Thyolo District Research Articles

Prevalence and Associated Factors of Psychological Distress among Diabetic Patients at Thyolo District Hospital in Malawi: Hospital-Based Cross-Section Study [Response to Letter

Prevalence and Associated Factors of Psychological Distress among Diabetic Patients at Thyolo District Hospital in Malawi: Hospital-Based Cross-Section Study [Response to Letter

Prevalence and Associated Factors of Psychological Distress Among Diabetic Patients at Thyolo District Hospital in Malawi: A Hospital-Based Cross-Sectional Study [Letter

Prevalence and Associated Factors of Psychological Distress Among Diabetic Patients at Thyolo District Hospital in Malawi: A Hospital-Based Cross-Sectional Study [Letter

Prevalence and Associated Factors of Psychological Distress Among Diabetic Patients at Thyolo District Hospital in Malawi: A Hospital-Based Cross-Sectional Study.

Emotional distress experienced by individuals with diabetes represents a type of psychological strain specific to the challenges posed by diabetes. It mirrors the emotional reactions arising from coping with the demands of the illness and the essential care associated with diabetes. The study aimed to determine the prevalence and associated factors of psychological distress among diabetic patients at Thyolo District Hospital in Malawi. To determine the prevalence and associated factors of psychological distress among diabetic patients at Thyolo District Hospital in Malawi. The cross-sectional study involved 171 participants chosen using a simple random sampling technique at Thyolo District Hospital. The study was conducted from June 28 to July 27, 2023. The data were inputted into SPSS version 23.0, and descriptive statistics were employed for analysis. Cross-tabulation, utilizing Pearson chi-square, and correlation analysis were performed. The statistical significance level was established at P <0.05. Out of the 171 participants included in the study, 44 (25.7%) reported experiencing diabetic distress. According to levels of psychological distress, the study reports that 27 (15.8%) had mild depression, while 5 (2.9%) presented with moderate depression and 1 (0.6%) had extremely severe depression. As regards to levels of anxiety, 14 (8.2%) had mild anxiety, while 5 (2.9%) had moderate anxiety. In terms of stress levels, only one participant (0.6%) reported mild stress, and an equal proportion reported moderate stress. Additionally, age was identified as a significant factor associated with psychological distress, with a p-value of 0.001. Approximately 33% of the diabetic patients involved in this study revealed psychological distress, and this condition showed a statistically significant association with age. Conducting routine assessments and implementing early control measures for the associated factors are crucial in mitigating both the prevalence and the impact of psychological distress among diabetic patients.

Risks, Opportunities and Challenges of E-payment System: The Social Cash Transfer Program in Thyolo District.

Risks, Opportunities and Challenges of E-payment System: The Social Cash Transfer Program in Thyolo District.

Testing a counseling message for increasing uptake of self-injectable contraception in southern Malawi: A mixed-methods, clustered randomized controlled study.

ObjectiveWhile self-injection of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) has well-documented benefits, uptake may be improved by addressing client concerns such as fear of self-injury and low self-efficacy. However, current training materials for family planning providers do not address these concerns. We used an iterative process with family planning providers and clients, male community leaders and partners, and stakeholders in Malawi to develop a counseling message addressing user-centered concerns about self-injection. We report on our testing of the effectiveness of this evidence-based message for increasing self-injection uptake in the context of full method choice.MethodsWe randomized 60 public facilities across two districts in southern Malawi to orient their providers to the message (treatment) or not (control). After strengthening data quality, we extracted routine service delivery data from the facilities six months before and after introducing the message. We compared pre- and post-orientation trends for the treatment and control groups using generalized linear mixed models. We conducted eight focus group discussions with a sample of providers oriented to the message.ResultsThe message was feasible to implement and highly acceptable to providers. During June 2020–June 2021, 16,593 new clients used injectables in Mangochi district (52% DMPA-SC; 15% self-injected). In Thyolo district, 7,761 new clients used injectables during July 2020–July 2021 (29% DMPA-SC; 14% self-injected). We observed high variability in number of clients and self-injection uptake across facilities and over time, indicating inconsistent offering of self-injection. In both districts, we found significant increases in self-injection in treatment facilities after message introduction. However, this increase was not sustained, especially when DMPA-SC was unavailable or about to expire.ConclusionBased on the study findings, we recommend the evidence-based message be used in programs offering DMPA-SC self-injection services. However, effective use of the message is contingent upon a consistent supply of DMPA-SC.

