Journalists as watchdogs of good governance: Challenges and some ways forward5

No Abstrac

‘I really appreciate you saying that’: the challenges of developing a partnership

Teacher Education in Sub-Saharan Africa (TESSA) is a community of teacher-educators in HEIs across Africa, led by the Open University UK. FAWEMA is the Malawian chapter of FAWE, the Forum for African Women Educationalists, committed to girls’ and women’s education in Malawi. TESSA/OU and FAWEMA have been working together since 2010, and in 2013 are beginning a new 4 year project, funded by DFID Malawi. The project is to facilitate rural women’s access to teacher education, by means of a 2 year ‘school experience programme’ where the women work as Teaching Assistants in local rural schools; and a programme of supported self-study, where the women take the secondary exams which could give them entry to teacher training college. The new project has provided a context for TESSA/OU and FAWEMA to interrogate how each constructs the partnership: the opportunity to look back and look forward. Negotiating the shape of the project, the share of the budget, and the parameters of responsibilities has allowed a much wider reflection on our relationship. The perspective of DfID Malawi has been key: their oversight is both of our project and of the ‘Keeping Girls in School’ programme, of which this project is one strand. This reflection by TESSA/OU and FAWEMA on our partnership has not been a particularly comfortable process, and this paper focuses on what continue to be some of the challenges ahead, as well as the opportunities

Dynamics of maternal lymphocyte subsets from 3rd trimester to postpartum and their impact on mother-to-child HIV-1 transmission

MSc (Med), Faculty of Health Sciences, University ofthe Witwatersrand, 2007Background Mother-to-child transmission of HIV infection is the primary cause of paediatric HIV infections worldwide. High HIV infection rates in women of childbearing age (15-49 years) and efficiency of PMTCT have resulted in the high rate of HIV incidence and prevalence in children of sub-Saharan Africa. The stark contrast in the success of PMTCT interventions between the western countries and less developed countries indicates the need for further research to develop alternative, easier, and more effective population-based interventions. Methodology This was a retrospective cohort study of the medical records of approximately 300 HIV infected women enrolled in the Nevirapine Resistance study between May 2002 and February 2003. An assessment of the significance of changes in immunological parameters (CD4 counts, CD4 percentages, CD4/CD8 ratios) and HIV RNA from 3rd trimester to 6 weeks postpartum and causal associations vi between these changes and increased risk of PMTCT was then conducted using logistic regression models. Results Mothers with CD4 counts above 200cells/μL were approximately exhibited onethird the likelihood of transmitting HIV-1 to their infants than mothers with CD4 counts below 200 cells/μL [OR 0.35 (0.13, 0.95)]. High maternal HIV RNA levels demonstrated a stronger association with increased risk of PMTCT with women with postpartum viral loads greater than 100 000 copies/μL exhibiting ten times the likelihood [OR 10.15 (2.17-47.55)]. Statistically significant mean increases in CD4 and CD8 cell counts from 3rd trimester to postpartum were observed. Mean increases in CD4 and CD8 counts demonstrated no association with PMTCT. Conclusion CD4 cell counts and CD8 cell counts underwent statistically significant changes from 3rd trimester to postpartum. These changes seem not to represent any clinically significant change in maternal disease progression during this time period and were found not to be associated with PMTCT

Control of schistosomiasis in sub-Saharan Africa: progress made, new opportunities and remaining challenges

Several other journal supplements have documented progress made in the control of schistosomiasis in Egypt, China and Brazil, however, with more than 97% of the schistosome infections now estimated to occur in Africa, the relevance of this special issue in Parasitology cannot be overemphasized. In total, 18 articles are presented, inclusive of a lead-editorial from the WHO highlighting a seminal resolution at the 54th World Health Assembly in 2001 that advocated de-worming. Facilitated by a US$ 30 million grant from the Bill and Melinda Gates Foundation in 2002, the Schistosomiasis Control Initiative subsequently fostered implementation of large-scale schistosomiasis (and soil-transmitted helminthiasis) control programmes in six selected African countries. From 2005, CONTRAST, a European union-funded consortium, was formed to conduct multi-disciplinary research pertaining to optimisation of schistosomiasis control. Progress made in schistosomiasis control across sub-Saharan Africa since the turn of the new millennium is reviewed, shedding light on the latest findings stemming from clinical, epidemiological, molecular and social sciences research, inclusive of public health interventions with monitoring and evaluation activities. New opportunities for integrating the control of schistosomiasis and other so-called neglected tropical diseases are highlighted, but more importantly, several opportune questions that arise from it frame the remaining challenges ahead for an enduring solutio

Internal and external imperial dynamics in Habakkuk : a contextual study of the Book of Habakkuk from a Malawian socio-economic and political viewpoint.

