Community Health Nursing

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Open Access
Effects of flooding on mental health of victims in Mzuzu City, Malawi
(2018-06-01) Mwafulirwa, Glory Wezi Sopera
Floods caused by climate change have large social consequences for communities and individuals. The mental health effect of floods on victims in Malawi is not documented. A cross-sectional quantitative study was conducted in Mzuzu city to investigate the effect of the April 2016 flood on the victims. An interviewer administered structured questionnaire was used to interview conveniently sampled adults who were living in the affected areas. Data was analyzed by comparing mental health indicators before and after the floods, using Statistical Package for Social Sciences(SPSS). A total of 351 interviews were completed; 70.7% of the respondents were females. The proportion of participants who reported being happy, had injuries, were able to provide for their dependents, accessed health services and had a good appetite before and after the floods were found to be statistically significant as they decreased after the floods and had p<0.001. On average, signs and symptoms of mental illnesses such as depression and post-traumatic stress disorder (PTSD) were reported in 56% of respondents. 19.3% received no support like others who did in form of food, shelter and counseling. Of those that received support, 79.8% reported that the support received had no effect on their mental health. Hence 61.5% indicated they needed to be provided with housing; 37.3% indicated they needed loans; 1.14% indicated they needed counseling services, for their mental health to be at optimal level. Flood victims in Mzuzu city had mental health issues as they presented with symptoms of mental problems. Their mental health indicators such as mood, physical health and eating pattern diverted from the normal state. A comprehensive mental health assessment should be considered for flood victims and a policy incorporating comprehensive mental health services in managing disaster victims should be developed.
Open Access
Experiences of community home based care volunteers in HIV and AIDS care in Dowa district
(2016-05-01) Bilesi, Rosemary
Malawi like many countries in the Sub-Saharan Africa is burdened by chronic and terminal illnesses including AIDS. As more people live with HIV and AIDS, home based care which utilizes community home based care (CHBC) volunteers’ remains necessary. The study was carried out with the aim of exploring the experiences of CHBC volunteers in HIV and AIDS care in Dowa district. The nature of the study was exploratory and descriptive which used qualitative methods. Individual in-depth interviews were carried out with CHBC volunteers (n=15). Thematic analysis of the data was done which was guided by framework approach. Findings of the study showed humane factors as motivators to join CHBC work emerging more than personal factors. There was less patient workload whilst common roles were household chores and basic nursing care. Common sources of support were from within the community but lacked adequate technical support from healthcare workers. CHBC volunteers felt frustrated and helpless because of lacking resources like CHBC kits and transport. This resulted into walking long distances and making money contributions for buying drugs and hiring transport for their patients. The study recommended that District Health Offices (DHOs) should orient healthcare workers on CHBC and conduct integrated supervision for community based health programs including CHBC. Furthermore, CHBC volunteer trainings should continue to enable them handle emerging conditions. CBOs should reduce donor dependency and resort to owning sustainable income generating activities (IGAs) like commercial farming.
Open Access
Factors affecting blood pressure control in patients attending outpatient hypertension clinic at Mwanza District Hospital in Malawi
(2016-03-01) Masinga, Gertrude Tissie
The goal of treatment of hypertension is to normalize the blood pressure and to prevent cardiovascular and renal complication. Assessment of factors related to hypertension control is important in treatment of hypertension. The overall aim was to assess factors affecting blood pressure control in patients attending outpatient hypertension clinic at Mwanza District in Malawi. Specific objectives were to (i) determine socio-demographic factors (ii) assess hypertensive patients‟ knowledge related factors (iii) identify compliance with antihypertensive medications factors (iv) investigate lifestyle factors affecting blood pressure control in hypertensive patients in outpatient clinic at Mwanza District Hospital One hundred and twenty six hypertensive patients (82 female and 44 male) were interviewed through a structured questionnaire from the outpatient hypertension clinic at Mwanza District Hospital between April to August, 2014. Pearson‟s chi-square statistical technique was used to test the significance of the factors affecting blood pressure control. The results were presented in tables. Among 126 participants, 37.0% (n=47) of the participants had controlled blood pressure while 63.0% (n=79) did not control. The results of the chi-square showed that gender; age; occupation; salt intake and physical exercises were factors significantly associated with blood pressure control among the hypertensive patients. Blood pressure can be controlled by regular exercise, reducing occupational stress and salt intake. Community health nursing providers can use the findings in designing and developing appropriate information, education and communication patients and community about the effect of the disease will help to control blood pressure.
