Welcome to Nkhokwe, KUHeS Libraries' online institutional repository
for learning resources and publications.
for learning resources and publications.
Select a community to browse its collections.
Now showing 1 - 9 of 9
Recent Submissions
Item
Open Access
Antibiotic medicine-related problems: pharmaceutical quality, availability, adherence to treatment guidelines and associated adverse drug reactions in Southern Malawi
(Kamuzu University of Health Sciences, 2024-11-16) Chiumia, Francis Kachidza
Globally, there are concerns of increasing incidence of antimicrobial resistance (AMR).
However, there is limited literature on antibiotic medicine-related problems that may
exacerbate the risk of AMR. The aim of this research was to assess the pharmaceutical
quality, availability and use of antibiotic medicines and the associated adverse drug
reactions in Southern Malawi. We tested the quality of 293 medicine samples from Zomba,
Machinga and Nsanje districts and retrospectively reviewed 304 patient files to evaluate
the clinical outcomes. Data on medicine availability was collected from stock cards. The
prevalence of substandard medicines among antibiotics was 25.4% and were associated
with local manufacturing and plastic primary packaging, p<0.01. Over six months, the
antibiotic stock outs were 12.5%, 64.3% and 85.7% for Zomba, Machinga and Nsanje
respectively. Adherence to treatment guidelines was lower for antibiotics that were stocked
out than those that were not stocked out, p< 0.002. About 75% of prescribed antibiotics
were from the watch class. The ADR prevalence was 24% of which 27% were serious events. The ADR occurrence was associated with age, polypharmacy and length of hospital
stay, p<0.005. Patients who received antibiotics with optimal content of the active
pharmaceutical ingredient (API) had higher rates of both ADR occurrence and patient
recovery as compared to the patients who received antibiotics with lower than the required
API content. However, the differences were not statistically significant. In summary, the
study revealed that high prevalence of SF antibiotic medicines, overuse of watch
antibiotics, poor adherence to standard treatment guidelines and occurrence of ADRs are
serious problems affecting antibiotic therapy. These problems need to be tackled as part of
antimicrobial stewardship and pharmacovigilance strategies in Malawi.
Item
Open Access
Psychological Consequences of Childbirth-Related Trauma Among Postpartum Mothers at Thyolo District Hospital, Malawi
(Kamuzu University of Health Sciences, 2024-11-10) Mwangala,Elizabeth Agness
Childbirth-related trauma occurs during labor and delivery, could cause psychological distress and increases the risk of post-traumatic stress disorder (PTSD). Etiological factors includes methods of birth. The prevalence is unrecognized in maternity
in Malawi. This study aimed to assess psychological consequences of childbirth-related
trauma and PTSD among postpartum mothers at Thyolo District Hospital.
A cross-sectional study of 250 randomly selected 6–12 weeks postpartum mothers. The
City Birth Trauma Scale (City BiTS) determined the prevalence of childbirth-related
trauma and PTSD. Data were analyzed using the IBM SPSS version 22. Pearson’s chisquare test, and binary logistic regression was used to examine factors associated with childbirth-related PTSD Prevalence of childbirth-related PTSD was 23.2% (95% CI 17.3% – 28.7%, n = 58).
Etiological factors:“vaginal birth” [OR = 3.70 (1.77–7.75), p ˂0.001]; “complications”
[OR = 8.12 (1.23–33.30), p = 0.02]; “virtually scathed” [OR = 7.18 (1.08–47.62), p == 0.04];
“excessively long labor” [OR = 12.84(2.84–57.99), p ˂0.001]; “feeling anxious” [OR =
5.24 (1.49–18.44), p = 0.01]; “feeling out of control” [OR = 8.83 (2.09–37.22), p = 0.003],
protective factor “ well communicated” [OR = 0.13 (0.03–0.52), p = 0.004].
This study confirmed the high prevalence of childbirth-related trauma and PTSD.
Excessively long labor was the strongest predictor of childbirth-related PTSD.
Item
Open Access
National Population Policy
(Malawi Government Ministry of Finance, 2023-06-01) Malawi Government Ministry of Finance
The revised National Population Policy (NPP) provides a guiding framework for managing population issues to improve the quality of life for all Malawians. A well-manageable population will enable the Government to provide adequate and quality social services and economic opportunities for Malawians so that they meaningfully contribute to national development.
Malawi has made some progress in demographic and socio-economic indicators since the last Population Policy was put in place. The average number of children a woman has during her lifetime – Total Fertility Rate – has declined from 5.7 in 2010 to 4.2 in 2018. Mortality has declined with life expectancy at birth increasing from 48 in 2008 to 62 in 2018 (males) and 51 in 2008 to 68 in 2018 (female). In addition, HIV prevalence rate reduced from 11.8 in 2004 to 8.8 in 2015-16. Malawi’s human development index improved from 0.431 in 2010 to 0.483 in 2019 representing a 12% increase. While there has been progress, the country still faces the challenge of rapid population growth whereby the population size increased at a fast pace and maternal death remain high. If the current trends continue, the situation will impact the country`s ability to achieve its development objectives.
