Case Of Malawi Research Articles

Harvesting “development minerals” for local needs in sub-Saharan Africa: The case of Malawi

This paper critically reflects on the impact of “development minerals” on rural livelihoods in sub-Saharan Africa, focusing on the case of Malawi. It does so by analysing data collected at multiple quarrying sites in Lilongwe District, with the objective of assessing how production of these commodities can help meet Malawi’s commitments to the Sustainable Development Goals (SDGs). Findings indicate that despite their extraction being associated with environmental problems, development minerals do impact positively on the livelihoods of Malawians in rural areas where very few viable alternative income-earning opportunities. To maximise the sector’s contribution to the SDGs in Malawi, however, greater emphasis must be placed on formalising and supporting quarrying operations and other activities oriented around development minerals.

Social media influence on COVID-19 vaccine perceptions among University students: a Malawi case study

IntroductionThe global fight against the COVID-19 pandemic relies significantly on vaccination. The collective international effort has been massive, but the pace of vaccination finds hindrance due to supply and vaccine hesitancy factors. Understanding public perceptions, especially through the lens of social media, is important. This study investigates the influence of social media on COVID-19 vaccine perceptions among university students in Malawi.MethodsThe study utilized a quantitative methodology and employed a cross-sectional study design to explore the relationship between social media dynamics and COVID-19 vaccine perceptions among 382 randomly sampled students at MUBAS. Data, collected by use of a Likert-scale questionnaire, was analyzed using IBM SPSS 20 for descriptive statistics and Pearson correlation tests.ResultsThe findings reveal crucial correlations. Specifically, trust in online vaccine information shows a positive correlation (r = 0.296, p < 0.01) with active engagement in social media discussions. Conversely, a negative correlation surfaces concerning individuals’ reactions to vaccine availability in Malawi (r = -0.026, p > 0.05). The demographic overview highlights the prevalence of the 16 to 30 age group, representing 92.9% of respondents.ConclusionsThe identified correlations emphasize the need for careful communication strategies tailored to combat misinformation and enhance vaccine acceptance among the younger demographic in Malawi. The positive correlation between trust in online vaccine information and social media engagement underscores digital platforms’ potential for disseminating accurate information. Conversely, the negative correlation with vaccine availability reactions suggest the presence of complex factors shaping public perceptions.

Enhancing SARS-CoV-2 surveillance in Malawi using telephone syndromic surveillance from July 2020 to April 2022

IntroductionMonitoring the SARS-CoV-2 pandemic in low-resource countries such as Malawi requires cost-effective surveillance strategies. This study explored the potential utility of phone-based syndromic surveillance in terms of its reach, monitoring...

The national distribution of lymphatic filariasis cases in Malawi using patient mapping and geostatistical modelling.

In 2020 the World Health Organization (WHO) declared that Malawi had successfully eliminated lymphatic filariasis (LF) as a public health problem. Understanding clinical case distributions at a national and sub-national level is important, so essential care packages can be provided to individuals living with LF symptoms. This study aimed to develop a national database and map of LF clinical cases across Malawi using geostatistical modelling approaches, programme-identified clinical cases, antigenaemia prevalence and climate information. LF clinical cases identified through programme house-to-house surveys across 90 sub-district administrative boundaries (Traditional Authority (TA)) and antigenaemia prevalence from 57 sampled villages in Malawi were used in a two-step geostatistical modelling process to predict LF clinical cases across all TAs of the country. First, we modelled antigenaemia prevalence in relation to climate covariates to predict nationwide antigenaemia prevalence. Second, we modelled clinical cases for unmapped TAs based on our antigenaemia prevalence spatial estimates. The models estimated 20,938 (95% CrI 18,091 to 24,071) clinical cases in unmapped TAs (70.3%) in addition to the 8,856 (29.7%), programme-identified cases in mapped TAs. In total, the overall national number of LF clinical cases was estimated to be 29,794 (95% CrI 26,957 to 32,927). The antigenaemia prevalence and clinical case mapping and modelling found the highest burden of disease in Chikwawa and Nsanje districts in the Southern Region and Karonga district in the Northern Region of the country. The models presented in this study have facilitated the development of the first national LF clinical case database and map in Malawi, the first endemic country in sub-Saharan Africa. It highlights the value of using existing LF antigenaemia prevalence and clinical case data together with modelling approaches to produce estimates that may be used for the WHO dossier requirements, to help target limited resources and implement long-term health strategies.

