The earthquake/seismic risk, vulnerability and capacity profile for Karonga town

The study was carried out to understand the risks posed by earthquakes in Karonga based on roles and perception of stakeholders. Information was collected from several stakeholders who were found responding to earthquakes impacts in Karonga Town. The study found that several stakeholders, governmental and  non-governmental department and organisation operate in Karonga District to respond to hazards and disasters that occur in the district however most of these stakeholders concentrate their activities in rural areas than the town despite having the town experiencing greater impacts from earthquake hazards. The study also found that people of Karonga are aware of earthquakes and how they can avoid their impacts however their economic status fail them from developing infrastructure that can help them to avoid or recover quickly from the impacts of earthquake disasters. It is therefore concluded that the people of Karonga town are vulnerable to earthquake hazards due to limited capacity to develop appropriate infrastructure that can survive seismic hazards.Key words: Earthquake, seismic, risk, vulnerability, capacity

Treading the thin line: pharmacy workers’ perspectives on medication abortion provision in Lusaka, Zambia

Context: Despite liberal abortion laws, safe abortion access in Zambia is impeded by limited legal awareness, lack of services, and restrictive clinical policies. As in many countries with restricted abortion access, women frequently seek abortions informally from pharmacies. Methods: We conducted 16 in-depth interviews in 2019 to understand the experiences and motivations of pharmacy workers who sell medication abortion (MA) drugs in Lusaka. Results: We found that pharmacy staff reluctantly assume a gatekeeper role for MA due to competing pressures from clients and from regulatory constraints. Pharmacy staff often decide to provide MA, motivated by their duty of care and desire to help clients, as well as financial interests. However, pharmacy workers’ motivation to protect themselves from legal and business risk perpetuates inequalities in abortion access, as pharmacy workers improvise additional eligibility criteria based on personal risk and values such as age, partner approval, reason for abortion and level of desperation. Conclusion: These findings highlight how pharmacy staff informally determine women’s abortion access when laws and policies prevent comprehensive access to safe abortion. Reform of clinical guidelines, public education, strengthened public sector availability, task-sharing, and improved access to prescription services are needed to ensure women can legally access safe abortion

Structural inheritance and border fault reactivation during active early-stage rifting along the Thyolo fault, Malawi

We present new insights on the geometry, initiation and growth of the Thyolo fault, an 85 km long active border fault in the southern Malawi Rift, from high-resolution topography, field and microstructural observations. The Thyolo fault is located towards the edge of the Proterozoic Unango Terrane, and is the border fault of the Lower Shire Graben, which has experienced four phases of extension since the Jurassic. Recent activity is demonstrated by an 18.6 ± 7.7 m high fault scarp, with two substantial reductions in scarp height along strike. However, the segment boundaries suggested by these displacement measurements do not coincide with changes in fault strike. Elsewhere, a ∼5 km long fault perpendicular scarp joins two overlapping sections, yet the scarp height in this linking section is similar to the bounding sections, and there is no evidence of significant pre-linkage strain accumulation. Microstructural analyses along the fault show a 15–45 m thick footwall damage zone with a 0.7 m thick core. We suggest that favourably-oriented, pre-existing shallow structures control changes in surface geometry and the narrow fault core, whereas exploitation of weak ductile zones at depth, possibly associated with the terrane boundary, control the displacement profile of the fault

Structural inheritance and border fault reactivation during active early-stage rifting along the Thyolo fault, Malawi

We present new insights on the geometry, initiation and growth of the Thyolo fault, an 85 km long active border fault in the southern Malawi Rift, from high-resolution topography, field and microstructural observations. The Thyolo fault is located towards the edge of the Proterozoic Unango Terrane, and is the border fault of the Lower Shire Graben, which has experienced four phases of extension since the Jurassic. Recent activity is demonstrated by an 18.6 ± 7.7 m high fault scarp, with two substantial reductions in scarp height along strike. However, the segment boundaries suggested by these displacement measurements do not coincide with changes in fault strike. Elsewhere, a ∼5 km long fault perpendicular scarp joins two overlapping sections, yet the scarp height in this linking section is similar to the bounding sections, and there is no evidence of significant pre-linkage strain accumulation. Microstructural analyses along the fault show a 15–45 m thick footwall damage zone with a 0.7 m thick core. We suggest that favourably-oriented, pre-existing shallow structures control changes in surface geometry and the narrow fault core, whereas exploitation of weak ductile zones at depth, possibly associated with the terrane boundary, control the displacement profile of the fault

