Are men missing in gender and health programmes? An analysis of the Malawi human rights resource center, a non-governmental organisation in Malawi.

Thesis (M.Dev.Studies)-University of KwaZulu-Natal, Durban, 2010.Literature has shown that the involvement of men in gender and health programmes remains unclear on the ground (Esplen, 2006:1; Rivers and Aggleton, 1999:2-3). This has been happening in the midst of claims to have moved from the Women in Development to the Gender and Development framework which calls for the involvement of men in gender and development work. Furthermore, it has been argued that where literature exists, the work is generally based on studies done in developed countries and the relevance of such findings to the developing world still remains unclear (Abraham, Jewkes, Hoffman and Laubsher, 2004:330; Connell, 1987:235-236). This study therefore attempts to fill this gap by looking at the work of the Malawi Human Rights Resource Center, one of the non-governmental organisations working on gender and health programmes in Malawi. A qualitative approach was used. Six project staff and eighteen project beneficiaries were interviewed to assess their perceptions and experiences. The study found out that men involvement continues to be minimal and unclear in gender and health programmes. Although there is awareness of the importance of men’s involvement this was not implemented effectively. The few men that were involved continue to be intimidated and humiliated by both men and women. The issues of masculinities and patriarchal also continue to shape gender inequalities in the area under study. All these discourage most men from active participation in such work. Furthermore, the few that are involved meet a number of barriers which deter them from greater involvement. Such barriers according to this study include, among other things, cultural barriers, lack of men’s own space where they can discuss their own gender related issues, the view held by some gender activists that gender is equal to women’s issues and men resistance to change considering the benefits accrued by being men. All these have impacted on the way people, especially men, view gender and health programmes. The study further found that although men are regarded as the main perpetrators of violence, not all men are as such, some do acknowledge the effects of the practise. Furthermore, some men also do experience violence. According to the study findings, this is an area which has also continued to be overlooked by most developmental agencies. In Malawi, this is also exacerbated by the fact that there are no specific programmes that target men’s welfare. Nevertheless, the study argues that men’s involvement is crucial in gender and health work. In areas where men were involved positive indicators were noted and reported. The indicators include improved communication within most families, peaceful family coexistence, happy families and changes in sexual behaviour. All these give hope regarding the reduction of HIV/AIDS and development as a whole. This suggests that where gender equality is to be achieved, men need to be actively involved, both as partners and victim of gender and health related violence. When implementing such programme, there is also need to acknowledge that not all men are violent, some are actually willing to join the fight against the malpractice

Does Type of Tumor Histology Impact Survival among Patients with Stage IIIB/IV Non-Small Cell Lung Cancer Treated with First-Line Doublet Chemotherapy?

Chemotherapy regimens may have differential efficacy by histology in nonsmall cell lung cancer (NSCLC). We examined the impact of histology on survival of patients (N = 2,644) with stage IIIB/IV NSCLC who received first-line cisplatin/carboplatin plus gemcitabine (C/C+G) and cisplatin/carboplatin plus a taxane (C/C+T) identified retrospectively in the SEER cancer registry (1997–2002). Patients with squamous and nonsquamous cell carcinoma survived 8.5 months and 8.1 months, respectively (P = .018). No statistically significant difference was observed in survival between C/C+G and C/C+T in both histologies. Adjusting for clinical and demographic characteristics, the effect of treatment regimen on survival did not differ by histology (P for interaction = .257). There was no statistically significant difference in hazard of death by histology in both groups. These results contrast the predictive role of histology and improved survival outcomes observed for cisplatin-pemetrexed regimens in advanced nonsquamous NSCLC

A Biodiverse Rich Environment Does Not Contribute to a Better Diet: A Case Study from DR Congo

The potential of biodiversity to increase and sustain nutrition security is increasingly recognized by the international research community. To date however, dietary assessment studies that have assessed how biodiversity actually contributes to human diets are virtually absent. This study measured the contribution of wild edible plants (WEP) to the dietary quality in the high biodiverse context of DR Congo. The habitual dietary intake was estimated from 2 multiple-pass 24 h dietary recalls for 363 urban and 129 rural women. All WEP were collected during previous ethnobotanical investigations and identified and deposited in the National Botanical Garden of Belgium (BR). Results showed that in a high biodiverse region with precarious food security, WEP are insufficiently consumed to increase nutrition security or dietary adequacy. The highest contribution came from Dacryodes edulis in the village sample contributing 4.8% of total energy intake. Considering the nutrient composition of the many WEP available in the region and known by the indigenous populations, the potential to increase nutrition security is vast. Additional research regarding the dietary contribution of agricultural biodiversity and the nutrient composition of WEP would allow to integrate them into appropriate dietary guidelines for the region and pave the way to domesticate the most interesting WEP

