easy access. Because most informal alcohol producers are women who rely upon sales for subsistence, policies must avoid limiting women's economic opportunities while protecting community health.
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High rates of cervical cancer among HIV-infected women at a referral hospital in Malawi.
Kohler, Racquel E; Tang, Jennifer; Gopal, Satish; Chinula, Lameck; Hosseinipour, Mina C; Liomba, N George; Chiudzu, Grace
2016-08-01
Cervical cancer is the most common cancer among women in Malawi. National guidelines recommend screening women aged 30-45 years every five years; however, no specific recommendations exist for women with HIV. We aimed to assess the frequency of high-grade dysplasia (CIN 2 or CIN3) and cervical cancer among women in central Malawi and to examine associations with CIN2+ (CIN2/3 or cancer). We extracted cervical Pap smear, biopsy, loop electrosurgical excision procedure and uterine specimen reports from a hospital pathology database from November 2012 to November 2013. We used logistic regression to estimate associations with CIN2+. We reviewed specimens from 824 women; we excluded 194 with unknown HIV status, leaving 630 in the analytic sample. Twelve percent had high-grade dysplasia and 109 women (17%) had cancer. Twenty-five percent of high-grade dysplasia cases and 35% of cancers occurred among women outside recommended screening ages. The odds of having CIN2+ were 6.55 times (95% CI 4.44-9.67) greater for HIV+ women. High-grade dysplasia and cervical cancer are very common among Malawian women, especially HIV+ women. HIV infection was strongly associated with CIN2+. Expanding screening to women not covered by current guidelines could avert a substantial proportion of cervical cancer cases in Malawi. © The Author(s) 2016.
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Chilopora, Garvey; Pereira, Caetano; Kamwendo, Francis; Chimbiri, Agnes; Malunga, Eddie; Bergström, Staffan
2007-01-01
Background Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. Methods During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation. All these surgeries were conducted either by clinical officers or by medical officers. Results During the study period, clinical officers performed 90% of all straight caesarean sections, 70% of those combined with subtotal hysterectomy, 60% of those combined with total hysterectomy and 89% of those combined with repair of uterine rupture. A comparable profile of patients was operated on by clinical officers and medical officers, respectively. Postoperative outcomes were almost identical in the two groups in terms of maternal general condition – both immediately and 24 hours postoperatively – and regarding occurrence of pyrexia, wound infection, wound dehiscence, need for re-operation, neonatal outcome or maternal death. Conclusion Clinical officers perform the bulk of emergency obstetric operations at district hospitals in Malawi. The postoperative outcomes of their procedures are comparable to those of medical officers. Clinical officers constitute a crucial component of the health care team in Malawi for saving maternal and neonatal lives given the scarcity of physicians. PMID:17570847
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The fertility decline in Kenya.
Robinson, W C; Harbison, S F
1995-01-01
In Sub-Saharan Africa Kenya is a prime example of a country experiencing a rapid decline in fertility and greater contraceptive prevalence. These changes have occurred since 1980 when fertility was high at 8.0 children per woman. In 1993 the total fertility rate (TFR) was 5.4, and the growth rate declined to about 2.0%. This transition is swifter than any country in contemporary Asia or historical Europe. The likely projection for Kenya is attainment of replacement level fertility during the 2020s and a leveling of population at about 100 million persons. Fertility has declined the most in urban areas and central and eastern regions. Bongaarts' proximate determinants (TFR, total marital fertility rate, total natural marital fertility rate, and total fecundity) are reduced to the proportion of currently married women using contraception, the proportion in lactational nonfecund status, and the proportion currently married. Actual fertility change is accounted for by total fertility change of 3.0 children. Lactational infecundability accounts for 0.5 potential births, and changes in marital fertility account for 1.0 reduced births per woman. About 70% of fertility reduction is accounted for by contraception and abortion. During 1977-78 80% of fertility control was due to lactational nonfecundity, 10% to nonmarriage, and 10% to contraception. In 1993 lactational nonfecundity accounted for 50% of the reduction, nonmarriage for 20%, and abortion about 30%. Future fertility is expected to be dependent on contraceptive prevalence. Kenya has experienced the Coale paradigm of preconditions necessary for demographic transition (willing, ready, and able). High fertility in Africa is not intractable. Creating the change in attitudes that leads to readiness is linked to education, health, and exposure to modernizing media and urban lifestyles. The public sector family planning program in Kenya has created the opportunity for access and availability of contraception. The key
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ERIC Educational Resources Information Center
International Planned Parenthood Federation, London (England).
Data relating to population and family planning in eight foreign countries are presented in these situation reports. Countries included are Hong Kong, Malawi, Pakistan, Panama, Philippines, Ryukyu Islands (Okinawa), Sabah, and Sarawak. Information is provided where appropriate and available, under two topics, general background and family planning…
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Growing Up in Kenya: Rural Schooling and Girls. Rethinking Childhood.
ERIC Educational Resources Information Center
Mungai, Anne M.
This book examines the education of rural girls in Kenya and reports on a study of factors influencing girls' educational success or failure. Three chapters provide background on traditional values and practices affecting girls' education; describe Kenya's education system, including preprimary, primary (grades 1-8), secondary, university,…
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Colbourn, Tim; Pulkki-Brännström, Anni-Maria; Nambiar, Bejoy; Kim, Sungwook; Bondo, Austin; Banda, Lumbani; Makwenda, Charles; Batura, Neha; Haghparast-Bidgoli, Hassan; Hunter, Rachael; Costello, Anthony; Baio, Gianluca; Skordis-Worrall, Jolene
2015-01-01
Understanding the cost-effectiveness and affordability of interventions to reduce maternal and newborn deaths is critical to persuading policymakers and donors to implement at scale. The effectiveness of community mobilisation through women's groups and health facility quality improvement, both aiming to reduce maternal and neonatal mortality, was assessed by a cluster randomised controlled trial conducted in rural Malawi in 2008-2010. In this paper, we calculate intervention cost-effectiveness and model the affordability of the interventions at scale. Bayesian methods are used to estimate the incremental cost-effectiveness of the community and facility interventions on their own (CI, FI), and together (FICI), compared to current practice in rural Malawi. Effects are estimated with Monte Carlo simulation using the combined full probability distributions of intervention effects on stillbirths, neonatal deaths and maternal deaths. Cost data was collected prospectively from a provider perspective using an ingredients approach and disaggregated at the intervention (not cluster or individual) level. Expected Incremental Benefit, Cost-effectiveness Acceptability Curves and Expected Value of Information (EVI) were calculated using a threshold of $780 per disability-adjusted life-year (DALY) averted, the per capita gross domestic product of Malawi in 2013 international $. The incremental cost-effectiveness of CI, FI, and combined FICI was $79, $281, and $146 per DALY averted respectively, compared to current practice. FI is dominated by CI and FICI. Taking into account uncertainty, both CI and combined FICI are highly likely to be cost effective (probability 98% and 93%, EVI $210,423 and $598,177 respectively). Combined FICI is incrementally cost effective compared to either intervention individually (probability 60%, ICER $292, EIB $9,334,580 compared to CI). Future scenarios also found FICI to be the optimal decision. Scaling-up to the whole of Malawi, CI is of greatest
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ERIC Educational Resources Information Center
International Planned Parenthood Federation, London (England).
Data relating to population and family planning in six foreign countries are presented in these situation reports. Countries included are Laos, Malawi, Pakistan, Republic of Korea, Somali Democratic Republic, and Tunisia. Information is provided under two topics, general background and family planning situation, where appropriate and if it is…
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ERIC Educational Resources Information Center
Glasson, George E.; Frykholm, Jeffrey A.; Mhango, Ndalapa A.; Phiri, Absalom D.
2006-01-01
The purpose of this 2-year study was to investigate Malawian teacher educators' perspectives and dispositions toward teaching about ecological sustainability issues in Malawi, a developing country in sub-Sahara Africa. This study was embedded in a larger theoretical framework of investigating earth systems science through the understanding of…
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Progress in measles control--Kenya 2002-2007.
2007-09-21
In 2000, countries represented by the World Health Organization (WHO) Regional Office for Africa established a goal to reduce, by the end of 2005, measles mortality to 50% of the 506,000 deaths from measles estimated in 1999. Strategies adopted included strengthening routine vaccination, providing a second opportunity for measles vaccination through supplemental immunization activities (SIAs), monitoring disease trends, and improving measles case management. In Kenya, an east African country with a population estimated at 33.4 million in 2005, the Kenya Expanded Programme on Immunization (KEPI) in the Ministry of Health began implementing these strategies in 2002 with a wide age range catch-up SIA and reduced the number of reported measles cases by >99%, from 11,304 in 2001 to 20 in 2004. A follow-up SIA, initially scheduled for July 2005, was postponed to 2006 to include concurrent distribution of long-lasting insecticide-treated bednets (LLINs). This report documents progress made in reducing measles morbidity and mortality in Kenya and describes the consequences of a large measles outbreak, beginning in September 2005, on the integrated measles follow-up SIA.
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7 CFR 319.56-45 - Shelled garden peas from Kenya.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 7 Agriculture 5 2013-01-01 2013-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319.56-45 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United...
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7 CFR 319.56-45 - Shelled garden peas from Kenya.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 7 Agriculture 5 2014-01-01 2014-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319.56-45 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United...
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7 CFR 319.56-45 - Shelled garden peas from Kenya.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 7 Agriculture 5 2012-01-01 2012-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319.56-45 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United...
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7 CFR 319.56-45 - Shelled garden peas from Kenya.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 7 Agriculture 5 2011-01-01 2011-01-01 false Shelled garden peas from Kenya. 319.56-45 Section 319.56-45 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH... Shelled garden peas from Kenya. Garden peas (Pisum sativum) may be imported into the continental United...
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2011-01-01
Background Only about one-third of eligible HIV/AIDS patients receive anti-retroviral treatment (ART). Decentralizing treatment is crucial to wider and more equitable access, but key obstacles are a shortage of trained healthcare workers (HCW) and challenges integrating HIV/AIDS care with other primary care. This report describes the development of a guideline and training program (PALM PLUS) designed to integrate HIV/AIDS care with other primary care in Malawi. PALM PLUS was adapted from PALSA PLUS, developed in South Africa, and targets middle-cadre HCWs (clinical officers, nurses, and medical assistants). We adapted it to align with Malawi's national treatment protocols, more varied healthcare workforce, and weaker health system infrastructure. Methods/Design The international research team included the developers of the PALSA PLUS program, key Malawi-based team members and personnel from national and district level Ministry of Health (MoH), professional associations, and an international non-governmental organization. The PALSA PLUS guideline was extensively revised based on Malawi national disease-specific guidelines. Advice and input was sought from local clinical experts, including middle-cadre personnel, as well as Malawi MoH personnel and representatives of Malawian professional associations. Results An integrated guideline adapted to Malawian protocols for adults with respiratory conditions, HIV/AIDS, tuberculosis, and other primary care conditions was developed. The training program was adapted to Malawi's health system and district-level supervision structure. PALM PLUS is currently being piloted in a cluster-randomized trial in health centers in Malawi (ISRCTN47805230). Discussion The PALM PLUS guideline and training intervention targets primary care middle-cadre HCWs with the objective of improving HCW satisfaction and retention, and the quality of patient care. Successful adaptations are feasible, even across health systems as different as those of
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Schooling and Basic Aspects of Intelligence: A Natural Quasi-Experiment in Malawi
ERIC Educational Resources Information Center
Van de Vijver, Fons J. R.; Brouwers, Symen A.
2009-01-01
The relationship between educational age and chronological age and measures of information processing and intelligence was studied in a group of children of 7 to 14 years of age (N=268) in a rural area in the Ntcheu district (Malawi). There was a relatively weak relationship between chronological and educational age in this area, and the impact of…
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Cost-Effectiveness and Quality of Care of a Comprehensive ART Program in Malawi
Orlando, Stefano; Diamond, Samantha; Palombi, Leonardo; Sundaram, Maaya; Shear Zinner, Lauren; Marazzi, Maria Cristina; Mancinelli, Sandro; Liotta, Giuseppe
2016-01-01
Abstract The aim of this study is to assess the cost-effectiveness of a holistic, comprehensive human immunodeficiency virus (HIV) treatment Program in Malawi. Comprehensive cost data for the year 2010 have been collected at 30 facilities from the public network of health centers providing antiretroviral treatment (ART) throughout the country; two of these facilities were operated by the Disease Relief through Excellent and Advanced Means (DREAM) program. The outcomes analysis was carried out over five years comparing two cohorts of patients on treatment: 1) 2387 patients who started ART in the two DREAM centers during 2008, 2) patients who started ART in Malawi in the same year under the Ministry of Health program. Assuming the 2010 cost as constant over the five years the cost-effective analysis was undertaken from a health sector and national perspective; a sensitivity analysis included two hypothesis of ART impact on patients’ income. The total cost per patient per year (PPPY) was $314.5 for the DREAM protocol and $188.8 for the other Malawi ART sites, with 737 disability adjusted life years (DALY) saved among the DREAM program patients compared with the others. The Incremental Cost-Effectiveness Ratio was $1640 per DALY saved; it ranged between $896–1268 for national and health sector perspective respectively. The cost per DALY saved remained under $2154 that is the AFR-E-WHO regional gross domestic product per capita threshold for a program to be considered very cost-effective. HIV/acquired immune deficiency syndrome comprehensive treatment program that joins ART with laboratory monitoring, treatment adherence reinforcing and Malnutrition control can be very cost-effective in the sub-Saharan African setting. PMID:27227921
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Experiences of self-disclosure among tuberculosis patients in rural Southern Malawi.
Zolowere, Davie; Manda, Kumbukani; Panulo, Ben; Muula, Adamson S
2008-01-01
Tuberculosis (Tb) is a significant public health problem in Southern Africa, largely as a consequence of the HIV/AIDS pandemic. Self-disclosure of diagnosis to others within the patients' social environment may be problematic because the diagnosis of Tb may attract stigma, largely derived from the association of this disease with HIV infection. In Malawi, there are limited reports of the diagnosis disclosure experiences of Tb patients. A qualitative study using in-depth interviews was conducted in Thyolo, a rural southern Malawi district to: (1) explore the relationship of persons to whom Tb patients disclose their diagnoses; and (2) identify the motivations for such disclosures. Thirty-two adult Tb patients participated in the study. Their ages ranged from 22 to 49 years (median 31 years), and 19 were male. The majority of patients reported having disclosed their disease status to close family members, such as spouses, siblings and parents; only a few had disclosed their status to their children. The most common way of disclosure was through personal discussion between the patient and their significant others. Study participants perceived that disclosure brought returns in terms of encouragement and empowerment. Some patients felt stigmatized or feared stigmatization following disclosure of their disease status, and some patients on antiretroviral therapy for HIV felt stigmatized by fellow patients. Patient-to-patient interaction was perceived as a valuable resource in trying to cope with a Tb diagnosis. The findings of this study suggest that Tb patients in southern Malawi were interested in disclosing their Tb diagnosis if they felt they would not be stigmatized or stood to gain as a result of self-disclosure. Disclosure of diagnosis was facilitated by trust, a feeling of safety, and a sense of obligation to others. The perceived stigmatization of patients by other patients is cause for concern. This study calls for the health education of patients, with the
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Determinants of under-five mortality in rural and urban Kenya.
Ettarh, R R; Kimani, J
2012-01-01
The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya. Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas. Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Household poverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province. The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.
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Behrman, Julia Andrea
2015-02-01
This paper explores the causal relationship between primary schooling and adult HIV status in Malawi and Uganda, two East African countries with some of the highest HIV infection rates in the world. Using data from the 2010 Malawi Demographic Health Survey and the 2011 Uganda AIDS Indicator Survey, the paper takes advantage of a natural experiment, the implementation of Universal Primary Education policies in the mid 1990s. An instrumented regression discontinuity approach is used to model the relationship between increased primary schooling and adult women's HIV status. Results indicate that a one-year increase in schooling decreases the probability of an adult woman testing positive for HIV by 0.06 (p < 0.01) in Malawi and by 0.03 (p < 0.05) in Uganda. These results are robust to a variety of model specifications. In a series of supplementary analyses a number of potential pathways through which such effects may occur are explored. Findings indicate increased primary schooling positively affects women's literacy and spousal schooling attainment in Malawi and age of marriage and current household wealth in Uganda. However primary schooling has no effect on recent (adult) sexual behavior. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.
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Walker, Deborah Kirk; Edwards, Rebecca L.; Bagcivan, Gulcan; Bakitas, Marie A.
2017-01-01
As the global cancer burden grows, so too will global inequities in access to cancer and palliative care increase. This paper will describe the cancer and palliative care landscape relative to nursing practice, education, and research, and emerging global collaborations in the United States (U.S.), Turkey, and Malawi. It is imperative that nurses lead efforts to advance health and strengthen education in these high-need areas. Leaders within the University of Alabama at Birmingham School of Nursing, through a Pan American Health Organization/World Health Organization Nursing Collaborating Center, have initiated collaborative projects in cancer and palliative care between the U.S., Turkey, and Malawi to strengthen initiatives that can ultimately transform practice. These collaborations will lay a foundation to empower nurses to lead efforts to reduce the global inequities for those with cancer and other serious and life-limiting illnesses. PMID:28695167
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Towards a Practical Proposal for Multilingualism in Education in Kenya
ERIC Educational Resources Information Center
Oduor, Jane A. N.
2015-01-01
This article proposes multilingualism in education, where indigenous languages are used alongside English as the media of instruction in schools to eventually promote their use in Kenya. It begins by stating Kenya's language policy in education. It then states the responses given by some primary and secondary school teachers who were interviewed…
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Benefits of family planning: an assessment of women's knowledge in rural Western Kenya.
Mutombo, Namuunda; Bakibinga, Pauline; Mukiira, Carol; Kamande, Eva
2014-03-18
The last two decades have seen an increase in literature reporting an increase in knowledge and use of contraceptives among individuals and couples in Kenya, as in the rest of Africa, but there is a dearth of information regarding knowledge about benefits of family planning (FP) in Kenya. To assess the factors associated with knowledge about the benefits of FP for women and children, among women in rural Western Kenya. Data are drawn from the Packard Western Kenya Project Baseline Survey, which collected data from rural women (aged 15-49 years). Ordinal regression was used on 923 women to determine levels of knowledge and associated factors regarding benefits of FP. Women in rural Western Kenya have low levels of knowledge about benefits of FP and are more knowledgeable about benefits for the mother rather than for the child. Only age, spousal communication and type of contraceptive method used are significant. Women's level of knowledge about benefits of FP is quite low and may be one of the reasons why fertility is still high in Western Kenya. Therefore, FP programmes need to focus on increasing women's knowledge about the benefits of FP in this region.
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Challenges for modelling spatio-temporal variations of malaria risk in Malawi
NASA Astrophysics Data System (ADS)
Lowe, R.; Chirombo, J.; Tompkins, A. M.
2012-04-01
Malaria is the leading cause of morbidity and mortality in Malawi with more than 6 million episodes reported each year. Malaria poses a huge economic burden to Malawi in terms of the direct cost of treating malaria patients and also indirect costs resulting from workdays lost in agriculture and industry and absenteeism from school. Malawi implements malaria control activities within the Roll Back Malaria framework, with the objective to provide those most at risk (i.e. children under five years, pregnant woman and individuals with suppressed immune systems) access to personal and community protective measures. However, at present there is no mechanism by which to target the most 'at risk' populations ahead of an impending epidemic. Malaria transmission is influenced by variations in meteorological conditions, which impact the biology of the mosquito and the availability of breeding sites, but also socio-economic conditions such as levels of urbanisation, poverty and education, which influence human vulnerability and vector habitat. The many potential drivers of malaria, both extrinsic, such as climate, and intrinsic, such as population immunity are often difficult to disentangle. This presents a challenge for modelling of malaria risk in space and time. Using an age-stratified spatio-temporal dataset of malaria cases at the district level from July 2004 - June 2011, we use a spatio-temporal modelling framework to model variations in malaria risk in Malawi. Climatic and topographic variations are accounted for using an interpolation method to relate gridded products to administrative districts. District level data is tested in the model to account for confounding factors, including the proportion of the population living in urban areas; residing in traditional housing; with no toilet facilities; who do not attend school, etc, the number of health facilities per population and yearly estimates of insecticide-treated mosquito net distribution. In order to account for
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District health managers' perceptions of supervision in Malawi and Tanzania.
Bradley, Susan; Kamwendo, Francis; Masanja, Honorati; de Pinho, Helen; Waxman, Rachel; Boostrom, Camille; McAuliffe, Eilish
2013-09-05
Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. This qualitative study took place as part of a broader project, "Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers". Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that is based on common understandings of the
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District health managers’ perceptions of supervision in Malawi and Tanzania
2013-01-01
Background Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. Methods This qualitative study took place as part of a broader project, “Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers”. Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Results Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Conclusion Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that
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Towards Near Real-time Convective Rainfall Observations over Kenya
NASA Astrophysics Data System (ADS)
Hoedjes, Joost; Said, Mohammed; Becht, Robert; Kifugo, Shem; Kooiman, André; Limo, Agnes; Maathuis, Ben; Moore, Ian; Mumo, Mark; Nduhiu Mathenge, Joseph; Su, Bob; Wright, Iain
2013-04-01
The existing meteorological infrastructure in Kenya is poorly suited for the countrywide real-time monitoring of precipitation. Rainfall radar is not available, and the existing network of rain gauges is sparse and challenging to maintain. This severely restricts Kenya's capacity to warn for, and respond to, weather related emergencies. Furthermore, the lack of accurate rainfall observations severely limits Kenya's climate change adaptation capabilities. Over the past decade, the mobile telephone network in Kenya has expanded rapidly. This network makes extensive use of terrestrial microwave (MW) links, received signal level (RSL) data from which can be used for the calculation of rainfall intensities. We present a novel method for the near-real time observation of convective rainfall over Kenya, based on the combined use of MW RSL data and Meteosat Second Generation (MSG) satellite data. In this study, the variable density rainfall information derived from several MW links is scaled up using MSG data to provide full rainfall information coverage for the region surrounding the links. Combining MSG data and MW link derived rainfall data for several adjacent MW links makes it possible to make the distinction between wet and dry pixels. This allows the disaggregation of the MW link derived rainfall intensities. With the distinction between wet and dry pixels made, and the MW derived rainfall intensities disaggregated, these data can then be used to develop instantaneous empirical relationships linking rainfall intensities to cloud physical properties. These relationships are then used to calculate rainfall intensities for the MSG scene. Since both the MSG and the MW data are available at the same temporal resolution, unique empirical coefficients can be determined for each interval. This approach ensures that changes in convective conditions from one interval to the next are taken into account. Initial results from a pilot study, which took place from November 2012
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National Assessment of Data Quality and Associated Systems-Level Factors in Malawi
O'Hagan, Richael; Marx, Melissa A; Finnegan, Karen E; Naphini, Patrick; Ng'ambi, Kumbukani; Laija, Kingsley; Wilson, Emily; Park, Lois; Wachepa, Sautso; Smith, Joseph; Gombwa, Lewis; Misomali, Amos; Mleme, Tiope; Yosefe, Simeon
2017-01-01
ABSTRACT Background: Routine health data can guide health systems improvements, but poor quality of these data hinders use. To address concerns about data quality in Malawi, the Ministry of Health and National Statistical Office conducted a data quality assessment (DQA) in July 2016 to identify systems-level factors that could be improved. Methods: We used 2-stage stratified random sampling methods to select health centers and hospitals under Ministry of Health auspices, included those managed by faith-based entities, for this DQA. Dispensaries, village clinics, police and military facilities, tertiary-level hospitals, and private facilities were excluded. We reviewed client registers and monthly reports to verify availability, completeness, and accuracy of data in 4 service areas: antenatal care (ANC), family planning, HIV testing and counseling, and acute respiratory infection (ARI). We also conducted interviews with facility and district personnel to assess health management information system (HMIS) functioning and systems-level factors that may be associated with data quality. We compared systems and quality factors by facility characteristics using 2-sample t tests with Welch's approximation, and calculated verification ratios comparing total entries in registers to totals from summarized reports. Results: We selected 16 hospitals (of 113 total in Malawi), 90 health centers (of 466), and 16 district health offices (of 28) in 16 of Malawi's 28 districts. Nearly all registers were available and complete in health centers and district hospitals, but data quality varied across service areas; median verification ratios comparing register and report totals at health centers ranged from 0.78 (interquartile range [IQR]: 0.25, 1.07) for ARI and 0.99 (IQR: 0.82, 1.36) for family planning to 1.00 (IQR: 0.96, 1.00) for HIV testing and counseling and 1.00 (IQR: 0.80, 1.23) for ANC. More than half (60%) of facilities reported receiving a documented supervisory visit for
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Physical attractiveness and women's HIV risk in rural Malawi.
Frye, Margaret; Chae, Sophia
2017-01-01
Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country's severe AIDS epidemic. We use interviewers' ratings of respondents' attractiveness, along with HIV test results and women's assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15-35. Results show that women who are rated by interviewers as 'much less' or 'less' attractive than other women their age are 9% more likely to test positive for HIV. We also find that attractiveness is associated with women's own assessments of their HIV risk: Among women who tested negative, those perceived as 'much less' or 'less' attractive than average report themselves to be at greater risk of HIV infection. These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings.
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Abdu, Mohammed; Wilson, Amie; Mhango, Chisale; Taki, Fatima; Coomarasamy, Arri; Lissauer, David
2018-02-01
To assess the availability of key resources for the management of maternal sepsis and evaluate the feasibility of implementing the Surviving Sepsis Campaign (SSC) recommendations in Malawi and other low-resource settings. A cross-sectional study was conducted at health facilities in Malawi, other low-income countries, and lower-middle-income countries during January-March 2016. English-speaking healthcare professionals (e.g. doctors, nurses, midwives, and administrators) completed a questionnaire/online survey to assess the availability of resources for the management of maternal sepsis. Healthcare centers (n=23) and hospitals (n=13) in Malawi showed shortages in the resources for basic monitoring (always available in 5 [21.7%] and 10 [76.9%] facilities, respectively) and basic infrastructure (2 [8.7%] and 7 [53.8%], respectively). The availability of antibiotics varied between Malawian healthcare centers (9 [39.1%]), Malawian hospitals (8 [61.5%]), hospitals in other low-income countries (10/17 [58.8%]), and hospitals in lower-middle-income countries (39/41 [95.1%]). The percentage of SSC recommendations that could be implemented was 33.3% at hospitals in Malawi, 30.3% at hospitals in other low-income countries, and 68.2% at hospitals in lower-middle-income countries. The implementation of existing SSC recommendations is unrealistic in low-income countries because of resource limitations. New maternal sepsis care bundles must be developed that are applicable to low-resource settings. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
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Ettarh, Remare R; Kyobutungi, Catherine
2012-09-01
The objective of the study was to determine the spatial variation in modern contraceptive use and unmet need for family planning across the counties of Kenya and to examine whether the spatial patterns were associated with inequalities in physical access to health facilities. Data were obtained from the 2008-2009 Kenya Demographic and Health Survey and linked to the location of health facilities in the country. Multivariate logistic regression was used to examine the influence of distance to the nearest health facility and health facility density, in addition to other covariates, on modern contraceptive use and unmet need. Overall, the prevalence of modern contraceptive use and unmet need among women aged 15-49 in Kenya was 42.1% and 19.7% respectively. Among the respondents who lived more than 5 km from the nearest health facility modern contraceptive use was significantly less likely compared to women resident 5 km or less from the nearest health facility. Women from counties with higher health facility density were 53% more likely to use modern contraceptives compared to women in counties with low health facility density. Distance and health facility density in the county were not significantly associated with unmet need. Physical access to health facilities is an important determinant of modern contraceptive use and unmet need in Kenya. Strategies should be developed in underserved counties to mitigate the challenge of distance to health facilities, such as delivering services by outreach and mobile facilities.
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E-Learning and Distance Education in Nigeria
ERIC Educational Resources Information Center
Ajadi, Timothy Olugbenga; Salawu, Ibrahim Olatunde; Adeoye, Femi Adetunji
2008-01-01
This paper discusses the relevance of e-learning in the position of distance education in Nigeria. It commences by discussing the meaning of e-learning and distance education. It also discusses the historical background of distance education in Nigeria as well as the operations of National Open University of Nigeria (NOUN) as the first federal…
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Nigeria: Developing a Strategy for Sub-Saharan Africa
1993-04-20
single Islamic government. This extension of Islam and consolidation of tne caliphate accounts for the dichotomy between northern and southern Nigeria...in Nigeria and its eventual colonization of Nigeria in the early twentieth century. Northern and Southern Nigeria were officially united as the Colony...south; a still larger dry central plateau, with much open woodland and savanna ; and a strip of semidesert on the fringes of the Sahel in the north
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Influence of Lake Malawi on regional climate from a double-nested regional climate model experiment
NASA Astrophysics Data System (ADS)
Diallo, Ismaïla; Giorgi, Filippo; Stordal, Frode
2017-07-01
We evaluate the performance of the regional climate model (RCM) RegCM4 coupled to a one dimensional lake model for Lake Malawi (also known as Lake Nyasa in Tanzania and Lago Niassa in Mozambique) in simulating the main characteristics of rainfall and near surface air temperature patterns over the region. We further investigate the impact of the lake on the simulated regional climate. Two RCM simulations, one with and one without Lake Malawi, are performed for the period 1992-2008 at a grid spacing of 10 km by nesting the model within a corresponding 25 km resolution run ("mother domain") encompassing all Southern Africa. The performance of the model in simulating the mean seasonal patterns of near surface air temperature and precipitation is good compared with previous applications of this model. The temperature biases are generally less than 2.5 °C, while the seasonal cycle of precipitation over the region matches observations well. Moreover, the one-dimensional lake model reproduces fairly well the geographical pattern of observed (from satellite measurements) lake surface temperature as well as its mean month-to-month evolution. The Malawi Lake-effects on the moisture and atmospheric circulation of the surrounding region result in an increase of water vapor mixing ratio due to increased evaporation in the presence of the lake, which combines with enhanced rising motions and low-level moisture convergence to yield a significant precipitation increase over the lake and neighboring areas during the whole austral summer rainy season.
