Districts In Malawi Research Articles

Multidimensional evaluation of the impacts of agricultural interventions to achieve food security in Malawi

AbstractMalawi's food and nutrition security heavily relies on rainfed agricultural production, which is prone to the effects of climate change, such as floods and dry spells. To improve the situation, policies have been established as a guide to assist in the implementation of agricultural technologies in the country. This study aims to evaluate the effect of two national policies on addressing nutrition, economics, and food security by introducing modern/existing technologies in the Phalombe district in Malawi. To gain insight into the representative farm operations, financial, demographic, and consumption behaviors of smallholder farmers, the data were obtained through a combination of focus group discussions, expert opinions, and various published reports, including both government and nongovernment sources. The farm simulation model (FARMSIM) was utilized to analyze district‐level crop and livestock farm operations. In this study, four irrigation technologies (treadle pump system, motorized pump system, solar‐powered system, and river diversion irrigation system) were assessed among the agricultural interventions implemented in Malawi. Also, seven land uses (i.e., corn, onion, bean, rice, tomato, leafy vegetable, and cabbage) were developed and simulated under irrigation scenarios. The irrigation systems and land use scenarios were evaluated based on economics, productivity, nutrition, and risk. The treadle pump and leafy vegetable scenario were generally identified as the most preferred combination. In addition, the productivity and riskiness of the other scenarios can be improved by selecting the best combination of crop and irrigation systems. The study concludes that government and private investment in subsidies for large‐scale irrigation systems, as well as improvements to market prices and infrastructure, are necessary to boost food security and enhance the livelihood of smallholder farmers in rural Malawi.

Critical shortage of capacity to deliver safe paediatric surgery in sub-Saharan Africa: evidence from 67 hospitals in Malawi, Zambia, and Tanzania.

Paediatric surgical care is a significant challenge in Sub-Saharan Africa (SSA), where 42% of the population are children. Building paediatric surgical capacity to meet SSA country needs is a priority. This study aimed to assess district hospital paediatric surgical capacity in three countries: Malawi, Tanzania and Zambia (MTZ). Data from 67 district-level hospitals in MTZ were collected using a PediPIPES survey tool. Its five components are procedures, personnel, infrastructure, equipment, and supplies. A PediPIPES Index was calculated for each country, and a two-tailed analysis of variance test was used to explore cross-country comparisons. Similar paediatric surgical capacity index scores and shortages were observed across countries, greater in Malawi and less in Tanzania. Almost all hospitals reported the capacity to perform common minor surgical procedures and less complex resuscitation interventions. Capacity to undertake common abdominal, orthopaedic and urogenital procedures varied-more often reported in Malawi and less often in Tanzania. There were no paediatric or general surgeons or anaesthesiologists at district hospitals. General medical officers with some training to do surgery on children were present (more often in Zambia). Paediatric surgical equipment and supplies were poor in all three countries. Malawi district hospitals had the poorest supply of electricity and water. With no specialists in district hospitals in MTZ, access to safe paediatric surgery is compromised, aggravated by shortages of infrastructure, equipment and supplies. Significant investments are required to address these shortfalls. SSA countries need to define what procedures are appropriate to national, referral and district hospital levels and ensure that an appropriate paediatric surgical workforce is in place at district hospitals, trained and supervised to undertake these essential surgical procedures so as to meet population needs.

Exploring the impact of COVID-19 on reported maternal and neonatal complications and access to maternal health care in five government health facilities in Blantyre, Malawi.

There is a dearth of studies assessing the effects of SARS-CoV-2 on the healthcare system and access to care, especially in lower- and middle-income countries such as Malawi. We aimed to assess the impacts of COVID-19 on reported maternal and neonatal complications as well as potential changes in maternal care access to care among five primary care health facilities in Blantyre, Malawi. This retrospective cohort study assessed maternal and neonatal register data from five participating health centers in Blantyre, Malawi using the Malawi District Health Information Software 2 (DHIS2) to compare outcomes from 15 months before COVID-19 emerged, defined as the pre-Covid period (January 2019 -March 2020) with nine months after COVID-19 (April 2020 -December 2020). There was a significant decrease in reported use of vacuum extraction, which went from <0.01%in the pre-COVID period to 0% in the COVID period (p = 0.01). The proportion of births reporting fetal distress almost tripled from 0.46% to 1.36% (p = 0.001) during the COVID-19 period. Additionally, reported anticonvulsant use significantly increased from 0.01% to 1.2% (p<0.01), and antibiotic use significantly increased from 0.45% to 1.6% (p = 0.01). Asphyxia was the only significant neonatal complication variable reported, increasing from 2.80% to 3.45% (p = 0.01). Our findings suggest that significant outcomes were mainly due to the indirect effects of COVID-19 rather than the virus itself. Based on our findings and the contextual qualitative interviews with two Malawian expert midwives, we concluded that mothers may have been affected more due to understaffing and shortage of skilled personnel in the study health facilities. Therefore, the development of highly skilled health workers may contribute to better outcomes, along with adequate staffing and a streamlined referral process.