Open Access
Factors associated with antiretroviral therapy adherence among HIV infected men at Chilomoni Health Centre in Blantyre District
(2014-12-01) Lijoni, Lilian Mercy
Low adherence to anti retro viral therapy (ART) increases morbidity and mortality rates among AIDS patients and promotes the emergence of ART resistance. Little is known regarding factors associated with adherence to ART among HIV-infected men at Chilomoni Health Centre in Blantyre District where the research was done. The purpose of the study to explore factors associated with adherence among HIV-infected men receiving Anti retro viral Therapy at Chilomoni Health Centre in Blantyre District. A quantitative cross sectional study was conducted to explore factors associated with adherence among HIV-infected men receiving Anti retro viral Therapy at Chilomoni Health Centre in Blantyre District and permission was granted by relevant authorities to conduct the study. Between May 19 to July 07 2014, 237 HIV-infected men were systematically randomly sampled from all HIV-infected men attending ART clinic at Chilomoni Health Centre. They gave a written consent before joining the study. Two hundred thirty seven questionnaires were completed at the clinic before the respondents left for home and were personally collected by the researcher. Descriptive analysis was used to analyze the data. This study found that there are variations in respondents’ knowledge of HIV/AIDS and the importance of adhering to Anti retro viral therapy. Most of the HIV-infected men (83.3%) had positive perception about patient level factors affecting their adherence to ART, medication level factors helping them to adhere to ART and the clinic level factors making it possible for them to adhere to ART. The respondents perceived that they received adequate support for them to adhere to ART. However, all the respondents 100% were not adhering to ART. In conclusion, it has been observed that despite HIV-infected men having knowledge on HIV and AIDS and the importance of adhering to ART, perceiving positively to patient, medication and clinic level factors and receiving support from family, friends and health care workers they are still not adhering to ART.
Open Access
Factors that predispose nurses and midwives to biological occupational health hazards at Kamuzu Central Hospital in Malawi
(2018-06-19) Gangata, Owen
Nursing and midwifery personnel experience a higher rate of workplace hazards exposure than other health care workers because nurses perform more bedside procedures. Not much was known about the extent of exposure to biological health hazards among nurses and midwives and the preventive measures put in place to avoid or minimize this exposure in Malawi. The study aimed at investigating factors that predispose nurses and midwives to biological occupational health hazards. A quantitative approach was adopted using a descriptive cross-sectional design. A self- administered structured questionnaire was used to collect data from a random sample of 160 nurse midwives. Ethical approval was sought from the College of Medicine Research and Ethics Committee (COMREC) and permission to conduct the study was obtained from the Hospital Director of Kamuzu Central Hospital. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. The study was conducted from October 2016 to April 2017. The study has revealed that 93.42% of the respondents were exposed to biological occupational health hazards. The number one leading factor to predispose respondents to occupational hazards was inadequate personal protective equipment (98%, n = 158), followed by workload (97.5%, n = 156) and poor hand washing practices (93.75%, n = 150). The study findings imply that knowledge of infection prevention, good sanitation in the working environment, adequate workload and adherence to hand-washing practices have proven to be some of the significant preventive measures to biological hazard exposure. The study recommends provision of adequate personal protective equipment, frequent in-service trainings on occupational hazards to be conducted and ensuring adequate nurse – patient ratio.
