Gotowa bibliografia na temat „Phalombe District (Malawi)”

Water is one of the renewable resources essential for sustaining all forms of life and quality of drinking water is very fundamental for human health. Human activities such as mining act as sources of water contamination which consequently lead to ecological, environmental and health problems. To the best of our knowledge, no study has been conducted around the Thundulu Phosphate Mine to establish the quality of drinking water. In this regard, this study was carried out to evaluate the physico-chemical water quality parameters of areas surrounding the Thundulu Phosphate Mine in Phalombe District. Groundwater samples from the villages surrounding the Phosphate Mine were collected both during the wet and dry seasons for analysis of physico-chemical water quality parameters (pH, electrical conductivity, turbidity, nitrate, chloride, sulphate, fluoride, iron, calcium and magnesium). The study also investigated microbiological water characteristics mainly Escherichia coli and faecal coliforms. Results showed that pH, electrical conductivity, turbidity, nitrate, chloride, sulphate, phosphate, calcium and magnesium complied with the national and international standards set by Malawi Bureau of Standards (MBS) and World Health Organization (WHO). As regards to microbiological characteristics, it was revealed that water from three sources (B2, B3 and B4) was contaminated with Escherichia coli and faecal coliforms. Keywords: Physico-chemical; Groundwater; Phalombe; Borehole; Electrical Conductivity; Turbidity; Phosphate;

Abstract 37 Background: Cancer of the cervix is one of the reproductive cancers that are claiming the lives of women worldwide, and Malawi has not been spared. Of the 16 countries with the highest incidence of cervical cancer in Africa, Malawi has been rated the highest, with an incidence of 75.9. Being a reproductive disease, male involvement is critical as men control approximately 95% of sexual relationships in Malawi, but their role in cervical cancer prevention is not known. This study was carried out to investigate the knowledge and practices of married men regarding cervical cancer and screening. Methods: A cross-sectional study recruited 396 married men. Collected data were analyzed by using SPSS for Windows version 16 (SPSS, Chicago, IL). Results: The majority of respondents were not knowledgeable about cervical cancer and cervical cancer screening, as 84.1% did not know the cause, nor did 88.9% know the signs or symptoms of cervical cancer. Only 4% of respondents knew the risk factors, whereas 75.5% had no knowledge. On prevention, 76.5% had no knowledge, and 68.2 % had some knowledge on cervical cancer treatment. Almost all respondents (99%) said they would encourage their spouses to undergo screening, and 71.7 % said that men, as heads of families, are responsible for deciding whether their spouse should access screening services or not. Conclusion: Men have a stake in taking part in cervical cancer prevention. This is a window of opportunity that the Ministry of Health can use to develop strategies that are tailored toward men to participate fully in cervical cancer prevention to reduce its burden. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from either author.

Background/Aims Assessing maternal satisfaction with care improves healthcare professionals' understanding of women's needs at maternal healthcare services and can encourage future use of hospital-based intrapartum care. This study's aim was to explore predictors of maternal satisfaction with their childbirth experience at health facilities in Phalombe District, Malawi. Methods A cross-sectional study was conducted with 254 first-time mothers, recruited using systematic random sampling. Data were collected using questionnaires and analysed using bivariate and multivariate analyses to determine predictors of maternal satisfaction. Results Only half (49.2%) of participants were satisfied with their childbirth experience. Welcoming and encouraging doctors/midwives (P<0.001) and being kept informed during labour (P=0.001) were the main predictors of maternal satisfaction. Conclusions Maternal satisfaction is impacted by a woman's relationship with her care providers and the information imparted during care. To improve maternal satisfaction with care at the study site, there is a need for healthcare providers to improve their interpersonal relationships with labouring women and provide adequate information during care.