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Ntenda, Peter Austin Morton; Mhone, Thomas Gabriel; Nkoka, Owen
2018-05-25
Overweight/obesity in young children is one of the most serious public health issues globally. We examined whether individual- and community-level maternal nutritional status is associated with an early onset of overweight/obesity in pre-school-aged children in Malawi. Data were obtained from the 2015-16 Malawi Demographic and Health Survey (MDHS). The maternal nutritional status as body mass index and childhood overweight/obesity status was assessed by using the World Health Organization (WHO) recommendations. To examine whether the maternal nutritional status is associated with overweight/obesity in pre-school-aged children, two-level multilevel logistic regression models were constructed on 4023 children of age less than five years dwelling in 850 different communities. The multilevel regression analysis showed that children born to overweight/obese mothers had increased odds of being overweight/obese [adjusted odds ratio (aOR) = 3.11; 95% confidence interval (CI): 1.13-8.54]. At the community level, children born to mothers from the middle (aOR: 1.68; 95% CI: 1.02-2.78) and high (aOR: 1.69; 95% CI: 1.00-2.90) percentage of overweight/obese women had increased odds of being overweight/obese. In addition, there were significant variations in the odds of childhood overweight/obesity in the communities. Strategies aimed at reducing childhood overweight/obesity in Malawi should address not only women and their children but also their communities. Appropriate choices of nutrition, diet and physical activity patterns should be emphasized upon in overweight/obese women of childbearing age throughout pregnancy and beyond.
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A review of measles control in Kenya, with focus on recent innovations.
Manakongtreecheep, Kasidet; Davis, Robert
2017-01-01
Despite the existence of a highly effective measles vaccine and the decrease in worldwide deaths from measles by more than 79% from the 2000 baseline levels, measles today remains one of the leading causes of vaccine-preventable deaths in the world. The African region is a key player in the global fight against measles. Africa has made tremendous progress in its effort to immunize children and to control the disease, increasing its regional measles vaccination coverage from 56% in 2001 to 85% in 2010. The Republic of Kenya has been a strong follower of the World Health Assembly and Measles Elimination 2020 resolutions, which aims to eliminate measles from the country. Since the beginning of the 21st century, Kenya has faced many challenges, but also aid, in the form of new innovations, in their fight against measles. In 2002, Kenya started its first SIA using A-D syringes, and from 2003-2005, GAVI funded injection safety support (INS) to Kenya, as an effort to scale-up safe injection in sub-Saharan Africa. In 2016, the Kenya introduced Measles-Rubella (MR) combined vaccine in its nationwide SIA campaign, after recognizing that rubella is a disease that must be controlled along with measles. In 2009 and 2012 SIAs, Red Cross volunteers conducted H2H visits to promote immunization as well as document information from the community with regards to immunization, including the current coverage, to campaign management levels. Case-based surveillance, using real-time PCR, measles-specific IgM detection and Epi-link were used to confirm and map measles infection during outbreaks. Alternative serosurveys such as Dried Blood Spot and Urine sample surveys were also tested in Kenya. In 2013 and 2016, two studies were also conducted in Kenya on the use of SMS reminder system for routine immunization. These studies, which showed SMS to significantly improve the vaccination coverage, paved way for use of SMS in a larger scale in Kenya.
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A review of measles control in Kenya, with focus on recent innovations
Manakongtreecheep, Kasidet; Davis, Robert
2017-01-01
Despite the existence of a highly effective measles vaccine and the decrease in worldwide deaths from measles by more than 79% from the 2000 baseline levels, measles today remains one of the leading causes of vaccine-preventable deaths in the world. The African region is a key player in the global fight against measles. Africa has made tremendous progress in its effort to immunize children and to control the disease, increasing its regional measles vaccination coverage from 56% in 2001 to 85% in 2010. The Republic of Kenya has been a strong follower of the World Health Assembly and Measles Elimination 2020 resolutions, which aims to eliminate measles from the country. Since the beginning of the 21st century, Kenya has faced many challenges, but also aid, in the form of new innovations, in their fight against measles. In 2002, Kenya started its first SIA using A-D syringes, and from 2003-2005, GAVI funded injection safety support (INS) to Kenya, as an effort to scale-up safe injection in sub-Saharan Africa. In 2016, the Kenya introduced Measles-Rubella (MR) combined vaccine in its nationwide SIA campaign, after recognizing that rubella is a disease that must be controlled along with measles. In 2009 and 2012 SIAs, Red Cross volunteers conducted H2H visits to promote immunization as well as document information from the community with regards to immunization, including the current coverage, to campaign management levels. Case-based surveillance, using real-time PCR, measles-specific IgM detection and Epi-link were used to confirm and map measles infection during outbreaks. Alternative serosurveys such as Dried Blood Spot and Urine sample surveys were also tested in Kenya. In 2013 and 2016, two studies were also conducted in Kenya on the use of SMS reminder system for routine immunization. These studies, which showed SMS to significantly improve the vaccination coverage, paved way for use of SMS in a larger scale in Kenya. PMID:29296150
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Nigeria's Satellite Programme Development: Prospects and Challenges
NASA Astrophysics Data System (ADS)
Akinyede, Joseph
Nigeria's desire to maximize the benefits of space technology for its sustainable development, has become a reality with the establishment of the National Space Research and Development Agency (NASRDA) in May 1999 and the approval of the national Space Policy and Programmes in July 2001. In November, 2000, the Federal Government took a bold step with the signing of an agreement with the Surrey Satellite Technology Limited (SSTL) of United Kingdom (UK) for the design, construction and launch of a medium resolution micro-satellite - NigeriaSat-1 with a Ground Sampling Distance of thirty-two (32) meters. The agreement also covers the Know-How-Technology-Training (KHTT) to Nigerian Engineers and Scientists for a period of 18th months at SSTL‘s facility in the U.K.. NigeriaSat-1 was successfully launched into Leo Earth Orbit on 27th September, 2003. NigeriaSat- 1 is one of the five (5) satellites belonging to Nigeria, Algeria, Turkey, United Kingdom and China being operated in a Disaster Monitoring Constellation (DMC). The launch of NigeriaSat-1 has promoted access to information which has become a strategy for mass socio-economic development, as information underscores all developmental effort be it in education, provision of health services, marketing, construction industry, tourism, defense, etc. As a follow-up to the successful launch of NigeriaSat-1, the government of Nigeria started the implementation of a Nigerian communication satellite (NigcomSat-1) to address the problem of communication which is the greatest drawbacks to the socio-economic development of the country, particularly in the areas of rural telephone, tele-education, tele-medicine, egovernment, e-commerce and real-time monitoring services. NigcomSat-1, which carries 40- hybrid transponders in the C, KU, KA and L bands, has a 15 years life span and coverage of the African continent, Middle East and part of Europe was launched in May 2007. To satisfy geospatial data needs in sectors such as survey
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Why the spending stopped in Nigeria
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rapoport, C.
Nigeria will have an income of about $14 billion this year from the sale of crude, mostly from the US. Nigeria is our second-largest foreign oil supplier. But, lacking the expertise and financial sophistication of other oil producers, Nigeria began squandering its oil earnings soon after petroleum prices quadrupled following the 1973 OPEC boycott. The country plunged into a series of overindulgent development plans that sent imports and government expenditures soaring, mainly on projects of little value. Improvements that were constructed have not been maintained or are not working, i.e., telecommunication systems, elevators in high-rise buildings, etc. The spiraling importsmore » and lavish spending was brought to an abrupt halt in mid-1978, when the country's military government began imposing a series of drastic restrictions on spending. This year, Nigeria's imports are running a full third below last year's level. The austerity measures have helped to plunge the counry into recession, but if things go according to plan, the hard times should enable Nigeria to right itself and to become an economic leader of Africa.« less
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Blaauw, Duane; Ditlopo, Prudence; Maseko, Fresier; Chirwa, Maureen; Mwisongo, Aziza; Bidwell, Posy; Thomas, Steve; Normand, Charles
2013-01-01
Background Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies. Objective The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Methods We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave. Results There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (χ2=140.3, p<0.001). 18.8% of health workers in Tanzania and 26.5% in Malawi indicated that they were actively seeking employment elsewhere, compared to 41.4% in South Africa (χ2=83.5, p<0.001). The country differences were confirmed by multiple regression. The study also confirmed that job satisfaction is statistically related to intention to leave. Conclusions We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less
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Outcomes of an HIV Prevention Peer Group Intervention for Rural Adults in Malawi
ERIC Educational Resources Information Center
Kaponda, Chrissie P. N.; Norr, Kathleen F.; Crittenden, Kathleen S.; Norr, James L.; McCreary, Linda L.; Kachingwe, Sitingawawo I.; Mbeba, Mary M.; Jere, Diana L. N.; Dancy, Barbara L.
2011-01-01
This study used a quasi-experimental design to evaluate a six-session peer group intervention for HIV prevention among rural adults in Malawi. Two rural districts were randomly assigned to intervention and control conditions. Independent random samples of community adults compared the districts at baseline and at 6 and 18 months postintervention.…
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Links between Higher Education and Employers in Malawi: The Need for a Dialogue?
ERIC Educational Resources Information Center
Hall, David; Thomas, Harold
2005-01-01
The development of skills for employment is an important international policy area, but one that has been relatively ignored in sub-Saharan Africa. This paper reports on findings from a research project in Malawi, supported by the Department for International Development (DFID), that explored the links that exist between employers and the higher…
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Mainstreaming conservation agriculture in Malawi: Knowledge gaps and institutional barriers.
Dougill, Andrew J; Whitfield, Stephen; Stringer, Lindsay C; Vincent, Katharine; Wood, Benjamin T; Chinseu, Edna L; Steward, Peter; Mkwambisi, David D
2017-06-15
Conservation agriculture (CA) practices of reduced soil tillage, permanent organic soil coverage and intercropping/crop rotation, are being advocated globally, based on perceived benefits for crop yields, soil carbon storage, weed suppression, reduced soil erosion and improved soil water retention. However, some have questioned their efficacy due to uncertainty around the performance and trade-offs associated with CA practices, and their compatibility with the diverse livelihood strategies and varied agro-ecological conditions across African smallholder systems. This paper assesses the role of key institutions in Malawi in shaping pathways towards more sustainable land management based on CA by outlining their impact on national policy-making and the design and implementation of agricultural development projects. It draws on interviews at national, district and project levels and a multi-stakeholder workshop that mapped the institutional landscape of decision-making for agricultural land management practices. Findings identify knowledge gaps and institutional barriers that influence land management decision-making and constrain CA uptake. We use our findings to set out an integrated roadmap of research needs and policy options aimed at supporting CA as a route to enhanced sustainable land management in Malawi. Findings offer lessons that can inform design, planning and implementation of CA projects, and identify the multi-level institutional support structures required for mainstreaming sustainable land management in sub-Saharan Africa. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Contraceptive Dynamics in Rural Northern Malawi: A Prospective Longitudinal Study
Dasgupta, Aisha Nandini Zoe; Zaba, Basia; Crampin, Amelia C.
2018-01-01
Context Increased use of contraceptives in Malawi has not translated into a commensurate reduction in fertility, but the reason is unknown. Insight into contraceptive switching and discontinuation may shed light on this conundrum and on whether the commonly used modern contraceptive prevalence rate (mCPR) is the best indicator of family planning program performance. Methods A one-year prospective longitudinal data set was created from patient-held family planning cards of 4,678 reproductive-age women living in a demographic surveillance site in rural northern Malawi. Contraceptive service data recorded on the women’s cards by providers were linked to their socioeconomic, demographic and health data. Contraceptive point prevalence estimates calculated from these data were compared with mCPR estimates from cross-sectional surveys. Survival analyses examined contraceptive adherence. Results The contraceptive point prevalence of 35% was slightly lower than comparable cross-sectional estimates of mCPR. Only 51% of users of the injectable—the most widely used modern method—received their first reinjection on time, and just 15% adhered to the method for 12 months. Although various study variables were associated with contraceptive use, none were associated with adherence. Conclusions Gaps in and discontinuation of use of the injectable may play a role in the discrepancy between mCPR and fertility. Interventions to help women adhere to injectable use and to promote long-acting methods should be strengthened. PMID:26600568
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Kaimenyi, Jacob T
2004-12-01
This paper gives general information on the location of Kenya, its demography, economy, organisation of health services, general health policy, health financing, oral health infrastructure, problems that hamper health financing and proposals on how to solve these problems. Further, a summary of health status of the Kenyan people is given based on the results of studies. The mean DMFT for the rural and urban populations is low and there is no evidence of an increase or decrease. Similarly, the prevalence of periodontitis is low (1-10%), with no increase. Ulcerative lesions are rare (0.12%). The most common birth defects are cleft lip and palate. Oral cancer is very low, accounting for 2% of all malignancies. Comparative studies have not demonstrated any dramatic change in the frequency of oral cancer for the last 25 years. Oral candidiasis is the most prevalent oral lesion amongst HIV/AIDS patients. In June 2003, Kenya formulated a National Oral Health Policy, which gives direction on how to improve the oral health status of the citizens.
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Extinctions, genetic erosion and conservation options for the black rhinoceros (Diceros bicornis)
Moodley, Yoshan; Russo, Isa-Rita M.; Dalton, Desiré L.; Kotzé, Antoinette; Muya, Shadrack; Haubensak, Patricia; Bálint, Boglárka; Munimanda, Gopi K.; Deimel, Caroline; Setzer, Andrea; Dicks, Kara; Herzig-Straschil, Barbara; Kalthoff, Daniela C.; Siegismund, Hans R.; Robovský, Jan; O’Donoghue, Paul; Bruford, Michael W.
2017-01-01
The black rhinoceros is again on the verge of extinction due to unsustainable poaching in its native range. Despite a wide historic distribution, the black rhinoceros was traditionally thought of as depauperate in genetic variation, and with very little known about its evolutionary history. This knowledge gap has hampered conservation efforts because hunting has dramatically reduced the species’ once continuous distribution, leaving five surviving gene pools of unknown genetic affinity. Here we examined the range-wide genetic structure of historic and modern populations using the largest and most geographically representative sample of black rhinoceroses ever assembled. Using both mitochondrial and nuclear datasets, we described a staggering loss of 69% of the species’ mitochondrial genetic variation, including the most ancestral lineages that are now absent from modern populations. Genetically unique populations in countries such as Nigeria, Cameroon, Chad, Eritrea, Ethiopia, Somalia, Mozambique, Malawi and Angola no longer exist. We found that the historic range of the West African subspecies (D. b. longipes), declared extinct in 2011, extends into southern Kenya, where a handful of individuals survive in the Masai Mara. We also identify conservation units that will help maintain evolutionary potential. Our results suggest a complete re-evaluation of current conservation management paradigms for the black rhinoceros. PMID:28176810
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Appau, Adriana; Drope, Jeffrey; Labonté, Ronald; Stoklosa, Michal; Lencucha, Raphael
2017-11-14
In principle, trade and investment agreements are meant to boost economic growth. However, the removal of trade barriers and the provision of investment incentives to attract foreign direct investments may facilitate increased trade in and/or more efficient production of commodities considered harmful to health such as tobacco. We analyze existing evidence on trade and investment liberalization and its relationship to tobacco trade in Sub-Saharan African countries. We compare tobacco trading patterns to foreign direct investments made by tobacco companies. We estimate and compare changes in the Konjunkturforschungsstelle (KOF) Economic Globalization measure, relative price measure and cigarette prices. Preferential regional trade agreements appear to have encouraged the consolidation of cigarette production, which has shaped trading patterns of tobacco leaf. Since 2002, British American Tobacco has invested in tobacco manufacturing facilities in Nigeria, Kenya and South Africa strategically located to serve different regions in Africa. Following this, British America Tobacco closed factories in Ghana, Rwanda, Uganda, Mauritius and Angola. At the same time, Malawi and Tanzania exported a large percentage of tobacco leaf to European countries. After 2010, there was an increase in tobacco exports from Malawi and Zambia to China, which may be a result of preferential trade agreements the EU and China have with these countries. Economic liberalization has been accompanied by greater cigarette affordability for the countries included in our analysis. However, only excise taxes and income have an effect on cigarette prices within the region. These results suggest that the changing economic structures of international trade and investment are likely heightening the efficiency and effectiveness of the tobacco industry. As tobacco control advocates consider supply-side tobacco control interventions, they must consider carefully the effects of these economic agreements and
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Kenya's Harambee Institutes of Technology.
ERIC Educational Resources Information Center
Kintzer, Frederick C.
1989-01-01
Reviews the history and current status of the Harambee Institutes of Technology in Kenya. Offers a critique of the parallel vocationalized system. Discusses the vocational-technical/general education controversy, diversification among types of schools, financing, and the 8-4-4 Plan. (DMM)
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Insight, psychopathology and global functioning in schizophrenia in urban Malawi.
Crumlish, Niall; Samalani, Prince; Sefasi, Anthony; Kinsella, Anthony; O'Callaghan, Eadbhard; Chilale, Harris
2007-09-01
Insight, 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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An Assessment of Peri-Urban Groundwater Quality from Shallow Dug Wells, Mzuzu, Malawi
NASA Astrophysics Data System (ADS)
Holm, R.; Felsot, A.
2012-12-01
Throughout Malawi, governmental, non-governmental, religious and civic organizations are targeting the human need for water. Diarrheal diseases, often associated with unsafe drinking water, are a leading cause of mortality in children under five in Malawi with over 6,000 deaths per year (World Health Organization, 2010). From January to March 2012, a field study was undertaken in Malawi to study water quality and develop a public health risk communication strategy. The region studied, Area 1B, represents a comparatively new peri-urban area on the edge of Mzuzu city. Area 1B is serviced by a piped municipal water supply, but many shallow dug wells are also used for household water. Groundwater samples were collected from 30 shallow dug well sites and analyzed for nitrate, total coliform, Escherichia coli, total hardness, total alkalinity and pH. In addition to water quality analyses, a structured household questionnaire was administered to address water use, sanitation, health, consumption patterns, and socioeconomics. Results showed that more than half of the groundwater samples would be considered of unacceptable quality based on World Health Organization (WHO) standards for E. coli contamination. Low levels of nitrate were found in groundwater, but only one well exceeded WHO standards. The structured questionnaire revealed that some residents were still consuming groundwater despite the access to safer municipal water. In general, the widespread E. coli contamination was not statistically correlated with well depth, latrine proximity, or surface features. Similarly, nitrate concentrations were not significantly correlated with proximity to latrines. On the other hand, nitrate was correlated with well depth, which is expected given the high potential for leaching of anionic highly water soluble compounds. E. coli was significantly correlated with nitrate concentration. Projects targeting the need for clean water need to recognize that households with access to a
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Undergraduate physiotherapy education in Malawi--the views of students on disability.
Amosun, S; Kambalametore, S; Maart, S; Ferguson, G
2013-06-01
The College of Medicine in Malawi offers an undergraduate physiotherapy programme which started in 2010. The programme aims at training competent physiotherapists who can address the needs of people with disabilities. Therefore it is important to ensure that the perceptions of physiotherapy students towards disability are appropriate. The study explored the views of the first cohort of physiotherapy students (n=19) in the pre-medical class in the College of Medicine, University of Malawi, on disability. An audit of the views of premedical physiotherapy students was carried out in 2010 using the Q methodology. Two independent factors emerged which captured the views of 19 students on disability. Most of the views expressed suggest that the students empathised with people with disabilities. Participants perceived that people with disabilities can have a good quality of life like everyone else, and are as intelligent as people without disabilities. However, some participants also expressed some discomfort when around people with disabilities. While there was consensus on some positive views, the negative viewpoints have the potential to act as a barrier to the rehabilitation of people with disabilities. The curriculum should ensure that the positive views are reinforced throughout the training programme, while the negative viewpoints are reversed.
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Health Care Factors Influencing Teen Mothers' Use Of Contraceptives in Malawi.
Machira, Kennedy; Palamuleni, Martin E
2017-06-01
The study seeks to examine factors associated with teen mothers' use of modern contraceptives after giving birth. The 2010 Malawi Demographic and Health Survey data was used to test the study objective. A sample of 12, 911 teen mothers aged between 10 and 18 years were extracted from 23, 020 women and were asked of contraceptive usage after first birth experiences, in which, a logistic regression model was employed to estimate correlates of contraceptive usage. The study found that 54.8% of the teen mothers are still at a risk of having a repeat teenage pregnancy due to their non-use of contraceptives. This implies that less than 50% of teen mothers use contraceptives after experiencing teen birth. It is noted that health care factors such as use of antenatal care, awareness of pregnancy complications, attainment of primary education and exposure to media predict teen mothers' use of modern contraceptives. Despite endeavours made by government to improve access to family planning, health care challenges still exist affecting women's use of contraceptives in Malawi. Ameliorating these health encounters call for wide-range approaches aimed at addressing teen birth comprehensively in order to prevent early motherhood and subsequently high fertility. None declared.
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Implementing Free Primary Education Policy in Malawi and Ghana: Equity and Efficiency Analysis
ERIC Educational Resources Information Center
Inoue, Kazuma; Oketch, Moses
2008-01-01
Malawi and Ghana are among the numerous Sub-Saharan Africa countries that have in recent years introduced Free Primary Education (FPE) policy as a means to realizing the 2015 Education for All and Millennium Development Goals international targets. The introduction of FPE policy is, however, a huge challenge for any national government that has…
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Perceptions of Special Educational Practices in Malawi: Voices from Primary Schools and Communities
ERIC Educational Resources Information Center
Lubeski, Nancy J.
2011-01-01
This doctoral research work explores the quality of educational experiences and access to opportunities for girls with disabilities in selected rural primary schools in Malawi. The context for this study lies within four of the six goals contained within the World Declaration on Education for All doctrine, a document which lays out a framework for…
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Two-stage rifting in the Kenya rift: implications for half-graben models
NASA Astrophysics Data System (ADS)
Mugisha, F.; Ebinger, C. J.; Strecker, M.; Pope, D.
1997-09-01
The Kerio sub-basin in the northern Kenya rift is a transitional area between the southern Kenya rift, where crustal thickness is 30 km, and the northern Kenya rift, where crustal thickness is 20 km. The lack of data on the shallow crustal structure, geometry of rift-bounding faults, and rift evolution makes it difficult to determine if the crustal thickness variations are due to pre-rift structure, or along-axis variations in crustal stretching. We reprocessed reflection seismic data acquired for the National Oil Corporation of Kenya, and integrated results with field and gravity observations to (1) delineate the sub-surface geometry of the Kerio sub-basin, (2) correlate seismic stratigraphic sequences with dated strata exposed along the basin margins, and (3) use new and existing results to propose a two-stage rifting model for the central Kenya rift. Although a classic half-graben form previously had been inferred from the attitude of uppermost strata, new seismic data show a more complex form in the deeper basin: a narrow full-graben bounded by steep faults. We suggest that the complex basin form and the northwards increase in crustal thinning are caused by the superposition of two or more rifting events. The first rifting stage may have occurred during Palaeogene time contemporaneous with sedimentation and rifting in northwestern Kenya and southern Sudan. The distribution of seismic sequences suggests that a phase of regional thermal subsidence occurred prior to renewed faulting and subsidence at about 12 Ma after the eruption of flood phonolites throughout the central Kenya rift. A new border fault developed during the second rifting stage, effectively widening the basin. Gravity and seismic data indicate sedimentary and volcanic strata filling the basin are 6 km thick, with up to 4 km deposited during the first rifting stage.
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Community Environment and Education of Girls: The Case of Communities in Marsabit County, Kenya
ERIC Educational Resources Information Center
Muyaka, Jafred
2018-01-01
The study sought to investigate the role of the community in inhibiting girls' access and participation in formal education in Marsabit County-Kenya. As one of the marginalized counties in Kenya, the county had among the highest rate of illiteracy in Kenya with 68 per cent of residents with no formal education. The study involved a total of 128…
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Msyamboza, Kelias Phiri; M'bang'ombe, Maurice; Hausi, Hannah; Chijuwa, Alexander; Nkukumila, Veronica; Kubwalo, Hudson Wenji; Desai, Sachin; Pezzoli, Lorenzo; Legros, Dominique
2016-01-01
Despite some improvement in provision of safe drinking water, proper sanitation and hygiene promotion, cholera still remains a major public health problem in Malawi with outbreaks occurring almost every year since 1998. In response to 2014/2015 cholera outbreak, ministry of health and partners made a decision to assess the feasibility and acceptability of conducting a mass oral cholera vaccine (OCV) as an additional public health measure. This paper highlights the burden of the 2014/15 cholera outbreak, successes and challenges of OCV campaign conducted in March and April 2015. This was a documentation of the first OCV campaign conducted in Malawi. The campaign targeted over 160,000 people aged one year or more living in 19 camps of people internally displaced by floods and their surrounding communities in Nsanje district. It was a reactive campaign as additional measure to improved water, sanitation and hygiene in response to the laboratory confirmed cholera outbreak. During the first round of the OCV campaign conducted from 30 March to 4 April 2015, a total of 156,592 (97.6%) people out of 160,482 target population received OCV. During the second round (20 to 25 April 2015), a total of 137,629 (85.8%) people received OCV. Of these, 108,247 (67.6%) people received their second dose while 29,382 (18.3%) were their first dose. Of the 134,836 people with known gender and sex who received 1 or 2 doses, 54.4% were females and over half (55.4%) were children under the age of 15 years. Among 108,237 people who received 2 doses (fully immunized), 54.4% were females and 51.9% were children under 15 years of age. No severe adverse event following immunization was reported. The main reason for non-vaccination or failure to take the 2 doses was absence during the period of the campaign. This documentation has demonstrated that it was feasible, acceptable by the community to conduct a large-scale mass OCV campaign in Malawi within five weeks. Of 320,000 OCV doses received
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Yoder, P Stanley; Nsabagasani, Xavier; Eckert, Erin; Moran, Allisyn; Yé, Yazoumé
2015-08-29
Nearly 20 years after the adoption by the government of Malawi of the provision of intermittent preventive treatment in pregnancy (IPTp) for malaria, only 55% of pregnant women received at least two doses of sulfadoxine-pyrimethamine (SP) in 2010. Although several reasons for the low coverage have been suggested, few studies have examined the views of health care providers. This study examined the experiences of the nurses and midwives in providing antenatal care (ANC) services. This study was conducted in health facilities in Malawi that provide routine ANC services. Providers of ANC in Malawi were selected from in eight health care facilities of Malawi. Selected providers were interviewed using a semi-structured interview guide designed to address a series of themes related to their working conditions and their delivery of IPTp. Nurses displayed detailed knowledge of ANC services and the rationale behind them. Nurses understood that they should provide two doses of IPTp during a pregnancy, but they did not agree on the timing of the doses. Nurses gave SP as directly observed therapy (DOT) at the clinic. Nurses did not give SP pills to women to take home with them because they did not trust that women would take the pills. Women who resisted taking SP explained they do not take drugs if they had not eaten, or they feared side effects, or they were not sick. Reasons for not giving the first or second dose of SP included a delay in the first ANC visit, testing positive for HIV, and presenting with malaria. None of the nurses were able to show any specific written guidelines on when to give SP. The challenges faced by the nurses include being overworked and persuading women to take SP under observation. The findings show that the nurses had gained the knowledge and technical skills to provide appropriate ANC services. With regard to IPTp, nurses need guidelines that would be available at the health facility about how and when to give SP. The adoption of the WHO
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The Contribution of the Secondary School Curriculum to Peace in Kenya
ERIC Educational Resources Information Center
Chiriswa, Andika Patrick; Thinguri, Ruth
2015-01-01
The Kenya Government recognizes the role of peace in socio economic development as emphasized in the national anthem while the national goals of education endeavour to promote national unity, sustainable development, peace, respect for diversity, and international consciousness among others. The Kenya vision 2030 underscores the need for peace and…
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Effectiveness of Communication on Students Discipline in Secondary Schools in Kenya
ERIC Educational Resources Information Center
Kindiki, Jonah Nyaga
2009-01-01
The influence of communication on student discipline in secondary schools is an issue of continued debate in Kenya. This study was necessitated by the growing concern by education stakeholders in Kenya over the rising reports of student indiscipline in secondary schools. The study utilized qualitative approach with questionnaires, interviews and…
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Orthobunyavirus antibodies among humans in selected parts of the Rift Valley and northeastern Kenya.
Odhiambo, Collins; Venter, Marietjie; Swanepoel, Robert; Sang, Rosemary
2015-05-01
Ngari, Bunyamwera, Ilesha, and Germiston viruses are among the mosquito-borne human pathogens in the Orthobunyavirus genus, family Bunyaviridae, associated with febrile illness. Although the four orthobunyaviruses have been isolated from mosquito and/or tick vectors sampled from different geographic regions in Kenya, little is known of human exposure in such areas. We conducted a serologic investigation to determine whether orthobunyaviruses commonly infect humans in Kenya. Orthobunyavirus-specific antibodies were detected by plaque reduction neutralization tests in 89 (25.8%) of 345 persons tested. Multivariable analysis revealed age and residence in northeastern Kenya as risk factors. Implementation of acute febrile illness surveillance in northeastern Kenya will help to detect such infections.
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ERIC Educational Resources Information Center
Akaranga, Stephen; Simiyu, Patrick Cheben
2016-01-01
In Kenya, Christian Religious Education is taught and examined by the Kenya National Examinations Council in the Kenya Certificate of Secondary Education at the end of the four years of Secondary Education cycle. The teaching of this subject in Secondary Schools ensures that learners are offered an opportunity to develop morally and spiritually…
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Malawi three district evaluation: Community-based maternal and newborn care economic analysis.