Farmers’ perception on the potential impact of Coronavirus disease on their livelihood in Malawi

Coronavirus disease 2019 (COVID-19) was a global health crisis. Its effects did not spare the smallholder farmers. This study aimed at assessing smallholder farmers’ perceived potential impact of COVID-19 on their livelihood in Malawi. During the first wave of the COVID-19, 606 smallholder farmers residing in 12 districts in Malawi were interviewed through an online survey. Farmers’ knowledge, attitudes, and practices on COVID-19 were evaluated. Results showed that 81% of the farmers had knowledge on transmission, prevention, signs and symptoms, groups which were at high risk, and that there was no availability of COVID-19 treatment. The majority of the farmers (96%) reported that the measures which the Government of Malawi instituted to contain the spread of the disease were effective. All the farmers interviewed reported practicing at-least one of the preventive measures as advised by the Government through the Ministry of Health. Ninety nine percent of the farmers reported that they would report using the channels designated by the Government through the Ministry of Health if they suspected that one has symptoms of COVID-19. The critical sources of COVID-19 information for the farmers were radio and television stations (80%), and digital platforms (73%). Based on the farmers’ views, the first wave of the disease negatively impacted their income (85%) and food (63%) sources. These results pinpoint the need for COVID-19 inclusive programming in existing and new developmental initiatives targeting smallholder farmers.

Community acceptability of public health measures during the coronavirus pandemic in Malawi: a cross-sectional survey of knowledge, attitudes, and practices.

The knowledge, attitudes, and practices (KAP) of people during the coronavirus pandemic are pivotal to the uptake of recommended preventative strategies. This paper describes the Malawian KAP related to coronavirus and associated public health measures. This was a multi-site cross-sectional survey where data was collected through personal one-on-one interviews in nine Malawian districts over 3 weeks (5-25 October 2020). 521 participants (>18 years) were enrolled to answer a questionnaire. We found that all respondents were aware of the ongoing coronavirus pandemic with the majority using the Radio. 75% of participants displayed knowledge of all key symptoms of coronavirus disease (cough, fever, and shortness of breath) and additionally, the majority of participants (97%) knew enough to take some sort of intervention (calling a hotline or visiting the nearest hospital) if they developed symptoms. Participants also demonstrated a high perception of the risk of coronavirus, where >60% believed to be susceptible to the coronavirus under the current preventative measures, and >50% believed they would die from the infection. Communities displayed a high perceived effectiveness of all preventative measures, with "hand hygiene using soap and water" being perceived as effective by the majority of respondents. Although the majority of the participants (>80%) were willing to self-isolate at home, various barriers to home isolation were raised which would ultimately influence their ability to do so. Baseline community psychosocial and behavioral information which influence the adoption of public health measures in Malawi has been highlighted alongside recommendations for best practices.

The Trends and Effects of Flood Occurrences in the Shire River Basin in Chikwawa District of Malawi: A Historical Perspective (1980 - 2019)