Factors associated with self-rated health in primary care in the South-Western health zone of Malawi

BackgroundSelf-rated health (SRH) is a single-item measure of current health, which is often used in community surveys and has been associated with various objective health outcomes. The prevalence and factors associated with SRH in Sub-Saharan Africa remain largely unknown. This study sought to investigate: (1) the prevalence of poor SRH, (2) possible associations between SRH, and socio-demographic and clinical parameters, and (3) associations between SRH and the patients’ assessment of the quality of primary care.MethodsA cross-sectional study was conducted in 12 primary care facilities in Blantyre, Neno, and Thyolo districts of Malawi among 962 participants who sought care in these facilities. An interviewer-administered questionnaire containing the Malawian primary care assessment tool, and questions on socio-demographic characteristics and self-rated health was used for data collection. Descriptive statistics were used to determine the distribution of variables of interest and binary logistic regression was used to determine factors associated with poor SRH.ResultsPoor SRH was associated with female sex, increasing age, decreasing education, frequent health care attendance, and with reported disability. Patients content with the service provided and who reported higher scores of relational continuity from their health care providers reported better SRH as compared with others.ConclusionThis study reports findings from a context where SRH is scarcely examined. The prevalence of poor SRH in Malawi is in line with findings from clinical populations in other countries. The associations between poor SRH and socio-demographic factors are also known from other populations. SRH might be improved by emphasizing continuity of care in primary care services.

Measuring the impact of a training intervention for early childhood centre staff on child development outcomes: Findings from a cluster randomized control field trial in rural Malawi.

BackgroundEvidence from low‐income settings around early education interventions that can improve young children's development is sparse, particularly with regard to the most marginalized children. This study used a two‐arm parallel cluster randomized control design to evaluate the impact of an adapted staff training programme on the developmental outcomes of children attending community‐based early learning centres in Thyolo district, rural Malawi.MethodsAt baseline we randomly selected 48 centres, from each of which 20 children were randomly selected, although data from one centre was incomplete resulting in 932 children from 47 centres. Centres were randomly allocated to either the intervention or control arm. Twelve months later, follow‐up data were collected from 44 centres. At baseline and endline, community‐based childcare centre (CBCC) managers provided information about the centre, and parents/guardians provided information on the children, including the primary outcomes of age‐standardized development scores in the language and social domains, measured using the Malawi Developmental Assessment Tool. Children in the bottom 2.5 percentile of either domain were considered to have a delay; a third outcome variable, Any Delay, was developed to indicate children with a delay in either or both domains. Centre‐level mean scores were calculated, and linear regression models were constructed to assess differences between baseline and endline and between allocation groups.ResultsAnalysis of the difference between baseline and endline measures in the allocation groups shows a non‐significant reduction in delay associated with the study intervention across all domains. Adjustment for baseline characteristics within the CBCCs showed little impact on the magnitude of the observed effect, and the difference remained non‐significant.ConclusionsDespite no observed differences between allocation groups, the data did indicate a positive change in the intervention groups in both domains, particularly language. Community‐based early learning in Malawi holds tremendous potential for promoting inclusive development and learning.

