THE CONSERVATION BIOLOGY OF BERBERIS HOLSTII ENGL. IN NYIKA NATIONAL PARK, MALAWI

Biological resources are particularly important in resource-limited countries where utilisation demands challenge conservation efforts. The study focussed on Berberis holstii, a plant resource on high demand in northern Malawi restricted to Nyika National Park. The uses, distribution, habitat characteristics, demography and seed germination requirements of this important species were investigated. Uses were investigated by means of ethnobotanical interviews. The species distribution in the park was mapped employing GIS. Habitats were characterised employing multivariate methods implemented in the programmes PC-ORD and PRIMER. Demographic studies employed matrix projections to characterise representative populations. Finally, laboratory germination trials allowed determination of light, cold stratification and temperature requirements for seed germination. Forty-seven uses were documented. Of these, thirty were medicinal and the rest for income generation. The most common uses included infusion for coughs, malaria, stomachache, sexually transmitted infections and pneumonia. Because roots are employed, whole plants are dug out. This lead to the extinction of five of the recorded 94 sites. Fire periodically kills the aerial part of plants, which then tend to recover through resprouting. The species is restricted to high altitude, open areas on sandy/loamy soils. Despite harvesting and fire, demographic projections showed positive population growth. Population growth rate is more sensitive to mortality of late juvenile stages and early adult stages than it is to demographic transitions and contributions by other stage classes. Germination was higher when seeds were stored for one year, had a prechilling treatment (cold stratification) and were germinated under light at -20°C. Seeds did not lose viability during two years of storage raising prospects for their artificial storage. The study provides important information for the conservation and management of this important African endemic. It highlights some of the difficulties confronted in projecting the population dynamics of species with sporadic simultaneous recruitment and tests the ability of a recently proposed model to determine germination requirements. In a wider context, the study shows that a combination of methodological approaches (ethnobotany, biogeography, demography and germination) allows a more complete understanding of the evolutionary, ecological and social factors that must be taken into account in the conservation of individual species

Poultry-based poverty alleviation projects in Ehlanzeni District Municipality: do they contribute to the South African government’s ‘developmental state’ ambition?

The aim of this study was to identify both institutional and production constraints to the success of poultry-based poverty alleviation projects (PAPs) in Bushbuckridge Municipality of the Ehlanzeni District of Mpumalanga Province. A mixed methods research design was used. Purposive sampling was used to select 10 Chairpersons, 20 ordinary members, and five extension officers of PAPs who served as respondents in the study. Face-to-face interviews were conducted using a semi-structured guide to collect qualitative data. The qualitative data was analysed using the Atlas ti 7.0.81 software. The results were used to develop a questionnaire employed to collect quantitative data from 116 respondents. The Statistical Package for Social Sciences (SPSS) version 23.0 was used to analyze the latter data. The major institutional constraints identified, in descending order of severity, were: lack of regulation of prices of poultry feed, lack of government start-up capital/subsidy, inadequate extension shows the poor support the PAPs receive. High price of poultry feeds force PAPs to stock fewer chickens was the major production constraint followed by diseases, in particular New Castle and Bronchitis are killing chickens and water supply is so erratic and unreliable that it affects effective running of poultry-based PAPs. It was concluded that despite the wide range of constraints facing them, PAPs were improving people’s livelihoods. The need for revamping the local extension service in order to deal with the numerous challenges that the PAPs faced was highlighted. Central to this reengineering of the extension support system is the need for creating platforms and opportunities for the PAPs to co-learn and learn from each other, both of which are fundamental ingredients of sustainability.Keywords: Constraints; developmental state; extension; povert

Extrinsic Motivation to Use mHealth Interventions in Maternal Healthcare in Rural Malawi

mHealth interventions have the potential to address the inequalities in accessing health information. In maternal healthcare, mHealth interventions provide information to pregnant women on how they can stay healthy during pregnancy, as well as on the danger signs in pregnancy that can contribute to maternal mortality. In this study we posit that extrinsic motivation could promote trialability of mHealth interventions. We employed qualitative research methods to investigate extrinsic factors that motivate maternal healthcare clients in rural Malawi to use mHealth interventions. Self-determination theory was used as the theoretical lens for the study. Data was collected using secondary data sources and semi-structured interviews with maternal clients who used the mHealth intervention. The study found that maternal healthcare clients were extrinsically motivated by incentives and the ability of the technology to suppress social-cultural norms. The study informs mHealth implementers on what they may focus on to bring in beneficiaries to try the intervention which eventually could lead to the adoption and use of interventions

rine shrimp lethality and phytochemical determination of aqueous extracts of Senna singueana, Musa paradisiaca, and Ziziphus mucronata in Malawi.