Purpose: The purpose of this study was to examine historical trends in flooding in Malawi’s Shire River Basin (SRB). The basin is prone to severe flooding and most affected in the country. For many years, flooding has posed a significant threat to communities in and around the basin. Therefore, the main objective of the study was to document the historical perspective of flood occurrences in terms of frequency and impact in the Shire River Basin of Chikwawa District, Malawi, from 1980 to 2019. &#x0D; Methodology: A mixed survey design was used for the study. Both random and purposive sampling were used to identify participants. A total of 384 respondents took part in the study. The study collected both primary and secondary data. Primary sources of data were collected using household surveys, interviews with key informants, and focus group discussions, while secondary sources of data were collected using documents from both non-governmental and Malawian governmental departments and agencies (MDAs) as well as existing literature. Data from focus group discussions (FGDs), interviews with community elders (CEIs), and key informant interviews (KIIs) were recorded in Chichewa with a voice recorder, transcribed in Chichewa, and then translated into English. Household survey data were processed using Statistical Package for Social Scientists (SPSS) version 25 and secondary data were converted to time series data and then analysed using STATA software to produce charts and graphs. &#x0D; Findings: The results showed that all three hydrometeorological extremes (mean annual temperature, average rainfall and baseflow index) increased, suggesting that both the intensity and frequency of flooding in the Shire River Basin of Chikwawa District were also increasing in absolute terms. People’s perceptions of flooding showed that the Shire River Basin in Chikwawa District experienced excessive flooding every 5 years. This 5-year cycle was, among other factors the result of climate change and forest loss in the study area, leading to an increase in river sedimentation.&#x0D; Recommendations: This article found that the local people in the Shire River Basin of Chikwawa District will always live with increasing levels of flooding. Therefore, they should be proactive in flood management and understand the process as an ongoing activity for future risk assessment. Analysing the history of river basin flooding is important as it helps the Malawi's Department of Disaster Management Affairs (DoDMA) officials to be alert and estimate the time frame for the next flood in the Shire River Basin of Chikwawa District to strengthen the flood forecasting accuracy.&#x0D;

Perspectives on DMPA-SC for self-injection among adolescents with unmet need for contraception in Malawi.

Malawi has made progress in expanding access to modern contraceptive methods over the last decade, including the introduction of depot-medroxyprogesterone acetate subcutaneous (DMPA-SC) in 2018. DMPA-SC offers women the option to self-inject at home and may benefit adolescents with unmet need for contraception due to its discretion. This qualitative study was conducted to assess perspectives and preferences of adolescents with unmet need for contraception regarding the self-injection option of DMPA-SC in Malawi. Six focus group discussions were conducted involving 36 adolescents with unmet need for contraception (aged between 15 and 19 years, married and never-married) in October 2021 in three districts in Malawi. Data were coded inductively and analyzed thematically, using Dedoose software. Two validation workshops were conducted with other adolescents with unmet need in February 2022 to elucidate the preliminary findings. DMPA-SC attributes such as discretion and reduced facility visits were ranked most appealing by both married and never-married adolescents, particularly for adolescents needing covert contraception use. Concerns about self-injection included fear of pain, injury, and doubt in ability to self-inject. Never-married adolescents had additional concerns around privacy at home if using covertly, and fears of affecting long-term fertility. Overall, health surveillance assistants (community-based healthcare workers) were voted to be the most private, convenient, and affordable sources for potential DMPA-SC self-injection training. Self-injection of DMPA-SC may offer an appealing option for adolescents in Malawi, aligning most closely to the needs of married adolescents who may wish to delay or space pregnancies conveniently and discreetly, and who also may face fewer access barriers to receiving self-injection training from health care providers. Access barriers including stigma and concerns about privacy at home for adolescents needing to use contraception covertly would need to be adequately addressed if never-married adolescents were to consider taking up this option.

Framing of HIV and AIDS messages of Zokonda Amayi phone-in radio programme in rural Malawi

This study examines how female listeners of a phone-in radio programme called Zokonda Amayi respond to the content of the phone-in radio programme’s HIV and AIDS awareness messages. The interrogation centered on female listeners residing in the grassroots locations of Lilongwe District in Malawi, central Africa. Zokonda Amayi phone-in radio programme is a weekly show which airs on Malawi Broadcasting Corporation (MBC), the national broadcasting station. Many women in Malawi are disproportionately affected by AIDS. A mixed approach model was used to shed light on the applicability of phone-in radio programmes in hosting HIV and AIDS broad-mindedness in rural Malawian ladies. Data was gathered in a standardized manner making use of questionnaires, interviews and focus group discussions on the research subjects. Results highlight the high appreciation that the targeted listeners have for the content of the phone-in radio programme, a demonstration of how much they have benefitted and are continuing to profit from framing of HIV and AIDS awareness messages on the phone-in radio programme. It is recommended that the producers of Zokonda Amayi phone-in radio programme should continue to invite health experts to the phone-in radio programme to be regularly talking about technical health related issues, for instance, how discordant couples can safely conceive if they wish to have a child or another child and other pertinent health issues

Barriers affecting COVID‑19 vaccination in Phalombe District, Malawi: A qualitative study.