Background Low uptake of family planning services by adolescent girls remains a public health concern. An estimated 120 out of every 1,000 girls aged 15 to 19 years are having unplanned pregnancies in the sub-Saharan region. Between January and June 2020, the Phalombe District of Malawi reported 3,030 adolescent pregnancies. At this stage, most Malawian schools were closed due to the COVID-19 pandemic. The high rate of adolescent pregnancies prompted the Ministry of Health to provide emergency contraceptives to reduce the number of unplanned pregnancies among adolescents. The provision of emergency contraceptives would be effective if girls were willing and able to access these family planning services. We thus explored the views of school-going adolescent girls regarding their preferences for modern family planning methods including emergency contraceptives in Phalombe, Malawi. Methods This was a cross-sectional, descriptive study, where quantitative data were collected using a structured questionnaire. Participants included randomly sampled school-going adolescent girls from eight purposively selected secondary schools and eight randomly selected primary schools. All the schools were sampled from three purposively selected Traditional Authorities namely Nkhulambe, Jenala and Nkhumba which had reported high numbers of adolescent pregnancies. We analyzed the GeoPoints for schools and health facilities using ArcGIS, while adolescent girls’ views were analyzed using STATA. Results Participants included 388 adolescent girls, ranging in age from 10 to 19 years (median age = 15.5 years, SD = 1.9 years). Participants were hesitant to use contraceptives because they were afraid of being stigmatized and embarrassed, had to travel long distances to reach the service center, knew little about modern family planning and were afraid of medical complications. Conclusion The uptake of family planning services by adolescent girls can be improved by bringing healthcare services closer to schools and homes. Family planning services should employ health workers who are non-judgmental and who are able to remove the stigma associated with family planning. Health workers should at any given opportunity, address the misconceptions and beliefs that adolescents have towards contraceptives. Community sensitization and health talks should be done to improve adolescent girls’ understanding of family planning services.

Malawi, in south-eastern Africa, is one of the poorest countries in the world. Food security in the country hinges on rainfed systems in which maize and sorghum are staple cereals and groundnut and pigeonpea are now major grain legume crops. While the country has experienced a considerable reduction in forest lands, population growth and demand for food production have seen an increase in the area dedicated to agricultural crops. From 2010, pigeonpea developed into a major export crop, and is commonly intercropped with cereals or grown in double-up legume systems. Information on the spatial extent of these crops is useful for estimating food supply, understanding export potential, and planning policy changes as examples of various applications. Remote sensing analysis offers a number of efficient approaches to deliver spatial, reproducible data on land use and land cover (LULC) and changes therein. Moderate Resolution Imaging Spectroradiometer (MODIS) products (fortnightly and monthly) and derived phenological parameters assist in mapping cropland areas during the agricultural season, with explicit focus on redistributed farmland. Owing to its low revisit time and the availability of long-term period data, MODIS offers several advantages, e.g., the possibility of obtaining cloud-free Normalized Difference Vegetation Index (NDVI) profile and an analysis using one methodology applied to one sensor at regular acquisition dates, avoiding incomparable results. To assess the expansion of areas used in the production of pigeonpea and groundnut resulting from the release of new varieties, the spatial distribution of cropland areas was mapped using MODIS NDVI 16-day time-series products (MOD13Q1) at a spatial resolution of 250 m for the years 2010–2011 and 2016–2017. The resultant cropland extent map was validated using intensive ground survey data. Pigeonpea is mostly grown in the southern dry districts of Mulanje, Phalombe, Chiradzulu, Blantyre and Mwanza and parts of Balaka and Chikwawa as a groundnut-pigeonpea intercrop, and sorghum-pigeonpea intercrop in Mzimba district. By 2016, groundnut extent had increased in Mwanza, Mulanje, and Phalombe and fallen in Mzimba. The result indicates that the area planted with pigeonpea had increased by 29% (75,000 ha) from 2010–2011 to 2016–2017. Pigeonpea expansion in recent years has resulted from major export opportunities to Asian countries like India, and its consumption by Asian expatriates all over the world. This study provides useful information for policy changes and the prioritization of resources allocated to sustainable food production and to support smallholder farmers.

