The extent to which African indigenous language tools are an instrument to promote or/and hinder gender equality: critical analysis of chichewa proverbs of Malawi.

Doctoral Degree. University of KwaZulu-Natal, Durban.This study is traced from the United Nation Sustainable Development goal number five of gender equality and women empowerment which supersede Millennium Development Goals number three. One way in which language is used is through the use of proverbs. The study aimed at finding out how Chichewa proverbs of Malawi can be an instrument to promote or hinder gender equality and women empowerment. The study followed hermeneutic phenomenological method and qualitative research approach to understand and interpret the connotations inscribed in Chichewa gendered proverbs. In order to unpack and analyze the proverbs, the study is underpinned within the Knowledge translation theory, along with critical discourse analysis and the reformist African feminism. Two methods of data collection were adopted in this study: desktop search and interviews which were conducted with the aid of semi-structured open ended questions. The interviews were conducted in two separate ways ie. Individual face to face as well as focus groups. In total, fourty four participants were from four different population groups namely; the block leaders, the ward councillors, the education managers and other respondents who were just residents of the area. Using content analysis, the data were analyzed qualitatively and findings presented and discussed thematically. On a positive note, the results of this study reveals that Chichewa proverbs may work positively towards enhancing gender equality and women empowerment. This is demonstrated when some proverbs portray women as symbols of warmth to the society while others encourage women empowerment and agency. Secondly, men’s bad and evil behaviors towards women are rebuked in some Chichewa proverbs. The results of this study further shows that within Malawi society, men are not completely free from proverbial negativity but are equally victims of proverbial messages. With special reference to matrilineal society, proverbs have shown elements of discrimination on the part of suitors (mkamwini). This is in conflict with some Eurocentric gender studies which completely ignore the dynamics and uniqueness of different context, cultures and traditions. With the aid of poly-epistemic research approach and methodologies, such tradition dynamics were unravelled to fill the gaps and contribute to already existing body of knowledge. However, to the larger extent Chichewa proverbs have elements that work against women in various aspects. The proverbs are tools used to create and sustain the construction of hegemonic masculinity and femininity hence the superiority of men and inferiority of women in Malawi is sustained. By creating a body of knowledge which portray women as gossipers, evil beings, weak and people lacking decision-making skills, women continue to suffer oppression, marginalization, subordination and discrination in various ways both in public and privatespheres. Even though the results of this study reveal that probably both men and women were involved in the construction of proverbs, but the knowledge contribution of women in this domain was just meant to serve the male chauvinistic. This study therefore concludes that although some Chichewa proverbs can be used by gender activists to promote gender equality in Malawi, the wisdom embedded in some proverbs seem to be a hindrance towards the advance

Factors Influencing the Implementation of Infant Warming Devices Among Healthcare Workers in Malawian Hospitals.

Objectives. Preterm infants are at risk of hypothermia. This study described the available infant warming devices (IWDs) and explored the barriers and facilitators to their implementation in neonates in Malawi. Methods. A qualitative descriptive study was conducted among 19 health care workers in Malawi from January to March 2020. All interviews were digitally recorded, transcribed, and managed using NVivo and analyzed using a thematic approach. Results. The warming devices included radiant warmers, Blantyre hot-cots, wall-mounted heaters, portable warmers, and incubators. Inadequate equipment and infrastructure and gaps in staff knowledge and capacity were reported as the main challenges to optimal IWD implementation. Caregiver acceptance was described as the main facilitator. Strategies to optimize implementation of IWD included continuous practical training and adequate availability of equipment and spare parts. Conclusion. Implementation of warming devices for the management of neonatal hypothermia is effective when there are adequate human and material resources

Can vaccination coverage be improved by reducing missed opportunities for vaccination? Findings from assessments in Chad and Malawi using the new WHO methodology.

BACKGROUND: In 2015, the World Health Organization (WHO) updated the global methodology for assessing and reducing missed opportunities for vaccination (MOV), when eligible children have contact with the health system but are not vaccinated. This paper presents the results of two pilot assessments conducted in Chad and Malawi. METHODS: Using the ten-step global WHO MOV strategy, we purposively selected districts and health facilities, with non-probabilistic sampling of <24 month old children for exit interviews of caregivers and self-administered knowledge, attitudes, and practices (KAP) surveys of health workers. MOV were calculated based on a child's documented vaccination history (i.e., from a home-based record (HBR) or a health facility vaccination register), including selected vaccines in the national schedule. RESULTS: Respondents included caregivers of 353 children in Chad and of 580 children in Malawi. Among those with documented vaccination history, 82% (195/238) were eligible for vaccination in Chad and 47% (225/483) in Malawi. Among eligible children, 51% (99/195) in Chad, and 66% (149/225) in Malawi had one or more MOV on the survey date. During non-vaccination visits, 77% (24/31) of children eligible for vaccination in Chad and 92% (119/129) in Malawi had a MOV compared to 46% (75/164) and 31% (30/96) during vaccination visits, respectively. Among health workers, 92% in Chad and 88% in Malawi were unable to correctly identify valid contraindications for vaccination. CONCLUSION: The new MOV tool was able to characterize the type and potential causes of MOV. In both countries, the findings of the assessments point to two major barriers to full vaccination of eligible children-a lack of coordination between vaccination and curative health services and incomplete vaccination during vaccination visits. National immunization programs should explore tailored efforts to improve health worker practices and to increase vaccine delivery by making better use of existing health service contacts

