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- ItemOpen AccessAssessing family involvement in chronically ill children health care at Queen Elizabeth Central Hospital, Malawi(2018-01-01) Kamwendo, AniziaFamily involvement has been recognized as the standard of care in caring for children with chronic illnesses. Studies have suggested that family involvement in child’s care increases family understanding of the child’s illness, management and sharing in decision-making between the family and the health care providers. In Malawi, though family members stay with their hospitalized children, they only played a role of providing food and supportive care due to cultural expectations and due to lack of available nursing care. Studies had revealed family members' desires to be involved in both the physical care of their children and in decisions regarding their care. However, there was no information regarding the perception of health providers on family involvement. The aim of this study was to assess the perception of healthcare providers on the practice of family involvement in chronically ill children’s health care at Queen Elizabeth Central Hospital. A descriptive qualitative study was done using semi structured interview guide to collect data from 16 health care providers working with children with cancer conditions. Thematic analysis was done guided by Collaizi’s framework. Five main themes identified from the data were: perception of health care providers on family involvement in the care of children, health care providers’ practice of family involvement in children’s care, inadequate involvement of other family members, lack of care giving role negotiation, factors that facilitate involvement of caregivers in children’s health care and challenges encountered by health care providers to involve families in children’s health care. From the study findings, it was found that there was a discrepancy between the health providers’ perception and practice in regards to most of the areas of family involvement in child’s care. For the few areas that the caregivers were involved, the health care providers only interacted with the caregiver who was available in the hospital with the child, the other family members were not involved. Furthermore, results have shown that health care providers were not aware of their role of negotiating the caregiver role in caring for their children. Health care providers need to have the appropriate theoretical knowledge and practical skills to negotiate roles with the families.
- ItemOpen AccessAssessment of quality of care offered to HIV exposed children under 24 months and their mothers during follow up visit at Mzimba North Health Centre- Malawi(2017-01-01) Chimbatata, Chikondi SharonLiterature in the Sub Saharan Africa indicates that, delivery of quality care during follow up period for HIV exposed children is poor leading to high rates of loss to follow up. According to national statistics of 2015 in Malawi, only 16% of HIV exposed children were retained in care at 24 months. Little is known in Malawi regarding the delivery of quality care to HIV exposed children during follow up period. A descriptive quantitative cross sectional study which was guided by Donabedian (SPO) framework was conducted to investigate the quality of care offered to HIV exposed children during follow up period. A sample size of 250 mother - baby pairs attending follow up visit at Mzimba North Health Centre was recruited. Data were collected using a structured questionnaire which was developed based on study objectives. The objectives were to; assess the availability of physical infrastructure, human and material resources for the delivery of quality care (Structure); to assess if children were provided with care according to national guidelines (Process) and to determine mothers’ satisfaction with the care they were provided during follow up visit (Outcome). Results on Structure found infrastructural deficiencies which included inadequate equipment, clients’ waiting area and counsultation rooms and there were also no counselling rooms while on Process, there was a higher uptake on Nevirapine (97.2%) and cotrimoxazole administration (100%), infant Deoxyribonucleic Acid test (89.2%) and exclusive breast feeding (95.6%) however, counselling and growth monitoring were inadequate. Under Outcome, all mothers were satisfied with the care provided. Overall, there were critical service delivery gaps on Structure and Process. It is critical that more efforts are invested on the improvement of these gaps.
- ItemOpen AccessAssessment of stress in caregivers with children admitted in critical care units at Queen Elizabeth Central Hospital, Blantyre, Malawi(2020-09-01) Jere, JesterAdmission of a child to Critical Care Unit (CCU) is an unexpected and stressful event for the caregiver which may result in physical and mental exhaustion. If stress in caregivers goes unnoticed, they become emotionally traumatised and this affects their role in the parenting of a critically ill child. This was a descriptive cross-sectional study that utilised quantitative data collection and analysis approaches to describe stress experienced by caregivers of critically ill children admitted in CCU at Queen Elizabeth Central Hospital. Caregivers who had critically ill children admitted in various CCU in the paediatric department were recruited using convenience sampling technique. The researcher in person conducted interviews using a structured questionnaire to 385 caregivers who were 18 years of age and above. Data analysis was done with the aid of the Statistical Package for Social Science (SPSS) version 20. Descriptive and inferential statistics were used to present results of the study. Results of the study revealed that the average level of stress in caregivers was 3.41. Appearance of the child was the most stressful element in CCUs while healthcare workers’ conduct caused minimal stress to caregivers. Two components emerged from Principal component analysis (PCA) and these were stress related to child situation and stress related to healthcare workers. The findings also show that the level of stress in caregivers was significantly associated with the age of the caregiver and child and the nature of admission. Gender, residence, religion, education, ethnicity, prior admission, the gender of the child did not affect the level of stress. Healthcare workers require knowledge and skill in assessment of stressful situations in caregivers. Healthcare workers’ support will assist caregivers to cope while fulfilling important caregiver roles that are therapeutic to the critically ill child.