Meeting long-term rural community water supply needs requires diligent geohydrological conceptualisation. Study of Malawi’s Lake Chilwa Basin, including sampling of 330 water points in Phalombe District, enabled assessment of groundwater quality influence upon supply. The control of larger Lake Chilwa paleo-environments on current Basin groundwater quality is demonstrated. Lacustrine sediment deposition forming high-level deposits under open lake conditions and terrace deposits under open and closed lake conditions significantly control the groundwater major-ion quality and salinity now observed. Paleo-lake extent marks the transition between low-TDS (total dissolved solids) groundwater suitable for water supply at higher elevations and high-TDS brackish groundwater in areas overlain by lacustrine deposits closer to the current lake level. Low-TDS groundwater is limited to mid-to-low reach influent leakage of rivers incising terraces. Permeable fluvial deposits within the deeper paleo-river channel may possibly provide low-TDS water. The conceptual model, whereby paleo-lake controls groundwater salinity, provides science-based evidence to address policy to manage the significant water point functionality concerns quantified at the district and river basin scales. Targeting of the low-TDS groundwater alongside improved use of upland low-TDS stream/river sources with fewer, but larger capacity, and better maintained gravity-fed supply schemes are recommended. This study hence shows the value of paleo-geohydrology interpretation of the lake–groundwater system conceptualisation to inform Sustainable Development Goal 6 (SDG 6.5.1)—integrated water resources management policy for rural water supply.

The efforts to prevent mother to child transmission of HIV in Malawi are impeded by the loss to follow-up of HIV-exposed infants (HEI) in care. Early infant diagnosis (EID) of HEI and linkage to care reduces morbidity and mortality. There has been limited attention to infants who are lost to follow up despite their mothers being compliant to the PMTCT program. This study explored factors that influence loss-to-follow up among HEI in the EID program whose mothers were retained in care for up to 24 months in Phalombe district, Malawi. We conducted a descriptive phenomenological qualitative study from May 2017 to July 2018. We purposively conducted 18 in-depth interviews among HIV positive mothers whose HEI were enrolled in the follow-up program and 7 key informant interviews among healthcare workers (HCW). All interviews were digitally recorded, transcribed, and translated verbatim. Data were analyzed manually using a thematic step-by-step approach. Results showed that retention in care is facilitated by aspirations to have a healthy infant and linkage to a nearer facility to a mother’s place of residency. The barriers to retention were non-disclosure of HIV status, inadequate resources, and support, suboptimal guidelines for, a lack of privacy, and unsynchronized hospital visits between a mother and her baby. The study has shown that successful implementation of EID services requires concerted efforts from various contextualized stakeholders whilst focusing on family-centered care. To maximize retention in EID and innovative ways of reaching mothers and babies through flexible guidelines are urgently needed.

Background: Malawi's National Malaria Control Programme (NMCP) is developing a new strategic plan for 2023-2030 to combat malaria and recognizes that a blanket approach to malaria interventions is no longer feasible. To inform this new strategy, the NMCP set up a task force comprising 18 members from various sectors, which convened a meeting to stratify the malaria burden in Malawi and recommend interventions for each stratum. Methods: The burden stratification workshop took place from November 29 to December 2, 2022, in Blantyre, Malawi, and collated essential data on malaria burden indicators, such as incidence, prevalence, and mortality. Workshop participants reviewed the malaria burden and intervention coverage data to describe the current status and identified the districts as a appropriate administrative level for stratification and action. Two scenarios were developed for the stratification, based on composites of three variables. Scenario 1 included incidence, prevalence, and under-five all-cause mortality, while Scenario 2 included total malaria cases, prevalence, and under-five all-cause mortality counts. The task force developed four burden strata (highest, high, moderate, and low) for each scenario, resulting in a final list of districts assigned to each stratum. Results: The task force concluded with 10 districts in the highest-burden stratum (Nkhotakota, Salima, Mchinji, Dowa, Ntchisi, Mwanza, Likoma, Lilongwe, Kasungu and Mangochi) 11 districts in the high burden stratum (Chitipa, Rumphi, Nkhata Bay, Dedza, Ntcheu, Neno, Thyolo, Nsanje, Zomba, Mzimba and Mulanje) and seven districts in the moderate burden stratum (Karonga, Chikwawa, Balaka, Machinga, Phalombe, Blantyre, and Chiradzulu). There were no districts in the low-burden stratum. Conclusion: The next steps for the NMCP are to review context-specific issues driving malaria transmission and recommend interventions for each stratum. Overall, this burden stratification workshop provides a critical foundation for developing a successful malaria strategic plan for Malawi.

