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Facilitating high quality acute care in resource- constrained environments: Perspectives of patients recovering from sepsis, their caregivers and healthcare workers in Uganda and Malawi

Limbani, F.; O. Kabajaasi, M. Basemera, et al. (2022) CC

PLOS Glob Public Health 2(8): e0000272. https://doi.org/10.1371/journal.pgph.0000272 Sepsis is a major global health problem, especially in sub-Saharan Africa. Improving patient care requires that healthcare providers understand patients’ priorities and provide quality care within the confines of... more

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WFP Malawi Country Brief, April 2022

World Food Programme (2022) CC

Malawi is a small landlocked country in Sub-Saharan Africa with a population expanding rapidly at 3 percent per year. With most livelihoods dependent on rainfed agriculture, the population is highly vulnerable to the effects of natural disasters, prolonged dry spells and flash floods.

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Malawi national action plan on antimicrobial resistance: review of progress in the human health sector

World Health Organization WHO (2022) C_WHO

This policy brief aims to provide a review of the current progress on implementing the Malawi national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing a... more

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Malawi National Communication and Advocacy Strategy for Pre-Exposure Prophylaxis (PrEP)

United States Agency for International Development; President's Emergency Plan for AIDS Relief; National AIDS Commission MAlawi (2022) CC

Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasises the role of preexposure prophylaxis (PrEP) in ... more

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The investment case for social protection in Malawi

Ministry of Gender, Children and Community Development; Unicef (2022) C_UNICEF

There has been a rapid expansion of cash-based, social protection programmes in sub-Saharan Africa (SSA) in recent years as Governments increasingly realise the enormous benefits cash transfers offer (World Bank, 2018). In fact, as an investment in human capital and inclusive economic development, ... more

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Publication: Gendered Impacts of the COVID-19 Crisis in Uganda and Opportunities for an Inclusive and Sustainable Recovery

Alys, W.; Aziz, A.; Caran Ann, M. (2022) CC2

As Uganda builds back from the COVID-19 shock, the Ugandan government is strengthening its commitment to a more gender-inclusive and sustainable economy. This report supports these efforts by describing the gendered impacts of COVID-19 and provides recommendations for Ugandan policy makers and World... more

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Dolutegravir Resistance in Malawi’s National HIV Treatment Program

van Ossterhout, J. J.; Chipungu, C.; Nkhoma, L. et all. (2022) CC2

Dolutegravir HIV drug resistance (HIVDR) data from Africa remain sparse. We reviewed HIVDR results of Malawians on dolutegravir-based antiretroviral therapy (November 2020– September 2021). Of 6462 eligible clients, 33 samples were submitted to South Africa, 27 were sequenced successfully, and 8 ... more

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Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to enhance their programmatic activities. Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal- lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi- tive work environment through supportive relationships between CHWs and supervisors enables the CHWs. Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec- tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha- sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided to the patients and communities, along with building supportive systems to recognize the work done by CHWs for the primary health care systems. more

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HIV Testing Approaches to Optimize Prevention and Treatment for Key and Priority Populations in Malawi

Rucinski, K.; Masankha Banda, L. et al. Open Forum Infectious Diseases (2022) CC

Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee... more

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Disability inclusive employment in urban Malawi: A multi-perspective interview study

Remnant, J.; Wånggren, L.; Huque, S. et al. Journal of International Development (2022) CC

The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with... more

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Tuberculosis profile: Malawi; Estimates of TB burden*, 2022

World Health Organization WHO (2022) C_WHO

Estimates of TB burden

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Malawi Country Operational Plan 2022 Strategic Direction Summary April 29, 2022

U.S. President's Emergency Plan for AIDS Relief (2022) CC2

PEPFAR Malawi’s Country Operational Plan 2022 (COP22) embodies joint priorities from national and subnational dialogues building on the 2020-2025 National Strategic Plan for HIV/AIDS. The interagency team has developed a person-centered, district-tailored and Malawi Population-Based HIV Impact Ass... more

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Open Access Re-envisioning Kangaroo Mother Care Implementation Through a Socioecological Model: Lessons From Malawi

Global Health: Science and Practice (2022) CC2

Kangaroo mother care (KMC) is a critical strategy to care for preterm and low birth weight infants in resource-limited settings. Despite evidence of its effectiveness and low cost, coverage has remained low, largely due to sociocultural barriers. We aimed to better understand social norms and commun... more

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Self-reported disability in rural Malawi: prevalence, incidence, and relationship to chronic conditions

Prynn, J.E.; Dube, A.; Mwaiyeghele, E. et al. Wellcome Open Research (2022) CC

Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of co... more

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Do Disability Inequalities Grow with Development? Evidence from 40 Countries

Lewis, E.; Mitra, S.; Yap, J. Sustainability (2022) CC

With development, people around the world have become wealthier and live longer. At the same time, development can lead to growing inequalities within and between nations. This paper analyses inequalities related to disability and how they vary across countries by development level. Using internatio... more

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Task-shifting to improve asthma education for Malawian children: a qualitative analysis

Nkhalamba, L.; Rylance, S.; Muula, S. A. et al. Human Resources for Health (2021) CC

Background Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a... more

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Individual- and Facility-Level Factors Associated with Facility Testing among Men in Malawi: Findings from a Representative Community Survey

Balakasi, K.; Nichols, B. E.; Mphande, M.; et al. (2021) CC2

Men are underrepresented in HIV testing services throughout sub-Saharan Africa. HIV testing is critical to achieve the UNAIDS 95-95-95 goals, as it is the first entry point to HIV care. In Malawi, an estimated 14% of HIV positive men are undiagnosed, while only 6% of HIV positive women remain undiag... more

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National Guidelines for Diabetic Eye Care

Ministry of Health Malawi (2021) CC

Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report... more

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National Guidelines for Glaucoma Eyecare

Ministry of Health Malawi (2021) CC

Glaucoma is a leading cause of irreversible blindness globally. In Malawi, glaucoma accounts for 15.8% of the blindness among people aged 50 years and above. Blindness from glaucoma is preventable with early detection and timely treatment. However, glaucoma management remains a challenge to eye care... more

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Building child-friendly and resilient communities

UN Children's Fund UNICEF (2021) CC

Imagine a child- friendly and resilient community in Malawi. A happy child, healthy parents, a latrine behind the house, livestock somewhere in the backyard, no-one panics when clouds come because people are prepared for the rain. At UNICEF, we are working with the Government and civil society of M... more