Perceived challenges in business development of smallholder dairy farmers in three Malawian regions

Dairy farmers face various challenges in developing their businesses. The current literature identifies several constraints towards a more efficient dairy sector that relate mostly to on-farm management practices. The available studies analyze constraints mostly from the objective viewpoint of the researcher, whereas very little is known about what farmers themselves perceive to be challenging. To better understand the farmers’ perspective and what they perceive to be challenging, and how these challenges differ across regions, this paper builds on a survey of 529 dairy farmers in Malawi. In the survey, respondents were asked in an open question to name their three main challenges. Based on the responses, a three-level coding scheme was elaborated. Data were then coded by two researchers to ensure reliability of coding. Codes were then used to calculate relative frequencies for the different challenges and to perform chi-square tests to check for regional differences in frequencies. Results suggest that farmers perceive low milk price and milk yield, animal health, availability of feedstock, and the costs for drugs as the main challenges. The analysis also revealed that the challenges vary strongly between the three main regions in the country – Blantyre (south), Lilongwe (central), and Mzuzu (north). The perceived challenges reflect the different production systems in the regions. In Blantyre, dairy farming is low in intensity, and farmers thus perceive inputs, in particular the availability of fodder, as well as outputs, in particular milk yields more frequently as a challenge than farmers in Lilongwe and Mzuzu. In contrast, dairy farming in Lilongwe is the most intense. Accordingly, farmers in Lilongwe perceive costs, in particular for inputs such as mash and concentrates as major constraints. Farmers in Mzuzu, which is a rather remote region, consider a lack of assistance, in particular concerning extension services significantly more challenging than the farmers in the other two regions do. Considering these insights, development work and extensions services may be able to increase outcomes in the dairy sector by targeting the regional challenges.Keywords: Challenges, dairy production, smallholders, Malawi, qualitative study, region

Reconstructing Prehistoric African Population Structure

We assembled genome-wide data from 16 prehistoric Africans. We show that the anciently divergent lineage that comprises the primary ancestry of the southern African San had a wider distribution in the past, contributing approximately two-thirds of the ancestry of Malawi hunter-gatherers ∼8,100–2,500 years ago and approximately one-third of the ancestry of Tanzanian hunter-gatherers ∼1,400 years ago. We document how the spread of farmers from western Africa involved complete replacement of local hunter-gatherers in some regions, and we track the spread of herders by showing that the population of a ∼3,100-year-old pastoralist from Tanzania contributed ancestry to people from northeastern to southern Africa, including a ∼1,200-year-old southern African pastoralist. The deepest diversifications of African lineages were complex, involving either repeated gene flow among geographically disparate groups or a lineage more deeply diverging than that of the San contributing more to some western African populations than to others. We finally leverage ancient genomes to document episodes of natural selection in southern African populations

Developing partnerships at the community level to promote equity: Community based research in poor urban Lilongwe

This paper highlights the processes of conducting community-based participatory research within an operational research project in Lilongwe under the title of Extending Services to Communities (ESC). The project involves developing partnerships with community leaders, storekeepers and community members to enhance knowledge and effective referral for TB and malaria. These challenges need further discussion and debate on decentralizing services and developing partnerships with providers close to communities to enhance the poor\'s access to services. Participatory and community-based research approaches are integral to these partnerships

Top ten public health challenges to track in 2022

Abstract We identify ten public health challenges that need to be closely tracked in 2022. These challenges are COVID‐19, inadequate human resources for health, poor health systems financing, conflict and humanitarian crises, mental health, poverty, climate change, the health of children, reproductive health issues, and the infodemic. These global priorities, based on opinion of experts and current evidence and literature, need immediate attention and scaled‐up actions. This list of priorities does not discount the existence of other major public health challenges. We forecast and highlight those that may impact global public health in 2022 in order to progress and to achieve the United Nations’ Sustainable Development Goals (SDG). Thus, we advocate for stronger international cooperation, solidarity, and sustainable funding to address these challenges, and improve health across and within populations globally

Elimination of lymphatic filariasis as a public health problem in Malawi.