Malawi’s Vision is to become an inclusively wealthy and self-reliant nation by 2063 with the medium-term goal of becoming a lower-middle-income economy by the year 2030. However, the prevailing rapid population growth will exacerbate poor living conditions forcing many to resort to unsustainable survival options that will have a detrimental effect on land, forests, and water resources, on which the nation thrives. The Policy, therefore, provides a guiding framework for programming and coordination of population programmes in Malawi. The Policy goals, objectives, and strategies presented are aligned to the national vision "Malawi 2063" and its first 10-year Implementation Plan (MIP-1). Specifically, the Policy is aligned to the Human Capital Development enabler that focuses on the size and quality of a population in relation to socio-economic development. A population characterized by a healthy, well-educated, and skilled workforce is critical in spurring economic growth. Government is committed to providing leadership and the necessary support for the effective implementation of the Policy. Furthermore, the implementation of the Policy requires multi-sectoral efforts. I, therefore, call upon all stakeholders and development partners to join Government in the implementation of the National Population Policy
Item
Open Access
National Male Engagement Strategy for Gender Equality, Gender Based Violence, HIV and Sexual Reproductive Health Rights: 2023-2030
(Malawi Government, 2023-07-01) Malawi Government Ministry of Gender, Community Development and Social Welfare
Meaningful engagement of men and boys is recognised as critical to the advancement of gender equality and equity. A number of creative strategies exist for engaging men and boys, and these include creating opportunities for men to examine and challenge gender socialisation; giving positive reinforcement to boys who support gender equality; and mobilising communities to counter harmful practices and norms. It has, however, been observed that changing norms is extremely challenging given the benefits that patriarchy bestows on men. Gender equality requires men to relinquish their unfair privileges, which is a complex and dynamic process. At an individual level, it can be difficult for men and women to transform beliefs
and practices that they have learnt from childhood. In addition, the desire
and ability of men and boys (and women) to change depends on their
broader contexts and the messages they receive from their environment
about gender norms and masculinity and femininity. The Ministry therefore
found it imperative to develop the strategy which looks at how best
men and boys can be engaged as clients, beneficiaries and agents of change in actively promoting gender equality, women’s empowerment and
the transformation of inequitable definitions of masculinity. The Government of Malawi, through the Ministry responsible for Gender, spearheaded the development of the first National Male Engagement Strategy to run from 2023 to 2028 through a wide consultative process, which involved other government ministries and departments, development partners, donors, civil society and NGOs. The strategy will guide all players in the gender sector on how males (boys and men) can complement and not compete with activities focusing on girls and women to achieving gender equity and equality. It is my sincere hope that the commitment that all stakeholders had shown in developing this strategy will continue during its implementation as we all strive to ensure that men and boys take an active role in preventing and responding to GBV, HIV treatment, care and support and SRHR.
Item
Open Access
Experiences of caregivers on healthcare and psychsocial services available for Celebral Palsy children in Mangochi District
(Kamuzu University of Health Sciences under the CHEER Project, 2023-06-01) Chiundira, Felistas; Masese, Ruth; Matenje, Anania; Kaonga, Mavuto; Chilemba, Winnie; Maleta, Maureen; Laher, Beverly; Manong'a, Chifundo
This was a cross sectional phenomenological qualitative study. Children with Cerebral Palsy (CP) require multidisciplinary and holistic care in order to comprehensively manage their medical needs as well as maximize their developmental and educational potential. 1. In addition, many children with Cerebral Palsy have complex limitations in self-care functions which renders them completely reliant on their caregivers. 2. The provision of such care may therefore be detrimental and stressful to both the physical health and the psychological well-being of parents of children with Cerebral Palsy3. Exploring experiences of caregivers on healthcare and psychosocial services available for children with Cerebral Palsy is key in addressing gaps existing in provision of quality health care and psychosocial services both at community and hospital settings. The study utilized qualitative research design which was cross sectional and phenomenological in nature. The study was conducted at Mangochi District Hospital and targeted caregivers of children with Cerebral Palsy. The duration of the study was 10 months; between December 2021 to September 2022. Convenient sampling was used with a sample size of 12 caregivers. Data collection was done using face to face in depth interviews with the aid of interview guide. Tape recorder was used and the information provided by the participants was transcribed. Data was presented in themes and subthemes.
Study findings: The findings of the study showed that majority of participants reported that their children received good physiotherapy services, health care workers were friendly and welcoming and they had short waiting time to receive the services. However, some of the participants received inadequate information related to etiology of CP, prognosis of CP, alternative treatments and on child care at home. There was also lack of follow up of CP children and lack of home visits by health care workers. Majority of participants received informal psychosocial support from their relatives and friends. However, majority of formal psychosocial services were lacking for example there was lack of counselling services, no visits by counsellors or social workers, unavailability of support groups and lack of assistive devices at home. Challenges which caregivers encountered were related to financial support resulting in their inability to meet basic needs for CP children and transport challenges to take their children to the hospital for monthly physiotherapy services. The study recommends that health care workers should be trained in order to provide evidence based CP information and psychosocial counselling services. CP children and their caregivers should also be followed up by community healthcare workers for support and continuity of services. There is need to engage non-governmental organization existing within Mangochi district to support caregivers in terms of basic needs and psychosocial support. All in all, there is need for multisectoral collaboration in order to manage CP children comprehensively. The study findings has been sent to COMREC, has been disseminated at RDC conference and will be disseminated at MOH conference and other upcoming national and international conferences, stakeholder and professional review meetings, seminars. Soft copies of research documents have been made available to Ministry of Health, Kamuzu University of Health Sciences and Mangochi DHO. The study findings will also be published in paediatric journals.