Open Access
Investigating psychiatric patients' experiences on the use of seclusion at Zomba Mental Hospital
(2016-04-01) Phiri, Zenaida
Experiences of psychiatric patients nursed in seclusion have not been adequately explored in Malawi despite that such patients are exposed to painful and traumatic experiences. This study described the experiences of psychiatric patients nursed in seclusion at Zomba Mental Hospital in Malawi. The specific objectives of this study were; to describe the perceptions and experiences of psychiatric patients on the use of seclusion and to identify the needs and problems of psychiatric patients who are nursed in seclusion. Ethical approval was granted by College of Medicine Research and Ethics Committee. A descriptive qualitative research design was used. Purposive sample of 16 participants were involved in face to face in-depth interviews using an interview guide. All participants gave written consent before being interviewed. Data were analysed using thematic content analysis. Findings of this study revealed that the psychiatric patients who were nursed in seclusions had both positive and negative experiences. The positive experiences included seclusion’s ability to: control patients’ disruptive behaviors; offer protection to patients, others and property and promote rest and sleep to patients. However, patients reported the following negative experiences about seclusion: punishment, torture, being isolated, appalling conditions of seclusion rooms, violation of patients’ rights, lack of interaction and involvement in care, limited access to basic needs and inadequate nursing care. In conclusion, there is need to review the use of seclusion so that patients are provided with humane nursing care which can make patients enjoy therapeutic benefits of seclusion. Health workers must also ensure that conditions of seclusion rooms are conducive for patients’ recovery. This can be made possible by training health workers on effective use of seclusion so that they can competently care for psychiatric patients without infringing on patients’ rights.
Open Access
Knowledge and perceptions of adolescents and community leaders on youth friendly health services: a case of selected communities in Salima
(2016-04-01) Chilalire Kapalamula, Esther
The aim of the study was to establish the extent of knowledge on and the perception of adolescents and community leaders towards Youth Friendly Health Services (YFHS) in communities of Traditional Authorities (T/A) Maganga and Kambwiri in Salima District. This was a cross sectional quantitative study that involved 268 adolescents of which 129were females and 139were male, and 84 community leaders from randomly selected village heads. Data were collected by administering a structured questionnaire during face to face interviews with the participants. Statistical package for social Scientists (SPSS) version 16.0 was used to analyse data. The study revealed the following; (a) that knowledge of YFHS as a concept is high among adolescents as well as community leaders but they both had limited information on services that are provided at delivery points and where to access the services. (b) The higher %age of adolescents and community leaders 51% and 43% respectively had positive perception towards YFHS. On the other hand there was another %age (46%) of adolescents who had negative perception towards fellow adolescents who seek YFHS and view them as prostitutes or sexually active. (c) that factors such as consent from parents to allow adolescents access the service, unfriendly services, long waiting hours, denial of services, and services offered at the delivery point influence the uptake of YFHS. (d) that community leaders have a role to play in order to promote service access. The roles of community leaders in YFHS were found out to be promoting active participation in YFHS activities, encouraging adolescents to access the YFHS, urging parents to allow adolescents participate in YFHS activities and encouraging adolescents delay sex until maturity. Results also show that there is a need for community involvement and sensitization and involvement in YFHS activities in order for the program to be accepted by the community. On the other hand health workers in service trainings on YFHS can help in changing their attitude towards adolescents who access the services.