Purpose: The purpose of this study was to explore and identify effects of Cyclone Freddy on vulnerable learners in the flood prone areas both at primary and secondary school levels. Methodology: This study used a qualitative study method, which depended on mostly secondary data, using online interviews, reviews of online news articles, social media postings and United Nations reports and observations. Data was collected from the most affected areas of Blantyre Urban, Phalombe, Mulanje, Nsanje and Chikwawa districts. Purposive and convenience sampling was applied to the education institutions to get a deeper understanding of the phenomenon. The study also targeted teachers, parents, and students of the affected schools in the districts. The tools for collecting data were questionnaires using face to face interviews, focus group interviews which mostly included observations. Information was coded and participants in this study were assured of for anonymity and confidentiality. Results: The results of the research provide a better understanding of the impacts of cyclones on education systems and possibly give pointers in terms of preparedness of education systems to cope with disasters of the same magnitude in future. Additionally, due to lack of rapid response on Psycho Social First Aid (PFA), a lot of the victims succumbed to trauma and depression. This made the go back to school campaign very difficult especially for the most vulnerable communities. Contribution to theory and practices and policy: The research findings validates the theory of disaster preparedness that exhaust all areas of rapid response as a recovery strategy, such as evacuation, supply of immediate basic needs in the areas of shelter, food, beddings and psycho-social support especially (PFA). The Government (DODMA) through Ministry of Education and other line Ministries, the donor communities and implementing partners should embark on harmonizing efforts for disaster preparedness and recovery strategies to speed up operations. Watt, (2019), suggests that, while it is a requirement to take pro-active measures to put in place realistic strategies for future natural disasters, education should also be taken as a priority in the recovery strategies.