Fault scarp and structural measurements along the Thyolo Fault, southern Malawi

Measurements of fault scarp height, topographic profiles used to measure fault scarp and metamorphic foliation measurements along the Thyolo Fualt, southern Malawi. This dataset is used in Wedmore, LNJ, Williams, JN, Biggs, J, Fagereng, Å, Mphepo, F, Dulanya, Z, Willoughby, J, Mdala, H, Adams, BA. 2020. Structural inheritance and border fault reactivation during active early-stage rifting along the Thyolo fault Malawi. Journal of Structural Geology, 139, 104097. https://doi.org/10.1016/j.jsg.2020.104097 For more information please contact [email protected]

Care-seeking patterns amongst suspected paediatric pneumonia deaths in rural Malawi.

Background: Pneumonia remains a leading cause of paediatric deaths. To understand contextual challenges in care pathways, we explored patterns in care-seeking amongst children who died of pneumonia in Malawi. Methods: We conducted a mixed-methods analysis of verbal autopsies (VA) amongst deaths in children aged 1-59 months from 10/2011 to 06/2016 in Mchinji district, Malawi. Suspected pneumonia deaths were defined as: 1. caregiver reported cough and fast breathing in the 2-weeks prior to death; or, 2. the caregiver specifically stated the child died of pneumonia; or 3. cause of death assigned as 'acute respiratory infection' using InterVA-4. Data were extracted from free-text narratives based on domains in the 'Pathways to Survival' framework, and described using proportions. Qualitative analysis used a framework approach, with pre-specified themes. Results: We analysed 171 suspected pneumonia deaths. In total, 86% of children were taken to a healthcare facility during their final illness episode, and 44% sought care more than once.  Of children who went to hospital (n=119), 70% were admitted, and 25% received oxygen. Half of the children died within a healthcare setting (43% hospital, 5% health centre and 2% private clinics), 64 (37%) at home, and 22 (13%) in transit. Challenges in delayed care, transport and quality of care (including oxygen), were reported. Conclusions: Healthcare was frequently sought for children who died of suspected pneumonia, however several missed opportunities for care were seen. Sustained investment in timely appropriate care seeking, quick transportation to hospital and improved case management at all levels of the system is needed

Fault scarp and structural measurements along the Thyolo Fault, southern Malawi

Measurements of fault scarp height, topographic profiles used to measure fault scarp and metamorphic foliation measurements along the Thyolo Fualt, southern Malawi. This dataset is used in Wedmore, LNJ, Williams, JN, Biggs, J, Fagereng, Å, Mphepo, F, Dulanya, Z, Willoughby, J, Mdala, H, Adams, BA. 2020. Structural inheritance and border fault reactivation during active early-stage rifting along the Thyolo fault Malawi. Journal of Structural Geology, 139, 104097. https://doi.org/10.1016/j.jsg.2020.104097 For more information please contact [email protected]

Predictive value of pulse oximetry for mortality in infants and children presenting to primary care with clinical pneumonia in rural Malawi: A data linkage study

BackgroundThe mortality impact of pulse oximetry use during infant and childhood pneumonia management at the primary healthcare level in low-income countries is unknown. We sought to determine mortality outcomes of infants and children diagnosed and referred using clinical guidelines with or without pulse oximetry in Malawi.Methods and findingsWe conducted a data linkage study of prospective health facility and community case and mortality data. We matched prospectively collected community health worker (CHW) and health centre (HC) outpatient data to prospectively collected hospital and community-based mortality surveillance outcome data, including episodes followed up to and deaths within 30 days of pneumonia diagnosis amongst children 0-59 months old. All data were collected in Lilongwe and Mchinji districts, Malawi, from January 2012 to June 2014. We determined differences in mortality rates using ConclusionsPulse oximetry identified fatal pneumonia episodes at HCs in Malawi that would otherwise have been missed by WHO referral guidelines alone. Our findings suggest that pulse oximetry could be beneficial in supplementing clinical signs to identify children with pneumonia at high risk of mortality in the outpatient setting in health centres for referral to a hospital for appropriate management