Open Access
Knowledge, attitude and practice of hypertensive clients about self-care home management at LCH (OPD II) medical clinic
(2004-10) Kamwedo-Muyakha Maria Isabella
A descriptive, quantitative and qualitative study was conducted at Kamuzu Central Hospital (OPD II) medical clinic. Experiences from the health workers at Kamuzu Central Hospital (KCH) had shown that the hypertensive clients lacked knowledge on the disease process hence clients do not know what actually happens in their bodies (Ozotiosauka, 2004). In this view, it was important to conduct a study whose purpose was to find out if hypertensive clients have got knowledge about how they can manage their condition at home. The study focused on knowledge, attitude, drug compliance and practice of hypertensive clients in the control of high blood pressure. Nursing literature in Malawi lacks information on the self-care home management for hypertensive clients. No such study has ever been conducted in Malawi. Orem's self-care model was used to guide the study with emphasis on self-care home management of hypertensive clients. Sample size of twenty clients was drawn from KCH Medical Clinic (OPD II) using a simple random sampling method. A pilot study was conducted at Likuni Hospital to ensure validity and reliability of the research instrument. Data was collected using an interview guide. Data was analysed manually using descriptive statistics and content analysis to describe qualitative data. Study findings revealed lack of adequate knowledge for hypertensive clients about the disease process and its cause, need for psychological support from health workers and also the usefulness of the medical clinic for the general public. Recommendations were made basing on the results, emphasizing the importance of the information, education and communication (IEC) to hypertensive clients and also establishment of other medical clinic services within the Central Region to cater for those clients living in other districts in order to promote health and maintain self-care management at home. In conclusion, we have seen that participants' lack of knowledge on the disease process was related to inadequate information, education and communication, low level of education and poor communication between clients and health workers.
Open Access
Lived experiences of older women of Traditional Authority Kachindamoto in Dedza: A psychosocial perspective
(2015-11-01) Mpeketula Matewere, Sekundina
Experiences of older women in Malawi have not been extensively explored despite evidence on abuse of older people and the growth of their population globally. This was a qualitative study which employed hermeneutic phenomenology to explore lived experiences of older women of Traditional Authority Kachindamoto in Dedza. Purposive sampling was done. The sample comprised of sixteen older women. Face to face in-depth interviews were conducted using a semi structured interview guide. Data analysis was done using Interpretive Phenomenological Analysis. Findings revealed multiple psychosocial challenges which older women experience as a result of elder abuse, HIV and AIDS, different forms of loss and finally being the uncertainty of obtaining support. A common psychosocial impact expressed was living a life of torture endured silently leading to low self-esteem. Despite these problems, some older women who were still living with their spouses expressed positive experiences. There is evidence that older women who still have their spouses are respected in society than those without. Additionally, the study has identified other coping mechanisms that facilitate positive living among older women without spouses. The implication is that the multifaceted and multidimensional nature of older person’s challenges calls for a renewed action that have to involve multi-disciplinary as well as multi-sectoral collaboration and coordination in offering services for older people.
Open Access
Mothers perceptions of one-week and six-weeks postnatal care at Mulanje Mission Hospital, Southern Malawi
(2017-01-01) Sisya, Joyce Chimwemwe
This study explored mothers’ perceptions of one-week and six weeks postnatal care. This information is important in planning better ways of increasing utilization at one-week and six weeks postnatal care services. Postnatal period is the critical phase in the lives of mothers and neonates. Postnatal care gives an opportunity to mothers to receive care, psychological support, as well as opportunity to promote health behaviors such as access to family planning, education on nutrition and PMTCT services. Lack of care at this time may results in death or disability. Studies have shown that despite free services offered by the Ministry of Health, and CHAM facilities, in Malawi statistics are still low on utilization of postnatal care with no significant improvement. This was a qualitative study that utilized in-depth interviews with mothers who had a normal delivery at Mulanje Mission Hospital, the southern region of Malawi and had come for reproductive health services including one-week and six weeks postnatal care. The key issues that emerged were, mothers’ understanding the need for one week and six weeks postnatal care services, barriers for not attending postnatal care services and mothers’ satisfaction on the postnatal care services. Purposive sampling was done to recruit participants. Twenty in-depth interviews were conducted, and data was analysed manually using thematic content analysis. Findings showed that majority of mothers came for one-week postnatal care but six weeks postnatal services were being underutilized despite mothers’ knowledge and positive attitude regarding both services. The main factor that hindered utilization of postnatal care services in this study was mothers’ feeling that they are well because there were no obstetric complications. Other factors were: physical distance, and rudeness of the health workers. Mothers preferred timely postnatal care services, polite health workers and a good reception. There is a need to provide a friendly environment for the mothers to help in promoting compliance. Frequent supportive supervision of the health workers at a health facility is necessary to resolve problems they experience that negatively impact on the provision of care. One week and six weeks postnatal care services should be given priority just like other services provided at the hospital.