- ItemOpen AccessCaregivers’ perception regarding parental participation in care of hospitalised children at Queen Elizabeth Central Hospital, Malawi(2015-10-01) Phiri, LophinaParental participation is one of the cornerstones of pediatric practice. Evidence from literature has shown that effective parental participation depends on caregivers’ preparedness, adequate communication between caregivers and Health Care Workers (HCW) and the negotiation process. Queen Elizabeth Central Hospital (QECH) is the major referral hospital for the country and caregivers stay with their children in the hospital and participate in the care. However, little is known about the perception of these caregivers regarding their participation in the care of their hospitalised children. The study aimed to explore caregivers’ perception regarding parental participation in the care of their hospitalised children at QECH. A descriptive qualitative design using a semi-structured interview guide was used to collect data from 20 caregivers in the pediatric department and thematic analysis was done guided by the Colaizzi method. Seven main themes emerged from the data and these were lack of role negotiation by health care workers, inadequate role preparation for caregivers, care given by caregivers to their hospitalised children, poor HCWs- Caregivers communication, benefits of caregivers’ participation in the care of hospitalised children, needs of caregivers participating in the care of hospitalised children and overall impression of caregiver’s participation. The study findings showed that caregivers view their participation in hospitalised child care as appropriate, important and satisfying. However, gaps exist in the way caregivers participate in the care of their hospitalised children due to inadequate role negotiation, role preparation for caregivers and inadequate information for caregivers. Given this, it is recommended that management should develop protocols and guidelines for the implementation of parental participation in the care of hospitalised children to promote best practices.
- ItemOpen AccessDeterminants of paediatric health services utilization at Daeyang Luke Hospital, Lilongwe - Malawi(2016-11-01) Khombe, Ida ApatsaHealth service utilization is crucial for the survival of under-five children. Underutilization of health services is associated with increased number of deaths among under-five children. There was a decline in paediatric health services utilization by under-five children from Daeyang Luke Hospital (DLH) catchment area between the years 2011 and 2013. Therefore, this study was conducted to explore the determinants of utilization of paediatric health services at the hospital. Andersen model of health service utilization was used to guide the study. The study used a cross-sectional descriptive quantitative design for data collection and analysis. A semistructured questionnaire was used to interview parents or guardians of under-five children. The results showed that 97 % (n=146) of parents and guardians had knowledge about the services that are offered at DLH, 98 % (n=147) had good health seeking behaviours in times of sickness of their under-five children, 70 % (n=105) were living within a distance of five kilometers from DLH and 80 percent of the respondents reported good waiting time at the hospital. However, the study also revealed inconsistence in utilization of paediatric services at DLH. Logistic regression analysis yielded significant results in marital status, religion, waiting time, distance, service delivery, bills and distance. Service delivery had almost five times likelihood of influencing service utilization (odds ratio 4.6). Just over half (53%) of parents or guardians could not afford to pay for the cost of care. Therefore, the results warrant the need to subsidize the cost of care to under-five children living within Daeyang catchment area, in order to enhance health service utilization.