Socio-Economic Factors Contributing to Female Students’ Dropout in Community Technical Colleges in Thyolo and Phalombe Districts: A Case of Milonga and Naminjiwa Technical Colleges

Most students in community technical colleges dropout before completion of their training course, particularly female students, which is counterproductive with regard to women empowerment. This paper therefore, reports on a study that was conducted at Milonga and Naminjiwa community technical colleges in Thyolo and Phalombe districts respectively. Thus, the study sought to establish probable socio-economic factors that influence dropout of female students from the two colleges, with a view of finding solutions to the problem. The two colleges were earmarked for the study because of their proximity to tea estates where manpower is the main source of labour for the tea industry. In addition, people in the two districts have similar cultural beliefs and economic status. Population of the study covered both female and male students including principals and instructors of the two technical colleges. In addition, identified parents of female students who dropped out of school were also part of the study. Thus, the study was conducted through qualitative research method so as to have an in-depth understanding of people views. Data was collected with reference to objectives of the study and then thematically analyzed. The study revealed several socio-economic factors that contribute to dropout of female students from the two colleges such as: cost of training and poverty, domestic chores and parents’ characteristics, cultural factors, early marriages and gender difference including training environment. However, the relationship among students and instructors showed that it had no effect on dropout as it was cordial and amicable. Recommendations to policy makers and other stakeholders were proposed as follows: Government and Ministry of Labour Skills and Innovation should have a national policy to provide bursaries and loans to needy students. The government should construct hostels at the two colleges to have conducive training environment. Ministry of Labour Skills and Innovation should organize awareness campaign programmes to sensitize the community surrounding the two colleges on the importance of TVET. Ministry of Labour Skills and Innovation should recruit more female instructors to act as role models to other female students.

Prevalence and Socio-Demographic Determinants of Unintended Pregnancy among Women Attending Antenatal Clinic in Thyolo District, Malawi

Background: Unintended pregnancies remain a public health problem. Unintended pregnancies continue to be a leading predisposing factor to the high total fertility rate, high maternal and child health morbidity and mortality. Unintended pregnancies lead to unsafe abortion and poor health-seeking behavior, especially among young and poor women. Knowledge of associated factors can help to design and implement appropriate interventions. Objectives: This study aimed to determine the prevalence and socio-demographic factors associated with unintended pregnancy among women attending antenatal clinic (ANC) at Thyolo District Hospital in Malawi. Methodology: It was a quantitative cross-sectional study. Data was collected through face-to-face interviews with 396 women using a questionnaire. Systematic random sampling was used to recruit study participants. STATA version 13 package was used for univariate descriptive statistics, and logistic regression for bivariate and multivariate data analysis. Results: Slightly over half (54%) of women attending the antenatal clinic at Thyolo District Hospital had an unintended pregnancy. Unintended pregnancy was more likely to be reported among women of less than 20 years, education below secondary school level, marriage before 20 years, and polygamous relationships. In addition, families relying on farming alone other than employment or business were more likely to have an unintended pregnancy. Primgravidity and having no living child were also significantly associated with unintended pregnancy. Conclusion: Prevalence of unintended pregnancy is a health burden in Thyolo. Strategies to keep the girl child in school and delay marriage could address this challenge. Increasing access to effective contraceptive methods for the youth could mitigate the problem.

Phenotypic characterisation of Listeria monocytogenes in cow milk from three catchment areas of Goliati Area in Thyolo District, Malawi

Background: Listeria monocytogenes is one of the food borne pathogens that cause an illness known as Listeriosis upon ingestion of contaminated food. Outbreaks of Listeriosis have been reported in Canada, USA, Europe, South Africa, Ghana and other countries but there is limited data on outbreaks due to Listeria monocytogenes and its isolation from contaminated foods in Malawi. This prompted our interest to determine the presence of Listeria monocytogenes in cow milk from Goliati area, Thyolo district in Malawi. Objectives: To determine the presence and concentration of Listeria monocytogenes in cow milk from daily farmers around Goliati area in Thyolo district in Malawi. Methodology: Nine raw milk samples from three bulk centers and two processed milk samples were cultured on both Nutrient Agar and Brain Heart Infusion agar as primary cultures. A pure culture of Listeria monocytogenes was obtained by sub culturing the primary culture on Brain Heart Infusion agar media. Colonies from the pure culture were further identified using Gram staining, Catalase test, Motility test and Beta hemolysis test on blood agar to phenotypically identify Listeria monocytogenes. Results: There was a 100% growth rate of colonies suggestive of Listeria monocytogenes on all the nine samples. These colonies were observed to contain Gram positive, purple, short, rod shaped bacteria which was motile and catalase positive and it caused complete beta hemolysis on blood agar. Conclusion: In this study, isolates of Listeria monocytogenes were phenotypically identified in cow milk that is produce from Goliath Area in Thyolo district. This is a major public health concern for milk farmers and consumers in the area and beyond. The findings from this work calls for improved hygienic practices in the handling of milk and milk products to reduce contamination.