Open Access
Pathways to care for clients with first episode psychotic disorders at Zomba Mental Hospital, Malawi
(2015-10-01) Nyirongo, Distress
The aim of this study was to describe the pathways to care taken by clients with first episode psychotic disorders at Zomba Mental Hospital. A quantitative descriptive study was conducted among clients with first episode psychotic disorders at Zomba Mental Hospital (ZMH) in Zomba District, Malawi. Consecutive sampling technique was used to recruit the participants and a total number of 266 clients were interviewed using a structured questionnaire. Data were analyzed using SPSS Version 16. Findings revealed that 58% of the participants first consulted general practitioners (GPs), 28% consulted traditional healers, 8% consulted religious healers, 4% went straight to ZMH and 2% were first in contact with police. However, 24% of the participants who consulted the general practitioners did not receive any treatment for their symptoms. The median duration before reaching ZMH was 42 weeks and clients who first consulted traditional healers had the longest delay. Gender, symptoms, diagnosis and proximity had a significant statistical association with first seeking help from health professionals. Conclusion was made that most clients with first episode psychotic disorders seek other pathways before going to ZMH, and that there is significant delay between the onset of symptoms and receipt of appropriate care. It is therefore recommended that mental health professionals should emphasize on mental health awareness campaigns in the communities and working collaboratively with all care providers involved.
Open Access
Primary school teachers' role in the promotion of mental health among school children in Zomba, Malawi
(2020-03-01) Yangairo, Isabella
The purpose of this study was to identify the role of primary school teachers’ in the promotion mental health among school children within Zomba district. A school is one of the settings where mental health of the children should be promoted through intervention of teachers as primary caretakers of the children at school. Good mental health among children increases their ability to live productive lives. The study followed a quantitative approach and it was a cross sectional study. The study was carried out in 32 primary schools in Zomba district. The study population included 300 primary school teachers (N=300) with more than six months’ work experience following stratified random sampling technique. Consent was sought from all study participants. Data was analyzed using Social Package for Statistical Science (SPSS) version 20.0. The study results have shown that primary school teachers have little knowledge on mental health promotion (35.4%, n = 106 strongly disagreed and 49.2%, n = 147disagreed with the true definition of mental health). Teachers reported that they promote mental health through good teacher – child relationship and encouraging child participation during physical activities (22.0%, n = 66), provision of positive feedback during classroom activities; 20.3% (n = 61), fostering anti-bullying behavioral activities 4.0% (n = 12); conducting other mental health activities; 1.3% (n = 4) while 30.3% (n = 91) did not respond to the question. Teachers are not aware of screening tools for mental health problems among school children and bullying is the most common factor within school environment that acts as a risk factor for mental health problems. Therefore, there is need for primary school teachers’ training on mental health promotion and screening tools for mental health problems among school children.
Open Access
Social factors associated with improper waste disposal at the central market in Lilongwe City
(2014-12-01) Banda, Modesta
Urbanization in the developing countries such as Malawi has brought about a serious environmental degradation due to a rapid and uncontrolled population growth. One of the consequences of such population increase is improper waste disposal as solid waste is enormously generated. Additionally, poor sanitation facilities, along with high population pressure and waste management systems, are becoming a threat to the health of the residents of the cities. Current solid waste management in many places has not met the required standard for proper waste collection and disposal creating excess waste that accumulate within the urban environment causing immense health and environmental hazards. The deterioration of sanitation in the urban environment has reinforced incorrect disposal habits as people do not understand their individual impact on such an environment. The overall aim of this study was to explore the social factors associated with improper waste disposal at the Central Market in Lilongwe City. The study used a descriptive cross-sectional design where quantitative method of data collection from the respondents was used at Lilongwe Central Market. The target population was vendors who have been doing business at the market within a period of 6 months prior to the study and buyers who have been shopping at the central market within that same period. Systematic random sampling was used to select 128 vendors and 127 buyers who met the inclusion criteria at Lilongwe Central Market. Data were collected using a structured questionnaire and the analysis of the quantitative data was done using SPSS 16.0. The major findings of this study on social factors associated with improper waste disposal were; use of un-recommended methods to dispose waste at the market because of lack of bins and responsibility by vendors and buyers towards waste management. However, results showed that 78% of the respondents were willing to participate on issues concerning waste management in order to reduce health and environmental problems. In conclusion, improper waste disposal can cause health and environmental problems to the general public if proper measures are not put into place. For example, making waste bins available at strategic places in the market. Therefore, waste should be managed at all times to prevent negative outcomes.