- ItemOpen AccessExperience of HIV positive mothers on delayed HIV testing of exposed infants at Mchinji District Hospital(2019-06-01) Mphatso, ChiyanjanoMany HIV-infected infants and children die from HIV/AIDS without HIV diagnosis or treatment. All HIV-exposed infants at the age of 4-6 weeks should receive a diagnostic test for DNA-PCR and early initiation of ART among those identified HIV infected. However, reports have indicated serious delays in HIV testing for HIV exposed infants. The aim of this study was to examine experiences of HIV positive mothers on delayed HIV diagnosis of exposed infants at Mchinji District Hospital. A descriptive qualitative design was used to conduct this study. Mchinji is among the districts in the central region of Malawi where HIV prevalence was estimated as high as 7.6 %. The site was selected because data from the facility had shown significant delay in HIV testing and diagnosis for exposed infants. The statistics for 2015/2016 extracted from the health information systems for Mchinji district hospital showed that only 47% of exposed infants were tested for DNA-PCR within six weeks of age. The study participants were women in the child bearing age (15-45 years) who were confirmed HIV positive and had an infant of more than six weeks of age who had not been tested for DNA-PCR or had been tested for DNA-PCR after six weeks of age. The participants were recruited from the study population using purposive sampling method. The sample size for the study was 15 and data saturation was the guiding principle in the sample size. Data were collected using a Chichewa translated interview guide for individual interviews. Data were recorded through audio-taping and field notes were taken. Data were analysed manually using thematic analysis. The findings of the study will facilitate early infant diagnosis of HIV as stipulated in the guidelines for policy implementation. The findings may also add knowledge to child health nursing practice and influence change and policy development in care of exposed infants. Ethical approval to conduct the study was obtained from the College of Medicine Research and Ethics Committee. Thereafter, permission to conduct the study was obtained from Mchinji District Hospital. The findings of the study showed that fear of stigma and discrimination, denial of one’s HIV status, home deliveries, laziness, and migration to and from neighboring countries affected early infant diagnosis of HIV. These findings are to be disseminated through meetings at Mchinji District Hospital which was the study setting. A written report is to be submitted to the study site, Kamuzu College of Nursing and College of Medicine Research and Ethics Committee.
- ItemOpen AccessExperiences of Blantyre urban primary school teachers in identifying and reporting child physical abuse(2020-08-01) Nyirenda Kayange, TauncioChild physical abuse is a serious public health problem because of its association with poor child health outcomes. Effective identification and reporting of child physical abuse is critical to break cycles of physical abuse and for developing a well-functioning child protection system. Teachers among other professionals are uniquely positioned to identify and report child abuse cases because of their daily contact with children. However, little is known about the experiences of teachers in identifying and reporting child abuse cases in their schools. This study explored the experiences of primary school teachers in identifying and reporting of child physical abuse cases in Blantyre urban. A descriptive qualitative study, with purposive sampling technique, was employed. The sample size was 10 key informants and 59 primary school teachers. In-depth interviews and focus group discussions were used to collect data with the aid of a semi structured interview schedule. Thematic data analysis using six steps of Braun and Clarke was employed to analyze data. The findings of the study revealed that teachers were aware of their responsibility to detect suspected child physical abuse and also to report the suspected cases but faced challenges such as lack of knowledge and skills, large classes, inadequate time and lack of clear guidelines for dealing with child physical abuse. It was also noted that some teachers were culprits of perpetrating child physical abuse and many had supportive attitudes towards the utilisation of corporal punishment as a means of child discipline. It was, therefore, suggested that there should be professional development for both primary school managers and teachers on handling child physical abuse cases and on alternative and effective strategies of disciplining students. With regards to safety concerns raised by the teachers and effective response to child physical abuse cases, the study further recommends a multiple disciplinary approach to the issue of child physical abuse with clear reporting lines and guidelines.
- ItemOpen AccessExperiences of caregivers of children receiving palliative care at Mzuzu Central Hospital, Malawi(2015-12-01) Chaputula, Bertha MwandidaThe number of children with life threatening and limiting illnesses requiring children palliative care is increasing each and every year. In response to the rising number of children requiring palliative care, family involvement in care giving has expanded. Caregivers play a major role in caring for children with life-limiting or threatening illnesses on palliative care at home as well as in hospital. However, for them to adequately provide the care, they require adequate support.This study reports on the caregivers’ experiences of caring for children receiving palliative care at Mzuzu Central Hospital Palliative Care Clinic. The study was aimed at exploring the caregivers’ experiences of caring for children receiving palliative care. A descriptive qualitative research method was used. The target group was caregivers of children with life threatening or limiting illnesses receiving palliative care at the clinic. A total of 30 caregivers were recruited for the study using purposive sampling technique. Qualitative data was collected using semi structured interview guide for in-depth interviews and a tape recorder while analysis was done using thematic analysis. Findings revealed that caregivers play a major role in caring for their children receiving palliative care. They provide assistance with activities of daily living and health care management in additional to their usual daily chores. The needs of the children receiving palliative care included transportation, finances, information, health care and daily needs. Family members and community members formed part of the caregivers’ support systems. Caregivers of children receiving palliative care reported facing financial, social, physical, and psychological and health service challenges. Proper assessment and availability of adequate support would positively influence the caregiver’s experiences of caregiving and the child’s quality of life. Hence, there is need to develop practical interventions that will lessen the caregivers’ challenges.