In Malawi, only 1 072 229 people out of a national target population of 13 546 324 had received at least one dose of the AstraZeneca COVID‑19 vaccine by 26 December 2021, and only 672 819 people were classified as fully vaccinated. Phalombe District in Malawi had particularly low COVID‑19 vaccine uptake, with only 4% (n=8 538) of 225 219 people being fully vaccinated by 26 December. To explore reasons for vaccine hesitancy and refusal among people living in Phalombe District. This cross-sectional qualitative study employed six focus group discussions (FGDs) and 19 in-depth interviews (IDIs) to collect data. We purposefully selected two traditional authorities (TAs), Nazombe and Nkhumba, as study areas, and conducted FGDs and IDIs in 6 randomly selected villages in these two TAs. Participants were religious leaders, traditional leaders, youths, traditional healers and ordinary community members. We explored reasons for vaccine refusal and hesitancy, how contextual cultural beliefs influenced people's decision to receive the COVID‑19 vaccine, and which sources of information were trusted in the community. Data were analysed using thematic content analysis. We conducted 19 IDIs and six FGDs. Themes that emerged from the data were reasons for vaccine refusal and hesitancy, contextual cultural beliefs affecting the decision whether to be vaccinated, ways to improve COVID‑19 vaccine uptake, and means of communicating information about COVID‑19 vaccines. Participants mentioned that myths contributing to vaccine refusal and hesitancy circulated in the community through social media. With regard to contextual cultural beliefs, most participants believed that COVID‑19 was a disease of rich people, while others believed that it signalled the end of the world and that it could not be cured. Health systems should recognise and acknowledge the reasons leading to vaccine hesitancy and refusal and address these appropriately to improve vaccine uptake. Effective community sensitisation and engagement should be enhanced to clarify myths and address misinformation about the COVID‑19 vaccine.

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.

Redesigning Sample Transportation in Malawi Through Improved Data Sharing and Daily Route Optimization

Problem definition: Healthcare systems in resource-limited settings rely on diagnostic networks in which medical samples (e.g., blood, sputum) and results need to be transported between geographically dispersed healthcare facilities and centralized laboratories. Academic/practical relevance: Existing sample transportation (ST) systems typically operate fixed schedules, which do not account for demand variability and lead to unnecessary transportation visits as well as delays. Methodology: We design an optimized sample transportation (OST) system that comprises two components: (i) a new approach for timely collection of information on transportation demand (samples and results) using low-cost technology based on feature phones, and (ii) an optimization-based solution approach to the problem of routing and scheduling courier trips in a multistage transportation system. Results: Our solution approach performs well in a range of numerical experiments. Furthermore, we implement OST in collaboration with Riders For Health, who operate the national ST system in Malawi. Based on analysis of field data describing over 20,000 samples and results transported during July–October 2019, we show that the implementation of OST routes reduced average ST delays in three districts of Malawi by approximately 25%. In addition, the proportion of unnecessary trips by ST couriers decreased by 55%. Managerial implications: Our approach for improving ST operations is feasible and effective in Malawi and can be applied to other resource-limited settings, particularly in sub-Saharan Africa. History: This paper has been accepted as part of the 2021 Manufacturing &amp; Service Operations Management Practice-Based Research Competition. Funding: This work was supported by Bill and Melinda Gates Foundation [Grant OPP1182217] and by the National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health [Grant U54EB027049]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding organizations. Supplemental Material: The e-companion is available at https://doi.org/10.1287/msom.2022.1182 .

The Effects of One Egg Per Day on Vitamin A Status Among Young Malawian Children: A Secondary Analysis of a Randomized Controlled Trial

BackgroundVitamin A deficiency (VAD) is common in populations with limited dietary diversity and access to vitamin A-rich foods. ObjectivesThis analysis aimed to determine the impact of supplementing children’s diets with 1 egg/d on the concentration of plasma retinol and RBP and the prevalence of VAD. MethodsChildren age 6–9 mo living in the Mangochi district of Malawi were individually randomly assigned to receive 1 egg/d for 6 mo (n = 331) or continue their usual diet (n = 329) in the Mazira trial (clinicaltrials.gov; NCT03385252). This secondary analysis measured plasma retinol by HPLC and RBP, CRP, and α-1-acid glycoprotein (AGP) by ELISA techniques at enrollment and 6 mo follow-up. Retinol and RBP were adjusted for inflammation, and mean concentrations were compared between groups using linear regression models. In addition, prevalence ratios of VAD (retinol <0.7 μmol/L) were compared between groups using log-binomial or modified Poisson regression models. ResultsAfter 6 mo of study participation, 489 were assessed for retinol (egg: n = 238; control: n = 251), and 575 (egg: n = 281; control: n = 294) were assessed for RBP. Prevalence of inflammation (CRP >5 mg/L or AGP >1 g/L: 62%) and inflammation-adjusted VAD (7%) at enrollment did not differ between groups. At follow-up, the egg intervention group did not differ from the control in inflammation-adjusted retinol [geometric mean (95% CI); egg: 1.10 μmol/L (1.07, 1.13); control: 1.08 (1.05, 1.12)], RBP [egg: 0.99 μmol/L (0.96, 1.02); control: 0.97 (0.94, 1.00)], or prevalence of VAD [egg: 6%; control: 3%; prevalence ratio: 1.87 (0.83, 4.24)]. ConclusionsProvision of 1 egg/d did not impact VAD, plasma retinol, or RBP among young children in rural Malawi, where the prevalence of VAD was low. Curr Dev Nutr 2023;x:xx.This trial was registered at [clinicaltrials.gov] as [NCT03385252].