Open Access
Substance use among the youth at Chaminade Boys Secondary School in Karonga District, Malawi
(2018-04-01) Mzumara, Lizzie Margaret
The aim of this study was to describe the present situation of substance use the youth at Chaminade Boys Secondary School in Karonga district. Substance use among adolescents and the youth continues to be a major public health and socioeconomic problem worldwide. Substance use is harmful for the adolescents and it leads to decreased academic performance, increased risk of contracting Human Immunodeficiency Virus, other sexually transmitted infections and mental health related problems. A quantitative study was done utilising a cross sectional descriptive design. The study was conducted, guided by four specific objectives; to determine the extent of substance use among the youth, to investigate the commonly used substances among the youth, to investigate the factors that influence the youth to use substances and to determine the knowledge level of the youth on the consequences of substance use. The study took place at Chaminade Boys Secondary school. The target population were males 18 years and above in forms 1 to 4 at Chaminade Boys Secondary School in Karonga district, Malawi. The sample size was 144 respondents. Simple random sampling technique was used to select the study respondents. The self-reported semi- structured questionnaire was used as an instrument of data collection. Data was analysed using Statistical Package for Social Sciences (SPSS) software Version 20. The study results showed that the 52.8 % of the respondents were using substance and 47.2 % had never used substances. The most commonly used substances were cannabis sativa 69.4 % and alcohol 66.0 %. The results also showed that there was a strong positive association between reasons for substance use and religious affiliations. The association was found p=0.03 < 0.05. Substance use among the students was prevalent. Based on the above results the researcher suggests to initiate awareness and coordination program with nearest health facility. Hence, there is need for collaborative initiatives in developing intervention strategies that will reduce substance use among adolescents and the youth. Laws and policies that facilitate and reinforce parents and educators in controlling substance use among adolescents should be clearly be put in place and be implementable.
Open Access
Traditional Birth Attendants (TBAs) are not Allowed to Assist Childbirth but why are Women in Mzimba District Still Giving Birth with the Assistance of (TBAs)?
(2015-11-01) Mwase, Atisiya Clara
Policy change for Traditional Birth Attendants stipulates that TBAs should not conduct deliveries because they contribute to high maternal mortality. TBAs are supposed to encourage women to deliver at a health facility with the assistance of skilled birth attendants. The study aimed at investigating the reasons women in Mzimba District specifically at catchment areas of Mkoma and Manyamula Health Centres and Mzimba District Hospital still prefer giving birth with the assistance of TBAs. A descriptive and exploratory qualitative method was used in this study to explore reasons women were still giving births at TBAs. Purposive sampling was used to select 3 health facilities within Mzimba District where many women prefer to deliver with the assistance of TBAs. Purposive sampling was also used to select both women and male participants for the study. Nineteen women of childbearing age of between 18-49 years; and men participated in the study. Data was collected through in-depth face to face interviews and focus group discussions. Data was analyzed manually using thematic content analysis. Descriptive statistics was used to analyse the demographic data using Statistical Package for the Social Science (SPSS) version 16.0. The demographic data showed that the majority of the participants were 18-24 years old; all were Christians and married; had primary level of education and their main source of income was peasant farming; and on average the participants had given birth to 3 children. Three main themes emerged from the qualitative data: awareness on policy change for TBAs, women’s lack of decision making power, and barriers to deliver with skilled attendants. Based on the results, it is vii recommended that a multi-sectoral collaborative approach should be used to address the challenges.