- ItemOpen AccessExperiences of caregivers of children with hydrocephalus at Queen Elizabeth Central Hospital(2018-04-01) Chidziwisano, CynthiaThe impairment of cortical connectivity involving the afferent and efferent pathways in hydrocephalus usually leads to cortical pathway dysfunction. Consequently, in most of the affected children the dysfunction is permanent causing both motor and cognitive deficits and behavioral difficulties. This causes the affected child to entirely depend on the caregiver for all daily functions. Therefore parents are responsible for helping the child in all the activities of daily living. Understanding parents’ experiences has the potential to improve parent–professional collaboration and the management of the child’s condition. To explore parents’ experiences of living with a child with hydrocephalus and their responsibility of having to care for a growing child who is entirely dependent on them. Design and methods: A descriptive qualitative method was undertaken, and twenty caregivers were interviewed using an in depth interview guide. Six themes were identified; strange illness, financial constraint, work overload, social stigmatization and support system. The identified themes were all from the parent’s verbalized experiences, the caregivers referred to hydrocephalus as a strange disease which they have never heard or seen. Financial constraint is a major challenge arising from their failure to work or do business and from frequent hospitalization. Social stigmatization was another major challenge which was deterring the caregivers form participating in important community events. Furthermore support system involved the support the caregivers received from their friends and relatives, health professionals and the organizations. Therefore, caregivers of children with such a condition must cope tremendous emotional, physical and economic burdens, although in the course of this, they gain a vast experience on care management approaches of the affected child. Therefore collaboration with parents requires health professionals to listen to parents’ concerns and value their experiences.
- ItemOpen AccessExperiences of caregivers of infants who have been on bubble continuous positive airway pressure at Queen Elizabeth Central Hospital(2016-03-01) Joshua Gondwe, MtisungeThe bubble Continuous Positive Airway Pressure (bCPAP) is a form of oxygen treatment given to children with severe respiratory distress. The bCPAP treatment might be stressful to caregivers caring for their sick infants. As such, caregivers may need continuous psychological support and adequate information for them to understand treatment better. This was a descriptive study that utilized qualitative method to explore experiences of caregivers of infants who have been on bCPAP at QECH. Data was collected from a purposive sample of twelve caregivers from Chatinkha and Paediatric nursery wards through in-depth interviews using a semi- structured interview guide. Qualitative data was analyzed using Colazzi’s framework which resulted in identifications of 3 themes; information about bCPAP, perception of caregivers and psychological support. The study found that information given about bCPAP was inadequate and not standardized for caregivers to understand bCPAP treatment. Most caregivers perceived bCPAP as a good treatment that saved lives of their infants. The caregivers were more stressed due to interrupted parent infant interaction and bCPAP machine as they prevented them to be in physical contact with their infants. The family members, friends and religious beliefs were among preferred source of psychological support rather than the healthcare workers. Therefore, the results have shown that there are gaps in providing support to caregivers of infants on bCPAP at QECH in terms of giving information and psychological care. As such, it is recommended that specific interventions be developed to minimize psychological distress and promote psychological health of caregivers with sick infants on bCPAP at QECH.
- ItemOpen AccessExperiences 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, ChifundoThis 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.