Traditional medicine is still practiced in different parts of the world; with traditional healers as powerful and important members of the society. Senna singueana, Musa paradisiaca, and Ziziphus mucronata plants are commonly used by traditional healers to treat different ailments in Malawi. There is need to conduct a scientific lethality evaluation of these plants to assess their fitness for human consumption as traditional medicine. The aqueous extraction of leaves and roots of Senna singuenna, Musa paradisiaca, and Ziziphus mucronata mimicking similar environment as provided by traditional healers, afforded dry extracts. Brine shrimp toxicity testing was done following a modified procedure to determine in-vitro cytotoxicity for the herbal extracts. The findings suggest that the leaves and roots tested exhibited concentration dependent toxicity against brine shrimps with the exception of Ziziphus mucronata roots which showed some toxicity to brine shrimps after 48 hours of incubation. Brine shrimp results suggest that the plant extracts were virtually non-toxic on the shrimps save Senna singueana leaves, Ziziphus mucronata roots, which exhibited low toxicity on brine shrimps after 48 hours of incubation. The observed toxic activity for Ziziphus mucronata roots may be due to the presence of well documented cytotoxic compounds such as Swertish and Apigenine glucoside

Exploring a framework for demandable services from antenatal to postnatal care: a deep-dive dialogue with mothers, health workers and psychologists.

BackgroundOne of the factors affecting quality of care is that clients do not demand care practises during antenatal, intrapartum and postnatal care. This study aimed to identify care practices that can be demanded by the mother in the continuum of care from antenatal to postnatal.MethodsThe study respondents included 122 mothers, 31 health workers and 4 psychologists. The researchers conducted 9 Key Informant Interviews with service providers and psychologists, 8 Focus Group Discussions with 8 mothers per group, and 26 vignettes with mothers and service providers. Data was analysed using Interpretative Phenomenological Analysis (IPA) where themes were identified and categorised.ResultsDuring antenatal and postnatal care, mothers demanded all recommended services presented to them. Some services seen as demandable during labour and delivery included 4-hourly assessments of vital signs and blood pressure, emptying of the bladder, swabbing, delivery counselling, administration of oxytocin, post-delivery palpation, and vaginal examination. For the child mothers demanded head to toe assessment, assessment of vital signs, weighing, cord stamp and eye antiseptics, and vaccines. Women observed that they could demand birth registration even though it was not among the recommended services. Respondents proposed empowerment of mothers with cognitive, behavioural and interpersonal skills to demand services e.g., knowledge of service standards and health benefits in addition to improved self-confidence and assertiveness. In addition, efforts have to be made to address perceived or real health worker attitudes, mental health for the client and the service provider, service provider workload, and availability of supplies.ConclusionThe study found that if a mother is informed in simple language about services that she is supposed to receive, she can demand numerous services in the continuum of care from antenatal to postnatal. However, demand cannot be a standalone solution for improving quality of care. What the mother can ask for is a step in the guidelines, but she cannot probe deeper to influence quality of the procedure. In addition, empowerment of mothers needs to be coupled with services and systems strengthening in support of health workers

Does mobile phone ownership matter? Insights on engagement in Health and e-government interventions from Southern Africa

The proliferation of mobile phones across the world has contributed to the rise of mHealth interventions as a complementary means for improving health outcomes in areas where health facilities are limited. However, community members who do not own or have access to mobile devices feel excluded from such interventions. In this paper, we seek to understand and explore engagement strategies that support the inclusion of non-mobile phone owners in Health interventions. We conducted a review of mHealth and community engagement literature to gauge the strategies different studies have employed to engage non-mobile phone owners and users. We further reflected on two Southern African case studies from health and citizen engagement sectors to gain insights on ways non-mobile phone owners may feel included in Health interventions. Through a process of thematic analysis, we have identified three areas that mHealth implementers could draw from when designing more inclusive Health interventions. These strategies include the need for sensitising communities, using multi-stakeholder and multi-sectoral collaboration, and embracing a braided approach to communication technologies. We hope that this paper will inform mHealth project implementers on different strategies they can use to include community members, regardless of whether they own mobile phones or not

