Determinants of non-institutional deliveries in Malawi

Malawi has one of the highest maternal mortality ratios in the world. One of the factors contributing to high maternal mortality is the non-use of health facilities during pregnancy and delivery. The aim of this study is to examine the factors associated with non-institutional deliveries in Malawi. Data from 2004 Malawi Demographic and Health Survey and multinomial logistic regression were used to assess the association between place of delivery and selected socio-economic factors. The study population comprised of 7,218 women, who had at least one child, aged less than five years, at the time the survey. Of these women, 58% delivered at a health facility, 29.4% delivered at home and 12.6% delivered at the home of a traditional birth attendant. Multivariate analysis indicate that region (OR = 1.29 for Central Region), place of residence (OR=0.319 for urban areas), wealth status (OR=6.289 for poor, OR=4.683 for middle), education (OR=3.823 for no education, OR=2.265 for primary education), number of prenatal visits (OR=4.732 no visits, OR=1.696 1-3 visits) and ever use of family (OR=1.29 for never used) showed significant association with non-institutional deliveries. These factors should be considered in designing strategies to improve the maternal health care system in Malawi

Contraceptive use among Malawian women 1992 – 2004

A comparison of four nationally representative household surveys of Malawian women of reproductive ages indicates a substantial increase in contraceptive prevalence during the twenty-year period 1984 to 2004 (see figure 1). Contraceptive Prevalence Rate (CPR) in Malawi has increased from less than one percent in 1984 to 7%, 12%, 21% and 22% in 1992, 1996, 2000 and 2004, respectively Malawi Medical Journal Vol. 20 (3) 2008: pp. 78-7

Evaluating land cover change and its impact on hydrological regime in Upper Shire River Catchment, Malawi

A study was conducted to investigate hydrological impacts of land cover changes in the degradation of the hydrological on flow regimes of the Upper Shire river, Malawi. Remote sensing techniques were used to inventory temporal changes of land cover changes in the catchment. Hydrological data were analyzed to reveal the alterations ecosystems, and water resources for an informed decision on proper catchment planning and management and trends for two periods; 1989 and 2002. The study revealed significant changes in magnitude and direction that have occurred in the catchment between 1989 and 2002, mainly in areas of human habitation. Trends in land cover change in the Upper Shire river catchment depict land cover transition from woodlands to mostly cultivated/ grazing and built-up areas. The land cover mapping showed that 23% of the land was covered by agricultural land in 1989. Subsistence agricultural area has increased by 18%, occupying 41% of the study area in 2002. The effects of the derived land cover changes on river flow in the Upper Shire river were investigated using the semi distributed soil and water assessment tool (SWAT) model. River flows were found to be highly variable and sensitive to land cover changes. Simulation results show that 2002 land cover data produces higher flow peaks and faster travel times compared to the 1989 land cover data. The changes detected indicate the effects of land use pressure in the catchment. The study highlights the importance of considering effects of land use and land cover changes on ecosystems, and water resources for an informed decision on proper catchment planning and management

Religious perceptions and attitudes of men towards discontinuation of female genital cutting in Nigeria: evidence from the 2013 Nigeria Demographic and Health Survey

Men‘s roles in any patriarchal society and the influence of their religious belief cannot be overemphasized especially in a culturally encrypted matter like female genital cutting (FGC).The study sample consisted of 8,111 men who had previous awareness of FGC from a cross-sectional nationally representative survey in Nigeria. The data took into cognizance the religious belief of the respondents as well as their attitude towards FGC among others. Analytical bivariate and multivariate ordered logistic estimates for FGC discontinuation were considered for the study. Of the total respondents, 29% reported that their religion required FGC for female children. A significantly higher proportion (89.4%; p<0.01) of men whose religion did not require FGC were found subscribing to its discontinuation. Significantly lower odds of FGC discontinuation exist among those whose religious belief requires FGC practice. Religious teachings and beliefs are crucial correlates of men‘s attitude towards FGC. There is therefore a need to consider the religious beliefs of men when engaging them in strategies to fight FGC.Keywords: Female Genital Cutting, Perception, Attitude, Religion, Nigeri