Health-related quality of life of inpatients and outpatients with TB in rural Malawi.

INTRODUCTION: Patients being treated for TB may suffer reductions in health-related quality of life (HRQoL). This study aims to assess the extent of such reductions and the trajectory of HRQoL over the course of treatment in rural Malawi.METHODS: We collected patient demographic and socioeconomic status, TB-related characteristics, and HRQoL data (i.e., EQ-5D and a visual analogue scale VAS) from adults (age ≥18 years) being treated for TB in 12 primary health centers and one hospital in rural Thyolo District, Malawi, from 2014 to 2016. Associations between HRQoL and patient characteristics were estimated using multivariable linear regression.RESULTS: Inpatients (n = 197) consistently showed lower median HRQoL scores and suffered more severe health impairments during hospitalization than outpatients (n = 156) (EQ5D and VAS: 0.79, 55 vs. 0.84, 70). Longer treatment duration was associated with higher HRQoL among outpatients (EQ5D: 0.034 increase per 2 months, 95%CI 0.012-0.057). We found no substantial associations between patients´ demographic and socioeconomic characteristics and HRQoL in this setting.CONCLUSION: HRQoL scores among patients receiving treatment for TB in rural Malawi differ by clinical setting and duration of treatment, with greater impairment among inpatients and those early in their treatment course.

P8 Successful Reintroduction of Landrace Orange Maize in Rural Malawi is not Dependent on Understanding Nutritional Advantages

<h3>Background</h3> Orange maize, rich in carotenoids, is a possible sustainable solution for combating Vitamin A deficiency and reducing dependence on fortification. The ProFarmer project in Malawi has successfully re-introduced landrace orange maize (MW5021) to replace or complement white hybrid varieties in over 2000 farms. <h3>Objectives</h3> This study was designed to determine the acceptability of foods made with orange maize in children and to assess the knowledge, attitudes and behaviors (KAB) of women in farming families that currently grow orange maize. <h3>Study Design, Setting, Participants</h3> Organoleptic evaluation of white and orange maize food products was carried out in school age children (n=160) of ProFarmer families living in the Dedza and Thyolo Districts. Additionally, a cross sectional study was completed in female household members (n=336) living on farms that produce orange maize. Participants were interviewed regarding reintroduction of orange maize and diet quality was assessed. <h3>Measurable Outcome/Analysis</h3> Acceptability of orange maize food products was determined using a 7-point hedonic scale. Women's responses to questionnaires were used to determine nutritional knowledge regarding orange maize. A Minimum Dietary Diversity questionnaire (MDD-W) evaluated diet adequacy. Independent t tests and Chi square tests were performed where appropriate. <h3>Results</h3> Organoleptic testing of orange maize porridges by children indicated high levels of acceptance. Survey results showed positive attitudes towards the orange maize with 75-85% of households consuming the product. However, only 32% of the women understood its nutritional benefits. Dietary Diversity scores, a proxy for nutrient adequacy, were low with only 34% of women consuming a sufficiently diverse diet. <h3>Conclusions</h3> Despite low levels of nutritional knowledge, landrace orange maize is well accepted by both children and adults in rural Malawi and is an option for increasing dietary sources of provitamin A. Nutrition education emphasizing the advantages of eating carotenoid-rich foods and expanding diet diversity are recommended.