The world is coming to an end! COVID-19, depression, and anxiety among adolescents in Malawi

IntroductionThis paper assessed the effects of Covid-19 on adolescent mental health in Malawi. There is minimal research on adolescent mental health in Africa, Malawi in particular. The study shows a link between the pandemic and mental health. Some factors that may have contributed to this link include; Covid-19 preventive measures, media exposure and the increase in unemployment.MethodsThe study used a mixed methods approach, quantitative and qualitative methods. It was conducted in Malawi's four districts (Blantyre, Mangochi, Lilongwe and Karonga).ResultsOverall 22%, 21%, and 23% of the respondents had depression, anxiety and post-traumatic stress disorder, respectively. The Chi-square test showed that significantly more adolescents with secondary education (28%) had anxiety than those with primary education (14%). Further, regression analysis revealed that adolescents with anxiety were 18 [95%CI: 9.34, 35.8] times more likely to have depression compared to those who did not have anxiety. The study found no significant differences in the proportions of adolescents with the three outcomes when comparing different groups within the explanatory variable. The ratio of female and male adolescents with depression and anxiety was the same.DiscussionThe adolescents expressed that Covid-19 affected their social, academic, and financial status. These effects had a significant bearing on their mental health in that they led to depression, anxiety, fear of the unknown, and stress. During the Covid-19 pandemic, adolescents' mental health diminished and posed a considerable risk to productivity of adolescents. As a result, adolescents may not fully realize their potential, form and maintain good relationships, contribute to their community and become resilient. These effects have devastating consequences for this young generation without proper coping strategies

Lay-screeners and Use of WHO Growth Standards Increase Case Finding of Hospitalized Malawian Children with Severe Acute Malnutrition

Objectives: Strategies to effectively identify and refer children with severe acute malnutrition (SAM) to Nutritional Rehabilitation units (NRU) can reduce morbidity and mortality

Probable antenatal depression at antiretroviral initiation and postpartum viral suppression and engagement in care

Objective: To estimate the association of probable antenatal depression with postpartum HIV care engagement among pregnant women in Malawi. Design: We conducted a prospective cohort study of 299 women who were initiating antiretroviral therapy (ART) through Option B+ at a government antenatal clinic in Malawi. Methods: Probable antenatal depression was assessed on the day of ART initiation with the validated Chichewa version of the Edinburgh Postnatal Depression Scale (EPDS). We estimated crude and adjusted risk differences (RD, aRD) of visit attendance and prevalence differences (PD, aPD) of viral suppression through 12 months post-ART initiation comparing women with versus without probable antenatal depression. Results: One in 10 women had probable antenatal depression. Most women were engaged in care through 12 months post-ART initiation: 85% attended all scheduled ART visits, and 81% were in care and virally suppressed. Women with and without probable antenatal depression had a comparable probability of attending all scheduled visits (RD: -0.02; 95% CI -0.16 to 0.12; aRD: -0.04; 95% CI -0.18 to 0.10), and of viral suppression (PD: -0.02; 95% CI -0.17 to 0.13; aPD: -0.01; 95% CI -0.17 to 0.15) in crude and adjusted analyses. Conclusion: Probable antenatal depression was not associated with engagement in HIV care through 12 months post-ART initiation. In a population with high HIV care engagement, antenatal depression may not impair HIV-related outcomes

Clinical Versus Rapid Molecular HIV Diagnosis in Hospitalized African Infants: A Randomized Controlled Trial Simulating Point-of-Care Infant Testing

Many African infants fail to receive their diagnostic HIV molecular test results and subsequently, antiretroviral therapy (ART). To determine whether a point-of-care molecular HIV test increases ART access for hospitalized Malawian infants, we simulated a point-of-care test using rapid HIV RNA polymerase chain reaction (Rapid PCR) and compared patient outcomes to an optimized standard care that included assessment with the World Health Organization (WHO) clinical algorithm for HIV infection plus a DNA PCR with a turnaround time of several weeks (standard care)