Open Access
The use of maternity waiting homes at Chiradzulu District Hospital, Southern Malawi
(2016-04-01) Kadzuwa, Blessings Ridson
The concept of maternity waiting home (MWH) was introduced at Chiradzulu District Hospital in 2012, in an effort to improve maternal and neonatal health in Chiradzulu District through the promotion of skilled attendance at birth in the district. Since then, no study has been conducted to examine the use of MWH at the district hospital. This comparative study was designed to examine the use of MWH at Chiradzulu District Hospital, Southern Malawi by identifying the characteristics of pregnant women who use MWH; identifying factors that influenced use of MWH; describing types of services offered at MWH, and comparing pregnancy outcomes of women who used MWH with those who did not use MWH. A comparative cross sectional study was conducted at Chiradzulu District Hospital, postnatal ward. Using a proportionate stratified random sampling method, a total 266 postnatal mothers were enrolled. The study had two strata-one stratum comprised mothers who used MWH and the other stratum comprised mothers who did not use MWH, but came direct from home to deliver at the district hospital. Systematic random sampling method was used to select the 133 participants in each stratum. Data collection was done using a well structured questionnaire through face to face interviews and review of participant’s records. Data was analysed quantitatively using SPSS version 16.0. Chi-square test at 5% level of significance was used to determine associations as well as to compare pregnancy outcomes between mothers who used MWH and those who did not use MWH. There was no significant difference in demographic attributes between mothers who used MWH and those who did not use MWH (P≥0.050). However, significant difference was identified on the following obstetric risk factors: malaria in pregnancy (p=0.030), severe anaemia in pregnancy (p=0.014), and breech presentation (p=0.042) between mothers who used MWH and those who did not use MWH. Furthermore, the study shows that there was no significant association between the utilisation of MWH and the pregnancy outcomes (p≥0.050). The only significant difference was on babies with very low Apgar score of 0-3 at five minutes (p=0.035); only one baby born to mothers who used MWH had severe asphyxia (Apgar score of ≤ 3) compared to seven babies born to mothers who did not use MWH. Although the results showed that MWH utilisation at Chiradzulu District Hospital, Southern Malawi did not significantly improve maternal and neonatal health outcomes; babies born to mothers who used MWH were more likely to survive the neonatal period.
Open Access
Utilization of family planning methods among women on antiretroviral therapy in Dedza district, Malawi
(2015-11-01) Namijingo Kamwendo, Nancy
There is evidence indicating that HIV infection reduces fertility desires, but does not eliminate it. ART initiation can restore fertility in women, influencing increased fertility intentions. Meeting contraceptive needs of HIV positive women can help avoid unintended pregnancies, which would reduce maternal deaths. Literature has shown that despite being beneficial to mother and child health outcomes, utilization of family planning among clients on ART is low. This study explored current FP use, identified frequent used FP methods and underlying factors among women on ART in Dedza. This was a descriptive quantitative study. Data collection was through face-to-face interviews using a structured questionnaire. The sample consisted of 382 reproductive age women on ART, attending Dedza district hospital ART clinic. Computation of descriptive statistics determined frequencies and proportions. Chi-square test at 5% level of significance determined associations. About 55% (210) of the respondents were using family planning methods, and most of them used condoms, followed by an injectable hormone. Only 74 (48%) used the condom consistently and 103 (49%) used dual methods. Parity of the client was the significant predictor of family planning utilisation for women on ART, at Dedza district ART clinic. Generally, current use of contraceptives other than condoms was very low. These findings highlight the need for integration of family planning services and ART clinics in order to strengthen family planning services among women living with HIV on ART.

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