Geospatial Variability of Cholera Cases in Malawi Based on Climatic and Socioeconomic Influences

Geospatial Variability of Cholera Cases in Malawi Based on Climatic and Socioeconomic Influences

The role of the community of purpose in maternal mHealth interventions in Sub-Saharan Africa context.

mHealth has increasingly been touted as having the potential to help Sub-Saharan Africa achieve their health-related sustainable development goals by reducing maternal mortality rates. Such interventions are implemented as one-way or two-way systems where maternal clients receive pregnancy related information via SMS. While such technologies often view the users (the maternal health client) as having agency to adopt, we know from pregnancy literature that the pregnancy experience in Africa and other developing countries is often more collective. In addition to the maternal health client, other members of the community have high stakes in the pregnancy, and this often affects maternal healthcare-seeking behavior. The aim of this paper, therefore, is to understand the pathways through which these other members of the community affect mHealth use. The study used a qualitative approach and a case study research design. We analyzed two mHealth cases from Kenya and Malawi. In the Kenyan case, maternal health clients had mobile phones to receive pregnancy-related messages, while in the Malawi case, maternal health clients did not have mobile phones. Data were collected through interviews and focus group discussions. The study used an inductive thematic analysis to analyze the data. The findings show that maternal stakeholders form a community of purpose (CoP) that plays a crucial role in the implementation, uptake, and use of mHealth. The CoP influences maternal health clients through a diverse range of mechanisms ranging from sensitization, bridging the digital literacy gap and legitimization of the intervention. The nature of influence is largely dependent on the contextual socio-cultural nuances. Our results provide useful insights to mHealth implementers to know how best to leverage the CoP for better mHealth uptake and usage. For example, engaging healthcare providers could champion adoption and use, while engaging other family-related stakeholders will ensure better usage and compliance, encourage behavior change, and reduce mHealth attrition.

Assessment of Academic Interventions to Enhance Learners` Academic Performance in the SDA School. The Case of Malawi.

Formal education in all countries has been considered very important for personal and societal development. Education remains the biggest instrument for academic progress, social mobilization, political survival and effective national development of any country. One of the church institutions offering formal education is the Seventh Day Adventist Church. This study assessed academic interventions to enhance learners` academic performance in the SDA secondary schools in Malawi. The Effective School Model’ by Lezotte (2010) was used as a framework in the study. A sample of 54 participants comprising 12 teachers, 30 learners, and 6 members of the school board, 3 station pastors, and 3 School administrators was purposively selected in this descriptive qualitative study. Data was collected using open-ended questionnaire, interview guides, and document analysis that were analysed using thematic analysis and descriptive statistics. Result of the study reveals that some students were highly motivated to learn and do better. However, students’ performance was affected by several factors. Meanwhile, the study findings show that focussing on use of English language, formation of the Parent Teacher Association, adequate teaching and learning resources, teachers` postings, use of aptitude test, time management, incentives, educational leadership, and frequent inspection would improve the performance of students in the SDA schools. Based on the study results, the study recommends consultative meetings with various stakeholders to bring their inputs on the matter, provision of adequate teaching materials, and selection of students must base on realistic results of the aptitude test administered.

Implication of the 2014 World Health Organization Integrated Management of Childhood Illness Pneumonia Guidelines with and without pulse oximetry use in Malawi: A retrospective cohort study.