Modelling the impact of women’s education on fertility in Malawi

Many studies have suggested that there is an inverse relationship between education and number of children among women from sub-Saharan Africa countries, including Malawi. However, a crucial limitation of these analyses is that they do not control for the potential endogeneity of education. The aim of our study is to estimate the role of women’s education on their number of children in Malawi, accounting for the possible presence of endogeneity and for nonlinear effects of continuous observed confounders. Our analysis is based on micro data from the 2010 Malawi Demographic Health Survey, and uses a flexible instrumental variable regression approach. The results suggest that the relationship of interest is affected by endogeneity and exhibits an inverted U-shape among women living in rural areas of Malawi, whereas it exhibits an inverse (nonlinear) relationship for women living in urban areas

Fertility decline in Malawi: An analysis of the proximate determinants

The paper examines trends in the proximate determinants of fertility (nuptiality or marriage, contraception and post-partum infecundability) in Malawi during the twelve-year period 1992-2004, with a view to explaining the factors responsible for fertility decline in the country. The study uses the Malawi Demographic and Health Surveys data sets of 1992, 2000 and 2004 and Bongaarts’ model of proximate determinants. The goal is to identify the important intermediate variables that are amenable to policy towards fertility reduction. Analysis of the data shows that there are increases in the absolute measures of all three determinants. The magnitude of change is greatest in contraceptive use, moderate in marriage, and least in duration of breast-feeding. Like similar studies conducted elsewhere in Africa, the study shows that postpartum infecundability has a far more dominant inhibiting effect on fertility than the other proximate fertility determinants. Specifically, the fertility suppressing effects of postpartum infecundability are more important than the effects of contraception and marriage patterns in explaining fertility levels and trends in the context of Malawi.KEYWORDS: Nuptiality, contraception, post-partum infecundability, fertility decline, proximate determinants, Malawi

An Analysis of the of Proximate Determinants of Fertility in Malawi, 1992-2004

The paper examines trends in the proximate determinants of fertility in Malawi during the period 1992 to 2004 with the view of explaining the factors responsible for fertility decline in the country. The study uses the Malawi Demographic and Health Surveys of 1992, 2000 and 2004 and the Bongaarts model of Proximate Determinants. The analysis shows that there are increases in all three proximate determinants. The magnitude of change is greatest in contraceptive use, moderate in marriage but least in breastfeeding. The study show that postpartum infecundability has a far more dominant inhibiting effect on fertility than the other two proximate fertility determinants.EASSRR Vol. 24 (1) 2008: pp. 15-4

Women’s perspectives on quality of maternal health care services in Malawi

Kennedy Machira,1,2 Martin Palamuleni2 1Department of Agriculture Economics, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi; 2Population and Research Unit, North West University, Mmabatho, Republic of South Africa Abstract: Despite promotion by many stakeholders to improve maternal health outcome in many developing countries including Malawi, many analysts agree that the utmost success in maternal health will arise if maternal health care services are an unparallel led source for women’s health care solutions for any problem related to childbirth. Health advocates worldwide claim that even though maternal services are provided, women’s utilization of such services has not been ascertained. The objective of this study was to explore women’s perspectives on the quality of health care service delivery in Malawi. This article therefore investigates women’s perspectives on the quality of maternal health care services in Malawi. We used six focus group discussions in six health facilities that were selected across Malawi. We found that erratic availability of medical resources and unethical practices among health workers adversely affected quality of maternal health care service delivery. We concluded that the expensive routine operational audits of medical resources and service delivery across health facilities are imperative if women’s health outcomes are to be enhanced in Malawi. Keywords: public health, health care, quality of care, access, Malawi, women’s healt