Greco, Giulia; Daviaud, Emmanuelle; Owen, Helen; Ligowe, Reuben; Chimbalanga, Emmanuel; Guenther, Tanya; Gamache, Nathalie; Zimba, Evelyn; Lawn, Joy E
2017-10-01
Malawi is one of few low-income countries in sub-Saharan Africa to have met the fourth Millennium Development Goal for child survival (MDG 4). To accelerate progress towards MDGs, the Malawi Ministry of Health's Reproductive Health Unit - in partnership with Save the Children, UNICEF and others - implemented a Community Based Maternal and Newborn Care (CBMNC) package, integrated within the existing community-based system. Multi-purpose Health Surveillance Assistants (HSAs) already employed by the local government were trained to conduct five core home visits. The additional financial costs, including donated items, incurred by the CBMNC package were analysed from the perspective of the provider. The coverage level of HSA home visits (35%) was lower than expected: mothers received an average of 2.8 visits rather than the programme target of five, or the more reasonable target of four given the number of women who would go away from the programme area to deliver. Two were home pregnancy and less than one, postnatal, reflecting greater challenges for the tight time window to achieve postnatal home visits. As a proportion of a 40 hour working week, CBMNC related activities represented an average of 13% of the HSA work week. Modelling for 95% coverage in a population of 100,000, the same number of HSAs could achieve this high coverage and financial programme cost could remain the same. The cost per mother visited would be US$6.6, or US$1.6 per home visit. The financial cost of universal coverage in Malawi would stand at 1.3% of public health expenditure if the programme is rolled out across the country. Higher coverage would increase efficiency of financial investment as well as achieve greater effectiveness. The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Human aflatoxin exposure in Kenya, 2007: a cross-sectional study
Yard, Ellen E.; Daniel, Johnni H.; Lewis, Lauren S.; Rybak, Michael E.; Paliakov, Ekaterina M.; Kim, Andrea A.; Montgomery, Joel M.; Bunnell, Rebecca; Abudo, Mamo Umuro; Akhwale, Willis; Breiman, Robert F.; Sharif, Shahnaaz K.
2013-01-01
Aflatoxins contaminate approximately 25% of agricultural products worldwide. They can cause liver failure and liver cancer. Kenya has experienced multiple aflatoxicosis outbreaks in recent years, often resulting in fatalities. However, the full extent of aflatoxin exposure in Kenya has been unknown. Our objective was to quantify aflatoxin exposure across Kenya. We analysed aflatoxin levels in serum specimens from the 2007 Kenya AIDS Indicator Survey – a nationally representative, cross-sectional serosurvey. KAIS collected 15,853 blood specimens. Of the 3180 human immunodeficiency virus-negative specimens with ≥1 mL sera, we randomly selected 600 specimens stratified by province and sex. We analysed serum specimens for aflatoxin albumin adducts by using isotope dilution MS/MS to quantify aflatoxin B1-lysine, and normalised with serum albumin. Aflatoxin concentrations were then compared by demographic, socioeconomic and geographic characteristics. We detected serum aflatoxin B1-lysine in 78% of serum specimens (range =
Kenya, and it could be substantially impacting human health. Wide-scale, evidence-based interventions are urgently needed to decrease exposure and subsequent health effects. PMID:23767939 -
Rethinking Staff Development in Kenya: Agenda for the Twenty-first Century.
ERIC Educational Resources Information Center
Wanzare, Zachariah; Ward, Kenneth L.
2000-01-01
Provides an overview of current staff development practices and procedures in Kenya and suggests that teachers and head teachers need staff development opportunities to grow professionally, although current inservice training programs in Kenya are skewed to meet the needs of only a few teachers. Discusses the role of the head teacher in…
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ERIC Educational Resources Information Center
Smith, William C.; Ikoma, Sakiko; Baker, David P.
2016-01-01
Education and health are both capital investments in national development, often viewed as independent factors on a country's labor force supply and productivity. This study uses the 2010-2011 Third Integrated Household Survey in Malawi to propose an Education-enhanced Health Human Capital (EHHC) model where education influences labor force supply…
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NASA Astrophysics Data System (ADS)
Dulanya, Zuze; Morales-Simfors, Nury; Sivertun, Åke
2010-06-01
Malawi is one of the poorest countries in the world and one of the most densely populated in south-eastern Africa. Its major power source is hydro-electricity. During the past few years, the power generation capacity has been reduced, which has impacted negatively on the socio-economic development of the country. The country holds an enormous potential to generate geothermal energy due to the country's position within the Great African Rift valley. This could contribute to economic growth, poverty reduction and technological development in Malawi. The paper presents findings of research on comparisons between silica (quartz and chalcedony) and cation geothermometers (Na-K, Na-K-Ca and K-Mg) of hot springs in the Malawi Rift, in order to deduce the temperature at depth of selected hot springs. The saturation indices of most springs have a bearing on the geology of the areas where these hot springs are found. The Na-K geothermometers are, in general, higher than the Na-K-Ca geothermometer and the K-Mg geothermometer shows temperatures that are too low to be considered. The difference in the results between the different geothermometers may indicate shallow conditions of mixing with groundwater. Results also indicate that some hot springs have sufficient heat-generating capabilities and warrant further exploration work to assess their suitability for energy generation.
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Igwe, S A
1992-05-01
Improved family and community support would prevent many youth in Nigeria from risk behavior including drinking alcohol, smoking, and using illicit drugs. In Rivers State, 70% of secondary students have had at least 1 alcoholic drink. Further, in Bendel State, 13% of 15-19 year olds in the coastal region drink alcohol compared with 75% of those in the hinterland. Since alcohol affects good judgment skills, this behavior is especially risky during rituals and social activities and causes accidents. Youth who drink are likely to have unplanned and unprotected sexual intercourse. Drinking during pregnancy is associated with miscarriages, low birth weight, and birth defects. Despite the problems with youth and drinking, Nigeria does not have law restricting sales of alcohol to youth. In Nigeria smoking was once predominantly a male habit but is now increasing quickly among women. Most smokers 1st begin their habit when 18 years old. Even thought he Nigerian government has restricted smoking in public places, it has not yet been effective. Smoking has numerous negative effects such as lung cancer, other cancers, shorter life spans, low birth weight, prematurity, higher perinatal mortality, and more labor complications. Moreover the tobacco and alcohol companies advertise widely using ingenious and persuasive promotions. Youth are especially vulnerable to these slick promotions. Cannabis remains the most common illegal drug. Heroin use is growing among urban adolescents in Nigeria, however. Nigeria also serves as a transhipment point for drugs to the US as well as a consumption point. Drug use results in rising numbers of patients in mental hospitals and treatment centers. A particular concern of drug use is transmission of HIV and hepatitis B via needles. Smokers and alcohol drinkers are likely to also be drug users. Families, government, and community organizations need to collaborate to prevent these risk behaviors among youth.
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Obstetric Facility Quality and Newborn Mortality in Malawi: A Cross-Sectional Study
Fink, Günther; Nsona, Humphreys
2016-01-01
Background Ending preventable newborn deaths is a global health priority, but efforts to improve coverage of maternal and newborn care have not yielded expected gains in infant survival in many settings. One possible explanation is poor quality of clinical care. We assess facility quality and estimate the association of facility quality with neonatal mortality in Malawi. Methods and Findings Data on facility infrastructure as well as processes of routine and basic emergency obstetric care for all facilities in the country were obtained from 2013 Malawi Service Provision Assessment. Birth location and mortality for children born in the preceding two years were obtained from the 2013–2014 Millennium Development Goals Endline Survey. Facilities were classified as higher quality if they ranked in the top 25% of delivery facilities based on an index of 25 predefined quality indicators. To address risk selection (sicker mothers choosing or being referred to higher-quality facilities), we employed instrumental variable (IV) analysis to estimate the association of facility quality of care with neonatal mortality. We used the difference between distance to the nearest facility and distance to a higher-quality delivery facility as the instrument. Four hundred sixty-seven of the 540 delivery facilities in Malawi, including 134 rated as higher quality, were linked to births in the population survey. The difference between higher- and lower-quality facilities was most pronounced in indicators of basic emergency obstetric care procedures. Higher-quality facilities were located a median distance of 3.3 km further from women than the nearest delivery facility and were more likely to be in urban areas. Among the 6,686 neonates analyzed, the overall neonatal mortality rate was 17 per 1,000 live births. Delivery in a higher-quality facility (top 25%) was associated with a 2.3 percentage point lower newborn mortality (95% confidence interval [CI] -0.046, 0.000, p-value 0.047). These
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Maternal Education and Immunization Status Among Children in Kenya.
Onsomu, Elijah O; Abuya, Benta A; Okech, Irene N; Moore, DaKysha; Collins-McNeil, Janice
2015-08-01
Child morbidity and mortality due to infectious diseases continues to be a major threat and public health concern worldwide. Although global vaccination coverage reached 90 % for diphtheria, tetanus and pertussis (DTP3) across 129 countries, Kenya and other sub-Saharan countries continue to experience under-vaccination. The purpose of this study was to examine the association between maternal education and child immunization (12-23 months) in Kenya. This study used retrospective cross-sectional data from the 2008-2009 Kenya Demographic and Health Survey for women aged 15-49, who had children aged 12-23 months, and who answered questions about vaccination in the survey (n = 1,707). The majority of the children had received vaccinations, with 77 % for poliomyelitis, 74 % for measles, 94 % for tuberculosis, and 91 % for diphtheria, whooping cough (pertussis), and tetanus. After adjusting for other covariates, women with primary, secondary, and college/university education were between 2.21 (p < 0.01) and 9.10 (p < 0.001) times more likely to immunize their children than those who had less than a primary education. Maternal education is clearly crucial in ensuring good health outcomes among children, and integrating immunization knowledge with maternal and child health services is imperative. More research is needed to identify factors influencing immunization decisions among less-educated women in Kenya.
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Food biotechnology and nutrition in Africa: a case for Kenya.
Ngichabe, Christopher K
2002-12-01
Household food consumption surveys indicate that the diet in Kenya is ill balanced and that many families cannot afford nutrient-rich foods such as meat and fruits. In this regard, rural populations-the majority of the Kenyan population-are much worse off than urban populations. Agriculture, the most important sector in the Kenyan economy, contributes 27% of the gross domestic product and generates 65% of the country's export earnings. Food-enhancing biotechnologies thus could increase national food yields and fill nutrition gaps by contributing to household and national food security and poverty reduction in Kenya. To overcome barriers to adopting biotechnology to improve food crops in Kenya and elsewhere in Africa, policy makers must create a receptive environment for, increase public understanding of, and stimulate investment in the new technology.
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Nigeria: Hydrocarbon Curse Fueling Instability in Niger Delta
2010-03-15
Christians and Muslims. 12 The largest ethnic groups are the Hausa-Fulani in theNorth, the Ibo in the Southeast, and the Yoruba in the Southwest. 13 Nigeria...0). AllAfrica.com. "Nigeria: The Fading Culture of Party System in Nigeria." http://allafrica.com/stories/200803190577.htm I (accessed February 9
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China's Cooperation in Education and Training with Kenya: A Different Model?
ERIC Educational Resources Information Center
King, Kenneth
2010-01-01
This is the first detailed study of the character and particularity of China's rapidly growing education and training cooperation with Kenya. Set against the 50-year history of Kenya's engagement with China, it pays special attention to the human resources targets of the Forum for China-Africa Cooperation (FOCAC) from 2000. It argues that the…
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Assessment of palliative care services in western Kenya.
Zubairi, Hijab; Tulshian, Priyanka; Villegas, Sarah; Nelson, Brett D; Ouma, Kennedy; Burke, Thomas F
2017-04-01
The need for palliative care services is rapidly increasing due to the rising number of patients with non-communicable diseases. The objective of this study was to assess the current availability and barriers to palliative care and healthcare worker knowledge and perceptions on palliative pain control in western Kenya. An evidence-based 40-question assessment tool was conducted between October 2015 and February 2016 in Siaya County, western Kenya. All level 4 and 5 facilities (e.g., regional and district hospitals) were assessed, as well as a selection of lower-level facilities chosen via convenience sampling, stratified by facility level (e.g., dispensaries, health centers, and health clinics). A key informant at each of 22 facilities was surveyed and included 1 medical officer (5%), 12 clinical officers (55%), and 9 nurses (41%). Key themes included training and education, awareness of palliative care and hospice, services provided, and pain control. All 22 providers had heard of palliative care and 4 (18%) had received formal training. Fourteen (64%) providers knew that morphine was on the World Health Organization (WHO) essential medication list, 8 (36%) had previously prescribed opioids, and 5 (23%) had prescribed them for palliation. Provider concerns for opioid use included its addictive properties (59%), appropriate dosing (9%), cost (5%), side effects (9%), and availability (5%). Palliative care and hospice services were identified by providers as important components in the management of chronic illnesses in western Kenya. Further provider education as well as increased access to pain medications including opioids is necessary to improve the care of patients in western Kenya.
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The seroprevalence and seroincidence of dengue virus infection in western Kenya.
Blaylock, Jason M; Maranich, Ashley; Bauer, Kristen; Nyakoe, Nancy; Waitumbi, John; Martinez, Luis J; Lynch, Julia
2011-09-01
Epidemics of dengue fever have been documented throughout the African continent over the past several decades, however little is known about the prevalence or incidence of dengue virus infection in the absence of an outbreak. No studies have analyzed the prevalence of dengue infection in western Kenya to date. This study describes the seroincidence and seroprevalence of dengue infection in western Kenya. Banked sera obtained from 354 healthy, afebrile children ages 12-47 months from Kisumu District, Kenya, were analyzed for antibodies to dengue virus using an IgG indirect ELISA. We found a seroprevalence of 1.1% (4 of 354 samples) and incidence of 8.5 seroconversions per 1000 persons per year in this study population. This appears to be similar to that previously reported in coastal regions of the country outside of known epidemic periods. Since there has never been a reported dengue epidemic in western Kenya, continued investigation and evaluation in a patient population presenting with fever is necessary to further confirm this finding. Published by Elsevier Ltd.
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The Situation Analysis Study of the family planning program in Kenya.
Miller, R A; Ndhlovu, L; Gachara, M M; Fisher, A A
1991-01-01
A new, relatively "quick and clean" operations research approach called a "situation analysis" was developed for examining the strengths and weaknesses of the family planning program of Kenya. Field research teams visited a stratified random sample of 99 of the Ministry of Health's approximately 775 service delivery points. Observation techniques and interviewing were used to collect information on program components and on the quality of care provided to new family planning clients during the observation day. As late as 1986, the Kenya program was rated "weak" and "poor" in the international literature. The Kenya Situation Analysis Study found a functioning, integrated maternal and child health/family planning program serving large numbers of clients, with an emphasis on oral contraceptives and Depo-Provera (and an underemphasis on permanent methods). Although a number of program problems were revealed by the study, overall, in terms of performance, a rating of "moderate" is suggested as more appropriate for Kenya's national family planning program today. In terms of the quality of care, a "moderate to moderate-high" rating is suggested.
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Sims Sanyahumbi, Amy; Sable, Craig A; Beaton, Andrea; Chimalizeni, Yamikani; Guffey, Danielle; Hosseinipour, Mina; Karlsten, Melissa; Kazembe, Peter N; Kennedy, Neil; Minard, Charles G; Penny, Daniel J
2016-12-01
Rheumatic heart disease (RHD) is the largest cardiac cause of morbidity and mortality in the world's youth. Early detection of RHD through echocardiographic screening in asymptomatic children may identify an early stage of disease, when secondary prophylaxis has the greatest chance of stopping disease progression. Latent RHD signifies echocardiographic evidence of RHD with no known history of acute rheumatic fever and no clinical symptoms. Determine the prevalence of latent RHD among children ages 5-16 in Lilongwe, Malawi. This is a cross-sectional study in which children ages 5 through 16 were screened for RHD using echocardiography. Screening was conducted in 3 schools and surrounding communities in the Lilongwe district of Malawi between February and April 2014. Children were diagnosed as having no, borderline, or definite RHD as defined by World Heart Federation criteria. The primary reader completed offline reads of all studies. A second reader reviewed all of the studies diagnosed as RHD, plus a selection of normal studies. A third reader served as tiebreaker for discordant diagnoses. The distribution of results was compared between gender, location, and age categories using Fisher's exact test. The prevalence of latent RHD was 3.4% (95% CI = 2.45, 4.31), with 0.7% definite RHD and 2.7% borderline RHD. There was no significant differences in prevalence between gender (P = .44), site (P = .6), urban vs. peri-urban (P = .75), or age (P = .79). Of those with definite RHD, all were diagnosed because of pathologic mitral regurgitation (MR) and 2 morphologic features of the mitral valve. Of those with borderline RHD, most met the criteria by having pathological MR (92.3%). Malawi has a high rate of latent RHD, which is consistent with other results from sub-Saharan Africa. This study strongly supports the need for a RHD prevention and control program in Malawi. © 2016 Wiley Periodicals, Inc.
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PREVENTING FUTURE SHOCK: A Case for Addressing Future Threats to America’s National Security
2001-04-01
both home and abroad and negotiating a convention to protect endangered sea turtles, whales and other limits to trade that threaten endangered species ...Botswana, and Zimbabwe have been decimated. In a region that would have calculated life expectancies to reach 70 years of age by 2010, many will...conditions is lower that 2.7% of the 1995 Gross Domestic Product for Kenya, Tanzania, Uganda, Zimbabwe , Botswana, Zambia and Malawi.71 African
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Cancer Treatment in Malawi: A Disease of Palliation.
Kendig, Claire E; Samuel, Jonathan C; Tyson, Anna F; Khoury, Amal L; Boschini, Laura P; Mabedi, Charles; Cairns, Bruce A; Varela, Carlos; Shores, Carol G; Charles, Anthony G
2013-06-01
Worldwide, new cancer cases will nearly double in the next 20 years while disproportionately affecting low and middle income countries (LMICs). Cancer outcomes in LMICs also remain bleaker than other regions of the world. Despite this, little is known about cancer epidemiology and surgical treatment in LMICs. To address this we sought to describe the characteristics of cancer patients presenting to the Surgery Department at Kamuzu Central Hospital in Lilongwe, Malawi. We conducted a retrospective review of adult (18 years or older) surgical oncology services at Kamuzu Central Hospital in Lilongwe, Malawi from 2007 - 2010. Data obtained from the operating theatre logs included patient demographics, indication for operative procedure, procedure performed, and operative procedures (curative, palliative, or staging). Of all the general surgery procedures performed during this time period (7,076 in total), 16% (406 cases) involved cancer therapy. The mean age of male and female patients in this study population was 52 years and 47 years, respectively. Breast cancer, colorectal cancer, gastric cancer, and melanoma were the most common cancers among women, whereas prostate, colorectal, pancreatic, and, gastric were the most common cancers in men. Although more than 50% of breast cancer operations were performed with curative intent, most procedures were palliative including prostate cancer (98%), colorectal cancer (69%), gastric cancer (71%), and pancreatic cancer (94%). Patients with colorectal, gastric, esophageal, pancreatic, and breast cancer presented at surprisingly young ages. The paucity of procedures with curative intent and young age at presentation reveals that many Malawians miss opportunities for cure and many potential years of life are lost. Though KCH now has pathology services, a cancer registry and a surgical training program, the focus of surgical care remains palliative. Further research should address other methods of increasing early cancer detection
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HIV prevention awareness and practices among married couples in Malawi.
Chirwa, Ellen; Malata, Address; Norr, Kathleen
2011-06-01
In this study we explored the level of awareness and practice on HIV prevention among married couples from selected communities in Malawi. We carried out the study from October to December, 2008 in four communities, two each from Chiradzulu and Chikhwawa districts of Malawi. We conducted face-to-face in-depth interviews with 30 couples in each district using a semi-structured interview guide. The interviews lasted approximately 60-90 minutes. The husbands and wives were interviewed separately. The interviews were audio taped using a digital recorder. We wrote field notes during data collection and later reviewed them to provide insights into the data collection process. We computed descriptive statistics from the demographic data using SPSS version 16.0. We analyzed qualitative data using Atlas ti 5.0 computer software. The coded data generated themes and we present the themes in qualitative narration. The couples' ages ranged from 20 to 53 years, the majority (52%) being in the 20-31 year age group. Most of the couples (67%) attained only primary school education and 84% had been married only to the current partner. Most couples (83%) depended upon substance farming and 47% had been married for 3 to 9 years. The number of children per couple ranged from 1 to 10, most couples (83%) having between 1 and 5 children. All couples were aware of HIV prevention methods and talked about them in their marriages. Both wives and husbands initiated the discussions. Mutual fidelity and HIV testing were appropriate for couples to follow the HIV prevention methods. For most couples (54) there was mutual trust between husbands and wives, and members of only a few couples (6) doubted their partners' ability to maintain mutual fidelity. Actual situations of marital infidelity were however detected among 25 couples and often involved the husbands. A few couples (5) had been tested for HIV. All couples did not favor the use of condoms with a marriage partner as an HIV prevention
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Ninetis russellsmithi n. sp., an unusual new pholcid spider species from Malawi (Araneae: Pholcidae)
Huber, Bernhard A.
2002-01-01
A new species Ninetis russellsmithi n. sp. is described from Malawi. It lacks the most prominent autapomorphy of pholcid spiders, the retrolateral projection of the cymbium (procursus). Biogeographically this species marks the first record for the genus in a 3000 km gap between its African congeners in Namibia and Tanzania. PMID:15455038
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Conformity and Change: Community Effects on Female Genital Cutting in Kenya
ERIC Educational Resources Information Center
Hayford, Sarah R.
2005-01-01
In this article, I analyze women's decisions to have their daughters circumcised based on data from 7,873 women in Kenya collected in the 1998 Kenya Demographic and Health Survey. I use multilevel models to assess the degree to which women's decisions are correlated with the decisions of other women in their community, in addition to studying the…
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Mwambene, J B; Muula, A S; Leo, J C
2013-06-01
Education is important in improving economies and creating literate, self-reliant and healthy societies. However, hunger is a barrier to basic education in Malawi. Hunger is also associated with a number of health risk behaviours, such as bullying, suicide ideation and unhygienic behaviours that may jeopardize the future of children. There are, however, limited data on the prevalence and associated factors of hunger among school children in Malawi. The study used data from the Malawi Global School-Based Health Survey conducted in 2009 to estimate the prevalence of self-reported hunger within the last 30 days among primary and secondary school age group. It also assessed the association between self-reported hunger and some selected list of independent variables using frequency distribution, chi-squared test and logistic regression. A total of 2359 students were available for analysis. The overall self-reported prevalence of hunger within the last 30 days was 12.5% (18.9% (172) in the rural and 8.3% (115) in urban areas; and 11.9%(123) for male and 12.5(148) for female children). In the final analysis, geographical location, eating fruits, having been bullied, suicide ideation, and washing hands with soap were significantly associated with hunger. Hunger in both primary and secondary school children in Malawi is a major social problem. The design of school feeding programmes aimed to reduce hunger should incorporate the factors identified as associated with hunger.
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Attitudes and Perceptions Towards Access and Use of the Formal Healthcare Sector in Northern Malawi.
Fisher, Emily; Lazarus, Rebecca; Asgary, Ramin
2017-01-01
We evaluated community attitudes, perceptions, and experiences regarding access and use of health care systems in Northern Malawi. Through a qualitative descriptive approach, 12 focus group discussions were conducted in 2014 with community members (n=71) in Mzimba North, Malawi. Data were transcribed and analyzed for major themes. Both formal health care systems and traditional medicine were widely used as complementary. Health care-seeking behavior was governed by previous treatment history and by whether a disease was believed to be biological or spiritual in nature, the latter being best treated with traditional medicine. Barriers to using formal health care included cost, hospital resources/environment, socio-cultural beliefs, and transportation. Transportation was a significant barrier, often linked to increased mortality. Support of local strategies to address transportation, structural approaches to improve hospital capabilities and environment, and community education reconciling traditional beliefs and modern medicine may mitigate access issues and improve use of the health care system.
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Changing household responses to drought in Tharaka, Kenya: vulnerability, persistence and challenge.
Smucker, Thomas A; Wisner, Ben
2008-06-01
Drought is a recurring challenge to the livelihoods of those living in Tharaka District, Kenya, situated in the semi-arid zone to the east of Mount Kenya, from the lowest slopes of the mountain to the banks of the Tana River. This part of Kenya has been marginal to the economic and political life of Kenya from the colonial period until the present day. A study of more than 30 years of change in how people in Tharaka cope with drought reveals resilience in the face of major macro-level transformations, which include privatisation of landownership, population growth, political decentralisation, increased conflict over natural resources, different market conditions, and environmental shifts. However, the study also shows troubling signs of increased use of drought responses that are incompatible with long-term agrarian livelihoods. Government policy needs to address the challenge of drought under these new macro conditions if sustainable human development is to be achieved.
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NASA Astrophysics Data System (ADS)
Accardo, N. J.; Shillington, D. J.; Gaherty, J. B.; Scholz, C. A.; Ebinger, C.; Nyblade, A.; McCartney, T.; Chindandali, P. R. N.; Kamihanda, G.; Ferdinand-Wambura, R.
2017-12-01
A long-standing debate surrounds controls on the development and ultimately abandonment of basin bounding border faults. The Malawi Rift in the the Western Branch of the East African Rift System presents an ideal location to investigate normal fault development. The rift is composed of a series of half graben basins bound by large border faults, which cross several terranes and pre-existing features. To delineate rift basin structure, we undertook 3D first arrival tomography across the North and Central basins of the Malawi Rift based on seismic refraction data acquired in Lake Malawi. The resulting 3D velocity model allows for the first-ever mapping of 3D basin structure in the Western Branch of the EAR. We estimate fault displacement profiles along the two border faults and find that each accommodated 7.2 km of throw. Previous modeling studies suggest that given the significant lengths (>140 km) and throws of these faults, they may be nearing their maximum dimensions or may have already been abandoned. While both faults accommodate similar throws, their lengths differ by 40 km, likely due to the influence of both preexisting basement fabric and large-scale preexisting structures crossing the rift. Over 4 km of sediment exists where the border faults overlap in the accommodation zone indicating that these faults likely established their lengths early. Portions of both basins contain packages of sediment with anomalously fast velocities (> 4 km/s), which we interpret to represent sediment packages from prior rifting episodes. In the Central Basin, this preexisting sediment traces along the inferred offshore continuation of the Karoo-aged Ruhuhu Basin that intersects Lake Malawi at the junction between the North and Central basins. This feature may have influenced the length of the border fault bounding the Central Basin. In the North Basin, the preexisting sediment is thicker ( 4 km) and likely represents the offshore continuation of a series of preexisting rift
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Climate, Birth Weight, and Agricultural Livelihoods in Kenya and Mali
Grace, Kathryn; Nawrotzki, Raphael J.
2018-01-01
Objectives. To examine an association between climate variability and birth weight in Mali and Kenya in relation to the local agricultural specialization. Methods. We combined health and sociodemographic data from the Demographic Health Surveys for Kenya (2008 and 2014) and Mali (2006 and 2012) with detailed data on precipitation, temperature, and vegetation. We analyzed the association between climate variability and birth weight by using multilevel regression models for the most common agricultural specializations: food cropping, cash cropping, and pastoralism. Results. There are differences in sensitivity to climate among different agricultural communities. An additional 100 millimeters of rainfall during the 12-month period before birth was associated with a 47-gram (P = .001) and 89-gram (P = .10) increase in birth weight for food croppers in Kenya and Mali, respectively. Every additional hot month in food-cropping communities in Kenya was associated with a 71-gram decrease in birth weight (P = .030), likely because of food croppers’ limited use of modern agricultural techniques. Overall, cash croppers are least sensitive to climate variability in both countries. Conclusions. Effective climate change adaptation strategies are essential for protecting and improving health outcomes and should be tailored to local households’ livelihood strategies. PMID:29072943
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Mkandawire, Matthews Tiwaone; Luo, Zubing; Maulidi, Felix Kondwani
2018-01-01
About half of the secondary school teachers in Malawi are professionally unqualified. Furthermore, the net enrolment of eligible pupils in secondary schools is at 36% per year. Hence, this study sought to establish factors affecting access to quality and relevant secondary education in Malawi with reference to coordination, collaboration, and feedback between secondary school teacher education institutions and the Ministry of Education. Officials from the Ministry of Education and secondary school teacher training colleges participated in the study. Findings suggest that there is weak collaboration, coordination, and feedback between teacher training institutions and the Ministry of Education which is affecting the quality and relevance of education in Malawi. The study has also established that the weak linkage has resulted into perceived mismatches between expectations of the ministry and those of the education institutions about the problem in question. Theoretical and practical implications of this study are discussed in this article. PMID:29417093
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The Cooking and Pneumonia Study (CAPS) in Malawi: Implementation of Remote Source Data Verification
Weston, William; Smedley, James; Bennett, Andrew; Mortimer, Kevin
2016-01-01
Background Source data verification (SDV) is a data monitoring procedure which compares the original records with the Case Report Form (CRF). Traditionally, on-site SDV relies on monitors making multiples visits to study sites requiring extensive resources. The Cooking And Pneumonia Study (CAPS) is a 24- month village-level cluster randomized controlled trial assessing the effectiveness of an advanced cook-stove intervention in preventing pneumonia in children under five in rural Malawi (www.capstudy.org). CAPS used smartphones to capture digital images of the original records on an electronic CRF (eCRF). In the present study, descriptive statistics are used to report the experience of electronic data capture with remote SDV in a challenging research setting in rural Malawi. Methods At three monthly intervals, fieldworkers, who were employed by CAPS, captured pneumonia data from the original records onto the eCRF. Fieldworkers also captured digital images of the original records. Once Internet connectivity was available, the data captured on the eCRF and the digital images of the original records were uploaded to a web-based SDV application. This enabled SDV to be conducted remotely from the UK. We conducted SDV of the pneumonia data (occurrence, severity, and clinical indicators) recorded in the eCRF with the data in the digital images of the original records. Result 664 episodes of pneumonia were recorded after 6 months of follow-up. Of these 664 episodes, 611 (92%) had a finding of pneumonia in the original records. All digital images of the original records were clear and legible. Conclusion Electronic data capture using eCRFs on mobile technology is feasible in rural Malawi. Capturing digital images of the original records in the field allows remote SDV to be conducted efficiently and securely without requiring additional field visits. We recommend these approaches in similar settings, especially those with health endpoints. PMID:27355447
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The Cooking and Pneumonia Study (CAPS) in Malawi: Implementation of Remote Source Data Verification.