Doctor of Philosophy in Theology.This study is an economic reading of the book of Habakkuk from Malawian socio-economic and political viewpoint. It is a good example of scholarly study of Scripture not done as „art for art‟s sake,‟ but undertaken because of the recognition that the Bible has something essential to say to a critical human situation. Designed as a dialogue between an ancient biblical text of Habakkuk and a modern context of Malawi, the study examines the internal and the external imperial dynamics in effort to better appreciate the shared relevance of these two chronologically disparate contexts. The two contexts share the common reality that both are socially, economically and politically shaped by the challenges of devastating imperialism. The dialogue is facilitated through a contextual biblical studies framework – using the tri-polar model or the African contextual biblical hermeneutics model – that recognizes the importance of our contexts in the interpretation of the biblical text. Since we cannot measure the people‟s well-being through the eyes of the elite but of those who suffer and struggle in life, this study deliberately chose the context of the poor and marginalized to be the subject of interpretation. To truly understand the Bible is to read it through the eyes of the oppressed, since the God who speaks in the Bible is the God of the oppressed (Fiorenza, 1981:100). The study will use liberation and postcolonial biblical hermeneutics belonging to the wider context of biblical interpretation in theology of liberation as sub-theoretical frameworks. The two frameworks are ideo-theological orientations where potential lines of connection between the biblical text with its contexts and today‟s readers and their contexts are drawn. This study is concerned with why Malawi is still rated among the ten poorest countries in the world with over half of its populace still living below the poverty line despite having been independent for fifty-one years? Malawi continues to face many socio-economic and political problems, which are caused by economies of extraction – a particular form of capitalism that African states inherited upon gaining independence from colonial masters. It is exploitive as it involves those who do not labour gaining from those who labour. In this study, economies of extraction are a useful link between economic dimensions of Habakkuk and those of Malawi. The study therefore aims at exploring what is contained in both Habakkuk and Malawi that assists us to understand and value both contexts. Such an interpretation within the context of a critical situation, theology of liberation offers a message that has as its aim emancipatory effects on the poor and marginalized (Fiorenza, 1981:109)

Controlling Soil-Transmitted Helminthiasis in Pre-School-Age Children through Preventive Chemotherapy

Pre-school age children account for 10%–20% of the 2 billion people worldwide who are infected with soil-transmitted helminths (STHs): Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), and Ancylostoma duodenale/Necator americanus (hookworms). Through a systematic review of the published literature and using information collated at World Health Organization headquarters, this paper summarizes the available evidence to support the recommendation that pre-school children should be included in regular deworming programmes. The first section describes the burden of STH disease in this age group, followed by a summary of how infection impacts iron status, growth, vitamin A status, and cognitive development and how STHs may exacerbate other high mortality infections. The second section explores the safety of the drugs themselves, given alone or co-administered, drug efficacy, and the importance of safe administration. The third section provides country-based evidence to demonstrate improved health outcomes after STH treatment. The final section provides country experiences in scaling up coverage of pre-school children by using other large scale public health interventions, including vitamin A programmes, immunization campaigns, and Child Health days. The paper concludes with a number of open research questions and a summary of some of the operational challenges that still need to be addressed

Examining the Relationship between Urogenital Schistosomiasis and HIV Infection

Urogenital schistosomiasis is a parasitic infection caused by a worm, Schistosoma haematobium, which lives in the bloodstream of infected individuals. It affects at least 112 million people, mostly in sub-Saharan Africa, and has been suggested to be a risk factor for becoming infected with HIV. We reviewed publications in order to examine whether it seems likely that this parasitic infection could be a risk factor for HIV. Evidence from many types of studies supports the hypothesis that urogenital schistosomiasis does increase a person's risk of becoming infected with HIV. Studies also suggest that individuals who have both urogenital schistosomiasis and HIV have a more aggressive HIV infection and can more easily transmit HIV to their sexual partners. Praziquantel is an oral, nontoxic, inexpensive medication that is safe in pregnancy and is recommended for treatment of schistosomiasis. In areas where both infections co-exist, regular administration of praziquantel both to young girls and to sexually-active women may be an important approach to reducing HIV transmission. Our findings support the importance of making praziquantel more available to people who live in areas of the world where both urogenital schistosomiasis and HIV infection are widespread

Investigating a strategy for quantifying schistosome infection levels in preschool-aged children using prevalence data from school-aged children

In 2012, the World Health Organisation (WHO) set out a roadmap for eliminating schistosomiasis as a public health problem by 2025. To achieve this target, preschool-aged children (PSAC; aged 6 years and below) will need to be included in schistosomiasis treatment programmes. As the global community discusses the tools and approaches for treating this group, one of the main questions that remains unanswered is how to quantify infection in this age group to inform treatment strategies. The aim of this study was thus to determine whether a relationship exists between levels of schistosome infection in PSAC and school-aged children (SAC), that can be used to determine unknown schistosome infection prevalence levels in PSAC. A systematic search of publications reporting schistosomiasis prevalence in African PSAC and SAC was conducted. The search strategy was formulated using the PRISMA guidelines and SPIDER search strategy tool. The published data was subjected to regression analysis to determine if a relationship exists between infection levels in PSAC and SAC. The interaction between SAC and community treatment history was also entered in the regression model to determine if treatment history significantly affected the relationship between PSAC and SAC prevalence. The results showed that a significant positive relationship exists between infection prevalence levels in PSAC and SAC for Schistosoma mansoni (r = 0.812, df (88, 1), p = <0.0001) and S. haematobium (r = 0.786, df (53, 1), p = <0.0001). The relationship was still significant after allowing for diagnostic method, treatment history, and the African sub-region where the study was conducted (S. mansoni: F = 25.63, df (88, 9), p = <0.0001; S. haematobium: F = 10.20, df (53, 10), p = <0.0001). Using the regression equation for PSAC and SAC prevalence, over 90% of the PSAC prevalence studies were placed in the correct WHO classifications category based on the SAC levels, regardless of treatment history. The study indicated that schistosome prevalence in SAC can be extended as a proxy for infection levels in PSAC, extending on its current use in the adult population. SAC prevalence data could identify where there is a need to accelerate and facilitate the treatment of PSAC for schistosomiasis in Africa