- ItemOpen AccessExperiences of caregivers on involvement in children's care at Mercy James Paediatric Intensive Care Unit in Blantyre, Malawi(2020-04-01) Chasweka, Grace GloryA child’s illness and admission in hospital is stressful and negatively affects the child, caregivers and the family. The stress is further exacerbated when a child is critically ill and has been admitted in an Intensive Care Unit. The effects can however be reduced when caregivers and families of the sick children are present and involved in the care of their hospitalized children. This practice is known as Family Centred Care (FCC) and it advocates that families should be involved in the care of their children. This was a descriptive study that used qualitative method to explore experiences of caregivers on their involvement in care at MJ PICU in Blantyre, Malawi. Data was collected from a purposive sample of ten caregivers who had been discharged from the PICU through in-depth interviews using a semi- structured interview guide. Qualitative data was analyzed using content analysis. The predetermined themes used were: caregivers’ experiences on their presence in PICU, information sharing by health workers to caregivers, participation in decision making and involvement in care activities. The study found several gaps as far as involvement of caregivers in the care of their children at MJ PICU is concerned. The information given to caregivers regarding their children’s care in the PICU was inadequate and was not standardized for caregivers to understand and adequately participate in their children’s care. Nurses and doctors were both found to have provided the information although ironically caregivers were unable to differentiate the two. The information was given verbally and in a language that the caregivers were able to understand. Caregivers were not adequately involved in decision making regarding their children’s care but were however involved in the physical care of their children. As such, it is recommended that specific interventions be developed to promote involvement of caregivers when they have been admitted with their children at MJ PICU.
- ItemOpen AccessExperiences of mothers separated from their children with pneumonia admitted in the paediatric high dependency unit at Kamuzu Central Hospital in Lilongwe, Malawi(2017-01-01) Chiundu, DianaMothers of children admitted in the paediatric general wards at Kamuzu Central Hospital are allowed to stay with their children in the ward and take part in caring for their children. When a child is very sick and requires high level of care, is transferred to paediatric high dependency unit where the mothers are not allowed to stay with their children all the time. Studies that have explored experiences of mothers separated from their children are limited in Malawi. The aim of this study was to explore experiences of mothers separated from their children with pneumonia admitted in the paediatric high dependency unit. The study utilized a descriptive research design using qualitative method to data collection and analysis. The study was conducted at Kamuzu Central Hospital in the paediatric high dependency unit in Lilongwe, Malawi. Twenty mothers separated from their children with pneumonia admitted in the paediatric high dependency unit were purposively sampled. Data was collected through in-depth interviews using semi structured interview guide. The data was analysed using thematic content analysis. On experiences, five themes emerged: being involved in the care of their children, receiving support and guidance from nurses when providing care to their sick children, negative experience regarding attitudes of nurses and other health workers while caring for their children, feelings of lack of trust on the nurses and other health workers and feelings of anxiety. On satisfaction with care, mothers’ reports were mixed. Some mothers were satisfied with care given while some were not satisfied. On parental needs, three needs were reported: the need to be with their sick child; information about condition of the child; and a good relationship with nurses and other health workers. Taking into account the findings of the study, mothers’ involvement in the care of the child should continue and be encouraged. Mothers should be given enough and continuous information, guidance and support throughout hospitalization. There should be good relationship and mutual trust between nurses and mothers to work hand in hand in caring for the sick children in order to meet their emotional needs. Health workers should avoid shouting at mothers but rather make them understand why some of the ward’s regulations should be followed and for their own benefit. The findings of the study could assist in making the nurses work in partnership with the mothers and support them during the stressful period of hospitalization in the high dependency unit. In addition, the results would also inform managers to develop policies that will address the needs of the mothers in Paediatric high dependency unit thereby improving patient care.
