Hospital-based injury data in Malawi: strategies for data collection and feasibility of trauma scoring tools

Injury is a major cause of morbidity and mortality in developing countries. Utilizing a partnership between Kamuzu Central Hospital (KCH) and the University of North Carolina Departments of Surgery, we describe an approach to injury surveillance, examine the utility of trauma scoring systems, and outline steps necessary before such scoring systems can be reliably instituted in a resource-constrained setting

Barriers to HIV service utilisation by people living with HIV in two provinces of Zimbabwe: Results from 2016 baseline assessment

Background: The emergence of antiretroviral therapy (ART) transformed HIV from a terminal illness to a chronic disease. However, limited access to health services remains one of many barriers to HIV service utilisation by people living with HIV (PLHIV) in low-resource settings. The goal of this study was to describe the barriers to HIV service utilisation in two provinces of Zimbabwe. Methods: A qualitative descriptive study was conducted with PLHIV and village health workers (VHW) in eight districts within the two provinces. Convenience sampling was used to select the participants. This sampling was limited to communities supported by health facilities with more than 500 PLHIV enrolled into HIV care and treatment. Interviews were audio-recorded and transcripts were subjected to thematic content analysis. Results: A total of 22 community focus group discussions (FGDs) were conducted. Barriers to using HIV services cited in PLHIV and VHW FGDs were similar. These were categorised as health system-related barriers, which include user fees, long waiting times, lack of confidentiality and negative attitudes by healthcare providers, and lack of consistent community-based HIV services. Community-related barriers cited were stigma and discrimination, food insecurity, distance to facilities and counterproductive messaging from religious sectors. Client-related factors reported were inadequate male involvement in HIV-related activities and defaulting after symptoms improved. Conclusion: Our assessment has indicated that there are several barriers to the utilisation of HIV services by PLHIV in the two provinces of Zimbabwe. As new strategies and programmes are being introduced in the current resource-constrained era, efforts should be made to understand the needs of the clients. If programmes are designed with an effort to address some of these challenges, there is a possibility that countries will quickly achieve the 90-90-90 targets set by The Joint United Nations Programme on HIV/AIDS

Epidemiology of Injuries at a Tertiary Care Center in Malawi

Injury surveillance is an ongoing process required for primary, secondary, and tertiary injury prevention. In Malawi, hospital-based injury data are not available

Under-Reporting of Road Traffic Mortality in Developing Countries: Application of a Capture-Recapture Statistical Model to Refine Mortality Estimates

Road traffic injuries are a major cause of preventable death in sub-Saharan Africa. Accurate epidemiologic data are scarce and under-reporting from primary data sources is common. Our objectives were to estimate the incidence of road traffic deaths in Malawi using capture-recapture statistical analysis and determine what future efforts will best improve upon this estimate. Our capture-recapture model combined primary data from both police and hospital-based registries over a one year period (July 2008 to June 2009). The mortality incidences from the primary data sources were 0.075 and 0.051 deaths/1000 person-years, respectively. Using capture-recapture analysis, the combined incidence of road traffic deaths ranged 0.192–0.209 deaths/1000 person-years. Additionally, police data were more likely to include victims who were male, drivers or pedestrians, and victims from incidents with greater than one vehicle involved. We concluded that capture-recapture analysis is a good tool to estimate the incidence of road traffic deaths, and that capture-recapture analysis overcomes limitations of incomplete data sources. The World Health Organization estimated incidence of road traffic deaths for Malawi utilizing a binomial regression model and survey data and found a similar estimate despite strikingly different methods, suggesting both approaches are valid. Further research should seek to improve capture-recapture data through utilization of more than two data sources and improving accuracy of matches by minimizing missing data, application of geographic information systems, and use of names and civil registration numbers if available

Teachers' frustrations in implementing environmental education in schools in Nsami circuit in Limpopo Province

This study focuses on the lack of support services necessary to implement Environmental Education, in the Nsami Circuit, Limpopo Province. The aims of the study were, firstly, to investigate how teacher’s needs are neglected and how retraining of teachers is being relegated. Secondly, if Environmental Education were introduced in schools, to investigate the possibilities that it would create with regards to an awareness of local environmental issues. Thirdly, when projects are initiated at schools, to investigate the benefits to both teachers and learners. Lastly, to investigate the assumption that for any implementation of Environmental Education to be effective, teachers’ needs should taken care of, in terms of training through workshops as a way of helping them to adapt accordingly. An extensive literature review was undertaken to examine core areas of Environmental Education and the current curricula to establish where the emphasis of Environmental Education lay. The theoretical framework constructed from the review concluded with the premise that the issue of Environmental Education is of immense importance as reported in the NEEP-GET Project. The study, to investigate the essence and intensity of frustrations teachers’ experience in offering Environmental Education in South African schools, recommends that the Department of Education should treat the issue of training teachers through in-service training, seminars, workshops and other means a priority if effective and successful teaching and learning of Environmental Education is to be experienced.Prof. H. G. van Rooye

Story skills and hierarchies of needs and values: a defence of the humanities

This article1 1The article was developed as a thought paper in the NRF's project Shifting Boundaries of Knowledge – The Role of Social Sciences, Law and Humanities. A first version was presented at a regional workshop of the project at Tshwane University of Technology on 28 May 2004. View all notes is a defence of the humanities that emphasises the nature and value of humanistic knowledge. I firstly outline the present negative perceptions of the humanities and the factors that constrain their development in South Africa. Chief among them is the privileging of technical rational knowledge above Bildung and self-development. Against the background of views on social dedifferentiation and the end of the book I emphasise the career value of the humanities. I try to reverse the opposition between technical rationalist knowledge and Bildung by analysing Maslow's hierarchy of needs and confronting his theory with a number of findings of our recent research into identity and literary space. Two keywords that feature strongly are centrality and narrativity. The implications of this view are explored in a brief analysis of Eben Venter's novel Foxtrot van die vleiseters (1993) [Foxtrot of the Meat-eaters].http://dx.doi.org/10.1080/0256471080202481