Weston, William; Smedley, James; Bennett, Andrew; Mortimer, Kevin
2016-01-01
Source data verification (SDV) is a data monitoring procedure which compares the original records with the Case Report Form (CRF). Traditionally, on-site SDV relies on monitors making multiples visits to study sites requiring extensive resources. The Cooking And Pneumonia Study (CAPS) is a 24- month village-level cluster randomized controlled trial assessing the effectiveness of an advanced cook-stove intervention in preventing pneumonia in children under five in rural Malawi (www.capstudy.org). CAPS used smartphones to capture digital images of the original records on an electronic CRF (eCRF). In the present study, descriptive statistics are used to report the experience of electronic data capture with remote SDV in a challenging research setting in rural Malawi. At three monthly intervals, fieldworkers, who were employed by CAPS, captured pneumonia data from the original records onto the eCRF. Fieldworkers also captured digital images of the original records. Once Internet connectivity was available, the data captured on the eCRF and the digital images of the original records were uploaded to a web-based SDV application. This enabled SDV to be conducted remotely from the UK. We conducted SDV of the pneumonia data (occurrence, severity, and clinical indicators) recorded in the eCRF with the data in the digital images of the original records. 664 episodes of pneumonia were recorded after 6 months of follow-up. Of these 664 episodes, 611 (92%) had a finding of pneumonia in the original records. All digital images of the original records were clear and legible. Electronic data capture using eCRFs on mobile technology is feasible in rural Malawi. Capturing digital images of the original records in the field allows remote SDV to be conducted efficiently and securely without requiring additional field visits. We recommend these approaches in similar settings, especially those with health endpoints.
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Characterizing Pediatric Non-Malarial Fever and Identifying the At-Risk Child in Rural Malawi.
Kortz, Teresa Bleakly; Blair, Alden; Scarr, Ellen; Mguntha, Andrew Masozi; Bandawe, Gama; Schell, Ellen; Rankin, Sally; Baltzell, Kimberly
2018-01-01
Objective . To characterize children with non-malarial fever at risk of nonrecovery or worsening in rural Malawi. Methods . This is a subgroup analysis of patients ≤14 years of age from a prospective cohort study in non-malarial fever subjects (temperature ≥37.5°C, or fever within 48 hours, and malaria negative) in southern Malawi cared for at a mobile clinic during the 2016 dry (August to September) or wet (November to December) season. Data collection included chart review and questionnaires; 14-day follow-up was conducted. We conducted univariate descriptive statistics on cohort characteristics, bivariate analyses to examine associations between characteristics and outcomes, and multivariate logistic regressions to explore factors associated with nonrecovery. Results . A total of 2893 patients were screened, 401 were enrolled, 286 of these were children, and 280 children completed follow-up. Eighty-seven percent reported symptom resolution, 12.9% reported no improvement, and there were no deaths or hospitalizations. No improvement was associated with dry season presentation (42.6% vs 75.0%, P < .0003), >2 days of symptoms (51.6% vs 72.2%, P = .03), and food insecurity (62.3% vs 86.1%, P = .007). Dry season subjects had a 4.35 times greater likelihood of nonimprovement (95% confidence interval [CI] = 1.96-11.11). Household food insecurity and being >2 hours from a permanent clinic were associated with no improvement (adjusted odds ratio [AOR] = 4.61, 95% CI = 1.81-14.29; and AOR = 2.38, 95% CI = 1.11-5.36, respectively). Conclusion . Outcomes were generally excellent in this rural, outpatient pediatric cohort, though risk factors for nonrecovery included food insecurity, access to a standing clinic, and seasonality. Ideally, this study will inform clinic- and policy-level changes aimed at ameliorating the modifiable risk factors in Malawi and throughout rural Africa.
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The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi.
Lancaster, Kathryn Elizabeth; Powers, Kimberly A; Lungu, Thandie; Mmodzi, Pearson; Hosseinipour, Mina C; Chadwick, Katy; Go, Vivian F; Pence, Brian W; Hoffman, Irving F; Miller, William C
2016-01-01
The HIV care continuum among female sex workers (FSW), a key population, has not been well characterized, especially within the generalized epidemics of sub-Saharan Africa. This was the first study to characterize the HIV care continuum among FSW in Lilongwe, Malawi. From July through September 2014, we used venue-based sampling to enroll 200 adult FSW in Lilongwe, Malawi into a cross-sectional evaluation assessing HIV care continuum outcomes. Seropositive FSW, identified using HIV rapid testing, received rapid CD4 counts in addition to viral loads using dried blood spots. We calculated proportions of HIV-infected FSW who had history of care, were on ART, and had suppressed viral load and we used Poisson regression to estimate the associations of demographic characteristics and transmission risk behaviors with each outcome. HIV seroprevalence was 69% (n = 138). Among all FSW the median age was 24 years (IQR: 22-28). Among the 20% who were newly diagnosed and reported previously testing negative, the median time since last HIV test was 11 months (interquartile range: 3-17). The majority (69%) of HIV-infected FSW had a history of HIV care, 52% reported current ART use, and 45% were virally suppressed. Of the FSW who reported current ART use, 86% were virally suppressed. Transmission risk behaviors were not associated with continuum outcomes. FSW in Lilongwe were predominately young and have a high HIV prevalence. Only half of HIV-infected FSW reported current ART use, but the majority of those on ART were virally suppressed. To reduce ongoing transmission and improve health outcomes, increased HIV testing, care engagement, and ART coverage is urgently needed among FSW. Universal testing and treatment strategies for all FSW in Malawi must be strongly considered.
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The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi
Lancaster, Kathryn Elizabeth; Powers, Kimberly A.; Lungu, Thandie; Mmodzi, Pearson; Hosseinipour, Mina C.; Chadwick, Katy; Go, Vivian F.; Pence, Brian W.; Hoffman, Irving F.; Miller, William C.
2016-01-01
Objective The HIV care continuum among female sex workers (FSW), a key population, has not been well characterized, especially within the generalized epidemics of sub-Saharan Africa. This was the first study to characterize the HIV care continuum among FSW in Lilongwe, Malawi. Methods From July through September 2014, we used venue-based sampling to enroll 200 adult FSW in Lilongwe, Malawi into a cross-sectional evaluation assessing HIV care continuum outcomes. Seropositive FSW, identified using HIV rapid testing, received rapid CD4 counts in addition to viral loads using dried blood spots. We calculated proportions of HIV-infected FSW who had history of care, were on ART, and had suppressed viral load and we used Poisson regression to estimate the associations of demographic characteristics and transmission risk behaviors with each outcome. Results HIV seroprevalence was 69% (n = 138). Among all FSW the median age was 24 years (IQR: 22–28). Among the 20% who were newly diagnosed and reported previously testing negative, the median time since last HIV test was 11 months (interquartile range: 3–17). The majority (69%) of HIV-infected FSW had a history of HIV care, 52% reported current ART use, and 45% were virally suppressed. Of the FSW who reported current ART use, 86% were virally suppressed. Transmission risk behaviors were not associated with continuum outcomes. Conclusions FSW in Lilongwe were predominately young and have a high HIV prevalence. Only half of HIV-infected FSW reported current ART use, but the majority of those on ART were virally suppressed. To reduce ongoing transmission and improve health outcomes, increased HIV testing, care engagement, and ART coverage is urgently needed among FSW. Universal testing and treatment strategies for all FSW in Malawi must be strongly considered. PMID:26808043
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The use of specialty training to retain doctors in Malawi: A discrete choice experiment.
Mandeville, Kate L; Ulaya, Godwin; Lagarde, Mylène; Muula, Adamson S; Dzowela, Titha; Hanson, Kara
2016-11-01
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not yet in specialty training. Over August 2012 to March 2013, 148 doctors took part out of 153 eligible in Malawi. Despite evidence that specialty training is highly sought after, Malawian junior doctors would not accept all types of training. Doctors preferred timely training outside of Malawi in core specialties (internal medicine, general surgery, paediatrics, obstetrics & gynaecology). Specialty preferences are particularly strong, with most junior doctors requiring nearly double their monthly salary to accept training all in Malawi and over six-fold to accept training in ophthalmology (representing a bundle of unpopular but priority specialties). In contrast, the location of work before training did not significantly influence most doctors' choices when guaranteed specialty training. Using a latent class model, we identified four subgroups of junior doctors with distinct preferences. Policy simulations showed that these preferences could be leveraged by policymakers to improve retention in exchange for guaranteed specialty training, however incentivising the uptake of training in priority specialties will only be effective in those with more flexible preferences. These results indicate that indiscriminate expansion of postgraduate training to slow emigration of doctors from sub-Saharan African countries may not be effective unless doctors' preferences are taken into account. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Impact and economic evaluation of a novel HIV service delivery model in rural Malawi.
McBain, Ryan K; Petersen, Elizabeth; Tophof, Nora; Dunbar, Elizabeth L; Kalanga, Noel; Nazimera, Lawrence; Mganga, Andrew; Dullie, Luckson; Mukherjee, Joia; Wroe, Emily B
2017-09-10
We performed an impact and cost-effectiveness analysis of a novel HIV service delivery model in a high prevalence, remote district of Malawi with a population of 143 800 people. A population-based retrospective analysis of 1-year survival rates among newly enrolled HIV-positive patients at 682 health facilities throughout Malawi, comparing facilities implementing the service delivery model (n = 13) and those implementing care-as-usual (n = 669). Through district-level health surveillance data, we evaluated 1-year survival rates among HIV patients newly enrolled between July 2013 and June 2014 - representing 129 938 patients in care across 682 health facilities - using a multilevel modeling framework. The model, focused on social determinants of health, was implemented throughout Neno District at 13 facilities and compared with facilities in all other districts. Activity-based costing was used to annualize financial and economic costs from a societal perspective. Incremental cost-effectiveness ratios were expressed as quality-adjusted life-years gained. The national average 1-year survival rate for newly enrolled antiretroviral therapy clients was 78.9%: this rate was 87.9% in Neno District, compared with 78.8% across all other districts in Malawi (P < 0.001; 95% confidence interval: 0.079-0.104). The economic cost of receiving care in Neno district (n = 6541 patients) was $317/patient/year, compared with an estimated $219/patient in other districts. This translated to $906 per quality-adjusted life-year gained. Neno District's comprehensive model of care, featuring a strong focus on the community, is $98 more expensive per capita per annum but demonstrates superior 1-year survival rates, despite its remote location. Moreover, it should be considered cost-effective by traditional international standards.
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Moyo, V B; Changadeya, W; Chiotha, S; Sikawa, D
2016-03-01
This study was designed to determine the prevalence of and risk factors for schistosomiasis among a group of preschool children in Malawi. Schistosomiasis burden among preschoolers in Malawi is not well documented in the literature. This study used field research (in the form of a snail survey), laboratory work (urinalysis and microscopy for parasite identification), and questionnaire-guided interviews to determine the prevalence of and risk factors for urinary schistosomiasis among children, aged between 6 and 60 months, in Malengachanzi, Nkhotakota District, Malawi. Urinary schistosomiasis prevalence among preschool children was 13%. Of the factors evaluated, only age (P = 0.027) was statistically significantly associated with urinary schistosomiasis risk. Four-year-old preschool children were five times more likely to contract urinary schistosomiasis than twoyear-old children (odds ratio [OR] = 5.255; 95% confidence interval [CI] = 1.014-27.237; P = 0.048). Increased contact with infested water among older children likely explains much of their increased risk. Infestation was evidenced by the presence of infected Bulinus globosus snails in the water contact points surveyed. Multiple regression analysis showed that visiting water contact sites daily (OR = 0.898, 95% CI = 0.185-4.350, P = 0.894), bathing in these sites (OR = 9.462, 95% CI = 0.036-0.00, P = 0.430) and lack of knowledge, among caregivers, regarding the causes of urinary schistosomiasis (OR = 0.235, 95% CI = 0.005-1.102, P = 0.066) posed statistically insignificant risk increases for preschoolers contracting urinary schistosomiasis. Urinary schistosomiasis was prevalent among preschool children in Malengachanzi, Nkhotakota District. Contact with infested water puts these children and the general population at risk of infection and reinfection. Inclusion of preschool children in treatment programmes should be considered imperative, along with safe treatment guidelines. To prevent infection, the
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Nigeria: Energy for sustainable development
DOE Office of Scientific and Technical Information (OSTI.GOV)
Eleri, E.O.
Though an essentially contested concept, it is safe to acknowledge that the attainment of sustainable development requires that the growth and well-being of present generations are brought about in such ways that the ability of future people to meet their own needs will not be compromised. The availability of safe and sound energy as a factor of production is a key element in such a development process. Despite the abundance of energy resources, acute shortages of energy services have become endemic in Nigeria. This paper reassesses the common proposition that energy has fueled growth and development in Nigeria by itsmore » role as the chief source of state revenue and through its input into economic activities in the country. It is argued here, however, that conventional energy management in Nigeria has tended to create development flaws of its own. The article is divided into six sections: 1st, a general account of the energy and development linkages in Nigeria; 2nd, the failures of these linkages are assessed; 3rd, policy initiatives are considered that would be reconcilable to the nation`s sustainable development; 4th, the present reform agenda, its inadequacies and barriers are surveyed; 5th, the achievement of sustainable development, it is argued, will demand the re-institutionalization of the political economy of the energy sector in Nigeria, which will depend largely on the resolution of the dilemmas and conflicts in the country`s broader political and economic reforms; and 6th, an outlook is suggested for future policy development.« less
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Physiologic specialization of Puccinia graminis f. sp. tritici in Kenya in 2011
USDA-ARS?s Scientific Manuscript database
A total of 12 collections of Puccinia graminis f. sp. tritici were obtained from Kenya during 2011. Collections were made around Mount Kenya and in wheat growing areas southwest towards Nakuru in the Rift Valley. Four collections were made from the international stem rust screening nursery in Njoro....
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Mwendera, Chikondi; de Jager, Christiaan; Longwe, Herbert; Hongoro, Charles; Phiri, Kamija; Mutero, Clifford M
2017-11-21
The existing gap between research evidence and public health practice has attributed to the unmet Millennium Development Goals in Africa and consequently, has stimulated the development of frameworks to enhance knowledge translation. These efforts aim at maximising health research utilisation in policy and practice to address the world's disease burdens, including malaria. This study aimed at developing a contextual framework to improve the utilisation of malaria research for policy development in Malawi. The study used two approaches including: two case studies of policy analysis exploring the policy-making process in Malawi, utilisation of local malaria research, and the role of key stakeholders in policy formulation process; and the assessment of facilitating factors and barriers to malaria research utilisation for policy-making in Malawi. From the case studies' lessons and elements identified during the assessment of facilitating factors and barriers, a framework is developed to promote an integrated approach to knowledge translation. In this framework the Ministry of Health is considered as the main user of knowledge from research through the demand created by the research directorate and the National Malaria Control Programme. Key documents identified as being particularly relevant to the Ministry of Health for purposes of knowledge translation include the National Health Research Agenda, Guidelines for Policy Development and Analysis, and Guidelines for Evidence Use in Policy-making. Institutions conducting academic and policy-relevant malaria research in Malawi are identified and a consolidation of their linkages with the users of research is established through the Knowledge Translation Unit, the Evidence Informed decision-making Centre, and the African Institute for Development Policy. Equally, key players in this framework are the funding partners for both research and programmes that need to see accountability and impact of their support. Independent
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NASA Astrophysics Data System (ADS)
Dugda, M. T.; Nyblade, A. A.; Julia, J.
2007-12-01
Shear-wave velocity structure of the crust and upper mantle beneath Kenya has been investigated using joint inversion of receiver functions, and Rayleigh wave group and phase velocities. Most of the data for this study come from the Kenya broadband seismic experiment, conducted between 2001 and 2002. Shear velocity models obtained from the joint inversion show crustal thicknesses of 37 to 42 km beneath the East African Plateau in Kenya and near the edge of the Kenya Rift, and a crustal thickness of about 30 km beneath the Kenya Rift. These crustal parameters are consistent with crustal thicknesses published previously by different authors. A comparison has been made between the lithosphere under Kenya and other parts of the East African Plateau in Tanzania. A comparison between the lithosphere under Kenya and that under Ethiopia has also been made, specifically between the lithosphere under the Ethiopian Plateau and the Kenya Plateau, and between the lithosphere beneath the Main Ethiopian Rift (MER) and the Kenya (Gregory) Rift. The lithospheric mantle beneath the East African Plateau in Kenya has a maximum shear wave velocity of about 4.6 km/s, similar to the value obtained under the East African Plateau in Tanzania. Beneath the Kenya Rift, the lithosphere extends to a depth of at most ~75 km. The average velocity of the mantle lithosphere under the East African Plateau in Kenya appears to be similar to the lithosphere under Tanzania away from the East African Rift System. The lithosphere under the Kenya Plateau is not perturbed as compared to the highly perturbed lithosphere beneath the Ethiopian Plateau. The lithosphere under the Kenya Rift is perturbed as compared to the rest of the region but is not as perturbed as that under the Main Ethiopian Rift or the Afar. Though Kenya and Ethiopia have similar uplift, volcanism and rifting at the surface, they have different lithospheric structures at the bottom. The Afar Flood Basalt Volcanism (AFB) may be the cause of
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ERIC Educational Resources Information Center
Zverev, Y. P.; Mipando, M.
2007-01-01
The present study was designed to assess cultural and environmental pressure against left-foot preference in urban and semi-urban Malawi. The findings demonstrated that, when compared to handedness, footedness appeared to be less biased behavioral laterality in culturally restrictive communities. The percentage of responders with negative views on…
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ERIC Educational Resources Information Center
Brown, Brendan; Nuberg, Ian; Llewellyn, Rick
2018-01-01
Purpose: The limited uptake of improved agricultural practices in Africa raise questions on the functionality of current agricultural research systems. Our purpose is to explore the capacity for local innovation within the research systems of Ethiopia, Malawi and Mozambique. Design/Methodology/Approach: Using Conservation Agriculture (CA) as a…
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Malawi's contribution to "3 by 5": achievements and challenges.
Libamba, Edwin; Makombe, Simon D; Harries, Anthony D; Schouten, Erik J; Yu, Joseph Kwong-Leung; Pasulani, Olesi; Mhango, Eustice; Aberle-Grasse, John; Hochgesang, Mindy; Limbambala, Eddie; Lungu, Douglas
2007-02-01
Many resource-poor countries have started scaling up antiretroviral therapy (ART). While reports from individual clinics point to successful implementation, there is limited information about progress in government institutions at a national level. Malawi started national ART scale-up in 2004 using a structured approach. There is a focus on one generic, fixed-dose combination treatment with stavudine, lamivudine and nevirapine. Treatment is delivered free of charge to eligible patients with HIV and there is a standardized system for recruiting patients, monthly follow-up, registration, monitoring and reporting of cases and outcomes. All treatment sites receive quarterly supervision and evaluation. In January 2004, there were nine public sector facilities delivering ART to an estimated 4 000 patients. By December 2005, there were 60 public sector facilities providing free ART to 37,840 patients using national standardized systems. Analysis of quarterly cohort treatment outcomes at 12 months showed 80% of patients were alive, 10% dead, 9% lost to follow-up and 1% had stopped treatment. Achievements were the result of clear national ART guidelines, implementing partners working together, an intensive training schedule focused on clinical officers and nurses, a structured system of accrediting facilities for ART delivery, quarterly supervision and monitoring, and no stock-outs of antiretroviral drugs. The main challenges are to increase the numbers of children, pregnant women and patients with tuberculosis being started on ART, and to avert high early mortality and losses to follow-up. The capacity of the health sector to cope with escalating case loads and to scale up prevention alongside treatment will determine the future success of ART delivery in Malawi.
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Old and new ways: family planning in Kenya.
Antarsh, L
1989-04-01
Kenya has the highest fertility rate in the world. The average woman has 8 children. Further, urban areas attract people from rural areas leaving fewer people to farm the finite land or raise cattle. Therefore a reduced need for children to partake in agricultural activities exists. Nevertheless many barriers to family planning continue in Kenya. Family planning services are scarce especially in rural areas. Husbands must agree to their wives undergoing voluntary sterilization by going to the clinic to sign a consent form. Children are highly valued. Succession of the generations is important. The higher a woman's fertility the more valuable she is to husband. The continuance of legal polygamy fosters competition among a man's wives to have many sons with the 1 having the most being his most prized wife. In spite of these obstacles, the president of Kenya promotes family planning through his speeches and requires the Ministry of Health (MOH) to provide family planning services at all government hospitals. Moreover, church hospitals also provide family planning services. Additionally, articles that cover teenage pregnancy and family planning programs appear in daily newspapers. The MOH and the National Council on Population and Development are organizing a network of government and nongovernment organizations that provide family planning services to the public. A sample of these organizations include the Family Planning Association of Kenya, an influential women's organization (Mandeleo ya Wanawake), and several church organizations. The Association for Voluntary Surgical Contraception's regional office has promoted minilaparotomies under local anesthesia since 1986. They are now used in maternal and child health programs in government hospitals, mission hospitals, and in several family planning clinics.
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Msyamboza, Kelias Phiri; M'bang'ombe, Maurice; Hausi, Hannah; Chijuwa, Alexander; Nkukumila, Veronica; Kubwalo, Hudson Wenji; Desai, Sachin; Pezzoli, Lorenzo; Legros, Dominique
2016-01-01
Introduction Despite some improvement in provision of safe drinking water, proper sanitation and hygiene promotion, cholera still remains a major public health problem in Malawi with outbreaks occurring almost every year since 1998. In response to 2014/2015 cholera outbreak, ministry of health and partners made a decision to assess the feasibility and acceptability of conducting a mass oral cholera vaccine (OCV) as an additional public health measure. This paper highlights the burden of the 2014/15 cholera outbreak, successes and challenges of OCV campaign conducted in March and April 2015. Methods This was a documentation of the first OCV campaign conducted in Malawi. The campaign targeted over 160,000 people aged one year or more living in 19 camps of people internally displaced by floods and their surrounding communities in Nsanje district. It was a reactive campaign as additional measure to improved water, sanitation and hygiene in response to the laboratory confirmed cholera outbreak. Results During the first round of the OCV campaign conducted from 30 March to 4 April 2015, a total of 156,592 (97.6%) people out of 160,482 target population received OCV. During the second round (20 to 25 April 2015), a total of 137,629 (85.8%) people received OCV. Of these, 108,247 (67.6%) people received their second dose while 29,382 (18.3%) were their first dose. Of the 134,836 people with known gender and sex who received 1 or 2 doses, 54.4% were females and over half (55.4%) were children under the age of 15 years. Among 108,237 people who received 2 doses (fully immunized), 54.4% were females and 51.9% were children under 15 years of age. No severe adverse event following immunization was reported. The main reason for non-vaccination or failure to take the 2 doses was absence during the period of the campaign. Conclusion This documentation has demonstrated that it was feasible, acceptable by the community to conduct a large-scale mass OCV campaign in Malawi within five
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75 FR 56509 - Multi-Sector Trade Mission to Nigeria
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-16
... DEPARTMENT OF COMMERCE International Trade Administration Multi-Sector Trade Mission to Nigeria...: Multi-Sector Trade Mission to Nigeria, March 8-10, 2011 I. Mission Description The United States... Mission to Nigeria March 8-10, 2011, to help U.S. firms find business partners and sell equipment and...
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Entrepreneurship Education and Graduates Unemployment in Oyo State, Nigeria
ERIC Educational Resources Information Center
Emunemu, B. O.; Kasali, O. J.
2014-01-01
This study investigated entrepreneurship and graduates' unemployment in Nigeria.The problem of unemployment in Nigeria has become endemic. There have been reported cases of under-employment, seasonal, casual and full blown unemployment. Previous studies on unemployment and factors influencing it in Nigeria identify poor educational standards,…
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USDA-ARS?s Scientific Manuscript database
Aedes mcintoshi and Ae circumluteolus are two common flood water mosquito species collected in Kenya. Both belong to the Aedes subgenus Neomelaniconion, a relatively large subgenus with representative species in the Ethiopian, Oriental, Australian and Palearctic regions. In Kenya, both have been imp...
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Applying a Reading Program Based on Cognitive Science in Rural Areas of Malawi: Preliminary Results
ERIC Educational Resources Information Center
Iyengar, Radhika; Karim, Alia; Chagwira, Florie
2016-01-01
Reading fluency is a skill foundational to academic performance, and acquiring this skill in early grades is crucial. Throughout sub-Saharan Africa, reading levels of students are far below grade level, and Malawi is no exception. Research suggests that students, particularly in consistently spelled languages, acquire automaticity most easily by…
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ERIC Educational Resources Information Center
Shawa, Lester B.; Mgomezulu, Victor Y.
2016-01-01
Utilising critical theory, we explored the causes of the conflict that arose between academic staff on fixed-term renewable contracts and university administrators at Mzuzu University in Malawi in order to draw lessons. We collected data using semi-structured, in-depth interviews and document analysis. Ten university employees were purposively…
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Cost-effectiveness of rotavirus vaccination in Kenya and Uganda.
Sigei, Charles; Odaga, John; Mvundura, Mercy; Madrid, Yvette; Clark, Andrew David
2015-05-07
Rotavirus vaccines have the potential to prevent a substantial amount of life-threatening gastroenteritis in young African children. This paper presents the results of prospective cost-effectiveness analyses for rotavirus vaccine introduction for Kenya and Uganda. In each country, a national consultant worked with a national technical working group to identify appropriate data and validate study results. Secondary data on demographics, disease burden, health utilization, and costs were used to populate the TRIVAC cost-effectiveness model. The baseline analysis assumed an initial vaccine price of $0.20 per dose, corresponding to Gavi, the Vaccine Alliance stipulated copay for low-income countries. The incremental cost-effectiveness of a 2-dose rotavirus vaccination schedule was evaluated for 20 successive birth cohorts from the government perspective in both countries, and from the societal perspective in Uganda. Between 2014 and 2033, rotavirus vaccination can avert approximately 60,935 and 216,454 undiscounted deaths and hospital admissions respectively in children under 5 years in Kenya. In Uganda, the respective number of undiscounted deaths and hospital admission averted is 70,236 and 329,779 between 2016 and 2035. Over the 20-year period, the discounted vaccine program costs are around US$ 80 million in Kenya and US$ 60 million in Uganda. Discounted government health service costs avoided are US$ 30 million in Kenya and US$ 10 million in Uganda (or US$ 18 million including household costs). The cost per disability-adjusted life-year (DALY) averted from a government perspective is US$ 38 in Kenya and US$ 34 in Uganda (US$ 29 from a societal perspective). Rotavirus vaccine introduction is highly cost-effective in both countries in a range of plausible 'what-if' scenarios. The involvement of national experts improves the quality of data used, is likely to increase acceptability of the results in decision-making, and can contribute to strengthened national
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Youth Reproductive & Sexual Health in Nigeria
ERIC Educational Resources Information Center
Sampson, Melodi
2010-01-01
Nearly one third of Nigeria's total population of 148.1 million is between the ages of 10 and 24. Nigerian adolescents' sizeable share of the population makes them integral to the country's social, political and economic development. Nigeria's development is compromised by the sexual and reproductive health issues afflicting its youth. Lack of…
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An appraisal of public water supply and coverage in Mzuzu City, northern Malawi
NASA Astrophysics Data System (ADS)
Wanda, Elijah M. M.; Gulula, Lewis C.; Phiri, Gift
Literature on water supply and coverage is mixed about whether Malawi will achieve the MDGs by 2015. Mzuzu City is one of the most rapidly growing urban areas that is faced with public water supply and coverage challenges in Malawi. In view of this, an appraisal was done through documentation review, field visits and face to face interviews in order to evaluate problems of public water supply and coverage. It was observed that inequitable distribution of water points, unreliability of the water supply services and financial losses are some of the problems affecting public water supply in Mzuzu City. The financial losses were attributed to poor financial performance resulting from accrued debts by some individual customers and most government institutions, the board’s reliance on loans for expansion of services which has led into more revenue being spent servicing the loan and accrued interests, and high levels of unaccounted for water. This study found out that only 17% of the study population has piped water in their dwelling homes and yards. It was also observed that 51% of the population accesses the water from community stand pipes supplied by the NRWB. This means that only 68% of the study population in Mzuzu City (mostly those from planned settlements) is covered by NRWB and 32% is not covered and relies on boreholes (13.6%), unprotected wells (16.5%) and rivers (1.9%) as sources of water. The percentage composition of the population not covered by NRWB is of great concern and threat to public health and safety. The study recommends that NRWB should ensure that available funds, which would otherwise have been paid out in form of interest, are used on projects in phases to improve water supply and coverage in Mzuzu City. The study also recommends that the government of Malawi should consider converting the NRWB’s loans into grants in order to alleviate the NRWB’s financial losses. Furthermore, the study recommends that the NRWB should equitably increase
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Childhood Malaria Admission Rates to Four Hospitals in Malawi between 2000 and 2010
Okiro, Emelda A.; Kazembe, Lawrence N.; Kabaria, Caroline W.; Ligomeka, Jeffrey; Noor, Abdisalan M.; Ali, Doreen; Snow, Robert W.