- ItemOpen AccessExploring knowledge, attitudes and practice of parents/guardians on home management of diarrhoea in children less than five years in Ekwendeni(2015-12-01) Kasonda, Esau AbrahamThis is a descriptive cross sectional study done to explore knowledge, attitude and practice of parents or guardians on home management of childhood diarrhoea. A semi structured questionnaire was used to interview parents or guardians of children less than five years old who presented to Ekwendeni Mission Hospital for the treatment of childhood diarrhoea and those who visited the underfive’s clinic for growth monitoring and immunizations. The specific objectives for the study were to assess knowledge of parents/guardians on the four basic rules of home management of childhood diarrhoea, to determine the attitude of parents/guardians on modern management of childhood diarrhoea and to find out home care practices of parents/guardians in the treatment of childhood diarrhoea before taking the child to the health facility. The study was conducted at Ekwendeni Mission Hospital in Mzimba District and the sample was drawn from parents or guardians of children aged five years or less who presented to the hospital’s outpatient department with a complaint of diarhoea and those who came to under five’s clinic for growth monitoring and immunizations. The study topic was chosen because it is one of the major concerns of the WHO in the reduction of deaths among children under the age of 5 years since diarrhoea accounts to 16% of all childhood death worldwide (WHO, 2010). Children from developing countries (including Malawi) are the worst hit as diarrhoeal diseases account for an estimated 17.5-21% of causes of death in children less than five years of age (WHO, 2010). However, a few studies have explored issues related knowledge, attitude and practice on management of childhood diarrhoea in Malawi. In addition, the results from the demographic and health surveys in Malawi do not give adequate information on the four rules of managing diarrhoea in children at home. This means that these demographic survey reports do not provide clear evidence on people’s attitude towards modern treatment of diarrhoea. Information from the current study will enable health workers to determine whether information given to parents and guardians on home management of childhood diarrhoea is adequate and if the information given has any impact on the home care practices in the communities. Two sampling methods were used in the selection of participants in this study. A consecutive sampling technique was used in selection of parents or guardians of children with diarrhoea and a random sampling technique was used to select parents or guardians of children who attended the underfive’s clinic at Ekwendeni Mission Hospital. A total of 327 parents or guardians were interviewed using a carefully designed semi structured questionnaire. Among the 327 respondents, 100 (30.6%) were parents/guardians of children who presented with diarrhoea at the time of data collection. Two data collectors administered a questionnaire to respondents at the hospital’s outpatient department from 12th December 2013 to 14th February 2014. Data was coded manually and entered into the computer. Analysis was done using Epi info version 7, a statistical package recommended for health related research. Presentation of results was done using tables and figures. The results have indicated that parents or guardians had partial knowledge about the four rules in home management of childhood diarrhoea. Knowledge about giving more fluids including oral rehydration solution (ORS) was better than knowledge about continued feeding and zinc. Most of the respondents had a positive attitude towards modern management of childhood diarrhoea but lack of resources and lack of knowledge about diarrhoea were the main barriers that affected the recommended home care practices of diarrhoea. It is recommended that health workers should give full information about diarrhoea and its management in order to improve home care practices for childhood diarrhoea.
- ItemOpen AccessExploring parent's participation in the care of their hospitalised children in a general paediatric ward at Zomba Central Hospital, Malawi(2018-10-01) Nsitu, George YotamuParental participation is regarded as an essential element of the quality of care for hospitalised children, and is the main element of Family Centered Care (FCC). Parental participation has been perceived significant in the reduction of adverse effects of hospitalisation and anxiety, and improvement of satisfaction. Parents in Malawi are allowed to stay with their sick children and participate in the provision of care in the ward. Their participation extends to the performance of almost all tasks related to care due to shortage of staff, which is critical in most public health facilities. The parents’ perspective of their participation in the care of the sick children in a paediatric context had not been explored in Malawi. This study therefore, aimed at exploring parents’ participation in the care of their hospitalised children. The study used a descriptive qualitative design, and it involved parents of children hospitalised for more than forty-eight (48) hours in a general paediatric ward at Zomba Central Hospital, Malawi. Purposive sampling method was used, and twenty three (23) parents who met the inclusion criteria and gave consent participated. Collection of data involved the use of an interview guide through face to face interviews and all responses were audio recorded. Findings showed that parents participate in care through roles which are not different from roles performed at home. The roles include mainly providing physical care and emotional care. There were various reasons also for the parents to participate in care that the study revealed. Parents’ participation is not without challenges. Challenges included limited support and guidance in care provision, and limited family support and needs. The study has highlighted other significant areas also that need the health worker’s attention if parental participation is to assist in improving the care outcomes of the hospitalised children. It was therefore recommended that policies and guidelines be formulated in the department, to guide parental participation in care.