Agricultural diversity linkage to income, wealth, diets and nutrition: Case of Lilongwe district in Malawi

There is global debate whether to diversify agricultural production. A study was conducted in 2016 and 2017 in Lilongwe district, Malawi, to determine effects of agricultural diversity on income, wealth, diets and nutrition. A cross-sectional design was used in surveys on agriculture, income, assets, and nutrition coupled with anthropometric measurements targeting children, men, and women in 424 households. Using an agricultural diversity index constituting crop livestock and fruit diversity, level of agricultural diversity was 28.22%). Bivariate correlation analysis showed that agricultural diversity had a significant positive relationship with household income (r = 0.369), wealth (r = 0.363), and dietary diversity (r = 0.144 for children, r = 0.298 for women, and r = 0.211 for men). However, agricultural diversity had no significant effect on nutritional status of children, women, and men. This implies that to influence nutrition, other factors, such as better health, need to complement agricultural diversity.

Geospatial Coronavirus Vulnerability Regression Modelling for Malawi Based on Cumulative Spatial Data from April 2020 to May 2021

In the past two to three years, the world has been heavily affected by the infectious coronavirus disease and Malawi has not been spared due to its interconnection with neighboring countries. There is no management tool to identify and model the vulnerabilities of Malawi’s districts in prioritizing health services as far as coronavirus prevalence and other infectious diseases are concerned. The aim of this study was to model coronavirus vulnerability in all districts in Malawi using Geographic Information System (GIS) to monitor the disease’s cumulative prevalence over the severely affected period between 2020 and 2021. To achieve this, four parameters associated with coronavirus prevalence, including population density, percentage of older people, temperature, and humidity, were prepared in a GIS environment and used in the modelling process. A multiscale geographically weighted regression (MGWR) model was used to model and determine the vulnerability of coronavirus in Malawi. In the MGWR modelling, the Fixed Spatial Kernel was used following a Gaussian distribution model type. The Results indicated that population density and older people (age greater than 60 years) have a more significant impact on coronavirus prevalence in Malawi. The modelling further shows that Malawi, between April 2020 and May 2021, Lilongwe, Blantyre and Thyolo were more vulnerable to coronavirus than other districts. This research has shown that spatial variability of Covid-19 cases using MGWR has the potential of providing useful insights to policymakers for targeted interventions that could otherwise not be possible to detect using non-geovisualization techniques.

A One-Year Follow-Up Evaluation of Frontline Healthcare Workers' Knowledge after Adverse Events Following Immunization (AEFI) Surveillance Training in Six Districts in Malawi

A One-Year Follow-Up Evaluation of Frontline Healthcare Workers' Knowledge after Adverse Events Following Immunization (AEFI) Surveillance Training in Six Districts in Malawi

Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.