2013-01-01
Introduction The last few years have witnessed rapid scaling-up of key malaria interventions in several African countries following increases in development assistance. However, there is only limited country-specific information on the health impact of expanded coverage of these interventions. Methods Paediatric admission data were assembled from 4 hospitals in Malawi reflecting different malaria ecologies. Trends in monthly clinical malaria admissions between January 2000 and December 2010 were analysed using time-series models controlling for covariates related to climate and service use to establish whether changes in admissions can be related to expanded coverage of interventions aimed at reducing malaria infection. Results In 3 of 4 sites there was an increase in clinical malaria admission rates. Results from time series models indicate a significant month-to-month increase in the mean clinical malaria admission rates at two hospitals (trend P<0.05). At these hospitals clinical malaria admissions had increased from 2000 by 41% to 100%. Comparison of changes in malaria risk and ITN coverage appear to correspond to a lack of disease declines over the period. Changes in intervention coverage within hospital catchments showed minimal increases in ITN coverage from <6% across all sites in 2000 to maximum of 33% at one hospital site by 2010. Additionally, malaria transmission intensity remained unchanged between 2000–2010 across all sites. Discussion Despite modest increases in coverage of measures to reduce infection there has been minimal changes in paediatric clinical malaria cases in four hospitals in Malawi. Studies across Africa are increasingly showing a mixed set of impact results and it is important to assemble more data from more sites to understand the wider implications of malaria funding investment. We also caution that impact surveillance should continue in areas where intervention coverage is increasing with time, for example Malawi, as decline may
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Capacity Development of Youth in Geospatial Tools for Addressing Climate Change in Kenya
NASA Astrophysics Data System (ADS)
Mubea, K.; Kasera, K.; Maina, C.
2017-12-01
SERVIR E&SA builds on the institutional partnerships and networks in Eastern and Southern Africa together with the network and partnerships associated with USAID country missions in the region. The RCMRD Space Challenge was meant to equip students from high/secondary schools and primary schools within Kenya and beyond with the necessary skills and awareness in relation to environmental degradation, climate change and its drivers. Furthermore, this contributes to the achievement of Sustainable Development Goals (SDGs), developing the youth in Science, Technology, Engineering and Math (STEM) and ultimately contributing to capacity building of the youth with the objective of promoting sustainable development. RCMRD partnered with GLOBE Program Kenya, 4-H Kenya and Esri Eastern Africa in this endeavor. The challenge involved students from seven schools analyzing data from automatic weather stations and plotting the results against other location of schools. The students were required to use TAHMO Automatic Weather Stations (AWS) normalized atmospheric data provided by GLOBE, TAHMO and RCMRD. The three parameters, humidity, precipitation and temperature were found to be very closely related. The students generated graphs that were obtained from the normalized data for the five climatic zones in Kenya. Nasokol Girls School located at Kishaunet in West Pokot County (Kenya) emerged the winners followed by St. Scholastica Catholic Primary School in Nairobi, and Moi Forces Academy Nairobi. The students were urged to utilize the knowledge acquired to address challenges related to climate change. RCMRD Space Challenge will be held annually in Kenya in collaboration with partners.
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NASA Astrophysics Data System (ADS)
Johnson, Thomas; Werne, Josef
2016-04-01
Hominin evolution underwent important changes in the last 1.3 million years, including the extinction of Paranthropus at about 1.2 Ma, leaving Homo as the sole hominin genus. Our genus experienced a major increase in cranial capacity at about 500 ka, and our species, H. sapiens, first appeared at ~200 ka. There was a major turnover in mammalian species in East Africa between 540 and 400 ka, favoring descendants of smaller size and less specialized diet. An understanding of what drove evolution in these directions is fundamental to understanding the development of modern H. sapiens. Climate certainly played a role, for it is the principal factor that influences the distribution of vegetation and habitability on the landscape. We present a 1.3 million year record of temperature and hydroclimate in the basin of Lake Malawi, the second deepest lake in Africa, derived from a 380 m sediment sequence taken from a water depth of 590 m by the Lake Malawi Drilling Project. Seismic reflection profiles used to select the site portray an undisturbed sedimentary section that was not impacted by erosion, turbidity currents or mass wasting events. Sediment samples were analyzed to produce records of temperature (TEX86) and aridity (Ca content and leaf wax δ13C). The temperature record displays progressively larger amplitude glacial-interglacial variations from MIS 13 (~500 ka) to MIS 5 (~125 ka). Intervals of low Ca abundance, which reflect lake high stands, correlate with times of depleted δ13Cwax and relatively warm temperatures. The Malawi basin experienced warm, wet interglacials and cooler (by about 2 - 4°C), dry glacial periods, with roughly a 100 ky periodicity since the Mid-Pleistocene Transition (MPT), about 900 ka. The paleoclimate record from Lake Malawi sediments portrays a transition from a highly variable and predominantly arid climate prior to 900 ka to a progressively more humid environment after the MPT dominated by 100 ky cycles consisting of warm, wet
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Maternal and child health project in Nigeria.
Okafor, Chinyelu B
2003-12-01
Maternal deaths in developing countries are rooted in womens powerlessness and their unequal access to employment, finance, education, basic health care, and other resources. Nigeria is Africa's most populous country, and it is an oil producing country, but Nigeria has one of the worst maternal mortality rates in Africa. These deaths were linked to deficiencies in access to health care including poor quality of health services, socio-cultural factors, and access issues related to the poor status of women. To address these problems, a participatory approach was used to bring Christian women from various denominations in Eastern Nigeria together. With technical assistance from a research unit in a university in Eastern Nigeria, the women were able to implement a Safe Motherhood project starting from needs assessment to program evaluation. Lessons learned from this program approach are discussed.
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Incidence of acute mountain sickness in UK Military Personnel on Mount Kenya.
Hazlerigg, Antonia; Woods, D R; Mellor, A J
2016-12-01
Acute mountain sickness (AMS) is a common problem of trekkers to high altitude. The UK military train at high altitude through adventurous training (AT) or as exercising troops. The ascent of Point Lenana at 4985 m on Mount Kenya is frequently attempted on AT. This study sought to establish the incidence of AMS within this population, to aid future planning for military activities at altitude. A voluntary questionnaire was distributed to all British Army Training Unit Kenya based expeditions attempting to ascend Mount Kenya during the period from February to April 2014. The questionnaire included twice daily Lake Louise and Borg (perceived exertion scale) self-scoring. All expeditions were planned around a 5-day schedule, which included reserve time for acclimatisation, illness and inclement weather. Data were collected on 47 participants, 70% of whom reached the summit of Point Lenana. 62% (29/47) self-reported AMS (defined as Lake Louise score (LLS) ≥3) on at least one occasion during the ascent, and 34% (10/29) suffered severe AMS (LLS ≥6). Those who attempted the climb within 2 weeks of arrival in Kenya had a higher incidence of AMS (12/15 (80%) vs 17/32 (53%), p=0.077). Participants recording a high Borg score were significantly more likely to develop AMS (16/18 vs 9/21, p=0.003). This represents the first informative dataset for Mount Kenya ascents and altitude. The incidence of AMS during AT on Mount Kenya using this ascent profile is high. Adapting the current ascent profile, planning the ascent after time in country and reducing perceived exertion during the trek may reduce the incidence of AMS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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Empirical evidence of child poverty and deprivation in Nigeria.
Ogwumike, Fidelis O; Ozughalu, Uche M
2018-03-01
Development economists and policy makers have in recent times focused attention on child poverty as a crucial aspect of poverty. The importance of the analysis of child poverty partly lies in the fact that children are the most vulnerable group in every society. This study used two poverty lines and the Foster-Greer-Thorbecke index to analyze extreme and overall child poverty headcount, depth and severity in Nigeria. The study also used the headcount ratio to analyze the extent of child deprivation in education, health, nutrition, child protection, water and sanitation. The study was based on the 2010 Harmonized Nigeria Living Standard Survey (HNLSS) and the 2011 Multiple Indicator Cluster Survey (MICS), obtained from the National Bureau of Statistics (NBS), Abuja, Nigeria. The study revealed that 23.22% of children in Nigeria were in extreme child poverty while 70.31% of children in the country were in overall child poverty. The study further showed that there was pronounced child deprivation in education, health, nutrition, child protection, water and sanitation. Both child poverty and child deprivation were more pronounced in the rural sector than in the urban sector and in Northern Nigeria than in Southern Nigeria. Therefore, the Nigerian government should take adequate steps to eradicate child poverty and obliterate all forms of child deprivation in Nigeria - particularly deprivation in basic needs. In taking such steps, more attention should be focused on rural areas and Northern Nigeria. Copyright © 2017 Elsevier Ltd. All rights reserved.
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The Abolition of Secondary School Fees in Kenya: Responses by the Poor
ERIC Educational Resources Information Center
Ohba, Asayo
2011-01-01
Following the 2007 presidential election, the Government of Kenya abolished secondary school fees in 2008. In the context of this significant change in policy, this study examines the effect of fees on transition to secondary schooling by following 109 primary school leavers in rural Kenya after the fee abolition, starting in 2007. The study draws…
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Rationale for Critical Pedagogy of Decolonization: Kenya as a Unit of Analysis
ERIC Educational Resources Information Center
Gatimu, M. Wangeci
2009-01-01
In December 2007, political violence erupted in Kenya after a general election. Both Kenya and the international community were confronted with the question as to why citizens of a hitherto peaceful nation would engage in acts of hooliganism and violence after exercising a democratic right in a national election. This paper examines how new…
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Equatorial Paleointensities from Kenya and the Well-behaved Geocentric Axial Dipole
NASA Astrophysics Data System (ADS)
Wang, H.; Kent, D. V.
2017-12-01
A previous study of Plio-Pleistocene lavas from the equatorial Galapagos Islands (latitude 1ºS) that used an adjustment for multidomain (MD) effects [Wang and Kent, 2013 G-cubed] obtained a mean paleointensity of 21.6 ± 11.0 µT (1σ, same in the following) from 27 lava flows [Wang et al., 2015 PNAS]. This is about half of the present-day value. Here, in a pilot study to check this result, we utilized previously thermally demagnetized specimens of Plio-Pleistocene lavas from the Mt. Kenya region (latitude 0º) and fresh specimens from the Loiyangalani region (latitude 3ºN) of Kenya that were previously studied for paleosecular variation [Opdyke et al., 2010 G-cubed] for paleointensity studies. We selected 2-3 specimens from each of 30 lava sites from Mt. Kenya region and 31 lava sites from Loiyangalani region with coherent directions and not exhibiting any indications of having been struck by severe lightning. Rock magnetic data show that the main magnetization carriers are fine-grained pseudo-single-domain magnetite with saturation remanence to saturation magnetization ratios (Mr/Ms) ranging from 0.05 to 0.60 [Opdyke et al., 2010, G-cubed]. Our preliminary MD-adjusted paleointensity results (Loiyangalani specimens with tTRM thermal alteration check [Wang and Kent, 2013 G-cubed]; Mt. Kenya specimens with an alternate thermal alteration check) show that the overall mean values are 15.3 ± 5.7 µT for the Mt. Kenya region (from 7 lava flows) and 16.4 ± 5.2 µT for the Loiyangalani region (from 8 lava flows). Along with paleointensities from Antarctica (latitude 78ºS, 33.4 ± 13.9 µT from 38 lava flows) [Lawrence et al., 2009 G-cubed], Iceland (latitude 64ºN, 37.7 ± 14.2 µT from 10 lava flows) [Cromwell et al., 2015 JGR] and Galapagos [Wang et al., 2015 PNAS], our preliminary Kenya lava results support a geocentric axial dipole (GAD) model of the time-averaged field in both direction (tan[inclination] = 2×tan[latitude]) and paleointensity (equatorial
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Wealth, education and urban-rural inequality and maternal healthcare service usage in Malawi.
Yaya, Sanni; Bishwajit, Ghose; Shah, Vaibhav
2016-01-01
Malawi is among the 5 sub-Saharan African countries presenting with very high maternal mortality rates, which remain a challenge. This study aims to examine the impact of wealth inequality and area of residence (urban vs rural) and education on selected indicators of maternal healthcare services (MHS) usage in Malawi. This study was based on data from the 5th round of Multiple Indicator Cluster Surveys (MICS) conducted in 2013-2014 in Malawi. Study participants were 7572 mothers aged between 15 and 49 years. The outcome variable was usage status of maternal health services of the following types: antenatal care, skilled delivery assistance and postpartum care. Univariate, bivariate and multivariate methods were used to describe the pattern of MHS usage in the sample population. Association between household wealth status, education as well as the type of residence, whether urban or rural, as independent variables and usage of MHS as dependent variables were analysed using the generalised estimating equations (GEE) method. Mean age of the sample population was 26.88 (SD 6.68). Regarding the usage of MHS, 44.7% of women had at least 4 ANC visits, 87.8% used skilled delivery attendants and 82.2% of women had used postnatal care. Regarding the wealth index, about a quarter of the women were in the poorest wealth quintile (23.6%) while about 1/6 were in the highest wealth quintile (15%). Rate of usage for all 3 types of services was lowest among women belonging to the lowest wealth quintile. In terms of education, only 1/5 completed their secondary or a higher degree (20.1%) and nearly 1/10 of the population lives in urban areas (11.4%) whereas the remaining majority live in rural areas (88.6%). The rates of usage of MHS, although reasonable on an overall basis, were consistently lower in women with lower education and those residing in rural areas. Maternal health service usage in Malawi appears to be reasonable, yet the high maternal mortality rate is disturbing and
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Kalua, Thokozani; Tippett Barr, Beth A; van Oosterhout, Joep J; Mbori-Ngacha, Dorothy; Schouten, Erik J; Gupta, Sundeep; Sande, Amakobe; Zomba, Gerald; Tweya, Hannock; Lungu, Edgar; Kajoka, Deborah; Tih, Pius; Jahn, Andreas
2017-05-01
The acceleration of prevention of mother-to-child transmission (PMTCT) activities, coupled with the rollout of 2010 World Health Organization (WHO) guidelines, led to important discussions and innovations at global and country levels. One paradigm-shifting innovation was Option B+ in Malawi. It was later included in WHO guidelines and eventually adopted by all 22 Global Plan priority countries. This article presents Malawi's experience with designing and implementing Option B+ and provides complementary narratives from Cameroon and Tanzania. Malawi's HIV program started in 2002, but by 2009, the PMTCT program was lagging far behind the antiretroviral therapy (ART) program because of numerous health system challenges. When WHO recommended Option A and Option B for PMTCT in 2010, it was clear that Malawi's HIV program would not be able to successfully implement either option without increasing existing barriers to PMTCT services and potentially decreasing women's access to care. Subsequent stakeholder discussions led to the development of Option B+. Operationalizing Option B+ required several critical considerations, including the complete integration of ART and PMTCT programs, systematic reduction of barriers to facilitate doubling the number of ART sites in less than a year, building consensus with stakeholders, and securing additional resources for the new program. During the planning and implementation process, several lessons were learned which are considerations for countries transitioning to "treat-all": Comprehensive change requires effective government leadership and coordination; national clinical guidelines must accommodate health system limitations; ART services and commodities should be decentralized within facilities; the general public should be well informed about major changes in the national HIV program; and patients should be educated on clinic processes to improve program monitoring.
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Dasgupta, Aisha N Z; Wringe, Alison; Crampin, Amelia C; Chisambo, Christina; Koole, Olivier; Makombe, Simon; Sungani, Charles; Todd, Jim; Church, Kathryn
2016-09-01
Malawi is a global leader in the design and implementation of progressive HIV policies. However, there continues to be substantial attrition of people living with HIV across the "cascade" of HIV services from diagnosis to treatment, and program outcomes could improve further. Ability to successfully implement national HIV policy, especially in rural areas, may have an impact on consistency of service uptake. We reviewed Malawian policies and guidelines published between 2003 and 2013 relating to accessibility of adult HIV testing, prevention of mother-to-child transmission and HIV care and treatment services using a policy extraction tool, with gaps completed through key informant interviews. A health facility survey was conducted in six facilities serving the population of a demographic surveillance site in rural northern Malawi to investigate service-level policy implementation. Survey data were analyzed using descriptive statistics. Policy implementation was assessed by comparing policy content and facility practice using pre-defined indicators covering service access: quality of care, service coordination and patient tracking, patient support, and medical management. ART was rolled out in Malawi in 2004 and became available in the study area in 2005. In most areas, practices in the surveyed health facilities complied with or exceeded national policy, including those designed to promote rapid initiation onto treatment, such as free services and task-shifting for treatment initiation. However, policy and/or practice were/was lacking in certain areas, in particular those strategies to promote retention in HIV care (e.g., adherence monitoring and home-based care). In some instances, though, facilities implemented alternative progressive practices aimed at improving quality of care and encouraging adherence. While Malawi has formulated a range of progressive policies aiming to promote rapid initiation onto ART, increased investment in policy implementation
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Amouzou, Agbessi; Banda, Benjamin; Kachaka, Willie; Joos, Olga; Kanyuka, Mercy; Hill, Kenneth; Bryce, Jennifer
2014-01-01
The rate of decline in child mortality is too slow in most African countries to achieve the Millennium Development Goal of reducing under-five mortality by two-thirds between 1990 and 2015. Effective strategies to monitor child mortality are needed where accurate vital registration data are lacking to help governments assess and report on progress in child survival. We present results from a test of a mortality monitoring approach based on recording of births and deaths by specially trained community health workers (CHWs) in Malawi. Government-employed community health workers in Malawi are responsible for maintaining a Village Health Register, in which they record births and deaths that occur in their catchment area. We expanded on this system to provide additional training, supervision and incentives. We tested the equivalence between child mortality rates obtained from data on births and deaths collected by 160 randomly-selected and trained CHWs over twenty months in two districts to those computed through a standard household mortality survey. CHW reports produced an under-five mortality rate that was 84% (95%CI: [0.71,1.00]) of the household survey mortality rate and statistically equivalent to it. However, CHW data consistently underestimated under-five mortality, with levels of under-estimation increasing over time. Under-five deaths were more likely to be missed than births. Neonatal and infant deaths were more likely to be missed than older deaths. This first test of the accuracy and completeness of vital events data reported by CHWs in Malawi as a strategy for monitoring child mortality shows promising results but underestimated child mortality and was not stable over the four periods assessed. Given the Malawi government's commitment to strengthen its vital registration system, we are working with the Ministry of Health to implement a revised version of the approach that provides increased support to CHWs.
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Munthali, Alister C; Ngwira, Bagrey M; Taulo, Frank
2015-01-01
Background Cervical cancer is the most common reproductive health cancer in Malawi. In most cases, women report to health facilities when the disease is in its advanced stage. In this study, we investigate service providers’ perceptions about barriers for women to access cervical cancer screening and early treatment services in Malawi. Methods We conducted in-depth interviews with 13 district coordinators and 40 service providers of cervical cancer screening and early treatment services in 13 districts in Malawi. The study was conducted in 2012. The district coordinators helped the research team identify the health facilities which were providing cervical cancer screening and early treatment services. Results Almost all informants reported that cervical cancer was a major public health problem in their districts and that prevention efforts for this disease were being implemented. They were aware of the test and treat approach using visual inspection with acetic acid (VIA). They, however, said that the delivery of cervical cancer screening and early treatment services was compromised because of factors such as gross shortage of staff, lack of equipment and supplies, the lack of supportive supervision, and the use of male service providers. Informants added that the lack of awareness about the disease among community members, long distances to health facilities, the lack of involvement of husbands, and prevailing misperceptions about the disease (eg, that it is caused by the exposure to the VIA process) affect the uptake of these services. Conclusion While progress has been made in the provision of cervical cancer screening and early treatment services in Malawi, a number of factors affect service delivery and uptake. There is a need to continue creating awareness among community members including husbands and also addressing identified barriers such as shortage of staff and supplies in order to improve uptake of services. PMID:25848229
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The mass media alone are not effective change agents.
Ruijter, J M
1991-01-01
Social mobilization programs for immunization have been used by African leaders, however, coverage from 20% to 70% in capitals like Mogadishu, Maputo, and Dakar were the result of short campaigns rather than the consequence of knowledge, attitudes, and practices (KAP) improvement. One-party states relied on their network of cadres issuing decrees from the top down to enforce completion of these immunization campaigns. Sometimes resistance developed against these programs, as the military mobilized people (e.g., Somalia). These efforts became rather superficial once the temporary pressure evaporated. In Mogadishu coverage increased from 22% to 70% in 1985, and within a year it dropped back to 8% above the original level. Nigeria, Senegal, and Togo where they used regular mini campaigns had better results. Research data from Botswana, Kenya, Lesotho, Malawi, Mozambique, and Zambia were analyzed. In 1983 in Kenya 73% of health workers never advised their clients, and 82% were incompetent to do so. Data also showed that clinics provided the bulk of information to women aged 15-45 in lower income groups, but they rarely consulted village health workers. Radio and TV programs were not reaching people because radio ownership was not universal (47% in Zambia and 30% in Zimbabwe), and batteries were often not available. In addition, most people turned to the radio for entertainment. In 1989, vaccination coverage was 19% in Luanda, Angola, but only 5% of 232 respondents to an evaluation could name the immunizable diseases. An identical percentage was familiar with these diseases in a Zambian study in 1986. Media experts proposed dramas to raise interest, but innovative mass media programs of dissemination of the message advocated in the 1960s did not prove effective to bring about KAP changes. Training of health and paramedical personnel by mass organizations as initiated in Ethiopia may prove to be worthwhile.
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1982-01-01
It is possible to assess population policies through statements and decisions taken by governments as they reflect the views and commitments of political authorities in the field of population and development. Cases in the following African countries are reviewed with focus on objectives and policy instruments: Algeria; Angola; Benin; Botswana; Cape Verde; Central African Republic; Congo; Djibouti; Egypt; Ethiopia; Guinea; Gabon; Gambia; Ghana; Equatorial Guinea; Guinea-Bissau; Ivory Coast; Kenya; Lesotho; Liberia; Libyan Arab Jamahiriya; Madagascar; Malawi; Mali; Mauritania; Mauritius; Morocco; Mozambique; Niger; Nigeria; Rwanda; Sao Tome and Principe; Senegal; Seychelles; Sierra Leone; Somalia; Sudan; Swaziland; Togo; Tunisia; Uganda; United Republic of Cameroon; Tanzania; Upper Volta; Zaire; Zambia; and Zimbabwe. The information presented was drawn from the following publications: UN Population Division, "Population Policy Briefs: Current Situation in Developing Countries and Selected Territories," and UNFPA, "Population Programs and Projects," Volume 2, 1980-1981. On the basis of this review the following conclusions are drawn, which could indicate areas in which technical assistance to the Economic Commission for Africa (ECA) member States would be required: among the 50 country members of ECA, 34 countries (68%) have as a development objective the reduction of mortality, and in particular, maternal and child mortality; the 2nd important objective is stabilizing or improving spatial distribution of population, and 44% of the 50 countries have adopted this objective which involves the distribution of population from 1 place to another within a country; the 3rd important objective consists of restricting the migratory flow from rural areas to urban areas; the countries of Botswana, Egypt, Ghana, Kenya, Lesotho, Mauritius, Morocco, Rwanda, Seychelles, Swaziland, and Tunisia adopted the objective of reducing the rate of population growth; 34% of African countries
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Systematics of Aedes Mosquito Project.
1985-01-01
that are important vectors of Dengue, Chi;:ungunya, Yellow Fever, Rift Valley Fever and Zika viruses . .a - During a field trip by the investigator to...1940’s British researchers in Uganda incriminated Aedes (Stegomyia) simpsoni (Theobald) as one of the primary ve rs of Yellow Fever virus in primates...Kenya, Tanzania and Malawi, has revealed that the species from which Mahaffy et al. (1942) isolated Yellow Fever virus is in fact Aedes (Stegomyia
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Under-reporting of sputum smear-positive tuberculosis cases in Kenya.
Tollefson, D; Ngari, F; Mwakala, M; Gethi, D; Kipruto, H; Cain, K; Bloss, E
2016-10-01
Although an estimated three million tuberculosis (TB) cases worldwide are missed by national TB programs annually, the level of under-reporting of diagnosed cases in high TB burden settings is largely unknown. To quantify and describe under-reporting of sputum smear-positive TB cases in Kenya. A national-level retrospective TB inventory study was conducted. All sputum smear-positive TB cases diagnosed by public or private laboratories during 1 April-30 June 2013 were extracted from laboratory registers in 73 randomly sampled subcounties and matched to TB cases in the national TB surveillance system (TIBU). Bivariate and multivariate analyses were conducted. In the subcounties sampled, 715 of 3409 smear-positive TB cases in laboratory registers were not found in TIBU. The estimated level of under-reporting of smear-positive TB cases in Kenya was 20.7% (95%CI 18.4-23.0). Under-reporting was greatest in subcounties with a high TB burden. Unreported cases were more likely to be patients aged ⩾55 years, have scanty smear results, and be diagnosed at large facilities, private facilities, and facilities in high TB burden regions. In Kenya, one fifth of smear-positive TB cases diagnosed during the study period went unreported, suggesting that the true TB burden is higher than reported. TB surveillance in Kenya should be strengthened to ensure all diagnosed TB cases are reported.
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Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.
Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam
2017-11-10
The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.
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Physical attractiveness and women’s HIV risk in rural Malawi
Frye, Margaret; Chae, Sophia
2017-01-01
BACKGROUND Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. OBJECTIVE We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country’s severe AIDS epidemic. METHODS We use interviewers’ ratings of respondents’ attractiveness, along with HIV test results and women’s assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15–35. RESULTS Results show that women who are rated by interviewers as ‘much less’ or ‘less’ attractive than other women their age are 9% more likely to test positive for HIV. We also find that attractiveness is associated with women’s own assessments of their HIV risk: Among women who tested negative, those perceived as ‘much less’ or ‘less’ attractive than average report themselves to be at greater risk of HIV infection. CONCLUSIONS These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. CONTRIBUTION This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings. PMID:29242708
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Blaney-Morin-Nigeria evapotranspiration model
NASA Astrophysics Data System (ADS)
Duru, J. Obiukwu
1984-02-01
An evapotranspiration model which parallels that proposed earlier by Blaney and Morin has been developed for application in Nigeria. The model, designated as the Blaney-Morin-Nigeria evapotranspiration model, predicts potential evapotranspiration with accuracy and consistency that are better than the Penman model, under Nigerian conditions. It is suggested that the Blaney-Morin evapotranspiration concept may have similar potential elsewhere when given specific form with appropriate constants derived to reflect climatic peculiarities.
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Process Evaluation of HIV Prevention Peer Groups in Malawi: A Look inside the Black Box
ERIC Educational Resources Information Center
McCreary, Linda L.; Kaponda, Chrissie P. N.; Kafulafula, Ursula K.; Ngalande, Rebecca C.; Kumbani, Lily C.; Jere, Diana L. N.; Norr, James L.; Norr, Kathleen F.
2010-01-01
This paper reports the process evaluation of a peer group intervention for human immunodeficiency virus (HIV) prevention which had positive outcomes for three target groups in Malawi: rural adults, adolescents and urban hospital workers. The six-session intervention was delivered to small groups of 10-12 participants by 85 trained volunteer peer…
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Trends in Educational Evaluations in Nigeria: Issues and Challenges
ERIC Educational Resources Information Center
Ndubueze, M. Okoloeze; Iyoke, J. O.; Okoh, S. C.; Beatrice, N. Akubuilo
2015-01-01
The paper highlights the trends in educational evaluations in Nigeria starting from the pre-colonial Nigeria to the contemporary. Nigeria first practiced traditional educational evaluation but the system was criticized for lack of documented data. Then the colonial one-shot end of programme evaluation which was later found to be judgmental, breeds…
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ERIC Educational Resources Information Center
Boerner, Heather
2016-01-01
Being a college president has been Kenya Ayers' goal since she started in higher education in the late 1990s. "I'm really clear," she says. "I want to do this." Ayers is well on her way. She's been a provost, an academic dean and an administrative one, and an associate vice president of academic affairs at colleges in…
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McCollum, Eric D.; Nambiar, Bejoy; Deula, Rashid; Zadutsa, Beatiwel; Bondo, Austin; King, Carina; Beard, James; Liyaya, Harry; Mankhambo, Limangeni; Lazzerini, Marzia; Makwenda, Charles; Masache, Gibson; Bar-Zeev, Naor; Kazembe, Peter N.; Mwansambo, Charles; Lufesi, Norman; Costello, Anthony; Armstrong, Ben
2017-01-01
Background The pneumococcal conjugate vaccine’s (PCV) impact on childhood pneumonia during programmatic conditions in Africa is poorly understood. Following PCV13 introduction in Malawi in November 2011, we evaluated the case burden and rates of childhood pneumonia. Methods and Findings Between January 1, 2012-June 30, 2014 we conducted active pneumonia surveillance in children <5 years at seven hospitals, 18 health centres, and with 38 community health workers in two districts, central Malawi. Eligible children had clinical pneumonia per Malawi guidelines, defined as fast breathing only, chest indrawing +/- fast breathing, or, ≥1 clinical danger sign. Since pulse oximetry was not in the Malawi guidelines, oxygenation <90% defined hypoxemic pneumonia, a distinct category from clinical pneumonia. We quantified the pneumonia case burden and rates in two ways. We compared the period immediately following vaccine introduction (early) to the period with >75% three-dose PCV13 coverage (post). We also used multivariable time-series regression, adjusting for autocorrelation and exploring seasonal variation and alternative model specifications in sensitivity analyses. The early versus post analysis showed an increase in cases and rates of total, fast breathing, and indrawing pneumonia and a decrease in danger sign and hypoxemic pneumonia, and pneumonia mortality. At 76% three-dose PCV13 coverage, versus 0%, the time-series model showed a non-significant increase in total cases (+47%, 95% CI: -13%, +149%, p = 0.154); fast breathing cases increased 135% (+39%, +297%, p = 0.001), however, hypoxemia fell 47% (-5%, -70%, p = 0.031) and hospital deaths decreased 36% (-1%, -58%, p = 0.047) in children <5 years. We observed a shift towards disease without danger signs, as the proportion of cases with danger signs decreased by 65% (-46%, -77%, p<0.0001). These results were generally robust to plausible alternative model specifications. Conclusions Thirty months after PCV13
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The Prevalence of Alcohol Abuse among Egerton University Students in Njoro-Kenya
ERIC Educational Resources Information Center
Boitt, Richard Kimuge
2016-01-01
The main objective of higher institutions of learning in Kenya is to provide education and growth experiences for its students but alcohol abuse has continued to be a problem in the university campuses that is slowing down their progress and the Kenya vision 2030 that envisages a healthy population free from the impact of alcohol abuse through the…
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The “Empty Chairs” Approach to Learning: Simulation-Based Train the Trainer Program in Mzuzu, Malawi
Sigalet, Elaine; Wishart, Ian; Lufesi, Norman; Haji, Faizal
2017-01-01
Together, a group of Canadian colleagues from St. John's, Newfoundland, Calgary, Alberta (some via Doha) and London, Ontario introduced the first Train the Trainer in Simulation-Based Learning (TTT-SBL) program in Mzuzu Central Hospital and Mzuzu University in Malawi. The team led by Elaine Sigalet (Doha) and consisting of Ian Wishart (Calgary), Faizal Haji (London) and Adam Dubrowski (St. John's) was invited to Malawi by Norman Lufesi to conduct a two-day TTT-SBL course for facilitators who teach an Emergency Triage, Assessment and Treatment (ETAT) plus Trauma course. The following technical report describes this course. All trainees-facilitators who took part in the first iteration of the TTT-SBL course were asked to participate in teaching an ETAT course and modify it to include elements of simulation. The new format of ETAT resulted in a reduction of time necessary to conduct the course from four days (based on historical data) to 2.5 days. PMID:28580202
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Rights of the Child in Nigeria.