Under-5 pneumonia mortality remains high in low-income countries. In 2014 the World Health Organization (WHO) advised that children with chest indrawing pneumonia, but without danger signs or peripheral oxygen saturation (SpO 2) < 90% be treated in the community, rather than hospitalized. In Malawi there is limited pulse oximetry availability. Secondary analysis of 13,413 under-5 pneumonia cases in Malawi. Pneumonia associated case fatality ratios (CFR) were calculated by disease severity under the assumptions of the 2005 and 2014 WHO Integrated Management of Childhood Illness (IMCI) guidelines, with and without pulse oximetry. We investigated if pulse oximetry readings were missing not at random (MNAR). The CFR of patients classified as having non-severe pneumonia per the 2014 IMCI guidelines doubled under the assumption that pulse oximetry was not available (1.5% without pulse oximetry vs 0.7% with pulse oximetry, P<0.001). When 2014 IMCI guidelines were applied with pulse oximetry and a SpO 2 < 90% as the threshold for referral and/or admission, the number of cases meeting hospitalization criteria decreased by 70.3%. Unrecorded pulse oximetry readings were MNAR with an adjusted odds for mortality of 4.9 (3.8, 6.3), similar to that of a SpO 2 < 90%. Although fewer girls were hospitalized, female sex was an independent mortality risk factor. In Malawi, implementation of the 2014 WHO IMCI pneumonia guidelines, without pulse oximetry, will miss high risk cases. Alternatively, implementation of pulse oximetry may result in a large reduction in hospitalization rates without significantly increasing non-severe pneumonia associated CFR if the inability to obtain a pulse oximetry reading is considered a WHO danger sign.

Effect of government intervention in relation to COVID-19 cases and deaths in Malawi

The COVID-19 pandemic affected the world in various ways. In response to this, countries set up various interventions such as lockdowns, physical distancing, and mandatory face covering, among others. Governments also put in place measures to ensure compliance. However, the extent to which the various responses impacted the deaths and confirmed cases remains debatable. This paper explores this question by looking at how government stringency measures impacted deaths and cases in Malawi. We employ an instrumental variable (IV) approach to assess the impact of government action on confirmed COVID-19 cases and deaths. We measure government policy by the stringency index. By leveraging the IV approach, we circumvent potential endogeneity concerns between our main policy variable and the outcome variables. Our data comes from the University of Oxford COVID-19 project and spans a daily frequency from 20 February 2020 to 25 April 2022, covering multiple waves of the pandemic. Overall, the findings show that despite Malawi never having implemented a full lockdown, the government policies may have helped to reduce both cases and deaths related to COVID-19. Specifically, the IV shows that a unit increase in the government stringency index results in a drop of 179 cases and 6 deaths. All the results are statistically significant at 1% level and remain robust to the use of the ordinary least-squares method. This study demonstrates the efficacy of non-pharmaceutical tools implemented by the government to fight COVID-19. Thus, policymakers need to place more emphasis on the need for the public to adhere to these stringency measures in the event of new waves of the pandemic or similar outbreaks.

Implication of the 2014 World Health Organization Integrated Management of Childhood Illness Pneumonia Guidelines with and without pulse oximetry use in Malawi: A retrospective cohort study

Background: Under-5 pneumonia mortality remains high in low-income countries. In 2014 the World Health Organization (WHO) advised that children with chest indrawing pneumonia, but without danger signs or peripheral oxygen saturation (SpO2) &lt; 90% be treated in the community, rather than hospitalized. In Malawi there is limited pulse oximetry availability. Methods: Secondary analysis of 13,413 under-5 pneumonia cases in Malawi. Pneumonia associated case fatality ratios (CFR) were calculated by disease severity under the assumptions of the 2005 and 2014 WHO Integrated Management of Childhood Illness (IMCI) guidelines, with and without pulse oximetry. We investigated if pulse oximetry readings were missing not at random (MNAR). Results: The CFR of patients classified as having non-severe pneumonia per the 2014 IMCI guidelines doubled under the assumption that pulse oximetry was not available (1.5% without pulse oximetry vs 0.7% with pulse oximetry, P&lt;0.001). When 2014 IMCI guidelines were applied with pulse oximetry and a SpO2 &lt; 90% as the threshold for referral and/or admission, the number of cases meeting hospitalization criteria decreased by 70.3%. Unrecorded pulse oximetry readings were MNAR with an adjusted odds for mortality of 4.9 (3.8, 6.3), similar to that of a SpO2 &lt; 90%. Although fewer girls were hospitalized, female sex was an independent mortality risk factor. Conclusions: In Malawi, implementation of the 2014 WHO IMCI pneumonia guidelines, without pulse oximetry, will miss high risk cases. Alternatively, implementation of pulse oximetry may result in a large reduction in hospitalization rates without significantly increasing non-severe pneumonia associated CFR if the inability to obtain a pulse oximetry reading is considered a WHO danger sign.