- ItemOpen AccessExploring perceptions of health care workers and caregivers on causes of poor treatment response of malnourished children at Queen Elizabeth Central Hospital, Blantyre, Malawi(2019-06-01) Ilepere, Sakina GloriaMalnutrition continues to be a major public health problem worldwide including Malawi as it leads to high morbidity and mortality rate in children less than five years. At Queen Elizabeth Central Hospital (QECH), malnutrition remains a big problem with poor treatment response. For instance, the average mortality rate at QECH in 2014-2015 was at 20.8% which is two times higher compared to the World Health Organization (WHO) cut off point of less than 10%. This poor response might be contributed by household and health management factors. This was a descriptive qualitative study which aimed at exploring perceptions of health care workers and caregivers on causes of treatment response of malnourished children at Queen Elizabeth Central Hospital-Nutritional Rehabilitation Unit. The study was conducted at QECH. Both caregivers taking care of malnourished children and healthcare workers participated in the study. Pre-testing of the study tool was conducted at Zomba Central Hospital Nutritional Rehabilitation Unit. Sampling was done using purposive sampling technique. The study recruited 13 participants; 10 caregivers and 3 nurses. Data was collected using semi structured in-depth interviews through face to face interviews and analysis was done using simple thematic analysis. The study findings revealed inadequate knowledge among caregivers regarding causes of malnutrition, poor relationship between caregivers and health care workers, impact of other conditions, inadequate resources and poor adherence to guidelines as some of the factors that contributed to the treatment outcome of malnourished children.
- ItemOpen AccessExploring perspectives of adolescents living with perinatally acquired HIV regarding antiretroviral therapy adherence at Mitundu Community Hospital, Malawi(2019-06-01) Chigwenembe, Chifundo PhalyceDespite having the National HIV and AIDS Strategy (2015 - 2020) with the 90-90-90 2020 target, almost 50% of ALWH do not adhere to their treatment in Malawi. It is evident that the ALWH’s perception towards treatment influences their adherence. Therefore, there was need to explore the perspectives of the ALWH regarding their treatment adherence. This was an exploratory qualitative study which was conducted at Mitundu Community Hospital, Lilongwe District in Malawi. 26 ALWH aged between 12 and 18 years were purposively sampled. Data were collected over a period of two months using focus group discussions and in-depth interviews. Data were analysed using Thematic Method of Analysis. The study observed that the ALWH need support from caregivers, peers, entire community and health care workers in order to ensure optimal treatment adherence. The study revealed that ALWH tend to miss ARV doses in the course of fulfilling their household chores and errands. Unbearable ARV side effects, forgetfulness and maintaining secrecy, were perceived as the factors which hinder the ALWH from adhering to treatment. In order to ensure that missing of doses is minimised, the ALWH increase the accessibility and visibility of the ARVs, link the mealtimes to drug administration schedules, set alarms and take the ARVs together with other family members. It is, therefore, recommended that ALWH should take a leading role in ensuring their treatment adherence by abiding to the prescriptions of the ARVs. The caregivers need to ensure that household chores are not interfering with treatment schedules for the ALWH.
- ItemOpen AccessKnowledge of clinicians to screen children under the age of five years for developmental disabilities at two selected hospitals in Lusaka District, Zambia(2021-04-01) Kasaro, Mutinta Fanny Hatontolaabout 93 million children have disabilities. Early identification of developmental disabilities (DDs) and application of measures to habilitate the affected can help such children reach their full prospective. Clinicians who regularly attend to children under the age of five years are the best people to identify children with DDs. The objective of this research was to assess clinicians’ knowledge to screen DDs in children under the age of five years from two selected hospitals in Lusaka, Zambia. A quantitative cross-sectional study was conducted from clinicians drawn from selected two hospitals in Lusaka district. Eighty-eight participants answered a self-administered questionnaire. Multiple logistic regression analysis was conducted to examine the association between participants’ sociodemographic characteristic and awareness of risks for children to develop DDs and the knowledge to screen for DDs. The data was analysed using Stata 13.1. A p-value of < 0.05 was considered statistically significant. Participants’ median age was 28 (IQR, 25-36.6) and the majority 67 (76.14%) were females. Thirty-six (40.91%) of participants were aware of risks for under-five children to have DDs and only 27 (30.68%) of participants had the knowledge to screen DDs in children under the age of five years. Factors that are associated with awareness are participants’ institution and profession. Physicians were the most aware of risks for children under the age of five years to have DDs while nurse-midwives were the least to be aware of risks for children under the age of five years to have DDs. Furthermore; participants’ institution was associated with participants’ knowledge. The study has shown that most clinicians do not routinely conduct developmental screenings. This might lead to under-detecting significant DDs. The study also agrees that screening instruments developed and used so far have had limitations in terms of key issues relevant to LAMI countries which may pose a challenge regarding compliance on the use of screening instruments and detection of DDs. There needs to be a tool that will promote relationships between care providers and caregivers at the community level.