ERIC Educational Resources Information Center
Lacroix, Anne Laurence; Shoenberg, Cheryl; Schonveld, Ben
This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the U.N. Convention on the Rights of the Child by the Federation of Nigeria. The report's introduction asserts that the rule by decree of Nigeria's present military regime has…
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Epidemiology and Epizootiological Investigations of Hemorrhagic Fever Viruses in Kenya
1988-05-30
1 " EPIDEMIOLOGY AND EPIZOOTICLOGICAL INVESTIGATIONS OF HEMORRHAGIC FEVER VIRUSES IN KENYA ANNUAL REPORT 0PETER M. TUKEI In 00 NMAY 30, 1988...Investigations of Hemorrhagic Fever Viruses in Kenya 12. PERSONAL AUTHOR(S) Peter M. Tukei 13a. TYPE OF REPORT 13b. TIME COVERED 14. DATE OF REPORT (Year...etneM’Orwy andidentifY by block jumb. FIELD GROUP j SUB-GROUP j’-1 , Hemorrhagic fever , Epidemiology, Ebola, Filovirus Ub 03 06 13 I I 19. ABSTRACT
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Rabies and African wild dogs in Kenya.
Kat, P W; Alexander, K A; Smith, J S; Munson, L
1995-11-22
Three packs of African wild dogs (Lycaon pictus) ranging to the north of the Masai Mara National Reserve in southwestern Kenya were monitored from 1988 to 1990. During a six week period (August 2-September 14, 1989), 21 of 23 members of one of these packs died. Histological examination of two brain samples revealed eosinophilic intracytoplasmic inclusions (Negri bodies), supporting a diagnosis of rabies viral encephalitis. An additional brain sample tested positive for rabies with a fluorescent antibody test. Nucleotide sequence of the rabies viral N and G genes from isolates of four African wild dogs (including an individual from Tanzania) indicated that infection was with a viral variant common among domestic dogs in Kenya and Tanzania. A hypothesis linking African wild dog rabies deaths to researcher handling is evaluated and considered implausible.
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Progress toward poliomyelitis eradication--Nigeria, January 2007-August 12, 2008.
2008-08-29
Nigeria is one of only four countries that have never interrupted poliovirus transmission (the others are Afghanistan, India, and Pakistan). A resurgence in wild poliovirus (WPV) transmission occurred in Nigeria during 2003-2004 after a loss of public confidence in oral poliovirus vaccine (OPV) and suspension of supplementary immunization activities (SIAs)* in several northern states. Subsequently, WPV spread within Nigeria and ultimately into 20 previously polio-free countries during 2003-2006. Even after national SIAs resumed, limited acceptance and ongoing operational problems resulted in low polio vaccination coverage and continued WPV transmission. Beginning in 2006, health authorities in Nigeria introduced new initiatives to control the spread of WPV, including a focus on interrupting type 1 WPV (WPV1) transmission and use of monovalent type 1 OPV (mOPV1) for most of the SIAs to increase vaccine effectiveness. Nigeria also instituted changes in SIA implementation to increase community acceptance of vaccination. Subsequently, 285 polio cases were reported in Nigeria in 2007, the lowest number since sensitive surveillance has been in place. As of August 12, 2008, confirmed polio cases reported in Nigeria totaled 556 (including 511 WPV1 cases), compared with 176 cases (53 WPV1) reported during the same period in 2007. This report updates overall progress toward polio eradication in Nigeria during 2007-2008. Given the increase in WPV transmission thus far in 2008, urgent measures are needed to reach all children during SIAs to bring WPV under control in Nigeria.
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Rift Valley fever outbreak--Kenya, November 2006-January 2007.
2007-02-02
In mid-December 2006, several unexplained fatalities associated with fever and generalized bleeding were reported to the Kenya Ministry of Health (KMOH) from Garissa District in North Eastern Province (NEP). By December 20, a total of 11 deaths had been reported. Of serum samples collected from the first 19 patients, Rift Valley fever (RVF) virus RNA or immunoglobulin M (IgM) antibodies against RVF virus were found in samples from 10 patients; all serum specimens were negative for yellow fever, Ebola, Crimean-Congo hemorrhagic fever, and dengue viruses. The outbreak was confirmed by isolation of RVF virus from six of the specimens. Humans can be infected with RVF virus from bites of mosquitoes or other arthropod vectors that have fed on animals infected with RVF virus, or through contact with viremic animals, particularly livestock. Reports of livestock deaths and unexplained animal abortions in NEP provided further evidence of an RVF outbreak. On December 20, an investigation was launched by KMOH, the Kenya Field Epidemiology and Laboratory Training Program (FELTP), the Kenya Medical Research Institute (KEMRI), the Walter Reed Project of the U.S. Army Medical Research Unit, CDC-Kenya's Global Disease Detection Center, and other partners, including the World Health Organization (WHO) and Médecins Sans Frontières (MSF). This report describes the findings from that initial investigation and the control measures taken in response to the RVF outbreak, which spread to multiple additional provinces and districts, resulting in 404 cases with 118 deaths as of January 25, 2007.
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Visceral Leishmaniasis Unresponsive to Pentostam Caused by Leishmania tropica in Kenya
1989-01-01
LARRY HENDRICKS , JOHANNES LEEUWENBURG DAVY KOECH, AND CLIFFORD ROBERTS Biomedical Sciences Research Centre, Clinical Research (entre. Kenya Medical...supplemented with 20% heat-inactivated fetal have implicated L. fropica as a causative agent bovine serum plus penicillin (250 U/ml), strep- of visceral...treatment with pentami- search Institute, Nairobi, Kenya. Larry Hendricks and dine. 7rans R Soc Trop .Lied Jlfpl 79:705-714. Clifford Roberts, U.S. Army
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Solar keratosis, pterygium, and squamous cell carcinoma of the conjunctiva in Malawi.
Clear, A S; Chirambo, M C; Hutt, M S
1979-01-01
The histological features of 234 conjunctival biopsies from Africans in Malawi have been re-examined. The appearances of solar keratosis, pinguecula, and pterygium are presented as part of a continuous spectrum of the same pathological process and aetiology, which may lead to carcinomatous change. The results are discussed with regard to the specific geographical distribution of such lesions found by other workers, with particular emphasis on ultraviolet radiation as the main aetiological factor. Images PMID:427069
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Creanga, Andreea A; Gullo, Sara; Kuhlmann, Anne K Sebert; Msiska, Thumbiko W; Galavotti, Christine
2017-05-22
The Malawi government encourages early antenatal care, delivery in health facilities, and timely postnatal care. Efforts to sustain or increase current levels of perinatal service utilization may not achieve desired gains if the quality of care provided is neglected. This study examined predictors of perinatal service utilization and patients' satisfaction with these services with a focus on quality of care. We used baseline, two-stage cluster sampling household survey data collected between November and December, 2012 before implementation of CARE's Community Score Card© intervention in Ntcheu district, Malawi. Women with a birth during the last year (N = 1301) were asked about seeking: 1) family planning, 2) antenatal, 3) delivery, and 4) postnatal care; the quality of care received; and their overall satisfaction with the care received. Specific quality of care items were assessed for each type of service, and up to five such items per type of service were used in analyses. Separate logistic regression models were fitted to examine predictors of family planning, antenatal, delivery, and postnatal service utilization and of complete satisfaction with each of these services; all models were adjusted for women's socio-demographic characteristics, perceptions of the closest facility to their homes, service use indicators, and quality of care items. We found higher levels of perinatal service use than previously documented in Malawi (baseline antenatal care 99.4%; skilled birth attendance 97.3%; postnatal care 77.5%; current family planning use 52.8%). Almost 73% of quality of perinatal care items assessed were favorably reported by > 90% of women. Women reported high overall satisfaction (≥85%) with all types of services examined, higher for antenatal and postnatal care than for family planning and delivery care. We found significant associations between perceived and actual quality of care and both women's use and satisfaction with the perinatal health
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Progress toward poliomyelitis eradication - Nigeria, January 2009-June 2010.
2010-07-09
Nigeria has maintained a high incidence of wild poliovirus (WPV) cases attributed to persistently high proportions of under- and unimmunized children, and, for many years, the country has served as a reservoir for substantial international spread. In 2008, Nigeria reported 798 polio cases, the highest number of any country in the world. This report provides an update on poliovirus epidemiology in Nigeria during the past 18 months, January 2009-June 2010, and describes activities planned to interrupt transmission. Reported WPV cases in Nigeria decreased to 388 during 2009 (24% of global cases), and WPV incidence in Nigeria reached an all-time low during January--June 2010, with only three reported cases. Cases of circulating type 2 vaccine-derived poliovirus (cVDPV2), which first occurred in Nigeria in 2005, also declined, from 148 during the 12 months of 2009, to eight during the 6-month period, January-June 2010. One indicator of the effectiveness of immunization activities is the proportion of children with nonpolio acute flaccid paralysis (AFP) who never have received oral poliovirus vaccine (OPV). In seven high-incidence northern states of Nigeria, this proportion declined from 17.6% in 2008 to 10.7% in 2009. During 2009-2010, increased engagement of traditional, religious, and political leaders has improved community acceptance of vaccination and implementation of high-quality supplementary immunization activities (SIAs). Enhanced surveillance for polioviruses, further strengthened implementation of SIAs, and immediate immunization responses to newly identified WPV and cVDPV2 cases will be pivotal in interrupting WPV and cVDPV2 transmission in Nigeria.
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NASA Astrophysics Data System (ADS)
Reed, C. A.; Gao, S. S.; Liu, K. H.; Yu, Y.; Chindandali, P. R. N.; Massinque, B.; Mdala, H. S.; Mutamina, D. M.
2015-12-01
In order to evaluate the influence of crustal and mantle heterogeneities upon the initiation of the Malawi rift zone (MRZ) and reactivation of the Zambian Luangwa rift zone (LRZ) subject to Cenozoic plate boundary stress fields and mantle buoyancy forces, we installed and operated 33 Seismic Arrays For African Rift Initiation (SAFARI) three-component broadband seismic stations in Malawi, Mozambique, and Zambia from 2012 to 2014. During the twenty-four month acquisition period, nearly 6200 radial receiver functions (RFs) were recorded. Stations situated within the MRZ, either along the coastal plains or within the Shire Graben toward the south, report an average crustal thickness of 42 km relative to approximately 46 km observed at stations located along the rift flanks. This implies the juvenile MRZ is characterized by a stretching factor not exceeding 1.1. Meanwhile, P-to-S velocity ratios within the MRZ increase from 1.71 to 1.82 in southernmost Malawi, indicating a substantial modification of the crust during Recent rifting. Time-series stacking of approximately 5500 RFs recorded by the SAFARI and 44 neighboring network stations reveals an apparent uplift of 10 to 15 km along both the 410- and 660-km mantle transition zone (MTZ) discontinuities beneath the MRZ and LRZ which, coupled with an apparently normal 250-km MTZ thickness, implies a first-order high-velocity contribution from thickened lithosphere. Preliminary manual checking of SAFARI shear-wave splitting (SWS) measurements provides roughly 650 high-quality XKS phases following a component re-orientation to correct station misalignments. Regional azimuthal variations in SWS fast orientations are observed, from rift-parallel in the vicinity of the LRZ to rift-oblique in the MRZ. A major 60° rotation in the fast orientation occurs at approximately 31°E, possibly resulting from the modulation of mantle flow around a relatively thick lithospheric keel situated between the two rift zones.
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Malaria research and its influence on anti-malarial drug policy in Malawi: a case study.
Mwendera, Chikondi; de Jager, Christiaan; Longwe, Herbert; Phiri, Kamija; Hongoro, Charles; Mutero, Clifford M
2016-06-01
In 1993, Malawi changed its first-line anti-malarial treatment for uncomplicated malaria from chloroquine to sulfadoxine-pyrimethamine (SP), and in 2007, it changed from SP to lumefantrine-artemether. The change in 1993 raised concerns about whether it had occurred timely and whether it had potentially led to early development of Plasmodium falciparum resistance to SP. This case study examined evidence from Malawi in order to assess if the policy changes were justifiable and supported by evidence. A systematic review of documents and published evidence between 1984 and 1993, when chloroquine was the first-line drug, and 1994 and 2007, when SP was the first-line drug, was conducted herein. The review was accompanied with key informant interviews. A total of 1287 publications related to malaria drug policy changes in sub-Saharan Africa were identified. Using the inclusion criteria, four articles from 1984 to 1993 and eight articles from 1994 to 2007 were reviewed. Between 1984 and 1993, three studies reported on chloroquine poor efficacy prompting policy change according to WHO's recommendation. From 1994 to 2007, four studies conducted in the early years of policy change reported a high SP efficacy of above 80%, retaining it as a first-line drug. Unpublished sentinel site studies between 2005 and 2007 showed a reduced efficacy of SP, influencing policy change to lumefantrine-artemether. The views of key informants indicate that the switch from chloroquine to SP was justified based on local evidence despite unavailability of WHO's policy recommendations, while the switch to lumefantrine-artemether was uncomplicated as the country was following the recommendations from WHO. Ample evidence from Malawi influenced and justified the policy changes. Therefore, locally generated evidence is vital for decision making during policy change.
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The impact of long term institutional collaboration in surgical training on trauma care in Malawi.
Young, Sven; Banza, Leonard; Mkandawire, Nyengo
2016-01-01
Attempts to address the huge, and unmet, need for surgical services in Africa by training surgical specialists in well established training programmes in high-income countries have resulted in brain drain, as most trainees do not return home on completion of training for various reasons. Local postgraduate training is key to retaining specialists in their home countries. International institutional collaborations have enabled Kamuzu Central Hospital (KCH) in Lilongwe, Malawi, to start training their own surgical specialists from 2009. The direct impact of this has been an increase in Malawian staff from none at all to 12 medical doctors in 2014 in addition to increased foreign faculty. We have also seen improved quality of care as illustrated by a clear reduction in the amputation rate after trauma at KCH, from nearly every fourth orthopaedic operation being an amputation in 2008 to only 4 % in 2014. Over the years the training program at KCH has, with the help from its international partners, merged with the College of Medicine in Blantyre, Malawi, into a national training programme for surgery. Our experiences from this on-going international institutional collaboration to increase the capacity for training surgeons in Malawi show that long-term institutional collaboration in the training of surgeons in low-income countries can be done as a sustainable and up-scalable model with great potential to reduce mortality and prevent disability in young people. Despite the obvious and necessary focus on the rural poor in low-income countries, stakeholders must start to see the value of strengthening teaching hospitals to sustainably meet the growing burden of trauma and surgical disease. Annual operating data from Kamuzu Central Hospital's Main Operating Theatre log book for the years 2008-2014 was collected. Observed annual numbers were presented as graphs for easy visualization. Linear regression curve estimations were calculated and plotted as trend lines on the
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Barnett, Brian S; Mulenga, Macjellings; Kiser, Michelle M; Charles, Anthony G
2017-05-01
While psychological care, including supportive group therapy, is a mainstay of burn treatment in the developed world, few reports of support groups for burn survivors and their caregivers in the developing world exist. This study records the findings of a support group in Malawi and provides a qualitative analysis of thematic content discussed by burn survivors and caregivers. We established a support group for burn survivors and caregivers from February-May 2012 in the burn unit at Kamuzu Central Hospital in Lilongwe, Malawi. Sessions were held weekly for twelve weeks and led by a Malawian counselor. The group leader compiled transcripts of each session and these transcripts were qualitatively analyzed for thematic information. Thematic analysis demonstrated a variety of psychological issues discussed by both survivors and caregivers. Caregivers discussed themes of guilt and self-blame for their children's injuries, worries about emotional distance now created between caregiver and survivor, fears that hospital admission meant likely patient death and concerns about their child's future and burn associated stigma. Burn survivors discussed frustration with long hospitalization courses, hope created through interactions with hospital staff, the association between mental and physical health, rumination about their injuries and how this would affect their future, decreased self-value, increased focus on their own mortality and family interpersonal difficulties. The establishment of a support group in our burn unit provided a venue for burn survivors and their families to discuss subjective experiences, as well as the dissemination of various coping techniques. Burn survivors and their caregivers in Malawi would benefit from the establishment of similar groups in the future to help address the psychological sequelae of burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
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Refractive errors, visual impairment, and the use of low-vision devices in albinism in Malawi.
Schulze Schwering, M; Kumar, N; Bohrmann, D; Msukwa, G; Kalua, K; Kayange, P; Spitzer, M S
2015-04-01
This study focuses on the refractive implications of albinism in Malawi, which is mostly associated with the burden of visual impairment. The main goal was to describe the refractive errors and to analyze whether patients with albinism in Malawi, Sub-Saharan Africa, benefit from refraction. Age, sex, refractive data, uncorrected and best-corrected visual acuity (UCVA, BCVA), colour vision, contrast sensitivity, and the prescription of sunglasses and low vision devices were collected for a group of 120 albino individuals with oculocutaneous albinism (OCA). Refractive errors were evaluated objectively and subjectively by retinoscopy, and followed by cycloplegic refraction to reconfirm the results. Best-corrected visual acuity (BCVA) was also assessed binocularly. One hundred and twenty albino subjects were examined, ranging in age from 4 to 25 years (median 12 years), 71 (59 %) boys and 49 (41 %) girls. All exhibited horizontal pendular nystagmus. Mean visual acuity improved from 0.98 (0.33) logMAR to 0.77 (0.15) logMAR after refraction (p < 0.001). The best improvement of VA was achieved in patients with mild to moderate myopia. Patients with albinism who were hyperopic more than +1.5 D hardly improved from refraction. With the rule (WTR) astigmatism was more present (37.5 %) than against the rule (ATR) astigmatism (3.8 %). Patients with astigmatism less than 1.5 D improved in 15/32 of cases (47 %) by 2 lines or more. Patients with astigmatism equal to or more than 1.5 D in any axis improved in 26/54 of cases (48 %) by 2 lines or more. Refraction improves visual acuity of children with oculocutaneous albinism in a Sub-Saharan African population in Malawi. The mean improvement was 2 logMAR units.
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Chinyama, Mathews Junior; MacLachlan, Malcolm; McVeigh, Joanne; Huss, Tessy; Gawamadzi, Sylvester
2017-07-29
Equity and social inclusion for vulnerable groups in policy development processes and resulting documents remain a challenge globally. Most often, the marginalization of vulnerable groups is overlooked in both the planning and practice of health service delivery. Such marginalization may occur because authorities deem the targeting of those who already have better access to healthcare a cheaper and easier way to achieve short-term health gains. The Government of Malawi wishes to achieve an equitable and inclusive HIV and AIDS Policy. The aim of this study is to assess the extent to which the Malawi Policy review process addressed regional and international health priorities of equity and social inclusion for vulnerable groups in the policy content and policy revision process. This research design comprised two phases. First, the content of the Malawi HIV and AIDS Policy was assessed using EquiFrame regarding its coverage of 21 Core Concepts of human rights and inclusion of 12 Vulnerable Groups. Second, the engagement of vulnerable groups in the policy process was assessed using the EquIPP matrix. For the latter, 10 interviews were conducted with a purposive sample of representatives of public sector, civil society organizations and development partners who participated in the policy revision process. Data was also collected from documented information of the policy processes. Our analyses indicated that the Malawi HIV and AIDS Policy had a relatively high coverage of Core Concepts of human rights and Vulnerable Groups; although with some notable omissions. The analyses also found that reasonable steps were taken to engage and promote participation of vulnerable groups in the planning, development, implementation, monitoring and evaluation processes of the HIV and AIDS Policy, although again, with some notable exceptions. This is the first study to use both EquiFrame and EquIPP as complimentary tools to assess the content and process of policy. While the findings
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Rosen, Barry; Itsura, Peter; Tonui, Philip; Covens, Alan; van Lonkhuijzen, Luc; Orang'o, Elkanah Omenge
2017-08-01
To provide information on the development of a gynecologic oncology training program in a low-resource setting in Kenya. This is a review of a collaboration between Kenyan and North American physicians who worked together to develop a gynecologic oncology training in Kenya. We review the published data on the increase of cancer incidence in sub-Saharan Africa and outline the steps that were taken to develop this program. The incidence of cervical cancer in Kenya is very high and is the leading cause of cancer mortality in Kenya. WHO identifies cancer as a new epidemic affecting countries in sub-Saharan Africa. In Kenya, a country of 45 million, there is limited resources to diagnose and treat cancer. In 2009 in western Kenya, at Moi University there was no strategy to manage oncology in the Reproductive Health department. There was only 1 gynecologic oncologists in Kenya in 2009. A collaboration between Canadian and Kenya physicians resulted in development of a gynecologic oncology clinical program and initiation of fellowship training in Kenya. In the past 4 years, five fellows have graduated from a 2 year fellowship training program. Integration of data collection on all the patients as part of this program provided opportunities to do clinical research and to acquire peer reviewed grants. This is the first recognized fellowship training program in sub-Saharan Africa outside of South Africa. It is an example of a collaborative effort to improve women's health in a low-resource country. This is a Kenyan managed program through Moi University. These subspecialty trained doctors will also provide advice that will shape health care policy and provide sustainable expertise for women diagnosed with a gynecologic cancer.
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Asiki, Gershim; Shao, Shuai; Wainana, Carol; Khayeka-Wandabwa, Christopher; Haregu, Tilahun N; Juma, Pamela A; Mohammed, Shukri; Wambui, David; Gong, Enying; Yan, Lijing L; Kyobutungi, Catherine
2018-05-09
In Kenya, cardiovascular diseases (CVDs) accounted for more than 10% of total deaths and 4% of total Disability-Adjusted Life Years (DALYs) in 2015 with a steady increase over the past decade. The main objective of this paper was to review the existing policies and their content in relation to prevention, control and management of CVDs at primary health care (PHC) level in Kenya. A targeted document search in Google engine using keywords "Kenya national policy on cardiovascular diseases" and "Kenya national policy on non-communicable diseases (NCDs)" was conducted in addition to key informant interviews with Kenyan policy makers. Relevant regional and international policy documents were also included. The contents of documents identified were reviewed to assess how well they aligned with global health policies on CVD prevention, control and management. Thematic content analysis of the key informant interviews was also conducted to supplement the document reviews. A total of 17 documents were reviewed and three key informants interviewed. Besides the Tobacco Control Act (2007), all policy documents for CVD prevention, control and management were developed after 2013. The national policies were preceded by global initiatives and guidelines and were similar in content with the global policies. The Kenya health policy (2014-2030), The Kenya Health Sector Strategic and Investment Plan (2014-2018) and the Kenya National Strategy for the Prevention and Control of Non-communicable diseases (2015-2020) had strategies on NCDs including CVDs. Other policy documents for behavioral risk factors (The Tobacco Control Act 2007, Alcoholic Drinks Control (Licensing) Regulations (2010)) were available. The National Nutrition Action Plan (2012-2017) was available as a draft. Although Kenya has a tiered health care system comprising primary healthcare, integration of CVD prevention and control at PHC level was not explicitly mentioned in the policy documents. This review revealed
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Berde, Anselm Shekwagu; Yalcin, Siddika Songul; Ozcebe, Hilal; Uner, Sarp; Caman, Ozge Karadag
2017-09-01
Prelacteal feeding (PLF) is a barrier to exclusive breast feeding. To determine factors associated with PLF in rural and urban Nigeria. We utilized data from the 2013 Nigerian Demographic and Health Survey. Bivariate and multivariate analyses were used to test for association between PLF and related factors. Prevalence of PLF in urban Nigeria was 49.8%, while in rural Nigeria it was 66.4%. Sugar or glucose water was given more in urban Nigeria (9.7% vs 2.9%), plain water was given more in rural Nigeria (59.9% vs 40.8%). The multivariate analysis revealed that urban and rural Nigeria shared similarities with respect to factors like mother's education, place of delivery, and size of child at birth being significant predictors of PLF. Mode of delivery and type of birth were significant predictors of PLF only in urban Nigeria, whereas, mother's age at birth was a significant predictor of PLF only in rural Nigeria. Zones also showed variations in the odds of PLF according to place of residence. Interventions aimed at decreasing PLF rate should be through a tailored approach, and should target at risk sub-groups based on place of residence.
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Vetrini, Damir; Kiire, Christine A; Burgess, Philip I; Harding, Simon P; Kayange, Petros C; Kalua, Khumbo; Msukwa, Gerald; Beare, Nicholas A V; Madan, Jason
2018-01-01
To investigate the economic impact of introducing targeted screening and laser photocoagulation treatment for sight-threatening diabetic retinopathy and macular edema in a setting with no previous screening or laser treatment for diabetic retinopathy in sub-Saharan Africa. A cohort Markov model was built to compare combined targeted screening and laser treatment for patients with sight-threatening diabetic retinopathy and macular edema against no intervention. Primary outcomes were incremental cost per quality-adjusted life year (QALY) gained and per disability-adjusted life year (DALY) averted. Primary data were collected on 357 participants from the Malawi Diabetic Retinopathy Study, a prospective, observational cohort study. Multiple scenarios were explored and a probabilistic sensitivity analysis was performed. In the base case (age: 50 years, service utilization rate: 80%), the cost of the intervention and the years of severe visual impairment averted per patient screened were $209 and 2.2 years respectively. Applying the World Health Organization threshold of cost-effectiveness for Malawi ($679), the base case was cost-effective when QALYs were used ($400 per QALY gained) but not when DALYs were used ($766 per DALY averted). The intervention was more cost-effective when it targeted younger patients (age: 30 years) and less cost-effective when the utilization rate was lowered to 50%. Annual photographic screening of diabetic patients attending medical diabetes clinics in Malawi, with the provision of laser treatment for those with sight-threatening diabetic retinopathy and macular edema, appears to be cost-effective in terms of QALYs gained, in our base case scenario. Cost-effectiveness improves if services are utilized more intensively and extended to younger patients.
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Q Fever, Scrub Typhus, and Rickettsial Diseases in Children, Kenya, 2011-2012.
Maina, Alice N; Farris, Christina M; Odhiambo, Antony; Jiang, Ju; Laktabai, Jeremiah; Armstrong, Janice; Holland, Thomas; Richards, Allen L; O'Meara, Wendy P
2016-05-01
To increase knowledge of undifferentiated fevers in Kenya, we tested paired serum samples from febrile children in western Kenya for antibodies against pathogens increasingly recognized to cause febrile illness in Africa. Of patients assessed, 8.9%, 22.4%, 1.1%, and 3.6% had enhanced seroreactivity to Coxiella burnetii, spotted fever group rickettsiae, typhus group rickettsiae, and scrub typhus group orientiae, respectively.
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Ngwira, Bagrey; Stockman, Lauren J.; Deming, Michael; Nyasulu, Peter; Bowie, Cameron; Msyamboza, Kelias; Meyrowitsch, Dan W.; Cunliffe, Nigel A.; Bresee, Joseph; Fischer, Thea K.
2014-01-01
Failure to access healthcare is an important contributor to child mortality in many developing countries. In a national household survey in Malawi, we explored demographic and socioeconomic barriers to healthcare for childhood illnesses and assessed the direct and indirect costs of seeking care. Using a cluster-sample design, we selected 2,697 households and interviewed 1,669 caretakers. The main reason for households not being surveyed was the absence of a primary caretaker in the household. Among 2,077 children aged less than five years, 504 episodes of cough and fever during the previous two weeks were reported. A trained healthcare provider was visited for 48.0% of illness episodes. A multivariate regression model showed that children from the poorest households (p=0.02) and children aged >12 months (p=0.02) were less likely to seek care when ill compared to those living in wealthier households and children of higher age-group respectively. Families from rural households spent more time travelling compared to urban households (68.9 vs 14.1 minutes; p<0.001). In addition, visiting a trained healthcare provider was associated with longer travel time (p<0.001) and higher direct costs (p<0.001) compared to visiting an untrained provider. Thus, several barriers to accessing healthcare in Malawi for childhood illnesses exist. Continued efforts to reduce these barriers are needed to narrow the gap in the health and healthcare equity in Malawi. PMID:24847595
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Influence of Examinations Oriented Approaches on Quality Education in Primary Schools in Kenya
ERIC Educational Resources Information Center
Mackatiani, Caleb Imbova
2017-01-01
This paper provides a critical appraisal of the influence of examinations oriented approaches on quality education in primary schools in Kenya. The purpose of the study was to determine effects of examination oriented teaching approaches on learning achievement among primary school pupils in Kakamega County, Kenya. It explored the assumptions…
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Gueye, Abdou; Speizer, Ilene S; Corroon, Meghan; Okigbo, Chinelo C
2015-12-01
Negative myths and misconceptions about family planning are a barrier to modern contraceptive use. Most research on the subject has focused on individual beliefs about contraception; however, given that myths spread easily within communities, it is also important to examine how the prevalence of negative myths in a community affects the aggregate level of method use. Baseline data collected in 2010-2011 by the Measurement, Learning & Evaluation project on women aged 15-49 living in selected cities in Kenya, Nigeria and Senegal were used. Multivariate analyses examined associations between modern contraceptive use and belief in negative myths for individuals and communities. In each country, the family planning myths most prevalent at the individual and community levels were that "people who use contraceptives end up with health problems," "contraceptives are dangerous to women's health" and "contraceptives can harm your womb." On average, women in Nigeria and Kenya believed 2.7 and 4.6 out of eight selected myths, respectively, and women in Senegal believed 2.6 out of seven. Women's individual-level belief in myths was negatively associated with their modern contraceptive use in all three countries (odds ratios, 0.2-0.7). In Nigeria, the women's community-level myth variable was positively associated with modern contraceptive use (1.6), whereas the men's community-level myth variable was negatively associated with use (0.6); neither community-level variable was associated with modern contraceptive use in Kenya or Senegal. Education programs are needed to dispel common myths and misconceptions about modern contraceptives. In Nigeria, programs that encourage community-level discussions may be effective at reducing myths and increasing modern contraceptive use.
