26 research outputs found
Comparing the Job Satisfaction and Intention to Leave of Different Categories of Health Workers in Tanzania, Malawi, and South Africa.
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. 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. 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. 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 (Ï2=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 (Ï2=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. 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 standardised and more targeted HRH strategies than has been practised to date
May measurement month 2018: an analysis of blood pressure screening results from Malawi.
Raised blood pressure (BP) is a growing health care problem in the world leading to over 10 million deaths annually. May Measurement Month (MMM), which aims at raising awareness and screening people for raised BP, is assisting people to know their BP status. In 2018, an opportunistic cross-sectional survey was carried out during May and June in 10Â 791 volunteers aged 18 years and above following that done in 2017. The screening took place in Lilongwe, Blantyre, Dedza, Kasungu, and Nkhatabay districts mostly in hospitals/clinics, marketplaces, workplaces, and churches/mosques with Kasungu and Nkhatabay in rural areas. After multiple imputation, 2404 (22.3%) had hypertension. Of individuals not receiving antihypertensive treatment, 2101 (20.0%) were found to have raised BP. Only 303 (12.6%) of those with hypertension were receiving antihypertensive treatment, and of these 101 (33.3%) had uncontrolled BP. MMM was the largest BP screening campaign ever undertaken in Malawi. The results identified a large number of individuals with raised BP who were unaware and not on treatment and over one-third of those on treatment were uncontrolled, indicating the need for better management of cases. These results suggest that opportunistic screening can identify significant numbers with raised BP
Measuring HIV stigma for PLHAs and nurses over time in five African countries
The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69), and 67.1% (N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63), and 88.6% (N=784) were females. Eighty-four per cent of all PLHAs reported one or more HIV-stigma events at baseline. This declined, but was still significant 1 year later, when 64.9% reported experiencing at least one HIV-stigma event. At baseline, 80.3% of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.7% 1 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions, particularly focused at health care providers who experience HIV stigma by association
Effects of early feeding on growth velocity and overweight/obesity in a cohort of HIV unexposed South African infants and children
BACKGROUND: South Africa has the highest prevalence of overweight/obesity in Sub-Saharan Africa. Assessing the
effect of modifiable factors such as early infant feeding on growth velocity and overweight/obesity is therefore important.
This paper aimed to assess the effect of infant feeding in the transitional period (12 weeks) on 12â24 week growth
velocity amongst HIV unexposed children using WHO growth velocity standards and on the age and sex adjusted body
mass index (BMI) Z-score distribution at 2 years.
METHODS: Data were from 3 sites in South Africa participating in the PROMISE-EBF trial. We calculated growth velocity
Z-scores using the WHO growth standards and assessed feeding practices using 24-hour and 7-day recall data. We used
quantile regression to study the associations between 12 week infant feeding and 12â24 week weight velocity (WVZ) with
BMI-for-age Z-score at 2 years. We included the internal sample quantiles (70th and 90th centiles) that approximated the
reference cut-offs of +2 (corresponding to overweight) and +3 (corresponding to obesity) of the 2 year BMI-for-age Z-scores.
RESULTS: At the 2-year visit, 641 children were analysed (median age 22 months, IQR: 17â26 months). Thirty
percent were overweight while 8.7% were obese. Children not breastfed at 12 weeks had higher 12â24 week mean WVZ
and were more overweight and obese at 2 years. In the quantile regression, children not breastfed at 12 weeks had a 0.37
(95% CI 0.07, 0.66) increment in BMI-for-age Z-score at the 50th sample quantile compared to breast-fed children. This difference
in BMI-for-age Z-score increased to 0.46 (95% CI 0.18, 0.74) at the 70th quantile and 0.68 (95% CI 0.41, 0.94) at the 90th
quantile . The 12â24 week WVZ had a uniform independent
effect across the same quantiles.
CONCLUSIONS: This study demonstrates that the first 6 months of life is a critical period in the development of childhood
overweight and obesity. Interventions targeted at modifiable factors such as early infant feeding practices may reduce the
risks of rapid weight gain and subsequent childhood overweight/obesity.Scopu
May Measurement Month 2019: an analysis of blood pressure screening results from Malawi
May Measurement Month (MMM) is a global initiative that aims at raising awareness and screening people for high blood pressure (BP). Malawi has participated in MMM since 2017. A 2017 STEPwise Survey conducted in Malawi among 4187 participants found that 65.2% had never had their BP measured before, 26.8% had their BPs measured but not diagnosed, 3.9% were diagnosed but not within the last 12âmonths, and 4.1% were diagnosed within the last 12âmonths. An opportunistic cross-sectional survey of volunteers aged 18 and above was carried out in May and June 2019. All BP measurements, definition of hypertension and statistical analysis followed the standard MMM protocol. The screening took place in Nkhatabay, Lilongwe, and Blantyre. A total number of 9723 participants were screened with a mean age of 42.0 (SD 16.6) years. Of these 8444 (86.8%) had never had their BP measured within the last 12âmonths, 2559 (26.3%) had raised BP, 2169 (23.2%) of those with raised BP were not on treatment whereas 390 (4.0%) were on treatment. The results showed that many of the participants had not had their BP checked in the past year. There is a significant need to expand BP screening opportunities within Malawi for early detection of hypertension