Sustainability of the Effectiveness of Complementary Feeding and Learning Session in Improving Nutrition Status and Feeding Practices of Children in Malawi-RCT

Abstract Objectives To estimate the proportion of children aged 6 to 9 months who met the minimum dietary diversity and minimum meal frequency between children in CCFLS group versus children in GMP and compare their anthropometric indices 6 months post-intervention in Thyolo district. Methods Children age 6 to 9 months from Thyolo district, Nchiramwera area were individually randomised into intervention or control arm of the study. Caregivers of children in the intervention arm received CCFLS sessions while those in control arm attended standard growth monitoring promotion sessions (GMP) at their nearest facility. Data on feeding practices were collected at baseline and after six months. Furthermore, data on anthropometric indices were collected monthly for six months. CCFLS vs control group comparisons of baseline-end-line change in proportions of achieving minimum dietary diversity (MDD) and frequency (MDF) were done. Additionally, both bivariate and multivariate logistic regression analyses were done to determine the effect of CCFLS on improving MDD and MDF at six months follow up. Student's t-test was used to compare the mean six months change in anthropometric indices in the CCFLS group to the control group. Results A cohort of 168 children were randomised; 84 in the CCFLS arm and 84 in the GMP arm. There was strong evidence of an association between receiving the CCFLS intervention and achieving MDD. Adjusting for the baseline MMD proportion the children that had CCFLS had a nearly 12 times higher odds of achieving MDD compared to controls, AOR (95% C.I.) 12.43 (5.39 –28.67 p value &amp;lt; 0.001). After 6 months follow up, the mean (95% C.I.) change in weight in the CCFLS group was + 1.45 kg (1.30–1.59) and + 1.22 kg (1.02 –1.42) in the GMP group and this was statistically significantly different (p-value 0.04 t-test). Analysis showed there was no association between receiving CCFLS intervention and achieving a change in MMF and MUAC. Conclusions Impact of CCFLS in improving MDD and weight gain is sustained post intervention, at least in the short term of 6 months follow up. Funding Sources Malawi Government; Ministry of Education Science and Technology.

Improving Maize Productivity under Rain-Fed Conditions through the Combined Use of Inorganic and Organic Fertilizer in Malawi

Integrated soil fertility management was promoted on-farm during the 2018/2019 cropping season in Thyolo, Phalombe, Mulanje and Zomba districts of southern Malawi, in purposively selected extension planning areas (EPAs). Sixty farmers, fifteen from each district were involved. Trials were established in farmers’ fields with smallholder farms as replicates and extension EPAs as blocks. The following were the treatments; Maize + 92 kg N ha-1 + 46 kg of P ha-1; Maize + 3 tons of compost manure ha-1; and Maize + 46 kg N ha-1 + 23 kg P ha-1 + 1.5 tons of compost manure. Grain yield data were collected at harvest. The data were analyzed in Genstat Discovery Edition 4 and were subjected to ANOVA at 95% level of confidence. Means were separated by the least significant difference (LSD0.05). No significant differences (&gt;0.05) in Maize grain yields were observed between the treatment with Maize + 46 kg N ha-1 + 23 kg P ha-1 + 1.5 tons of compost manure and the treatment with Maize + 92 kg N ha-1 + 46 kg of P ha-1 in all the districts. Maize grain yields were significantly lower in plots treated with the full rate of manure (3 tons of compost manure ha-1) in Thyolo, Mulanje and Zomba district. Higher maize grain yields were registered in Phalombe (3,867-4,838 kg ha-1), followed by Thyolo (1,764-2,374 kg ha-1) and Zomba (740-1,120 kg ha-1). The trials confirmed that applying a combination of organic and inorganic fertilizer to maize, increase grain yields.