"So sometimes, it looks like it's a neglected ward": Health worker perspectives on implementing kangaroo mother care in southern Malawi

IntroductionKangaroo mother care (KMC) involves continuous skin-to-skin contact of baby on mother's chest to provide warmth, frequent breastfeeding, recognizing danger signs of illness, and early discharge. Though KMC is safe, effective and recommended by the World Health Organization, implementation remains limited in practice. The objective of this study is to understand barriers and facilitators to KMC practice at tertiary and secondary health facilities in southern Malawi from the perspective of health workers.MethodsThis study is part of the "Integrating a neonatal healthcare package for Malawi" project in the Innovating for Maternal and Child Health in Africa initiative. In-depth interviews were conducted between May-Aug 2019 with a purposively drawn sample of service providers and supervisors working in newborn health at a large tertiary hospital and three district-level hospitals in southern Malawi. Data were analyzed using a thematic approach using NVivo 12 software (QSR International, Melbourne, Australia).FindingsA total of 27 nurses, clinical officers, paediatricians and district health management officials were interviewed. Staff attitudes, inadequate resources and reliance on families emerged as key themes. Health workers from Malawi described KMC practice positively as a low-cost, low-technology solution appropriate for resource-constrained health settings. However, staff perceptions that KMC babies were clinically stable was associated with lower prioritization in care and poor monitoring practices. Neglect of the KMC ward by medical staff, inadequate staffing and reliance on caregivers for supplies were associated with women self-discharging early.ConclusionThough routine uptake of KMC was policy for stable low birthweight and preterm infants in the four hospitals, there were gaps in monitoring and maintenance of practice. While conceptualized as a low-cost intervention, sustainable implementation requires investments in technologies, staffing and hospital provisioning of basic supplies such as food, bedding, and KMC wraps. Strengthening hospital capacities to support KMC is needed as part of a continuum of care for premature infants

Barriers and enablers of implementing bubble continuous positive airway pressure (CPAP) : perspectives of health professionals in Malawi

The study explored the factors that influence the implementation of Continuous Positive Airway Pressure (bubble CPAP) among health care professionals in secondary and tertiary hospitals in Malawi. Influencing factors occurred in an interconnected manner and included: inadequate healthcare provider training; rigid division of roles and responsibilities among providers; lack of effective communication between providers and newborn’s caregivers; human resources constraints; and inadequate equipment and infrastructure. Complications of prematurity are the leading cause of neonatal deaths, an important consideration in Malawi, which has the highest rate of preterm births in the world, at 18% of live-births.Global Affairs Canada (GAC)Canadian Institutes for Health Research (CIHR

Unwilling Subjects of Financialization

This paper seeks to advance debates about the financialization of housing by focusing on the emergence of rental housing as a frontier for financialization, a dynamic that is increasingly relevant since the global financial crisis. Situated in New York City, the research focuses on an aggressive wave of investment in affordable, rent-stabilized properties by private equity firms, their efforts to release value from these properties, and the implications of the 2008 financial crisis for their investment strategies and thus for tenants’ experience of home. Through detailed empirical analysis tracing the connections between how rental housing has been constituted as a new site for private equity investment globally, the local conditions facilitating this process in New York, and how it reshaped everyday life for tenants, the article theorizes tenants as unwilling subjects of financialization. Yet unwillingness does not necessarily translate to being overtaken; it also connotes reluctance, and indeed struggle. This novel conceptualization highlights the ways in which financialization meets with dissent, and its necessarily contingent and incomplete nature. The paper therefore moves forward the wider intellectual project of understanding financialization not as a monolithic and inevitable process, but as one characterized by resistance from without and contradiction from within

Brain abscesses in Malawian children: value of CT scan

The clinical presentation and management of brain abscess in three HIV-uninfected Malawian children are reported. One case was associated with staphylococcal empyema and severe malarial anaemia and another case with chronic suppurative otitis media and mastoiditis. The third case had no identified extracranial focus of infection. These cases illustrate the difficulties of diagnosis and management of brain abscesses in the resource-poor setting where other causes of encephalopathy caused by infection are common, and highlight the value of neuro-radiological imaging