A qualitative evaluation of gender aspects of agricultural intensification practices in central Malawi

United States Agency for International Developmen

Community-linked maternal death review (CLMDR) to measure and prevent maternal mortality: a pilot study in rural Malawi.

In Malawi, maternal mortality remains high. Existing maternal death reviews fail to adequately review most deaths, or capture those that occur outside the health system. We assessed the value of community involvement to improve capture and response to community maternal deaths

Management of Cholangiocarcinomas in Developing Countries: Report of Seven Cases and Review of Literature

No Abstract

Ward Round – A patient with multi-organ failure

No Abstract

A cost effectiveness analysis of different ways of analyzing sputum for turberculosis diagnosis: direct smear microscopy, natural sedimentation and centrifugation

Includes bibliographical references.In Malawi, sputum smear microscopy (Ziehl-Neelsen) is a major diagnostic technique for pulmonary tuberculosis (TB). Though relatively rapid, it tends to be poorly sensitive since it requires a large number of organisms to be present in the specimen before they can be detected. Two approaches that improve sensitivity of direct smear microscopy are sputum liquefaction with chemicals such as sodium hypochlorite (household bleach) and subsequent concentration with gravity (natural) sedimentation and centrifugation. This study estimated the costs and cost-effectiveness of these techniques in processing sputum for detecting new cases of pulmonary tuberculosis in Malawi. Bleach natural sedimentation and bleach centrifugation methods were compared with direct smear microscopy. Cost and effectiveness data were collected from a randomized controlled trial from one major TB health facility. Effectiveness was determined by number of smear positive TB cases detected by each method. Cost-effectiveness was estimated from a provider's perspective in terms of cost per TB cases diagnosed and cost per smear positive TB case detected. Cost per positive TB case detected was least in natural (gravity) sedimentation (US $9.35), compared to centrifugation (US$11.48) and direct smear microscopy (US $15.93). The study findings indicate that natural sedimentation can significantly reduce cost of sputum processing. There is a strong economic case supporting the use of natural sedimentation for diagnosing tuberculosis in Malawi. In addition, bleach digests sputum making it less infectious and easy to work with thereby increasing the safety of specimens to clinicians. Therefore, introducing natural sedimentation technique would not only reduce costs but also improve safety to health workers

Youth clubs’ contributions towards promotion of Sexual and Reproductive Health Services in Machinga District, Malawi

 Background: In Malawi more than 50% of the population are young people less than 24 years old. Adolescents and young people face a lot of sexual and reproductive health (SRH) challenges such as unplanned and early pregnancies, sexually transmitted infections (STIs) including HIV and AIDS and abusive intimate relationships. Provision of SRH services through Youth clubs is one strategy that has potential to contribute to addressing the SRH challenges. We conducted a study in Machinga district, southern Malawi to assess the contributions of youth clubs towards promotion of SRH services.Methods: A cross sectional study was conducted in 2014 among youths aged 15 – 24 years. The participants were drawn from Machinga boma and Liwonde Township. We used both quantitative and qualitative methods.  Quantitative data were collected using questionnaires, while Focus Group Discussions (FGDs) and Key informant interviews were used to collect qualitative data. Quantitative data were analysed by estimating proportions and Chi square tests while thematic content analysis was used for qualitative data.  The study was approved by University of Malawi’s College of Medicine Research and Ethics Committee (COMREC).Results: Frequently offered services in youth clubs were HIV and AIDS education reported by 48.4% of the study participants, STI education (16.7%), family planning(16.7%) and life skills education (9.7%). On service utilisation there was no association between attendance to youth clubs and HIV Testing Counselling (χ2 =0.76, p=0.4) and there was no association between attendance to the youth clubs and family planning utilisation (χ2 =3.1, p=0.3). Condom use was the most used contraceptive method among the study participants. Misconception, accessibility and poor attitude of health workers were some of the factors reported as contributing to low utilisation of family planning methods. All youth club participants, reported  by 89 study participants and only 29.4% of club non-attendees had adequate SRH knowledge. The services  provided by health workers to youth clubs reported by study participants were HIV and AIDS education, HIV testing and counselling (HTC) and condom distribution.Conclusion: Our findings highlight the need of youth clubs to promote SRH services.Efforts should be made to ensure that the identified challenges are dealt with to ensure effective participation of youth clubs

Development of a public audiology service in Southern Malawi: profile of patients across two years

Objective To describe the profile of patients attending the Queen Elizabeth Central Hospital (QECH) audiology clinic in Malawi, over a two-year period (2016–2017). Design A retrospective patient record review. Study sample There were 2299 patients assessed at the QECH audiology department between January 2016 and December 2017. Adult patients’ ages ranged from 18 to 94 years (M = 45.8, SD = 19.22). The mean age of children included in this study was 7.7 years (SD= 5.21). Overall, 45.4% of patients were female. Results Of the 61.6% of adults and 41.7% of children found to have some degree of hearing loss, 28.3% and 15.4% were fitted with hearing aids, respectively. The number of patients seen in 2017 (n = 1385) was 34% higher than that of 2016 (n = 914). Conclusion This study found that demand for hearing services is increasing in this public sector Malawian audiology department but uptake of hearing aids for those in need is low. Future evaluation of service provision and treatment outcomes is needed. Results from this study can be used to inform the development of future audiology clinics in low resource settings