“All we need is Food…” Rural Politics and Peasant Struggles Amidst Unresolved Land Question in Southern Malawi

Peasants in Thyolo and Mulanje [1] districts in Malawi have been at constant loggerheads with estate owners over the issue of land usage. With dwindling land-holdings among peasants chiefly due to high population growth and highly skewed land ownership (and usage) towards the tea estate owners, scores of peasants have managed to occupy idle tea estate lands to reproduce themselves. Livelihoods have relatively changed to this group of peasants, for the better. This study was done to understand the political processes surrounding access to tea plantation land and everyday peasant resistance initiatives. Using qualitative research design, results showed that a portion of peasants has managed to occupy idle estate land for over a decade now while majority still swim in land poverty. The number of new land occupants continues increasing with increased pressure from poverty. The peasants ‘sugar-coat’ their occupation by occupying only idle estate land, and forming local-level mechanisms to deter other peasants from vandalizing estate crops. The occupied lands have bred ‘village-rich’ group of people who have acquired much wealth (at village level) from the land while others barely survive. With widespread insecurity of tenure in the occupied lands, the study recommends formal restitution of idle land to locals as a poverty reduction initiative. DOI: 10.7176/DCS/10-5-05 Publication date: May 31 st 2020 [1] Thyolo and Mulanje are the two tea-growing districts in southern Malawi. Huge thatches of land are used to grow the same. The estates are largely foreign owned. In the article, Thyolo and Mulanje districts; and Southern Malawi will be used interchangeably.

Estimated prevalence of disability and developmental delay among preschool children in rural Malawi: Findings from "Tikule Limodzi," a cross-sectional survey.

BackgroundEarly childhood development (ECD) is a critical stage in children's lives, influencing future development and social integration. ECD research among children with disability and developmental delay in low‐ and middle‐income countries is limited but crucial to inform planning and delivery of inclusive services. This study is the first to measure and compare the prevalence of disability and developmental delay among children attending preschool centres in rural Malawi.MethodsA cross‐sectional survey was conducted in 48 preschool centres in Thyolo district, Malawi. Data were collected from parents or guardians of 20 children per centre. Disability was ascertained using the Washington Group/UNICEF Child Functioning Module. Child development was measured using the language and social domains of the Malawi Development Assessment Tool.ResultsA total of 960 children were enrolled; 935 (97.4%) children were assessed for disability and 933 (97.2%) for developmental delay; 100 (10.7%) children were identified as having a disability. The prevalence of disability was higher among children 5+ years (n = 60; 29.3%) than children 2–4 years (n = 40; 5.5%); 109 of 933 (11.7%) children were classified as having developmental delay, 41 (4.4%) in “language” and 77 (8·3%) in “social” domains.ConclusionsThis study found that disability and developmental delays are common among preschool children in Malawi. It is one of the first to measure disability and delay among children in a preschool setting in Africa.

An Intervention to Improve Uptake of Referrals for Children with Ear Disease or Hearing Loss in Thyolo District, Malawi: Acceptability and Feasibility

(1) Introduction: Poor uptake of referral for ear and hearing services in Malawi has been demonstrated in previous research. A multi-component educational intervention was developed to address poor uptake. The aim of this study was to explore the feasibility and acceptability of the intervention. In addition, we aimed to provide a case study of an intervention development and feasibility testing process in preparation for a potential randomised trial. (2) Methods: The intervention included three components: (i) an information booklet; (ii) personalised counselling by a community health worker and an expert mother; (iii) a text message reminder. To assess feasibility, the counselling and information booklet were provided for caregivers of eligible children (<18 years) at ear and hearing outreach camps in Thyolo. Text message reminders were sent to caregivers after the camps. After 4 weeks, all caregivers were revisited and completed a structured questionnaire and a subset were interviewed in-depth. (3) Results: 30 children were recruited, and 53% took up the referral. Interviews found counselling with a booklet was acceptable. It provided motivation, enabled a two-way conversation, and helped dispel fear. It allowed information to be shared with social networks, initiating conversations about raising funds. The text message reminder was reported to be a valued prompt. Challenges to feasibility included low network coverage, and time needed for counselling. Residual barriers included the costs of transportation. The cost was £3.70/camp. (4) Conclusions: The study found that counselling with an information booklet was feasible and acceptable. The process of testing the feasibility of the intervention identified some adaptations to the intervention components and delivery which could be implemented before it is tested in a trial. This study highlighted the value of the feasibility testing process.