Fall injuries in Sub-Saharan Africa: analysis of prospective injury registry from 23 health facilities in Malawi and Tanzania

BackgroundLow-and middle-income countries account for over 80% of fall-related fatalities globally. However there is little emphasis on the issue and limited high quality data to understand the burden, and to inform preventive and management strategies. We characterise the burden of fall injuries in Malawi and Tanzania.MethodsThis multi-centre prospective descriptive study utilized trauma registry data from 10 hospitals in Malawi and 13 hospitals in Tanzania. The study included twelve months of data in Tanzania (October 2019 to September 2020), and eighteen months of data from Malawi (September 2018 to March 2020). We describe patient demographics, the causes, location, and nature of injuries, timing of arrival to hospital, and final disposition. Regression analyses were performed to determine risk factors for serious injuries.ResultsThere were 93,178 trauma patients in the registries of both countries, of which 44,609 (47.9%) had fall related complaints. Fall injuries accounted for 55.3% and 17.4% of all trauma cases in Malawi and Tanzania respectively. Overall the median age was 16 years (Interquartile range (IQR) 8–31 years), and 62.8% were male. Most fall injuries (69.9%) occurred at home, were unintentional (98.1%), and were due to a ground level fall (74.9%). Nearly half of patients (47.9%) arrived at a facility using public transport, with median arrival time of 10 h (IQR 8–13 h) from initial injury. Extremities (87.0%) were the most commonly injured region, followed by head and neck (4.4%). Overall 3275 (7.4%) patients had potentially serious injuries. Age > 60 years was associated with two times odds of having serious injuries than those < 5 years, and those sustaining injury at work (adjusted Odds Ratio (aOR) 1.95 95% CI; 1.56–2.43) or recreational areas (aOR 3.47 95% CI; 2.93–4.10) had higher odds of serious injuries compared to those injured at home.ConclusionsIn these facilities in Sub-Saharan Africa, fall injuries accounted for a substantial fraction of all injuries. While most common in younger males, those aged 5–13 and over 60 years were more likely to have serious injuries. Most falls occurred at home, but serious injuries were more likely to occur at recreational and work areas. Future efforts should focus on preventive strategies to mitigate these injuries.

Analysing a Transnational Advocacy Network of Internet Data Affordability in Malawi

This paper analysed how advocacy groups and consumers influenced government, telecommunications regulators, and mobile network operators to reduce the cost of internet data. The study used a case of Malawi as an example of a low-income country with high cost of internet. Transnational advocacy network theory was used to analyse secondary data from online databases, websites of regulatory organisations, online news, and social media posts. The findings showed that transnational advocacy network drew members from international, regional and local organisations. Consumers also participated in the transnational advocacy network. Information sharing was crucial in highlighting the high cost of internet data in the country. Local network actors used information, symbolic, leverage, and accountability politics to persuade government agencies, the telecommunications regulators, and mobile network operators to reduce the cost of internet data. The study provides insights into the understanding of issues related to internet data affordability in the context of a developing country.

Tackling the challenges of assessing socioeconomic impacts of farmland restoration: The case of Malawi

This research explores the potential of using the secondary household survey data to identify key socioeconomic indicators for tracking farmland restoration progress in Malawi since 2017. A two-year panel data for the periods between 2016–2017 and 2019–2020 was created for the analysis, building on data collected from Malawi’s Integrated Household Panel Survey (IHPS). An initial data analysis shows that estimated average Household Restoration Intensity Score (HRIS) increased from 2.05 in 2016 to 2.24 in 2019, indicating increased intensification of farmland restoration at the household level over time. The average Food Consumption Score (FCS) of all the households also significantly improved over time, rising from 43.19 in 2016 to 47.43 in 2019. A Difference-in-Difference (DiD) model was developed to quantitatively estimate the causal effects of the farmland restoration interventions on the socioeconomic improvement of rural households. Overall, the model shows some promising results. All four regressions generated statistically significant results regarding the positive impact of restoration interventions over time on four socioeconomic indicators, including food and non-food expenditure, crop sales, and FCS at the household level. However, the model results should be interpreted with care due to clear caveats on secondary household survey data. In response, this study recommended three concrete ways that surveys can be improved to collect data that is relevant for assessing the socioeconomic impacts of farmland restoration. This study also calls for urgent global actions to construct a robust restoration monitoring and evaluation system that will allow systemically monitoring and tracking socioeconomic improvements resulting from restoration interventions in a consistent manner over time.