A research report submitted in partial fulfilment of the requirements for the degree of Master of Public Health in the field of Social Behavior Change and Communication. Faculty of Health Sciences. The University of the Witwatersrand. August, 2015
Introduction Cholera is one of the major public health problems in Malawi; with outbreaks occurring every year since 1998, mostly in the Southern region of Malawi, either during the rainy season or sometimes throughout the year (1). It is mainly due to insufficiency of drinking water and sanitation, under-employment, reduced education and poor schooling (1). The occurrence and severity of cholera outbreaks is mostly enhanced by human behaviour in regard to practising healthy hygiene and sanitation (1). The health education, aimed at behaviour change is very important in preventing and controlling cholera (2). Nevertheless, much of cholera prevention lies at the level of individual responsibility with regards to the practice of healthy hygiene and sanitation (2). There is little documented evidence which describes either the practice of cholera prevention messages by people in Phalombe District in Malawi, or their knowledge of the subject. This is why this study aims to explore and describe the knowledge, perception and the practice of hygiene (Cholera prevention messages) among women aged 18 and older in Phalombe District in 2014. The results from the study will help in the future interventions regarding hygiene practices among women. Methods An explorative, qualitative study was done. The research sample was comprised of women, 18 years of age and older staying in cholera prone areas in Phalombe District. In depth face-to-face interviews were conducted in Mpasa, Nkhwayi, 2 Chitekesa and Nambazo areas and the participants’ statements were recorded. Two focus group discussions were also conducted at Mpasa and Nambazo in Phalombe District, Malawi. The analysis process started during data correction whereby the interview guide was developed against the constructs of the Health Belief Model (HBM). The data was collected in Chichewa (a vernacular language), translated and transcribed in English. Data was then analysed qualitatively and deductively, drawing on the constructs of HBM. Codes, categories and emerging themes were formulated and Max QDA was used for analysis. The following research ethics were observed during the study: informed consent, permission from authorities, confidentiality and voluntary participation. References from existing literature were also sought. 20 (n=20) women from Mpasa, Nkhwayi, Nambazo and Chitekesa areas in Phalombe District, Malawi participated in the in depth interviews (IDI’s) and two focus group discussions (FGD’s) were also conducted, each comprising of ten women different from the ones in the IDIs. Results The following themes emerged during the analysis: Knowledge of cholera prevention messages, sources of the messages, message content, perception, motivators and barriers to practice, cholera and Gender and cholera and Lake Chilwa. (Table 2). Cholera prevention messages available to women in Phalombe were from different sources like the Malawi government, through the Ministry of Health, Non- governmental organisations (NGOs), village chiefs, friends and billboards. Radio and television, despite being mentioned, were said to be not effective sources of messages in the study areas because most women said they did not have radios or 3 televisions. The content of the messages were; the need to have a latrine and care for it, washing hands with soap or ash and water, the use of safe drinking water, and sanitation, where every household is told to have a latrine, a refuse pit and a plate rack. Although most women were able to recall the messages, they were not able to recall that they were supposed to wash hands with soap and water. They were not able to recall some critical times they were supposed to wash hands like before they started cooking. Most of them mentioned the need to wash hands after defaecation. The results show there is a gap between knowledge and practice. The women have a positive attitude and perception towards the hygiene messages. The study observed that there are some barriers to practice which are; poverty, marital status, access to safe water, illiteracy, inconsistency of the interventions, cultural beliefs and negligence. Some motivators were also indicated in the study; perceived severity and the threat of cholera, perceived benefits, past illness of friends and relatives and campaigns by Health care workers (HCW’s) and NGOs. The results show that despite cholera affecting both men and women, women regard themselves as very important in preventing cholera because of the roles they play in the home, based on the hygiene messages. Lake Chilwa was described by women as a great threat in as far as cholera is concerned. 4 Conclusions Although the women in Phalombe have some general knowledge about hygiene and cholera prevention messages, the extent of that knowledge is quite limited. The knowledge of hygiene is usually not carried out in practice by the people for various reasons; which include poverty, marital status, cultural beliefs, insufficient water supply, insufficient knowledge and lack of access to sanitation facilities. HBM constructs may be used to understand the behaviour of individuals. The findings of this study suggest that apart from providing information about cholera prevention, the barriers and motivators to practice need to be addressed if the interventions are to be successful. Gender issues and issues surrounding Lake Chilwa should be addressed too.

The EU-funded ‘Strengthening Land Governance System for Smallholder Farmers in Malawi’ project was implemented from 2015 to 2020 by a consortium made up of Oxfam in Malawi, LANDNET (until 2018) and CEPA, with technical support from DAI. The objective was to pilot, test and recommend for scale-up improved gender-sensitive land governance systems. This Effectiveness Review evaluates the success of this project to achieve the following focal outcomes: (1) By 2019, laws have been enacted that are relevant to the registration and titling of customary estates and are ready for implementation and (2) By 2020, women and men in two or more of the target Group Village Headpersons (GVHs) in Phalombe, Kasungu and Rumphi districts have secure land tenure with supporting land governance structures. Using a process tracing approach, achievement of these focal outcomes and the consortium's contribution were assessed. Find out more by reading the full report now.