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Nursing in Malawi: nursing theory in the movement to professionalize nursing.
Bultemeier, Kaye I
2012-04-01
Nursing in Malawi has been predominately a technical trade and only recently has begun the transition to a profession with autonomy and advanced degree preparation. Nursing theories provide a framework for the evolution of nursing to an independent profession. Theories provide a means for the articulation of the nursing role to other members of the healthcare team including consumers. Healthcare and human needs are basic and the guidance provided by nursing theories, including Nightingale's, gives language and structure to the education of nurses as the profession moves into advanced practice in a developing country.
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Sex work and the construction of intimacies: meanings and work pragmatics in rural Malawi.
Tavory, Iddo; Poulin, Michelle
2012-05-01
This article focuses on Malawian sex workers' understandings of exchange and intimacy, showing how multiple historically emergent categories and specific work pragmatics produce specific patterns of relational meanings. As we show, sex workers make sense of their relationships with clients through two categories. The first is sex work; the second is the chibwenzi , an intimate premarital relational category that emerged from pre-colonial transformations in courtship practices. These categories, in turn, are also shaped differently in different work settings. We use narratives from in-depth interviews with 45 sex workers and bar managers in southern Malawi to describe how the everyday pragmatics of two forms of sex work-performed by "bargirls" and "freelancers"-foster distinct understandings of relationships between them and men they have sex with. Bargirls, who work and live in bars, blurred the boundaries between "regulars" and chibwenzi; freelancers, who are not tethered to a specific work environment, often subverted the meanings of the chibwenzi , presenting these relationships as both intimate and emotionally distant. Through this comparison, we thus refine an approach to the study of the intimacy-exchange nexus, and use it to capture the complexities of gender relations in post-colonial Malawi.
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Young, Sven; Banza, Leonard; Munthali, Boston S; Manda, Kumbukani G; Gallaher, Jared; Charles, Anthony
2016-12-01
Background and purpose - The burden of road traffic injuries globally is rising rapidly, and has a huge effect on health systems and development in low- and middle-income countries. Malawi is a small low-income country in southeastern Africa with a population of 16.7 million and a gross national income per capita of only 250 USD. The impact of the rising burden of trauma is very apparent to healthcare workers on the ground, but there are very few data showing this development. Patients and methods - The annual number of femoral fracture patients admitted to Kamuzu Central Hospital (KCH) in the Capital of Malawi, Lilongwe, from 2009 to 2014 was retrieved from the KCH trauma database. Linear regression curve estimation was used to project the growth in the burden of femoral fractures and the number of operations performed for femoral fractures over the same time period. Results - 992 patients with femoral fractures (26% of all admissions for fractures) presented at KCH from 2009 through 2014. In this period, there was a 132% increase in the annual number of femoral fractures admitted to KCH. In the same time period, the total number of operations more than doubled, but there was no increase in the number of operations performed for femoral fractures. Overall, there was a 7% mortality rate for patients with femoral fractures. Interpretation - The burden of femoral fractures in Malawi is rising rapidly, and the surgical resources available cannot keep up with this development. Limited funds for orthopedic trauma care in Malawi should be invested in central training hospitals, to develop a sustainable number of orthopedic surgeons and improve current infrastructure and equipment. The centralization of orthopedic surgical care delivery at the central training hospitals will lead to better access to surgical care and early return of patients to local district hospitals for rehabilitation, thus increasing surgical throughput and efficiency in a more cost-effective manner
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Wang, Qun; Brenner, Stephan; Leppert, Gerald; Banda, Thomas Hastings; Kalmus, Olivier; De Allegri, Manuela
2015-03-01
Malawi is facing a rising chronic non-communicable disease (CNCD) epidemic. This study explored health seeking behaviour and related expenditure on CNCDs in rural Malawi, with specific focus on detecting potential differences across population groups. We used data from the first round of a panel household health survey conducted in rural Malawi between August and October 2012 on a sample of 1199 households. Multinomial logistic regression was used to analyse factors associated with health seeking choices for CNCDs, distinguishing between no care, informal care and formal care. Descriptive statistics (mean, standard deviation and median) were used to describe related household out-of-pocket expenditure. There were 475 individuals (equivalent to 8.4% of all respondents) reporting at least one CNCD. Among them, 37.3% did not seek any care, 42.5% sought formal care (facility-based care), and 20.2% opted for informal care (traditional or home treatment). Regression analysis showed that illness severity and duration, socio-economic status, being a household head, and the proportion of household members living with a CNCD were significantly associated with health care utilization. Among those seeking care, 65.8% incurred out-of-pocket expenditure with an average of USD 1.49 spent on medical treatment and an additional USD 0.50 spent on transport. Further qualitative inquiry is needed to understand the reasons for low service utilization and to explore the potential role of supply-side factors. To increase access to care for people suffering from CNCDs, the provision of a free Essential Health Package in Malawi ought to be strengthened through the integration of system-wide screening, risk factor modification and continuity of care options for people suffering from CNCDs. This would ensure affordable services to modulate health seeking behaviour of patients at risk of major chronic illnesses. Published by Oxford University Press in association with The London School of
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Bar-Zeev, Naor; Tate, Jacqueline E.; Pecenka, Clint; Chikafa, Jean; Mvula, Hazzie; Wachepa, Richard; Mwansambo, Charles; Mhango, Themba; Chirwa, Geoffrey; Crampin, Amelia C.; Parashar, Umesh D.; Costello, Anthony; Heyderman, Robert S.; French, Neil; Atherly, Deborah; Cunliffe, Nigel A.
2016-01-01
Background. Rotavirus vaccination reduces childhood hospitalization in Africa, but cost-effectiveness has not been determined using real-world effectiveness and costing data. We sought to determine monovalent rotavirus vaccine cost-effectiveness in Malawi, one of Africa's poorest countries and the first Gavi-eligible country to report disease reduction following introduction in 2012. Methods. This was a prospective cohort study of children with acute gastroenteritis at a rural primary health center, a rural first referral–level hospital and an urban regional referral hospital in Malawi. For each participant we itemized household costs of illness and direct medical expenditures incurred. We also collected Ministry of Health vaccine implementation costs. Using a standard tool (TRIVAC), we derived cost-effectiveness. Results. Between 1 January 2013 and 21 November 2014, we recruited 530 children aged <5 years with gastroenteritis. Costs did not differ by rotavirus test result, but were significantly higher for admitted children and those with increased severity on Vesikari scale. Adding rotavirus vaccine to the national schedule costs Malawi $0.42 per dose in system costs. Vaccine copayment is an additional $0.20. Over 20 years, the vaccine program will avert 1 026 000 cases of rotavirus gastroenteritis, 78 000 inpatient admissions, 4300 deaths, and 136 000 disability-adjusted-life-years (DALYs). For this year's birth cohort, it will avert 54 000 cases of rotavirus and 281 deaths in children aged <5 years. The program will cost $10.5 million and save $8.0 million in averted healthcare costs. Societal cost per DALY averted was $10, and the cost per rotavirus case averted was $1. Conclusions. Gastroenteritis causes substantial economic burden to Malawi. The rotavirus vaccine program is highly cost-effective. Together with the demonstrated impact of rotavirus vaccine in reducing population hospitalization burden, its cost-effectiveness makes a strong argument
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Bar-Zeev, Naor; Tate, Jacqueline E; Pecenka, Clint; Chikafa, Jean; Mvula, Hazzie; Wachepa, Richard; Mwansambo, Charles; Mhango, Themba; Chirwa, Geoffrey; Crampin, Amelia C; Parashar, Umesh D; Costello, Anthony; Heyderman, Robert S; French, Neil; Atherly, Deborah; Cunliffe, Nigel A
2016-05-01
Rotavirus vaccination reduces childhood hospitalization in Africa, but cost-effectiveness has not been determined using real-world effectiveness and costing data. We sought to determine monovalent rotavirus vaccine cost-effectiveness in Malawi, one of Africa's poorest countries and the first Gavi-eligible country to report disease reduction following introduction in 2012. This was a prospective cohort study of children with acute gastroenteritis at a rural primary health center, a rural first referral-level hospital and an urban regional referral hospital in Malawi. For each participant we itemized household costs of illness and direct medical expenditures incurred. We also collected Ministry of Health vaccine implementation costs. Using a standard tool (TRIVAC), we derived cost-effectiveness. Between 1 January 2013 and 21 November 2014, we recruited 530 children aged <5 years with gastroenteritis. Costs did not differ by rotavirus test result, but were significantly higher for admitted children and those with increased severity on Vesikari scale. Adding rotavirus vaccine to the national schedule costs Malawi $0.42 per dose in system costs. Vaccine copayment is an additional $0.20. Over 20 years, the vaccine program will avert 1 026 000 cases of rotavirus gastroenteritis, 78 000 inpatient admissions, 4300 deaths, and 136 000 disability-adjusted-life-years (DALYs). For this year's birth cohort, it will avert 54 000 cases of rotavirus and 281 deaths in children aged <5 years. The program will cost $10.5 million and save $8.0 million in averted healthcare costs. Societal cost per DALY averted was $10, and the cost per rotavirus case averted was $1. Gastroenteritis causes substantial economic burden to Malawi. The rotavirus vaccine program is highly cost-effective. Together with the demonstrated impact of rotavirus vaccine in reducing population hospitalization burden, its cost-effectiveness makes a strong argument for widespread utilization in other low-income, high
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Characterisation of adopters and non-adopters of dairy technologies in Ethiopia and Kenya.
Kebebe, E G; Oosting, S J; Baltenweck, I; Duncan, A J
2017-04-01
While there is a general consensus that using dairy technologies, such as improved breeds of dairy cows, can substantially increase farm productivity and income, adoption of such technologies has been generally low in developing countries. The underlying reasons for non-adoption of beneficial technologies in the dairy sector are not fully understood. In this study, we characterised adopters and non-adopters of dairy technologies in Ethiopia and Kenya based on farmers' resources ownership in order to identify why many farmers in Ethiopia and Kenya have not adopted improved dairy technologies. As compared to non-adopters, farmers who adopt dairy technology own relatively more farm resources. The result signals that differences in resource endowments could lead to divergent technology adoption scenarios. Results show that a higher proportion of sample smallholders in Kenya have adopted dairy technologies than those in Ethiopia. Except for the use of veterinary services, fewer than 10% of sample farmers in Ethiopia have adopted dairy technologies-less than half the number of adopters in Kenya. The higher level of dairy technology adoption in Kenya can be ascribed partly to the long history of dairy development, including improvements in the value chain for the delivery of inputs, services and fluid milk marketing. Interventions that deal with the constraints related to access to farm resources and input and output markets could facilitate uptake of dairy technology in developing countries.
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Changing Patterns of Access to Basic Education in Malawi: A Story of a Mixed Bag?
ERIC Educational Resources Information Center
Chimombo, Joseph
2009-01-01
Malawi was the first sub-Saharan African country to take a bold decision and declare free primary education after the Jomtien conference in 1990. Fourteen years after the policy was first implemented no serious attempt has been made to find out what has happened to the influx of pupils joining the system. Using secondary sources of data, this…
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The New Language of Instruction Policy in Malawi: A House Standing on a Shaky Foundation
ERIC Educational Resources Information Center
Kamwendo, Gregory Hankoni
2016-01-01
This research note is a critique of Malawi's new language of instruction (LOI) policy. The new policy stipulates English as the medium of instruction from the first year (Standard 1) of primary school in a country where English is not the dominant language of household communication. The children are now expected to learn (and that includes…
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Erectile dysfunction management options in Nigeria.
Afolayan, Anthony Jide; Yakubu, Musa Toyin
2009-04-01
In Nigeria, the prevalence of erectile dysfunction (ED) among patients attending primary care clinics, age-standardized to the U.S. population in 2000 is 57.4%. This is considered high enough to warrant the attention of scientist for critical studies and analysis. The high ED prevalence is associated with etiologies such as psychosexual factors, chronic medical conditions, and some lifestyles. ED constitutes a major public health problem, influencing the patient's well-being and quality of life. It also leads to broken homes and marriages, psychological, social, and physical morbidity. To give an account of various ED management options in Nigeria. Review of peer-reviewed literature, questionnaire, and ethnobotanical survey to some indigenous herb sellers and herbalists. Cross cultural perspectives of ED management in Nigeria. The review suggests that traditional (phytotherapy, zootherapy, and occultism) and nontraditional, orthodox practice (drug therapy, psychological, and behavioral counseling) are applicable to ED management in Nigeria. This review should help in creating awareness into various options available for managing ED in the country, but does not recommend self medication of any form, be it the use of orthodox or herbal remedy.
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Computational biology and bioinformatics in Nigeria.
Fatumo, Segun A; Adoga, Moses P; Ojo, Opeolu O; Oluwagbemi, Olugbenga; Adeoye, Tolulope; Ewejobi, Itunuoluwa; Adebiyi, Marion; Adebiyi, Ezekiel; Bewaji, Clement; Nashiru, Oyekanmi
2014-04-01
Over the past few decades, major advances in the field of molecular biology, coupled with advances in genomic technologies, have led to an explosive growth in the biological data generated by the scientific community. The critical need to process and analyze such a deluge of data and turn it into useful knowledge has caused bioinformatics to gain prominence and importance. Bioinformatics is an interdisciplinary research area that applies techniques, methodologies, and tools in computer and information science to solve biological problems. In Nigeria, bioinformatics has recently played a vital role in the advancement of biological sciences. As a developing country, the importance of bioinformatics is rapidly gaining acceptance, and bioinformatics groups comprised of biologists, computer scientists, and computer engineers are being constituted at Nigerian universities and research institutes. In this article, we present an overview of bioinformatics education and research in Nigeria. We also discuss professional societies and academic and research institutions that play central roles in advancing the discipline in Nigeria. Finally, we propose strategies that can bolster bioinformatics education and support from policy makers in Nigeria, with potential positive implications for other developing countries.
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Computational Biology and Bioinformatics in Nigeria
Fatumo, Segun A.; Adoga, Moses P.; Ojo, Opeolu O.; Oluwagbemi, Olugbenga; Adeoye, Tolulope; Ewejobi, Itunuoluwa; Adebiyi, Marion; Adebiyi, Ezekiel; Bewaji, Clement; Nashiru, Oyekanmi
2014-01-01
Over the past few decades, major advances in the field of molecular biology, coupled with advances in genomic technologies, have led to an explosive growth in the biological data generated by the scientific community. The critical need to process and analyze such a deluge of data and turn it into useful knowledge has caused bioinformatics to gain prominence and importance. Bioinformatics is an interdisciplinary research area that applies techniques, methodologies, and tools in computer and information science to solve biological problems. In Nigeria, bioinformatics has recently played a vital role in the advancement of biological sciences. As a developing country, the importance of bioinformatics is rapidly gaining acceptance, and bioinformatics groups comprised of biologists, computer scientists, and computer engineers are being constituted at Nigerian universities and research institutes. In this article, we present an overview of bioinformatics education and research in Nigeria. We also discuss professional societies and academic and research institutions that play central roles in advancing the discipline in Nigeria. Finally, we propose strategies that can bolster bioinformatics education and support from policy makers in Nigeria, with potential positive implications for other developing countries. PMID:24763310
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The Score Reliability of Draw-a-Person Intellectual Ability Test (DAP: IQ) for Rural Malawi Students
ERIC Educational Resources Information Center
Khasu, Denis S.; Williams, Thomas O., Jr.
2016-01-01
In this brief article, the reliability of scores for the Draw-A-Person Intellectual Ability Test for Children, Adolescents, and Adults (DAP: IQ; Reynolds & Hickman, 2004) was examined through several analyses with a sample of 147 children from rural Malawi, Africa using a Chichewa translation of instructions. Cronbach alpha coefficients for…
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ERIC Educational Resources Information Center
Mdolo, Margaret M.; Mundalamo, Fhatuwani J.
2015-01-01
This paper reports on the relationship between the subject matter knowledge of two underqualified teachers and their topic-specific pedagogical content knowledge (TSPCK) as they taught genetics at two community secondary schools in Malawi. The study was qualitative and used the multiple case study approach. The sample was purposefully chosen. Data…
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Cook, Sinead; de Kok, Bregje; Odland, Maria Lisa
2017-04-01
Malawi has one of the highest maternal mortality ratios in the world. Unsafe abortions are an important contributor to Malawi's maternal mortality and morbidity, where abortion is illegal except to save the woman's life. Postabortion care (PAC) aims to reduce adverse consequences of unsafe abortions, in part by treating incomplete abortions. Although global and national PAC policies recommend manual vacuum aspiration (MVA) for treatment of incomplete abortion, usage in Malawi is low and appears to be decreasing, with sharp curettage being used in preference. There is limited evidence regarding what influences rejection of recommended PAC innovations. Hence, drawing on Greenhalgh et al. 's (2004. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Quarterly 82: 581-629.) diffusion of healthcare innovation framework, this qualitative study aimed to investigate factors contributing to the limited and declining use of MVA in Malawi. Semi-structured interviews with 17 PAC providers in a central hospital and a district hospital indicate that a range of factors coalesce and influence PAC and MVA use in Malawi. Factors pertain to four main domains: the system (shortages of material and human resources; lack of training, supervision and feedback), relationships (power dynamics; expected job roles), the health workers (attitudes towards abortion and PAC; prioritization of PAC) and the innovation (perceived risks and benefits of MVA use). Effective and sustainable PAC policy must adopt a broader people-centred health systems approach which considers all these factors, their interactions and the wider socio-cultural, legal and political context of abortion and PAC. The study showed the value of using Greenhalgh et al. 's (2004. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Quarterly 82: 581-629.) framework to consider the complex interaction of factors surrounding innovation use
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ERIC Educational Resources Information Center
Okilwa, Nathern S. A.
2015-01-01
As a developing country in sub-Saharan Africa, Kenya has fared comparatively well in educating its young people. The new constitution of Kenya and various acts of parliament identify education as a fundamental human right and mandates the government to provide basic education for all. Consistent with the government's "Vision 2030," most…
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Dating, Sex, and Schooling in Urban Kenya
Clark, Shelley; Mathur, Rohini
2013-01-01
Completion of secondary school is increasingly viewed as a desirable life goal for young men and women in urban Kenya. Yet achieving this goal often conflicts with other key transitions to adulthood, such as becoming sexually active, marrying, having children, and finding employment. Drawing upon exceptionally rich life-history calendar data from young people in Kisumu, Kenya, we explore how the timing and sequencing of key transitions affects the likelihood of secondary school completion. Conversely, we also examine how school enrollment and performance affect the timing of sexual initiation. Our findings indicate that sexual activity and the transition toward family formation are largely incompatible with young women’s schooling. For men, however, romantic and sexual partnerships have no impact on schooling unless a partner becomes pregnant. Instead, paid employment appears to be least compatible with continued education. PMID:23185860
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The cost of health professionals' brain drain in Kenya.
Kirigia, Joses Muthuri; Gbary, Akpa Raphael; Muthuri, Lenity Kainyu; Nyoni, Jennifer; Seddoh, Anthony
2006-07-17
Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. The total cost of educating a single medical doctor from primary school to university is 65,997 US dollars; and for every doctor who emigrates, a country loses about 517,931 US dollars worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is 43,180 US dollars; and for every nurse that emigrates, a country loses about 338,868 US dollars worth of returns from investment. Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill-health and
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The cost of health professionals' brain drain in Kenya
Kirigia, Joses Muthuri; Gbary, Akpa Raphael; Muthuri, Lenity Kainyu; Nyoni, Jennifer; Seddoh, Anthony
2006-01-01
Background Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries (Canada, Denmark, Finland, Ireland, Portugal, UK, USA); and (iii) to describe other losses from brain drain. Methods The costs of primary, secondary, medical and nursing schools were estimated in 2005. The cost information used in this study was obtained from one non-profit primary and secondary school and one public university in Kenya. The cost estimates represent unsubsidized cost. The loss incurred by Kenya through emigration was obtained by compounding the cost of educating a medical doctor and a nurse over the period between the average age of emigration (30 years) and the age of retirement (62 years) in recipient countries. Results The total cost of educating a single medical doctor from primary school to university is US$ 65,997; and for every doctor who emigrates, a country loses about US$ 517,931 worth of returns from investment. The total cost of educating one nurse from primary school to college of health sciences is US$ 43,180; and for every nurse that emigrates, a country loses about US$ 338,868 worth of returns from investment. Conclusion Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak. Such continued plunder of investments embodied in human resources contributes to further underdevelopment of Kenya and to keeping a majority of her people in the vicious circle of ill
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Scherer, Laura; Curran, Michael; Alvarez, Miguel
2017-04-01
Biodiversity is highly valuable and critically threatened by anthropogenic degradation of the natural environment. In response, governments have pledged enhanced protected-area coverage, which requires scarce biological data to identify conservation priorities. To assist this effort, we mapped conservation priorities in Kenya based on maximizing alpha (species richness) and beta diversity (species turnover) of plant communities while minimizing economic costs. We used plant-cover percentages from vegetation surveys of over 2000 plots to build separate models for each type of diversity. Opportunity and management costs were based on literature data and interviews with conservation organizations. Species richness was predicted to be highest in a belt from Lake Turkana through Mount Kenya and in a belt parallel to the coast, and species turnover was predicted to be highest in western Kenya and along the coast. Our results suggest the expanding reserve network should focus on the coast and northeastern provinces of Kenya, where new biological surveys would also fill biological data gaps. Meeting the Convention on Biological Diversity target of 17% terrestrial coverage by 2020 would increase representation of Kenya's plant communities by 75%. However, this would require about 50 times more funds than Kenya has received thus far from the Global Environment Facility. © 2016 Society for Conservation Biology.
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Challenges in regulation of biomedical research: The case of Kenya.
Wekesa, M
2015-12-01
Unregulated biomedical research has previously caused untold suffering to humankind. History is full of examples of abuse of animal and human subjects for research. Several codes and instruments have been formulated to regulate biomedical research. In Kenya, the Science, Technology and Innovation Act, 2014, together with the Constitution of Kenya, 2010, provide a fairly robust legal framework. Possible challenges include capacity building, overlap of functions of institutions, monitoring and evaluation, scientific/technological advances, intellectual property rights, funding for research, and dispute resolution. It is hoped that the new legislation will adequately address these challenges.
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Early Primary Literacy Instruction in Kenya
ERIC Educational Resources Information Center
Dubeck, Margaret M.; Jukes, Matthew C. H.; Okello, George
2012-01-01
We report on a study that used observations, conversations, and formal interviews to explore literacy instruction in 24 lower-primary classrooms in coastal Kenya. Specifically, we report the ways literacy instruction is delivered and how that delivery aligns with practices understood to promote reading acquisition. We find (1) prioritization of…
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Sexual and reproductive health and HIV/AIDS risk perception in the Malawi tourism industry.
Bisika, Thomas
2009-06-01
Malawi has for a long time relied on agriculture for the generation of foreign exchange. Due to varied reasons like climate change, the Malawi government has, therefore, identified tourism as one way of boosting foreign exchange earnings and is already in the process of developing the sector especially in the area of ecotourism. However, tourism is associated with increasing prostitution, drug abuse and a whole range of other sexual and reproductive health (SRH) problems such as teenage pregnancies, HIV/AIDS and sexually transmitted infections (STIs). This paper examines the knowledge, attitudes, practices and behaviour as well as risk perceptions associated with HIV/AIDS, sexually transmitted infections and unwanted pregnancies among staff in the tourism industry and communities around tourist facilities in Malawi. The study was descriptive in nature and used both qualitative and quantitative research methods. The qualitative methods involved in-depth interviews and focus group discussions. The quantitative technique employed a survey of 205 purposively selected subjects from the tourism sector. The study concludes that people in the tourism sector are at high risk of HIV/AIDS, sexually transmitted infections and unwanted pregnancies and should be considered as a vulnerable group. The study further observes that this group of people has not adopted behaviours that can protect them from HIV/AIDS, sexually transmitted infections and unwanted pregnancies although there is high demand for voluntary counselling and testing (VCT) which offers a very good entry point for HIV prevention and treatment in the tourism sector. The study recommends that a comprehensive tourism policy covering tourists, employees and communities around tourist facilities is required. Such a policy should address the rights of HIV infected employees and the provision of prevention and treatment services for HIV/AIDS and STIs as well as a broad range of SRH and family planning services especially
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Treatment outcomes of drug-resistant tuberculosis patients in Kenya.
Mibei, D J; Kiarie, J W; Wairia, A; Kamene, M; Okumu, M E
2016-11-01
Successful treatment of drug-resistant tuberculosis (DR-TB) is crucial in preventing disease transmission and reducing related morbidity and mortality. A standardised DR-TB treatment regimen is used in Kenya. Although patients on treatment are monitored, no evaluation of factors affecting treatment outcomes has yet been performed. To analyse treatment outcomes of DR-TB patients in Kenya and factors associated with successful outcome. Retrospective analysis of secondary data from Kenya's National Tuberculosis, Leprosy and Lung disease programme. DR-TB data from the national database for January to December 2012 were reviewed. Of 205 DR-TB patients included in the analysis, 169 (82.4%) had a successful treatment outcome, 18 (9%) died and 18 (9%) were lost to follow-up. Only sex (P = 0.006) and human immunodeficiency virus (HIV) status (P = 0.008) were predictors of successful treatment. Females were more likely to attain treatment success (OR 3.86, 95%CI 1.47-10.12), and HIV-negative status increased the likelihood of successful treatment (OR 3.53, 95%CI 1.4-8.9). Treatment success rates were higher than World Health Organization targets. Targeted policies for HIV-positive patients and males will improve treatment outcomes in these groups.
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Detection of Rift Valley fever viral activity in Kenya by satellite remote sensing imagery
NASA Technical Reports Server (NTRS)
Linthicum, Kenneth J.; Bailey, Charles L.; Davies, F. Glyn; Tucker, Compton J.
1987-01-01
Data from the advanced very high resolution radiometer on board the National Oceanic and Atmospheric Administration's polar-orbiting meteorological satellites have been used to infer ecological parameters associated with Rift Valley fever (RVF) viral activity in Kenya. An indicator of potential viral activity was produced from satellite data for two different ecological regions in Kenya, where RVF is enzootic. The correlation between the satellite-derived green vegetation index and the ecological parameters associated with RVF virus suggested that satellite data may become a forecasting tool for RVF in Kenya and, perhaps, in other areas of sub-Saharan Africa.
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Childhood Disability Risk Factors in Kenya: Impact of Poverty and Other Socio-Demographics
ERIC Educational Resources Information Center
Mugoya, George C. T.; Mutua, Kagendo N.
2015-01-01
The overarching purpose of this study was to ascertain the prevalence of maternal and infant/child health indices that have an established link to childhood disability (CHD) and their association with socio-economic status (SES) in Kenya. Data were drawn from the 2008/2009 Kenya Demographic and Health Survey. Descriptive and weighted Pearson's…
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Attitudes towards mental illness in Malawi: a cross-sectional survey
2012-01-01
Background Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi. Methods A cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the “World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia”. Results 210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%). This was closely followed by brain disease (92.8%), spirit possession (82.8%) and psychological trauma (76.1%). There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample. Conclusions Our study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue. PMID:22823941
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Women Education in Nigeria: Predicaments and Hopes
NASA Astrophysics Data System (ADS)
Akubuilo, Francis; Omeje, Monica
2012-10-01
This paper is focused on women education in Nigeria. It traces the genesis of western education in Nigeria and bias that existed from the traditional Nigerian society against women education. It identified and discussed barriers to women education in Nigeria. Recent trend in enrolment at various levels of education shows improvement in favor of women. In view of this realization, this paper argues that if the current momentum is sustained, women will not only achieve equal status to men in educational attainment but also have the tendency to surpass men within the next ten to fifteen years. The implications could be outreaching as the paper proffers some recommendations.
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The seismicity related to the southern part of the Kenya Rift
NASA Astrophysics Data System (ADS)
Hollnack, D.; Stangl, R.
1998-04-01
In 1990 the Geology Department of the University of Nairobi started to build up a seismological network for Kenya, which has been operating since 1993. In this paper the actual state of this seismological network is described. Additionally, the first results on the seismic activity in the southern part of Kenya and adjacent areas between October 1993 and August 1996 are presented and are compared with historical data. Out of more than 2000 recorded local earthquakes 435 could be localised within the study area with local magnitudes of up to 5. The distribution of the events shows three areas of prominent seismicity: the Rift Valley between Nakuru and northern Tanzania; the area northeast of Kilimanjaro; and the Nyanza Rift in western Kenya. In a first attempt to assess the seismic hazard for the study area, a seismic energy map for the period of observation is given.