BackgroundLymphatic filariasis (LF) is a parasitic disease transmitted by mosquitoes, causing severe pain, disfiguring, and disabling clinical conditions such as lymphoedema and hydrocoele. LF is a global public health problem affecting 72 countries, primarily in Africa and Asia. Since 2000, the World Health Organization (WHO) has led the Global Programme to Eliminate Lymphatic Filariasis (GPELF) to support all endemic regions. This paper focuses on the achievements of the Malawi LF Elimination Programme between 2000 and 2020 to eliminate LF as a public health problem, making it the second sub-Saharan country to receive validation from the WHO.Methodology/principal findingsThe Malawi LF Programme addressed the widespread prevalence of LF infection and disease across the country, using the recommended WHO GPELF strategies and operational research initiatives in collaboration with key national and international partners. First, to stop the spread of infection (i.e., interrupt transmission) and reduce the circulating filarial antigen prevalence from as high as 74.4% to below the critical threshold of 1-2% prevalence, mass drug administration (MDA) using a two-drug regime was implemented at high coverage rates (>65%) of the total population, with supplementary interventions from other programmes (e.g., malaria vector control). The decline in prevalence was monitored and confirmed over time using several impact assessment and post-treatment surveillance tools including the standard sentinel site, spot check, and transmission assessment surveys and alternative integrated, hotspot, and easy-access group surveys. Second, to alleviate suffering of the affected populations (i.e., control morbidity) the morbidity management and disability prevention (MMDP) package of care was implemented. Specifically, clinical case estimates were obtained via house-to-house patient searching activities; health personnel and patients were trained in self-care protocols for lymphoedema and/or referrals to hospitals for hydrocoele surgery; and the readiness and quality of treatment and services were assessed with new survey tools.ConclusionsMalawi's elimination of LF will ensure that future generations are not infected and suffer from the disfiguring and disabling disease. However, it will be critical that the Malawi LF Elimination programme remains vigilant, focussing on post-elimination surveillance and MMDP implementation and integration into routine health systems to support long-term sustainability and ongoing success.SummaryLymphatic filariasis, also known as elephantiasis, is a disabling, disfiguring, and painful disease caused by a parasite that infected mosquitoes transmit to millions of people worldwide. Since 2000, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) has supported endemic countries such as Malawi in south-eastern Africa, to eliminate the disease as a public health problem. The Malawi National LF Elimination Programme has worked tirelessly over the past two decades to implement the GPELF recommended strategies to interrupt the transmission with a two-drug regime, and to alleviate suffering in patients with lymphoedema and/or hydrocoele through morbidity management and disability prevention. Additionally, the LF Programme has collaborated with national and international stakeholders to implement a range of supplementary operational research projects to address outstanding knowledge gaps and programmatic barriers. In 2020, the World Health Organisation validated that Malawi had successfully eliminated LF as a public health problem, making it the second country in sub-Saharan Africa to achieve this, which is remarkable given that Malawi previously had very high infection rates. The LF Programme now remains vigilant, putting its efforts towards post-elimination surveillance and the continued implementation of care for patients with chronic conditions. Malawi's elimination of LF will ensure that future generations are not affected by this devastating disease

Reconstructing Prehistoric African Population Structure

We assembled genome-wide data from 16 prehistoric Africans. We show that the anciently divergent lineage that comprises the primary ancestry of the southern African San had a wider distribution in the past, contributing approximately two-thirds of the ancestry of Malawi hunter-gatherers ∼8,100–2,500 years ago and approximately one-third of the ancestry of Tanzanian hunter-gatherers ∼1,400 years ago. We document how the spread of farmers from western Africa involved complete replacement of local hunter-gatherers in some regions, and we track the spread of herders by showing that the population of a ∼3,100-year-old pastoralist from Tanzania contributed ancestry to people from northeastern to southern Africa, including a ∼1,200-year-old southern African pastoralist. The deepest diversifications of African lineages were complex, involving either repeated gene flow among geographically disparate groups or a lineage more deeply diverging than that of the San contributing more to some western African populations than to others. We finally leverage ancient genomes to document episodes of natural selection in southern African populations

Tackling antimicrobial resistance across sub-Saharan Africa; current challenges and implications for the future

Introduction: Antimicrobial resistance (AMR) is a concern as this increases morbidity, mortality and costs, with sub-Saharan Africa having the highest rates globally. Concerns with rising AMR have resulted in international, Pan-African and country activities including the development of national action plans (NAPs). However, there is variable implementation across Africa with key challenges persisting. Areas covered: Consequently, there is an urgent need to document current NAP, other activities, and challenges across sub-Saharan Africa to provide future guidance. This builds on a narrative review of the literature. Expert Commentary: All surveyed sub-Saharan African countries have developed their NAPs; however, there is variable implementation. Countries including Botswana and Namibia are yet to officially launch their NAPs with Eswatini only recently launching its NAP. Cameroon is further ahead with its NAP than these countries; though, there are concerns with implementation. South Africa appears to have made the greatest strides with implementing its NAP including regular monitoring of activities and instigation of antimicrobial stewardship programmes. Key challenges remain across Africa. These include available personnel, expertise, capacity and resources to undertake agreed NAP activities including active surveillance, lack of focal points to drive NAPs, and competing demands and priorities including among donors. These challenges are being addressed, with further co-ordinated efforts needed to reduce AM