Community-Level Incentive Mechanisms for the Conservation of Crop Wild Relatives: A Malawi Case Study

Despite being an increasingly important source of genes for crop breeding aimed at improving food security and climate change adaptation, crop wild relatives (CWRs) are globally threatened. A root cause of CWR conservation challenges is a lack of institutions and payment mechanisms by which the beneficiaries of CWR conservation services (such as breeders) could compensate those who can supply them. Given that CWR conservation generates important public good values, for the significant proportion of CWRs found outside of protected areas, there is a strong justification for the design of incentive mechanisms to support landowners whose management practices positively contribute to CWR conservation. This paper contributes to facilitating an improved understanding of the costs of in situ CWR conservation incentive mechanisms, based on a case study application of payments for agrobiodiversity conservation services across 13 community groups in three districts in Malawi. Results demonstrate a high willingness to participate in conservation activities, with average conservation tender bids per community group being a modest MWK 20,000 (USD 25) p.a. and covering 22 species of CWRs across 17 related crops. As such, there appears to be significant potential for community engagement in CWR conservation activities that is complementary to that required in protected areas and can be achieved at modest cost where appropriate incentive mechanisms can be implemented.

Tackling noncommunicable diseases in Africa through football: The case of Malawi

AbstractThere is evidence that physical inactivity and dietary factors are more common among modifiable risk factors for noncommunicable diseases (NCDs) which are on the rise in Malawi. Football has been shown to have a wide range of health‐related benefits in health education programs, including the promotion of physical activity as a potential intervention in addressing NCDs. In Malawi, few football‐based health promotion programs have been implemented to address NCDs. Among the programs implemented were the Federation Internationale de Football Association 11 for Health initiative which was a school‐based health education program for the youth and the Malawi Ministry of Health's SPORTS FOR HEALTH initiative targeting civil servants. These programs produced significant improvement in physical activity in the participants and also increased their knowledge of both communicable and NCDs. However, these initiatives were not rolled out to many sites across Malawi. As Malawi is tackling rising cases of NCDs, football can be used as a powerful tool in promoting physical activity and it also provides an important platform for the delivery of NCDs’ health promotion messages to a wider audience. Such football‐based initiatives must be designed to directly address modifiable risk factors of NCDs. For successful implementation, there must be a good collaboration among the Ministries of Health and Sports, local football leagues, and other stakeholders.

Correlates of Transport Mode Choice: Dry Commodity Movement. A Case of Malawi.

Goods from Malawi face a range of challenges in competing on the international market which in part, is as a result of high transportation costs. Despite rail transportation being cheaper than road transportation, Malawi commodity shippers prefer the latter, thus affecting the pricing of the goods on the market. Therefore, the purpose of the study was to investigate the correlates of transport modal choices and the Theory of Planned Behavior (TPB) was used to guide the study. The study employed quantitative approach and descriptive research design in which a questionnaire was used to collect data from a sample of 104 respondents in a population of 141 dry commodity shippers by using simple random probability sampling technique. The key objective of the study was to determine the correlates of transport modal choice in Malawi. The study found that shipment travel time, freight costs, transport mode availability and transport service reliability had a relationship with transport modal choices that shippers made. The study therefore recommends that transport service providers should endeavor take into account these correlates for proper transport planning and management.

Investigating and Weighing the Importance of Transport Mode Choice Factors: Dry-Cargo Shipping. A Case of Malawi

Understanding the transport mode choice factors that are important to the commodity shippers is one of the important key aspects to consider when aiming for efficient and effective transport planning. Over the years, several studies have been conducted in other countries trying to establish the factors that influence commodity shippers’ decisions when choosing transport modes. While these factors have been unearthed, little is known about how these factors are prioritized in shipping decisions. This study therefore aimed to investigate the factors that influence transport mode choices and also examine how shippers weigh and rank these factors with regard to their importance. A descriptive research design within quantitative methodology was employed. Using a simple random sampling technique, 84 participants were recruited for this study. The findings of the study revealed that shipment travel time, transport cost, transport mode availability, and transport service reliability have an influence on how shippers choose a transport mode for their shipments. The study further revealed that transportation cost was the ranking transport modal choice factor among the factors. It was therefore recommended that the government should consider revitalising low-cost rail transportation to make it more efficient and responsive to shippers’ demands.