Performance of primary care in different healthcare facilities: a cross-sectional study of patients’ experiences in Southern Malawi

ObjectiveIn most African countries, primary care is delivered through a district health system. Many factors, including staffing levels, staff experience, availability of equipment and facility management, affect the quality of...

Effectiveness of grain storage facilities and protectants in controlling stored-maize insect pests in a climate-risk prone area of Shire Valley, Southern Malawi

Shire Valley is one of Malawi's most vulnerable areas to climate change (CC). In addition to other impacts, CC is expected to affect storage insect pest status, and the efficacy of grain storage facilities and protectants. On-farm grain storage trials were therefore conducted in Shire Valley to assess the performance of storage facilities and grain protectants against storage insect pests. Eight smallholder farmers hosted the trials in Thyolo and Chikwawa districts. Seven grain storage treatments were evaluated for 32 weeks during two storage seasons: Neem leaf powder (NM), Actellic Super dust (ASD), ZeroFly® bag (ZFB), Purdue Improved Crop Storage bag (PICS), Super Grain Bag (SGB), hermetic metal silo (MS) and untreated grain in a polypropylene bag (PP). Insect pest populations and grain damage increased with storage duration and differed significantly between treatments (p < 0.05). Grain stored in hermetic bags (PICS, SGB) sustained significantly lower (p < 0.05) insect damage and weight loss compared to other treatments across sites and seasons. The hermetic bags also outperformed the other treatments in suppressing insect numbers. However, germination rates of undamaged grains stored in the hermetic storage facilities (MS, PICS, SGB) for 40 weeks were extremely low (<15%) compared to that of undamaged grains from NM treatment (53–58%) and the other treatments (>75%) at both sites. The hermetic MS, ZFB bags, ASD and NM treatments did not effectively protect grain from insect damage. High in-store mean temperature (35.6 °C) and high initial grain moisture content (13.7%) may have negatively affected efficacy of some treatments and seed germination. Tribolium castaneum survival in the MS requires further investigation. The hermetic storage bags (PICS, SGB) can be recommended for long-term maize grain storage (≥32 weeks) by smallholder farmers in Shire Valley and other similar climate change-prone areas in sub-Saharan Africa.

Measuring Social Norms Related to Child Marriage Among Adult Decision-Makers of Young Girls in Phalombe and Thyolo, Malawi

PurposeGiven the importance of developing appropriate measures for assessing social norm change, this article documents the process, results, and lessons learned from a baseline survey measuring social norms related to child marriage in Phalombe and Thyolo districts in Southern Malawi. MethodsA quantitative questionnaire was administered to a representative sample of all adults (age ≥18 years) who self-identified as a decision-maker for at least one girl between the ages of 10 and 17 years, for a total sample size of 1,492 respondents. Measures of empirical expectations, normative expectations, and sanctions related to child marriage were modeled after previously developed measures and social norm theory. ResultsUsing an established social norm diagnostic process, this study found that, despite Southern Malawi having the lowest median age of first marriage in the country, child marriage may not be a strong social norm in the intervention communities. Specifically, although 89.3% of respondents expressed the empirical expectation that “Most girls in this community marry before the age of 18,” agreement with the normative expectation that “Most people in this community expect girls to marry before the age of 18” was just 53.2% overall and fear of sanctions was just 36.4%. ConclusionsTaken together, the presence of prudential reasons for child marriage and the weak evidence of normative expectations and sanctions indicate that child marriage may not be a social norm in these communities although it may be indirectly perpetuated by other norms related to adolescent sexuality and access to contraception.