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Concerned that the prevalence of Child Marriage in Malawi, at 42 per cent, is one of
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the highest in the Sub-Saharan Africa; and that cases of child marriage continue to rise despite the various interventions on the ground. If unabated, Child Marriage inflicts significant socio-economic and political cost for Malawi and derails the nation’s developmental aspirations.
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The Leonard Cheshire Disability and Inclusive Development Centre | University College London | 4 Taviton Street | London WC1H OBT | United Kingdom| Principal Investigator: Dr Raymond Lang | Email: r.lang@ucl.ac.uk | Tel: +44 (0)207 679 1519 | Resear
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ch Commissioned by the Southern African Federation of the Disabled’s (SAFOD) |
DFID-funded Research Programme
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To identify and to assess factors enhancing or hindering the delivery of breast and cervical cancer screening services in Malawi with regard to acc
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essibility, uptake, acceptability and effectiveness.
Systematic review of published scientific evidence. A search of six bibliographic databases and grey literature was executed to identify relevant studies conducted in Malawi in the English language, with no time or study design restrictions. Data extraction was conducted in Excel and evidence synthesis followed a thematic analysis approach to identify and compare emerging themes.
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control
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of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Africa, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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Healthy Settings, a key component of Malawi’s Health Sector Strategic Plan (HSSP) 2011–2016, is the World Health Organization’s (WHO) holisti
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c community-led approach to achieving health improvement by addressing social determinants of health, an approach which is central to the current WHO framework on integrated people-centred health services. Healthy Settings projects by their construct have many different components which vary from one group and community to another depending on their priorities: from housing, hospital improvements and waste management to “softer” interventions like leadership skills training and health promotion. It can be challenging to find relevant indicators to monitor and assess the impact of such a complex holistic project, this paper explores if social capital data can provide useful impact assessment indicators at the start of such a project.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in
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Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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COVID-19 is stretching formal and informal aspects of community life. The pandemic is overwhelming health systems. Country economies are reaching a breaking point, with particularly significant impa
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ct for the livelihoods of vulnerable families and those dependent on daily wages. COVID-19 is also affecting community relationships and trust. Lack of trust in government leaders or health officials can lead citizens to be unwilling to accept essential health messages and take the necessary steps to combat the spread of the disease. The stress, fear and emotional vulnerabilities of children and their caregivers can be particularly acute, especially in light of prolonged school closures and the uncertainty about their health system’s capacity to withstand the pandemic or how long community and household quarantines will last.
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The World Health Organization Regional Office for Africa (WHO AFRO), in accordance with recommendations from various WHO committees, has developed three flagship initiatives to support Member States in the
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African region to prepare for, detect and respond to public health emergencies. They are the result of extensive consultations with more than 30 African government ministers, technical actors, and partners across the continent as well as regional institutions such as the Africa Centres for Disease Control and Prevention (Africa CDC), whose contributions have shaped the priority activities. This report provides the fourth quarterly summary of progress in implementing the flagship initiatives.
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Growing evidence indicates that large proportions of children around the world experience physical, sexual and emotional violence every year, with enormous implications for human rights, public heal
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th and economic and social development.1 Over the last five years, national governments and Together for Girls – a global public-private partnership comprising UNICEF,
other United Nations (UN) agencies, the United States (US) Government and various private sector agencies – have worked to mobilize and sustain a global movement to end violence against children, with a focus on sexual violence against girls.
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Barriers to HIV Services and Treatment for Persons with Disabilities in Zambia
The 80-page report documents the obstacles faced by people with disabilities in both
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the community and healthcare settings. These include pervasive stigma and discrimination, lack of access to inclusive HIV prevention education, obstacles to accessing voluntary testing and HIV treatment, and lack of appropriate support for adherence to antiretroviral treatment. The report also describes the sexual and intimate partner violence women and girls with disabilities face, and the need for the government and international donors to do more to ensure inclusive and accessible HIV services.
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In October 2022, President Biden signed the Global Malnutrition Prevention and Treatment Act (GMPTA) into law, which directs USAID to prevent and treat malnutrition globally. The GMPTA further codif
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ies USAID’s leadership on nutrition, with a focus on evidence-based interventions across health systems and food systems, in both development and humanitarian settings.
Realizing the potential of good nutrition to save lives and ensure a brighter future for generations to come is central to U.S. Government priorities. For over 60 years, USAID has been a leader in the fight to end global malnutrition. Nutrition affects every aspect of human development: from the ability to fight disease, to children’s performance in school, to a nation’s health and economic advancement. There is overwhelming evidence of the power of good nutrition but, due to challenges in accessing safe, nutritious foods and health and sanitation services, many people in low- and middle-income countries remain undernourished.
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Coronavirus Disease-19 (COVID-19) was declared a global pandemic on 11 March 2020, and Malawi declared its first case on 2 April. As of 30 April, there were 36 confirmed positive cases
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of COVID-19 and 3 deaths. A State of Disaster was declared by President Arthur Peter Mutharika on 20 March and a 21-day lockdown was implemented from 18 April to 9 May. The lockdown measures include: bans on public gatherings; closure of schools; and bans on international flights and cross-border passenger buses.
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Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective
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The objective of this initiative was to improve reporting of adverse events (AEs) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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Community health workers (CHWs) play a significant role in Primary health Care due to their proximity to households, communities and the health care system. Many studies focus on CHWs and the work t
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hey do. However, few have examined their experiences and identity and how that might influence how they view and perform their roles. The objectives of the study were to: Describe the role of CHWs in community-based health care in Northern Cape, Identify the perceived barriers and enablers to CHWs role performance, Explore CHWs views regarding the support from the communities and the formal healthcare system in Northern Cape. An exploratory qualitative design using focus groups was adopted. Forty-six (46) CHWs were purposively selected using the critical case sampling approach. Data were collected through three focus group interviews in three regions. Analysis followed the Graneheim & Lundman thematic analysis. Three themes emerged from data: perceived contribution to Primary Health Care, recognition of CHWs role, measures to improve working conditions. Findings showed that CHWs were engaged in various health and social care roles, they believed that they made a significant contribution to PHC, and that the health system persistently relied on their services. The enabler for finding meaning in their work was the positive community response and the good relations they had with the team leaders. The major barrier was the structure of the CHWs programme and the perceived lack of support by the government. The complex issues CHWs address in the community call for a review of their roles and workload as well as the support they receive from the formal healthcare system.
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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
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Malawi, an estimated 14% of HIV positive men are undiagnosed, while only 6% of HIV positive women remain undiagnosed. Improved HIV testing among men is key to reaching UNAIDS goals, and to curbing HIV epidemics in the region.
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