Does Conservation Agriculture Enhance Household Food Security? Evidence from Smallholder Farmers in Nkhotakota in Malawi

The study identified factors that influence the adoption and contribution of conservation agriculture (CA) on household food security among smallholder farmers. To determine factors that affect the adoption of CA among smallholder farmers, a probit regression model was used. Then, the study compared estimated production function between adopters and non- adopters of CA. From the descriptive statistics, there are significant difference in the number of years of schooling, household land size, income levels and potential labour availability. From the probit regression results, age, education level of the household head, increase in the number of extension visits and land holding size are important in influencing the adoption of CA in the study area. Further results indicate that adoption of CA technology increases household maize production. Cobb-Douglas production estimates showed that CA adopters had more than 50% higher maize production than that of non-adopters. In addition, there are greater than proportionate unit increase in maize production with unit increase in all input factors of production among CA adopters. The paper recommends that there should be improvement in the delivery of extension services in the promotion and dissemination of agricultural technology to improve adoption rates and improve food security status in the study areas. This can be achieved by increasing number of extension workers operating in the areas and increase number of demonstrations when introducing CA technology to farmers. Again, access to formal education should be improved to enhance knowledge acquisition and understanding of CA technology components

Does Conservation Agriculture Enhance Household Food Security? Evidence from Smallholder Farmers in Nkhotakota in Malawi

The paper identified factors that influence the adoption and contribution of conservation agriculture (CA) on household food security using household-level data collected in 2010 from Nkhotakota District, Central Malawi where Total Land Care (TLC) a local Non-governmental Organization (NGO) has been promoting CA. To determine factors that influence adoption of CA, a Probit regression model was used. Then, the paper compared estimated production function between adopters and non- adopters of CA. The Probit results show that age and education level of the household head, number of extension visits, and land holding size are important factors that influence farmers’ adoption of CA in the study area. Further results showed that CA adopters had more than 50% higher maize production than that of non-adopters from the Cobb-Douglas production estimates. From the findings, there should be improvement in the delivery of extension services in the promotion and dissemination of agricultural technology to foster wider adoption and improve food security status in the study areas. This can be achieved through increased number of extension workers, increase number of demonstrations when introducing CA technology and improved access to formal education. Our overall results show consistently that CA adopters are better off than non-adopters in various aspects such as maize production, per capita maize requirements and meal frequency. As such, the promoting and up-scaling of CA technologies to smallholder farmers should be intensified as an effective strategy for addressing household food insecurity than the promotion of chemical fertilizers use through programs such as the Farm Inputs Subsidy Program, which is not only unsustainable, but also inappropriate for poor resource farmers

The use of cancer treatment summaries and care plans among Massachusetts physicians

PURPOSE: Cancer survivorship presents many challenges for affected individuals and their health care providers. Reports from The Institute of Medicine document these challenges and recommend the use of survivorship treatment summaries and care plans to improve communication and coordination of care for cancer survivors. The purpose of our study was to assess current use of treatment summaries and care plans in Massachusetts and identify obstacles to greater use. METHODS: A survey was mailed to cancer specialist physicians (CSPs) and primary care physicians (PCPs) in Massachusetts. The survey asked CSPs about their preparation of treatment summaries and care plans for their cancer survivor patients and perceived barriers to the provision of these documents. PCPs were asked about receipt and utility of treatment summaries and care plans and information they would like to see in these reports. RESULTS: One hundred eight CSPs and 400 PCPs answered the survey. Fifty-six percent of CSPs reported that they, or their staff, prepared treatment summaries for their cancer survivor patients; however, only 14% reported preparing care plans. Fifty-four percent of PCPs reported ever receiving a treatment summary, but only 16% ever received a care plan. CSPs cited lack of training, reimbursement, and templates as barriers to preparing care plans. CONCLUSIONS: Interventions are needed to make treatment summaries and care plans a part of standard care for all cancer survivors. Increasing the use of treatment summaries and care plans will require specific training and reimbursement and may be facilitated by templates that capture automated data