- ItemOpen AccessKnowledge, attitudes and practices of health care workers on management of severe acute malnutrition at Kamuzu Central Hospital, Lilongwe, Malawi(2018-04-01) Chitete Ngoma, Lucy LusekeroMalnutrition is responsible for 35% of deaths among children under five years of age globally (Black et al., 2008). In 2013, an estimated 2.9 million children under-five were admitted globally for treatment of severe acute malnutrition (UNICEF, 2015). The 2015 Malawi annual SAM burden was estimated at about 79, 301 under five children (Kouam, 2016). The need for health care workers to have knowledge in management of severe acute malnutrition has been emphasized in many studies. Evidence has shown that health care workers’ knowledge in management of severe acute malnutrition promote good practices and positive attitudes which result in quality care hence decrease in mortality. The aim of the study was to explore the knowledge, attitudes and practices of health care workers on management of severe acute malnourished children at Kamuzu Central Hospital. This was a cross sectional descriptive study. Participants were from the paediatric department. Simple random sampling was used to select 51participants for the study. A structured questionnaire and observation checklist were used to collect data. 9 observations were done on actual provision of care. Analysis was done using the Statistical Package for Social Sciences (SPSS) version 20. Findings on knowledge, attitudes and practices of health care workers were presented in descriptive form using tables, graphs, charts and percentages. Majority of the participants were females with a ratio of 4:1. High number of participants were in the age range of 25-34. Overall, 65% of health care workers had inadequate knowledge in management of severe acute malnutrition. 75% of health care workers had positive attitudes towards management of severe acute malnutrition. In practice, health care workers did not follow the recommended guidelines in management of severe acute malnutrition. Correlation between knowledge and practices as well as attitude and practices was not significant (p> 0.05). Shortage of staff, lack of resources, lack of adequate space and lack of in-service trainings in management of SAM were some of the challenges mentioned by most respondents. Health care workers did not have adequate knowledge in management of severe acute malnutrition which led to substandard care. The study recommended in-service trainings of health care workers in management of SAM. Training institutions should also strengthen the pre-service curriculum on managing children with severe acute malnutrition.
- ItemOpen AccessKnowledge, beliefs and practices of mothers related to anaemia in under-five children at Kamuzu Central Hospital, Malawi(2015-10-01) Macheso, FelistasChildhood anaemia is a major health burden which contributes to underfive morbidity and mortality in Malawi. It is estimated that 63% of children in Malawi have anaemia, however, anaemia is preventable. The purpose of this study was to explore knowledge, beliefs and practices among mothers whose underfive children were admitted with anaemia at Kamuzu Central Hospital. The study was cross sectional descriptive and it used both quantitative and qualitative methods. The study recruited 198 participants for the structured quantitative interviews and 12 participants were recruited for the qualitative in-depth interviews. The quantitative data was analyzed using descriptive and Kruskal- Wallis H statistical tests using SPSS version 16.0. The qualitative data was analyzed following principles of qualitative content analysis. The findings revealed that majority of mothers were young mothers within the age group of 20-24 years (41.4%; n=82) and unemployed (44.4%; n=88). The findings also revealed that majority of mothers (59.1%; n=117) had average knowledge related to causes and symptoms of anaemia in under-five children. Anaemia in under-five children was positively related to the education status of mothers (p = 0.005) such that mothers with higher education level (college level) had adequate knowledge of anaemia than mothers who had primary or no formal education. The study also found that majority of children had inadequate consumption of food containing iron. In addition, the study revealed that mothers received information related to nutrition from under-five clinics however mothers were not given information related to anaemia. The challenges that participants encountered in accessing health care services for under-five children were long walking distances, lack of medicine and lack of comprehensive screening of children. There is need to educate mothers on early recognition of signs of anaemia in children to prevent complications; update health workers on nutrition counselling, anaemia checkups and follow up. Furthermore, there is need for multisectoral collaboration to improve the health and nutrition status of the children.