It is widely accepted that maternal healthcare is vital for improving maternal and neonatal mortality rates. Furthermore, the continuum of care-the integrated delivery of antenatal, delivery and postnatal care-has been shown to be particularly important. Sub-Saharan Africa has the highest neonatal and maternal mortality rates in the world; significant improvements in the provision and utilisation of the continuum are urgently needed, therefore the barriers preventing access need to be better understood. This study aimed to identify key factors associated with the utilisation of maternal healthcare, in the Mchinji District of Malawi. 4,244 pregnant women from the Mchinji District of Malawi were interviewed between March and December 2013. The overall utilisation of maternal healthcare was calculated by combining the use of antenatal, delivery and postnatal care into one variable-continuum of care. Univariate and multivariate logistic regressions were performed to determine the factors associated with utilisation of maternal healthcare. Utilisation of maternal healthcare in the Mchinji District was inadequate; only 24% of women received the recommended package. Being further from a healthcare facility (OR = 0.2, 95%CI = 0.04-0.96), having at least one live child (OR = 0.87, 95%CI = 0.84-0.99), previous experience of miscarriage (OR = 0.64, 95%CI = 0.50-0.82) or abuse (OR = 0.81, 95%CI = 0.69-0.95) reduced utilisation, whereas being in the richest 20% (OR = 1.33 95%CI = 1.08-1.65), having a planned pregnancy (OR = 1.3, 95%CI = 1.11-1.51) or more control over decisions (OR = 1.09, 95%CI = 0.80-1.49) increased utilisation. Seven groups of women were identified as having an increased risk of low utilisation of maternal healthcare; women living >5km from a healthcare facility, within the poorest socio-economic group, experiencing an unplanned pregnancy, with at least one live child, experience of a previous miscarriage, no control over their healthcare decisions or experience of abuse. Policy makers should pay extra attention to these high-risk groups when designing and delivering strategies to improve maternal healthcare utilisation.

Challenges Facing the Implementation of the New Secondary School Curriculum in Malawi

Abstract In its recent attempt to improve the quality of education in Malawi, the Malawian Ministry of Education, Science and Technology changed its secondary school curriculum; the new curriculum began to be implemented in 2017. So far, little is known about the challenges facing the implementation of this new secondary school curriculum. It is against this background of a knowledge gap that this study was undertaken: to investigate in depth the challenges facing the implementation of the new curriculum from the perspectives of school management, and ways of overcoming those challenges to improve the implementation. The study adopted the concerns-based adoption model. This model describes the process of change experienced by those at school level attempting to implement the new curriculum. The theory is concerned with the effect of the nature of the investment in people, time and resources as they pertain to the implementation of educational innovations. The study was conducted in four secondary schools in Lilongwe district in Malawi. A qualitative research method was used, employing a case study design. The participants were four head teachers, four deputy head teachers and 12 heads of department from the sample schools. Data were collected through interviews, document review and classroom observation of heads of departments’ lessons in order to provide methodological triangulation. Data were analysed using the inductive thematic content analysis method. The results of the study indicate that the implementation of the new secondary school curriculum faces multiple challenges, the main ones being ineffective orientation training for curriculum implementers; inadequate numbers of qualified teachers, especially in science subjects; insufficient teaching and learning materials; too few and inadequately equipped science laboratories; and discrepancy in the administration of continuous assessment. Based on the findings, recommendations are made for better implementation of the curriculum.

The Impact of Physics Education Technology (PhET) Interactive Simulation-Based Learning on Motivation and Academic Achievement Among Malawian Physics Students.

The online version contains supplementary material available at 10.1007/s10956-022-10010-3.

Experiences from Cyclone Anna and Cyclone Dumako: A short report

In the third week of January 2022, the southern districts of Malawi were hit by Cyclone Ana. The worst affected areas were Chikwawa and Nsanje. Four weeks following Cyclone Ana, a rather smaller cyclone, Dumako, hit the same areas, causing more damage. The Partners in Health or Abwenzi Pa Za Umoyo, an international humanitarian nongovernmental organisation that provides primary health care (PHC), organised teams to join Chikwawa District Council - Health, providing PHC assistance in the most affected district (Chikwawa); these teams were joined by three senior residents in family medicine from Kamuzu University of Health Sciences.Contribution: From the experiences of the interventions reported here, it was learnt that a multidisciplinary team of PHC providers is the key to the success of the emergency PHC programmes in times of natural disasters. While immediate PHC may be important at the actual time of disaster, it was learnt that PHC is also very important for continuation of care for chronic conditions, antenatal clinics and other clinics that are interrupted by the disaster. The experiences emphasised the importance of involving the PHC physicians and other PHC cadres in planning PHC programmes in natural disaster-prone areas.

Spatial analysis of aquatic food access can inform nutrition-sensitive policy

Aquatic foods are critical for food and nutrition security in Malawi, but it is unclear which populations benefit from different aquatic foods and what factors shape food access. Spatial analysis of food flows across value chains from Lake Malawi to domestic consumers shows that usipa (Engraulicypris sardella) reaches more consumers than chambo (Oreochromis karongae) across all Malawi districts, particularly rural populations. Higher number of markets, nutrient content, and overall supply coupled with lower retail prices and volumes make usipa more accessible to consumers than chambo. Spatial analysis of food flows can guide policymakers towards supporting fisheries that reach vulnerable populations and designing interventions that enhance physical and economic access to fish.