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Household Structure and Living Conditions in Nigeria
ERIC Educational Resources Information Center
Mberu, Blessing Uchenna
2007-01-01
Data on 7,632 households from the 1999 Nigeria Demographic and Health Survey are used to examine household structure and living conditions in Nigeria. The study finds significant disadvantage in living conditions of single-adult, female- and single-adult, male-headed households relative to two-parent households. Extended households show no…
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ERIC Educational Resources Information Center
Swainson, Nicola
The causes and manifestations of gender inequalities in education in Malawi, Zambia, and Zimbabwe and policy options for redressing them were examined through a review of literature on the causes, nature, and extent of gender disparities in education in the study region and information on efforts to eliminate gender inequality. Special attention…
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ERIC Educational Resources Information Center
Wellard, Kate; Rafanomezana, Jenny; Nyirenda, Mahara; Okotel, Misaki; Subbey, Vincent
2013-01-01
Purpose: Farmer-to-farmer extension offers a potentially low-cost and wide-reach alternative in supporting agricultural innovation. Various approaches are being promoted but information on their impact and sustainability is sparse. This study examines experiences of Self Help Africa and partners in Ghana, Uganda and Malawi. It asks: What is good…
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The African cholera surveillance network (Africhol) consortium meeting, 10-11 June 2015, Lomé, Togo.
Munier, Aline; Njanpop-Lafourcade, Berthe-Marie; Sauvageot, Delphine; Mhlanga, Raymond B; Heyerdahl, Léonard; Nadri, Johara; Wood, Richard; Ouedraogo, Issaka; Blake, Alexandre; Akilimali Mukelenge, Laurent; Anné, Jean-Claude B; Banla Kere, Abiba; Dempouo, Lucienne; Keita, Sakoba; Langa, José P M; Makumbi, Issa; Mwakapeje, Elibariki R; Njeru, Ian J; Ojo, Olubunmi E; Phiri, Isaac; Pezzoli, Lorenzo; Gessner, Bradford D; Mengel, Martin
2017-01-01
The fifth annual meeting of the African cholera surveillance network (Africhol) took place on 10-11 June 2015 in Lomé, Togo. Together with international partners, representatives from the 11 member countries -Cameroon, Côte d'Ivoire, Democratic Republic of Congo, Guinea, Kenya, Mozambique, Nigeria, Tanzania, Togo, Uganda, Zimbabwe- and an invited country (Malawi) shared their experience. The meeting featured three sessions: i) cholera surveillance, prevention and control in participating countries, ii) cholera surveillance methodology, such as cholera mapping, cost-effectiveness studies and the issue of overlapping epidemics from different diseases, iii) cholera laboratory diagnostics tools and capacity building. The meeting has greatly benefitted from the input of technical expertise from participating institutions and the observations emerging from the meeting should enable national teams to make recommendations to their respective governments on the most appropriate and effective measures to be taken for the prevention and control of cholera. Recommendations for future activities included collecting precise burden estimates in surveillance sites; modeling cholera burden for Africa; setting up cross-border collaborations; strengthening laboratory capacity for the confirmation of suspected cholera cases and for vaccine impact assessment in settings where oral cholera vaccine would be used; adapting cholera surveillance to concurrent issues (e.g., Ebola); and developing national cholera control plans including rationale vaccination strategies together with other preventive and control measures such as improvements in water, sanitation and hygiene (WASH).
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Major incidents in Kenya: the case for emergency services development and training.
Wachira, Benjamin W; Smith, Wayne
2013-04-01
Kenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality. This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.
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Ethnicity, petroeconomy, and national integration in Nigeria
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yeri-Obidake, E.Z.
1985-01-01
Among several related phenomena, this study presents as its focal points the examination of some of the variables that influence and shape the structure of sociopolitical, cultural and socioeconomic relations in the course of national integration in Nigeria. The exploitation of petroleum resources since 1958 in the Niger Delta has largely influenced the course of the political as well as the socioeconomic development of Nigeria. Due to its rich petroleum resources, the Rivers territory ranked high in the political calculus of both the Federal Government and secessionist Biafra. The central thesis of this study is that oil is the singlemore » glue that has held the Federation of Nigeria together in the last two decades, and prevented it from being balkanized. This study attempts to put into perspective the various eruptions and episodes of secessionist tendencies and agitations in Nigeria. The ebb and flow of separatist agitations seem to reflect the changing geoeconomic, socioeconomic, and sociopolitical environment of the country. Should the petroeconomy collapse, and/or oil losses its significance in the international economy, what will happen to Nigeria as a nation. The present study points up the need to develop other sources of economic interdependence via the proper utilization of the enormous oil revenues before it is written off as a lost opportunity.« less
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2003-03-05
hyacinth infestation in Lake Victoria; deforestation; soil erosion; desertification; and poaching of wildlife, especially elephant and rhinoceros...with limited prospects for their personal and family improvement. a) To what extent has Kenya succeeded in overcoming the negative impact of...tension among non-African traders from Asia and the Middle East? Has such tension, to the extent that they exist, been overcome? c) What was the impact
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The Contextual Impact on School Leadership in Kenya and Need for Trust Formation
ERIC Educational Resources Information Center
Abaya, Joel; Normore, Anthony H.
2014-01-01
This article is based on a qualitative case study carried out along the Nyanza-Rift Valley Provinces border in Southwestern Kenya. The purpose of this paper is to examine the context in which school leader's work and operate in southwestern Kenya. We further postulate how best the influence of these contexts can be minimized through the formation…
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NASA Astrophysics Data System (ADS)
Chidya, Russel C. G.; Matamula, Swithern; Nakoma, Oliver; Chawinga, Charles B. J.
2016-06-01
Many people in in the Sub-Saharan region rely on groundwater for drinking and other household uses. Despite this significance, information on the chemical composition of the water in the boreholes and emperical data on groundwater quality is limited in some rural areas of Malawi. This study was conducted to evaluate the physico-chemical quality of water from boreholes (n = 20) in Zombwe Extension Planning Area (EPA), Mzimba in Northern Malawi to ascertain their safety. Desktop studies and participatory approaches were employed to assess the socio-economic activities and water supply regime in the study areas. The water samples were analysed for pH, conductivity (EC), turbidity, water temperature, nitrate (NO3-), magnesium (Mg), calcium (Ca), zinc (Zn), fluoride (F-), and sulphate (SO42-). In-situ and laboratory analyses were carried out using portable meters and standard procedures. The results were compared with national (Malawi Bureau of Standards - MBS) and international standards (World Health Organization - WHO) for drinking water. The following ranges were obtained: pH (6.00-7.80), EC (437-3128 μS/cm), turbidity (0.10-5.80 NTU), water temperature (27.0-30.60 °C), NO3- (0.30-30.00 mg/L), F- (0.10-8.10 mg/L), Mg (31.00-91.00 mg/L), Ca (20.00-197.10 mg/L), SO42- (10.20-190 mg/L), Fe (0.10-3.60 mg/L) and Zn (0.00-5.10 mg/L). Generally, some parameters tested at several sites (>80%, n = 20) complied with both MBS and WHO limits. No significant differences (p > 0.05) was observed for most parameters (>65%, n = 11). Groundwater contamination was not significant in the area despite some parameters like F-, Ca and SO42- showing higher levels at other sites. Some sites registered very hard water (244.60-757.80 mg/L CaCO3) probably due to mineralization influenced by underground rock material. Further studies are needed to ascertain the groundwater quality of other parameters (like F-, and SO42-) which registered higher levels at some sites. Routine monitoring of the
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Choosing an Indigenous Official Language for Nigeria.
ERIC Educational Resources Information Center
Mann, Charles C.
A discussion of the choice of official languages in Nigeria first gives an overview of the current language situation in Nigeria, particularly of indigenous language usage, sketches the history of English, French, and Anglo-Nigerian Pidgin (ANP) both before and after independence, outlines the main proposals for language planning, and draws some…
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Observations on the epidemiology of Rift Valley fever in Kenya.
Davies, F G
1975-10-01
The epizootic range of Rift Valley fever in Kenya is defined from the results of virus isolations during epizootics, and form an extensive serological survey of cattle which were exposed during an epizootic. A study of the sera from a wide range of wild bovidae sampled immediately after the epizootic, showed that they did not act as reservoir or amplifying hosts for RVF. Virus isolation attempts from a variety of rodents proved negative. Rift Valley fever did not persist between epizootics by producing symptomless abortions in cattle in areas within its epizootic range. A sentinel herd sampled annually after an epizootic in 1968 revealed not one single seroconversion from 1969 to 1974. Certain forest and forest edge situations were postulated as enzootic for Rift Valley fever, and a small percentage of seroconversions were detected in cattle in these areas, born four years after the last epizootic. This has been the only evidence for the persistence of the virus in Kenya since 1968, and may be a part of the interepizootic maintenance cycle for Rift Valley fever in Kenya, which otherwise remains unknown.
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2011-06-01
struggle in the region. They cause relentless strife, including refugee problems, environmental degradation, deforestation , small arms proliferation...human and natural resources, extreme poverty and hunger abound on the continent.”42 Furthermore, a snapshot of Africa reveals deforestation , fast...Malawi, while Tanzania is disadvantaged . Since players selfishly attempt to maximize their outcomes, via ‘maximin theorem,’ the outcome is BD that
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Composition of the crust beneath the Kenya rift
Mooney, W.D.; Christensen, N.I.
1994-01-01
We infer the composition of the crust beneath and on the flanks of the Kenya rift based on a comparison of the KRISP-90 crustal velocity structure with laboratory measurements of compressional-wave velocities of rock samples from Kenya. The rock samples studied, which are representative of the major lithologies exposed in Kenya, include volcanic tuffs and flows (primarily basalts and phonolites), and felsic to intermediate composition gneisses. This comparison indicates that the upper crust (5-12 km depth) consists primarily of quartzo-feldspathic gneisses and schists similar to rocks exposed on the flanks of the rift, whereas the middle crust (12-22 km depth) consists of more mafic, hornblende-rich metamorphic rocks, probably intruded by mafic rocks beneath the rift axis. The lower crust on the flanks of the rift may consist of mafic granulite facies rocks. Along the rift axis, the lower crust varies in thickness from 9 km in the southern rift to only 2-3 km in the north, and has a seismic velocity substantially higher than the samples investigated in this study. The lower crust of the rift probably consists of a crust/mantle mix of high-grade metamorphic rocks, mafic intrusives, and an igneous mafic residuum accreted to the base of the crust during differentiation of a melt derived from the upper mantle. ?? 1994.
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The Palliative Care Journey in Kenya and Uganda.
Kamonyo, Emmanuel S
2018-02-01
Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial, and spiritual problems. This update is aimed at examining palliative care development/achievements and challenges in Kenya and Uganda and the role of various actors in palliative care establishment in the region. It assesses the policy environment, progress in education, access to essential medicines, palliative care implementation efforts, and legal and human rights work. East African nations have huge disease burdens, both communicable and noncommunicable. HIV and cancer are the major causes of mortality in Kenya and Uganda and put huge demands on the health care system and on the country's economies. All these conditions will require palliative care services as the disease burden increases. Unfortunately, for many African countries, accessing palliative care services, including access to pain relief, remains very limited resulting in serious suffering for patients and their families. The interventions in Kenya and Uganda help palliative care organizations engage with their respective governments to ensure that the social and legal barriers impeding access to palliative care services are removed. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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Childhood disability in Malawi: a population based assessment using the key informant method.
Tataryn, Myroslava; Polack, Sarah; Chokotho, Linda; Mulwafu, Wakisa; Kayange, Petros; Banks, Lena Morgon; Noe, Christiane; Lavy, Chris; Kuper, Hannah
2017-11-28
Epidemiological data on childhood disability are lacking in Low and Middle Income countries (LMICs) such as Malawi, hampering effective service planning and advocacy. The Key Informant Method (KIM) is an innovative, cost-effective method for generating population data on the prevalence and causes of impairment in children. The aim of this study was to use the Key Informant Method to estimate the prevalence of moderate/severe, hearing, vision and physical impairments, intellectual impairments and epilepsy in children in two districts in Malawi and to estimate the associated need for rehabilitation and other services. Five hundred key informants (KIs) were trained to identify children in their communities who may have the impairment types included in this study. Identified children were invited to attend a screening camp where they underwent assessment by medical professionals for moderate/severe hearing, vision and physical impairments, intellectual impairments and epilepsy. Approximately 15,000 children were identified by KIs as potentially having an impairment of whom 7220 (48%) attended a screening camp. The estimated prevalence of impairments/epilepsy was 17.3/1000 children (95% CI: 16.9-17.7). Physical impairment (39%) was the commonest impairment type followed by hearing impairment (27%), intellectual impairment (26%), epilepsy (22%) and vision impairment (4%). Approximately 2100 children per million population could benefit from physiotherapy and occupational therapy and 300 per million are in need of a wheelchair. An estimated 1800 children per million population have hearing impairment caused by conditions that could be prevented or treated through basic primary ear care. Corneal opacity was the leading cause of vision impairment. Only 50% of children with suspected epilepsy were receiving medication. The majority (73%) of children were attending school, but attendance varied by impairment type and was lowest among children with multiple impairments (38
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Relative importance of climatic, geographic and socio-economic determinants of malaria in Malawi
2013-01-01
Background Malaria transmission is influenced by variations in meteorological conditions, which impact the biology of the parasite and its vector, but also socio-economic conditions, such as levels of urbanization, poverty and education, which impact human vulnerability and vector habitat. The many potential drivers of malaria, both extrinsic, such as climate, and intrinsic, such as population immunity are often difficult to disentangle. This presents a challenge for the modelling of malaria risk in space and time. Methods A statistical mixed model framework is proposed to model malaria risk at the district level in Malawi, using an age-stratified spatio-temporal dataset of malaria cases from July 2004 to June 2011. Several climatic, geographic and socio-economic factors thought to influence malaria incidence were tested in an exploratory model. In order to account for the unobserved confounding factors that influence malaria, which are not accounted for using measured covariates, a generalized linear mixed model was adopted, which included structured and unstructured spatial and temporal random effects. A hierarchical Bayesian framework using Markov chain Monte Carlo simulation was used for model fitting and prediction. Results Using a stepwise model selection procedure, several explanatory variables were identified to have significant associations with malaria including climatic, cartographic and socio-economic data. Once intervention variations, unobserved confounding factors and spatial correlation were considered in a Bayesian framework, a final model emerged with statistically significant predictor variables limited to average precipitation (quadratic relation) and average temperature during the three months previous to the month of interest. Conclusions When modelling malaria risk in Malawi it is important to account for spatial and temporal heterogeneity and correlation between districts. Once observed and unobserved confounding factors are allowed for
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Gaps in universal health coverage in Malawi: A qualitative study in rural communities
2014-01-01
Background In sub-Saharan Africa, universal health coverage (UHC) reforms have often adopted a technocratic top-down approach, with little attention being paid to the rural communities’ perspective in identifying context specific gaps to inform the design of such reforms. This approach might shape reforms that are not sufficiently responsive to local needs. Our study explored how rural communities experience and define gaps in universal health coverage in Malawi, a country which endorses free access to an Essential Health Package (EHP) as a means towards universal health coverage. Methods We conducted a qualitative cross-sectional study in six rural communities in Malawi. Data was collected from 12 Focus Group Discussions with community residents and triangulated with 8 key informant interviews with health care providers. All respondents were selected through stratified purposive sampling. The material was tape-recorded, fully transcribed, and coded by three independent researchers. Results The results showed that the EHP has created a universal sense of entitlements to free health care at the point of use. However, respondents reported uneven distribution of health facilities and poor implementation of public-private service level agreements, which have led to geographical inequities in population coverage and financial protection. Most respondents reported affordability of medical costs at private facilities and transport costs as the main barriers to universal financial protection. From the perspective of rural Malawians, gaps in financial protection are mainly triggered by supply-side access-related barriers in the public health sector such as: shortages of medicines, emergency services, shortage of health personnel and facilities, poor health workers’ attitudes, distance and transportation difficulties, and perceived poor quality of health services. Conclusions Moving towards UHC in Malawi, therefore, implies the introduction of appropriate interventions
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Public by Day, Private by Night: Examining the Private Lives of Kenya's Public Universities
ERIC Educational Resources Information Center
Wangenge-Ouma, Gerald
2012-01-01
This article examines the emergence of the public university in Kenya as a key provider of private higher education, characterised mainly by the phenomenon of the "private public university student." It probes the broader socio-economic reforms circumscribing the privatisation of Kenya's public universities and the local and global…
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Progress toward poliomyelitis eradication --- Nigeria, January 2010-June 2011.
2011-08-12
The Global Polio Eradication Initiative (GPEI) was launched by the World Health Assembly in 1988. By 2006, transmission of indigenous wild poliovirus (WPV) was interrupted in all countries except Nigeria, Afghanistan, Pakistan, and India. Among the 36 states and Federal Capital Territory of Nigeria, WPV transmission has persisted in eight northern states considered at high risk; in addition, four other northern states have been considered at high risk for WPV transmission. In these 12 high-risk states, type 2 circulating vaccine-derived poliovirus (cVDPV2) transmission also was observed during 2005-2011. This report updates GPEI progress in Nigeria during January 2010--June 2011 and describes activities required to interrupt transmission. In Nigeria, confirmed WPV cases decreased 95%, from 388 in 2009 to 21 in 2010; cVDPV2 cases decreased 82%, from 154 in 2009 to 27 in 2010. However, as of July 26, 2011, Nigeria had reported 24 WPV cases (including one WPV/cVDPV2 coinfection) and 11 cVDPV2 cases during January-June 2011, compared with six WPV cases and 10 cVDPV2 cases during January-June 2010. Despite substantial progress, immunization activities and surveillance sensitivity will need to be enhanced further to interrupt WPV transmission in Nigeria by the end of 2011.
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What is a good life? Selecting capabilities to assess women's quality of life in rural Malawi.
Greco, Giulia; Skordis-Worrall, Jolene; Mkandawire, Bryan; Mills, Anne
2015-04-01
There is growing interest in using Sen's Capability Approach to assess quality of life and to evaluate social policies. This paper describes the formative stages of developing a quality of life measure: the selection of the relevant capabilities. This measure is intended to provide a more comprehensive outcome measure for the evaluation of complex interventions such as Maimwana womens' groups, a community based participatory intervention to improve maternal health in rural Malawi. Fifteen focus group discussions with 129 women were conducted to explore relevant concepts of quality of life in rural Malawi. Data collection started in October 2009. Findings were elicited based on framework analysis. The findings portray a complex and highly nuanced perception that women in rural Malawi have of their life and wellbeing. Quality of life was described using a variety of dimensions that are highly interconnected. Quality of life emerges to be not only shaped by the realisation of basic material needs such as being sufficiently nourished and adequately sheltered, but is also highly dependent on complex feelings, relations and social norms. The full exposition of wellbeing with its domains was organised into a framework constituting six different spheres of wellbeing: physical strength, inner wellbeing, household wellbeing, community relations, economic security and happiness. Despite the list being developed in a specific context and for a specific group of people, the similarities with lists developed in other contexts, with different methods and for different purposes, are considerable. This suggests that there are a number of core aspects of wellbeing considered a minimum requirement for a life of human dignity, that should be included in any attempt to assess quality of life and human development across populations. Copyright © 2015 Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Mbano, Nellie
2003-01-01
Investigates whether the critical period for cognitive transition from concrete operations to formal operations at 12-14 years of age actually exists. Uses the Cognitive Acceleration through Science Education (CASE) intervention program in Malawi. Discusses the existence of the critical period, academic achievement, and explanations for age and…
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ERIC Educational Resources Information Center
Psaki, Stephanie R.; Mensch, Barbara S.; Soler-Hampejsek, Erica
2017-01-01
Growing evidence of the prevalence of school-related gender-based violence (SRGBV) has raised concerns about negative effects on education. Previous quantitative research on this topic has been limited by descriptive and cross-sectional data. Using longitudinal data from the Malawi Schooling and Adolescent Study, we investigate associations…
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Wirtz, Andrea L; Trapence, Gift; Kamba, Dunker; Gama, Victor; Chalera, Rodney; Jumbe, Vincent; Kumwenda, Rosemary; Mangochi, Marriam; Helleringer, Stephane; Beyrer, Chris; Baral, Stefan
2017-06-01
Epidemiological assessment of geographical heterogeneity of HIV among men who have sex with men (MSM) is necessary to inform HIV prevention and care strategies in the more generalised HIV epidemics across sub-Saharan Africa, including Malawi. We aimed to measure the HIV prevalence, risks, and access to HIV care among MSM across multiple localities to better inform HIV programming for MSM in Malawi. Between Aug 1, 2011, and Sept 13, 2014, we recruited MSM into cross-sectional research via respondent-driven sampling (RDS) in seven districts of Malawi. RDS and site weights were used to estimate national HIV prevalence and engagement in care and in multilevel regression models to identify correlates of prevalent HIV infection. The comparative prevalence ratio of HIV among MSM relative to adult men was calculated by use of direct age-stratification. 2453 MSM were enrolled with a population HIV prevalence of 18·2% (95% CI 15·5-21·2), as low as 4·1% (2·2-7·6) in Mzuzu and as high as 24·5% (19·5-30·3) in Mulanje. The comparative HIV prevalence ratio was 2·52 when comparing MSM with the adult male population. Age-stratified HIV prevalence showed early onset of infection with 11·8% (95% CI 7·3-18·4) of MSM aged 18-19 years HIV infected. Factors positively associated with HIV infection included being aged 21-30 years and reporting female or transgender identity. Among HIV infected MSM, less than 1% reported ever being diagnosed with HIV infection (0·9%, 95% CI 0·4-2·5) and initiated antiretroviral treatment (0·2%, 0·2-0·3). HIV disproportionately affects MSM in Malawi with disparities sustained across the HIV care continuum. These issues are geographically heterogeneous and begin among young MSM, supporting geographically focused and age-specific approaches to confidential HIV testing with linkage to HIV services. Malawi Department of Nutrition, HIV and AIDS (DNHA), UNDP, UNFPA, UNAIDS, and UNICEF. Copyright © 2017 Elsevier Ltd. All rights reserved.
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What Do Secondary Trainee Teachers Say about Teaching as a Profession of Their "Choice" in Malawi?
ERIC Educational Resources Information Center
Mtika, Peter; Gates, Peter
2011-01-01
This interview-based qualitative study is concerned with the recruitment of secondary teachers in Malawi. This study shows a range of perspectives for pursuing a teacher training course: failure to follow a desired career, springboard to other careers, to upgrade, and teaching out of vocation. It shows that trainee teachers held a range of images…
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ICT and Higher Educational System in Nigeria
ERIC Educational Resources Information Center
Idowu, Adeyemi I.; Esere, Mary
2013-01-01
This paper examines the integration of ICT in higher education in Nigeria. The possibilities and reach of information technologies can tear down territorial boundaries and make available equal information and knowledge of different categories as soon as necessary data are fed on the website. Nevertheless, Nigeria as a nation is yet to take full…
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Catastrophic health expenditure and its determinants in Kenya slum communities.
Buigut, Steven; Ettarh, Remare; Amendah, Djesika D
2015-05-14
In Kenya, where 60 to 80% of the urban residents live in informal settlements (frequently referred to as slums), out-of-pocket (OOP) payments account for more than a third of national health expenditures. However, little is known on the extent to which these OOP payments are associated with personal or household financial catastrophe in the slums. This paper seeks to examine the incidence and determinants of catastrophic health expenditure among urban slum communities in Kenya. We use a unique dataset on informal settlement residents in Kenya and various approaches that relate households OOP payments for healthcare to total expenditures adjusted for subsistence, or income. We classified households whose OOP was in excess of a predefined threshold as facing catastrophic health expenditures (CHE), and identified the determinants of CHE using multivariate logistic regression analysis. The results indicate that the proportion of households facing CHE varies widely between 1.52% and 28.38% depending on the method and the threshold used. A core set of variables were found to be key determinants of CHE. The number of working adults in a household and membership in a social safety net appear to reduce the risk of catastrophic expenditure. Conversely, seeking care in a public or private hospital increases the risk of CHE. This study suggests that a substantial proportion of residents of informal settlements in Kenya face CHE and would likely forgo health care they need but cannot afford. Mechanisms that pool risk and cost (insurance) are needed to protect slum residents from CHE and improve equity in health care access and payment.
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Panunzi, Isabella; Spijker, Saskia; Brant, William E; Duran, Laura Triviño; Kosack, Cara S; Murowa, Michael Mitchell
2012-01-01
Abstract Problem Malawi has one of the world’s highest rates of human immunodeficiency virus (HIV) infection (10.6%), and southern Malawi, where Thyolo district is located, bears the highest burden in the country (14.5%). Tuberculosis, common among HIV-infected people, requires radiologic diagnosis, yet Malawi has no radiologists in public service. This hinders rapid and accurate diagnosis and increases morbidity and mortality. Approach Médecins Sans Frontières, in collaboration with Malawi’s Ministry of Health, implemented teleradiology in Thyolo district to assist clinical staff in radiologic image interpretation and diagnosis. Local setting Thyolo district’s 600 000 inhabitants are mostly subsistence-level or migrant farmers living in extreme poverty. Health facilities include one public hospital and 38 primary health centres. Understaffing and the absence of a radiologist make the diagnosis of tuberculosis difficult in a population where this disease affects 66% of patients with HIV infection. Relevant changes From September 2010–2011, 159 images (from 158 patients) were reviewed by teleradiology. Teleradiology changed patient management in 36 cases (23.5%). Two (1.3%) of them were cases of pulmonary tuberculosis not previously suspected by clinical staff. In addition, the radiologist’s review corrected the misdiagnosis of tuberculosis and averted inappropriate treatment in 16 patients (10.5%). Lessons learnt Teleradiology can improve tuberculosis diagnosis and case management, especially if criteria to identify the patients most suitable for referral are developed and the radiologist is conversant with local resources and health problems. Designating a clinical focal point for teleradiology ensures sustainability. Staff need time to adapt to a new teleradiology programme. PMID:22984316
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Ash from the Toba supereruption in Lake Malawi shows no volcanic winter in East Africa at 75 ka
Lane, Christine S.; Chorn, Ben T.; Johnson, Thomas C.
2013-01-01
The most explosive volcanic event of the Quaternary was the eruption of Mt. Toba, Sumatra, 75,000 y ago, which produced voluminous ash deposits found across much of the Indian Ocean, Indian Peninsula, and South China Sea. A major climatic downturn observed within the Greenland ice cores has been attributed to the cooling effects of the ash and aerosols ejected during the eruption of the Youngest Toba Tuff (YTT). These events coincided roughly with a hypothesized human genetic bottleneck, when the number of our species in Africa may have been reduced to near extinction. Some have speculated that the demise of early modern humans at that time was due in part to a dramatic climate shift triggered by the supereruption. Others have argued that environmental conditions would not have been so severe to have such an impact on our ancestors, and furthermore, that modern humans may have already expanded beyond Africa by this time. We report an observation of the YTT in Africa, recovered as a cryptotephra layer in Lake Malawi sediments, >7,000 km west of the source volcano. The YTT isochron provides an accurate and precise age estimate for the Lake Malawi paleoclimate record, which revises the chronology of past climatic events in East Africa. The YTT in Lake Malawi is not accompanied by a major change in sediment composition or evidence for substantial temperature change, implying that the eruption did not significantly impact the climate of East Africa and was not the cause of a human genetic bottleneck at that time. PMID:23630269
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Ash from the Toba supereruption in Lake Malawi shows no volcanic winter in East Africa at 75 ka.
Lane, Christine S; Chorn, Ben T; Johnson, Thomas C
2013-05-14
The most explosive volcanic event of the Quaternary was the eruption of Mt. Toba, Sumatra, 75,000 y ago, which produced voluminous ash deposits found across much of the Indian Ocean, Indian Peninsula, and South China Sea. A major climatic downturn observed within the Greenland ice cores has been attributed to the cooling effects of the ash and aerosols ejected during the eruption of the Youngest Toba Tuff (YTT). These events coincided roughly with a hypothesized human genetic bottleneck, when the number of our species in Africa may have been reduced to near extinction. Some have speculated that the demise of early modern humans at that time was due in part to a dramatic climate shift triggered by the supereruption. Others have argued that environmental conditions would not have been so severe to have such an impact on our ancestors, and furthermore, that modern humans may have already expanded beyond Africa by this time. We report an observation of the YTT in Africa, recovered as a cryptotephra layer in Lake Malawi sediments, >7,000 km west of the source volcano. The YTT isochron provides an accurate and precise age estimate for the Lake Malawi paleoclimate record, which revises the chronology of past climatic events in East Africa. The YTT in Lake Malawi is not accompanied by a major change in sediment composition or evidence for substantial temperature change, implying that the eruption did not significantly impact the climate of East Africa and was not the cause of a human genetic bottleneck at that time.
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Exploring Cultural Influences of Self-Management of Diabetes in Coastal Kenya
Abdulrehman, Munib Said; Woith, Wendy; Jenkins, Sheryl; Kossman, Susan; Hunter, Gina Louise
2016-01-01
In spite of increasing prevalence of diabetes among Kenyans and evidence suggesting Kenyans with diabetes maintain poor glycemic control, no one has examined the role of cultural attitudes, beliefs, and practices in their self-management of diabetes. The purpose of this ethnographic study was to describe diabetes self-management among the Swahili of coastal Kenya, and explore factors that affect diabetes self-management within the context of Swahili culture. Thirty men and women with type 2 diabetes from Lamu town, Kenya, participated in this study. Diabetes self-management was insufficiently practiced, and participants had limited understanding of diabetes. Economic factors such as poverty and the high cost of biomedical care appear to have more influence in self-management behavior than socio-cultural and educational factors do. Economic and socio-cultural influences on diabetes self-management should not be underestimated, especially in a limited resource environment like coastal Kenya, where biomedical care is not accessible or affordable to all. PMID:28462335