XPHACTOR cross-sectional patient cost dataset

The costs incurred by patients in seeking care are considered a potential barrier to healthcare seeking behaviour. Given the global move towards Universal Health Care (UHC) which includes financial protection from the cost of ill health, there is a need to estimate the burden of costs incurred by patients to identify possible policy interventions. We used patient cost data collected alongside the “Xpert for people attending HIV/AIDS care: test or review?” (XPHACTOR) study to estimate the costs incurred by the study population when accessing care. In addition, we also looked at the cost burden on caregivers. This dataset includes observations for 289 people accessing HIV/AIDS care amon

Linear Growth Faltering Among HIV-Exposed Uninfected Children

Background: HIV-exposed uninfected (HEU) children experience increased mortality compared wit their HIV-unexposed uninfected (HUU) peers. It is unclear whether HEU children are also at increased risk for undernutrition, a modifiable risk factor for mortality. Methods: We conducted a cross-sectional, population-based survey of children under 5 years of age in five health districts in Botswana. Linear mixed-effects models were used to assess continuous outcomes while generalized estimating equations were used to estimate relative risks of stunting, wasting, and underweight between HEU (n=396) and HUU (n=1,109) children. Secondary analyses examined potential mediation by low birthweight. Results: The association between maternal HIV-exposure and child stunting varied significantly by child age (p<0.01). HEU children <1 year and ≥2 years of age had 1.85 (95% CI: 1.03-3.31; p=0.04) and 1.41 (95% CI: 1.06-1.88; p=0.02) times the risk of stunting compared with HUU children after multivariate adjustment, respectively. During the period of 1-2 years of age, when breastfeeding cessation occurred among HUU children, HUU children had increased risk of stunting compared with HEU children who were predominantly formula fed (RR: 1.56; 95% CI: 1.05-2.32; p=0.03). A mediation analysis estimated 67% of the excess risk of stunting among HEU children ≥2 years was attributable to low birthweight (p=0.02). There was no difference in risk of wasting or underweight. Conclusion: HEU children are at increased risk of stunting compared with their HUU peers; however, interventions to increase birthweight may significantly ameliorate this excess risk. Interventions to support optimal growth during weaning are needed for all breastfed children

An internal communication assessment of the Lilongwe City Assembly

Thesis (MA (Public and Development Management))--University of Stellenbosch, 2009.Internal communication has the potential of improving the ability of local authorities to deliver effective and efficient basic services. Local authorities are the pillar upon which governments rely to champion the decentralisation process which has been widely hailed as enabling service delivery to the communities. The Lilongwe City Assembly recognises the need to address internal communication issues, but have neither carried out any meaningful analysis of its internal communication nor has it developed an internal communication plan or guidelines. The communication audit methodology is relatively unknown in the public sector in Malawi and it is hoped that this study brings to light the advantages of giving organisational communication its deserved role in activities of the public sector. It is hoped that this study would be replicated in the remaining 38 local assemblies with a view to improving service delivery. This study assessed the internal communication of the Assembly as part of a broader perspective of organisational communication. Specifically, it measured the effectiveness of internal communication at the Lilongwe City Assembly. The methodology involved measuring the perceived current and ideal amounts of information in eight fundamental areas of internal communication, namely receiving information from others, sending information to others, action on information sent, channels of communication, communication relationships, communication and work satisfaction, timeliness of information received from key sources and sources of information. Findings from a sample of 186 respondents of the Assembly indicated a great need to receive information and to interact with Assembly management more frequently than what is happening currently. The communication between subordinates and co-workers seems to be satisfactory. However, the majority of respondents expressed the need to engage with Assembly management on a number of key issues, including staff welfare, salaries and benefits. In addition, a concern about the inability of employees to master the English language was cited as reducing the capacity of the Assembly to fully implement its work activities.cmc201

The Management of the Zambezi River Basin and Kariba Dam

This book brings together articles and conference papers on the Zambezi River and Kariba Dam written by Dr. Tumbare between 1998-2010. Part I discusses issues of river basin and integrated water resources management and Part II contains papers in infrastructure development in the water and energy sectors

Implementing Zimbabwean projects in the Zambezi Valley

Projects such as the Kazungula-Kasane Bridge, Victoria Falls North Bank Power Station, Hwange 7 and 8 Thermal Power Station Extension, Batoka Gorge Hydro-electric Scheme, Zambezi-Bulawayo Water Supply Scheme, Devil's Gorge Hydro-electric Scheme, Gokwe North Thermal Power Station, Kariba South Bank Power Station Extension and Mupata Gorge Hydro-electric Scheme have been on the Zimbabwean infrastructure development cards for a long time but are yet to see the light of day. The objective of the Paper is to highlight some of the opportunities and challenges that each Project presents to policy/decision makers and potential developers utilising information in the public domain, interviews held with relevant potential developers and from the author's experiences and knowledge of the Projects. Some of the opportunities cited relate to the availability of the production raw materials, markets for the end products whilst the challenges include environmental concerns, politics, trust and confidence between development partners and technical issues.,Zimbabwe Institution of Engineer