Zambezi Evangelical Church’s role in addressing poverty in Malawi: A public practical theological reflection

The high poverty levels in Malawi are a cause of concern resulting in many questions being asked. Among these questions is what role the faith communities can play to meaningfully contribute towards addressing this. Importantly, these high poverty levels challenge the church to reflect on the following questions: Beyond the clerical paradigm, what role can the church play in poor communities? How can the church effectively contribute to addressing the challenge of poverty? Thus, using the case of Malawi, in this article is considered the role that the church can perform to address public social issues. It reflects on literature and empirical data that were collected from the Zambezi Evangelical Church in Malawi to assess the role that the church has been playing to address poverty in the country. The article concludes by suggesting ways that the Malawian church could consider strengthening its role in addressing poverty.Contribution: Through using an empirical approach, this article provides insight into the contribution that churches can make to address poverty. It locates such a ministerial approach as an endeavour in public practical theology that could be employed effectively on congregational level.

Health care workers' knowledge on identification, management and treatment of snakebite cases in rural Malawi: A descriptive study.

Snakebite envenoming remains a public health threat in many African countries, including Malawi. However, there is a shortage of literature on the knowledge of Health Care Workers (HCWs) and the prevalence of snakebite cases in Malawi. We interviewed HCWs in Neno District to assess their knowledge of snake identification and management of snakebites. We further reviewed patient registers from 2018 to 2021 in all 15 health facilities in the district. We used descriptive statistics to characterize the survey population, knowledge, snake antivenom (SAV) administration, and snake identification. Using "shapefiles" from Open Street Maps, we mapped villages with snakebite cases. Of the 105 HCWs interviewed, 58% were males, and 60% had worked for less than five years. The majority (n = 93, 89%) reported that snakebite envenoming was a problem in the district. Among the clinicians, 42% said they had prescribed SAV previously, while among nurses, only 26% had ever administered SAV. There were discrepancies among clinicians regarding the dosing of snake antivenom. Significant gaps in knowledge also existed regarding snake identification. While two-thirds of HCWs could correctly name and identify venomous snake species, most (> 90%) failed for non-venomous snakes. Most (n = 100, 95%) reported that snakebite victims visit traditional healers more than the hospital. Between 2018 and 2021, the Neno District registered 185 snakebites with a yearly average of 36 cases per 100,000 population. Fifty-two percent (n = 97) were treated as an inpatient; of these cases, 72% were discharged in less than three days, and two died. More snakebite cases were recorded in the eastern part of the district. Significant knowledge gaps exist among HCWs in Neno regarding prescription and administration of SAV and snake identification, which likely challenges the quality of services offered to snakebite victims.

Sustainable Scaling of Climate-Smart Agricultural Technologies and Practices in Sub-Saharan Africa: The Case of Kenya, Malawi, and Nigeria

In the wake of climate change, climate-smart agriculture has been proposed as an option for mitigation and adaptation to the attendant harsh impacts among smallholder farmers in Africa. The approach has been promoted for nearly two decades in Kenya, Nigeria, and Malawi, but with low adoption among farmers. This study therefore sought to determine the pathways for sustainable scaling of climate-smart agricultural technologies and practices in the three countries. Secondary and primary data were obtained from desk review, field survey, key informant interviews, and focus group discussions. Data was analyzed using descriptive statistics and multivariate probit regression. The multivariate probit regression result showed eight negative correlated coefficients between the climate-smart agriculture technologies and practices adopted, thus implying that the practices are substitutes for each other. It was observed that gender had no significant influence on the adoption of a set of practices (refuse retention, minimum tillage, green manure, and mulching) but influenced significantly the adoption of early maturing varieties. Implicitly, therefore, apart from gender, the adoption of climate-smart agriculture technologies and practices might often be due to other factors.