Dissertations

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Open Access
Availability and usage of occupational health services in Kanengo industrial area.
(Kamuzu University of Health Sciences, 2000-04-30) Matale, Edna
A descriptive study on availability and usage of occupational health services was done in Kanengo industrial area in the city of Lilongwe in order to establish the availability and usage of these services in this industrial area. The study involved a sample of 10 companies, which were selected through systematic random sampling. Data was collected using a questionnaire in an interview schedule. The data was later shared among 11 researchers who did the data collection and was then analysed using descriptive statistics and description of facts. The study results indicated that most occupational health services are available in Kanengo industries and generally used by workers. The results further revealed that noise from machines, fatigue and lifting are the major hazards in Kanengo while malaria is the common illness. It can therefore be concluded that Kanengo industries have most of the occupational health services, which are used by most workers.
Open Access
Challenges faced by commercial sex workers using the female condom in light of HIV and AIDS at Chigwirizano in Lilongwe district.
(Kamuzu University of Health Sciences, 2009-12-04) Salima, Racheal B.
This is a study which was conducted on challenges faced by commercial sex workers using the female condom in light of HIV/AIDS in Lilongwe district. The main aim of this study was to explore the challenges faced by commercial sex workers using the female condoms. The methodology used in this research study was the qualitative method and 10 in-depth interviews were conducted so as to assess the subjects individually about their experience with the female condoms. During the interviews the information was recorded using the tape recorder, the information which was transcribed in Chichewa was later on translated into English. In order to conduct the study in respect of human dignity, integrity and authority, ethical considerations were considered. The findings in this study revealed that the commercial sex workers using the female condoms meet challenges such as problems with insertion and maintenance of the female condom during sex, resistance of the male clients to using the female condom due to lack of knowledge about the female condoms, female condom being expensive, unavailability of the female condoms in the community shops and the female condom being expensive.
Open Access
Challenges of partner notification faced by HIV-positive women attending art clinic.
(Kamuzu University of Health Sciences, 2008-11-26) Nyalapa, Macdonald Williams
Human Immunodeficiency Virus (HIV) infection prevention and control depend on the strategies put in place to prevent new infections and to treat currently infected individuals. Voluntary HIV counselling and testing is one of the strategies employed in the prevention, control and treatment of HIV and AIDS. However, there are significant limitations of these strategies that need to be addressed in order to achieve maximum potential benefits from these programs. One of the most striking limitations is the low serostatus disclosure rate to sex partners among clients who have been counselled and tested for HIV which is a serious public health concern. A qualitative study was done to explore the existing challenges of partner notification faced by HIV-positive women and specifically, the study focused on the women's knowledge on the concept of partner notification and its importance, beliefs held about partner notification, problems related to partner notification faced and the perceived feelings before and after partner notification. The study setting for the study was Kawale Health centre, Lilongwe. Fifteen in-depth interviews were conducted among fifteen HIV-positive women who were attending ART clinic at Kawale Health centre. The participants were purposively sampled and the data was analysed manually using descriptive statistics and content analysis. The study revealed that HIV-positive women perceive partner notification as a very important and beneficial measure of increasing the rate of HIV testing and also a measure of HIV and AIDS control. It also indicated that the rate of HIV status disclosure among HIV-positive women to their sexual partners is high because of the understanding of the benefits of partner notification. Generally, challenges of partner notification faced by HIV-positive women are not very common. However, lack of understanding of the benefits of partner notification by some husbands still compromises the rate of HIV status disclosure by these women. The study also revealed a growing need for the enhancement of the role of the nurse for instance educating and counselling spouses on the benefits of partner notification to minimize these challenges. Based on the findings, relevant recommendations have been made to nurse practitioners, managers, educators and researchers in order to improve the practice of partner notification.
Open Access
Clients satisfaction with health services at Zingwangwa health centre.
(Kamuzu University of Health Sciences, 2009-11-20) Nyirenda, Florence Luhanga
Survey research into client satisfaction is responsible for developing a number of related concepts concerning the ways in which clients evaluate the health care that they receive. Recently, doubts have been expressed to the adequacy of understanding how clients anticipate and respond to medical encounters and health services. The current study assesses client satisfaction with health services at Zingwangwa Health Centre and also explores ways of improving client satisfaction. In a field study, questionnaires were administered to a convenient sample of 30 clients at Zingwangwa Health Centre ranging from outpatients (male or female, old or young), antenatal mothers, postnatal mothers, family planning clients and those are coming for voluntary counseling and testing. Client satisfaction as an independent variable was measured by three dependent variables such as waiting time, level of interaction between health personnel and clients, and quality of the facilities and service providers. The results indicate that client satisfaction at Zingwangwa Health Centre was rated highly by the respondents on all the three variables. Over 50% of the respondents rated the three variables positively and this is contrary to findings from other studies that client satisfaction is low in health services.
Open Access
Concurrent use of traditional medicine and Antiretroviral therapy among AIDS support group members in Lunzu, Blantyre
(Kamuzu University of Health Sciences, 2010-07-14) Gwesere, D. Dennis
Open Access
Concurrent use of traditional medicine and antiretroviral therapy among aids support group members in Lunzu, Blantyre.
(Kamuzu University of Health Sciences, 2010-12-01) Gwesere, Dennis D.
The descriptive study used both quantitative and qualitative approaches. The general aim of the study was to explore the practice of concurrent use of traditional medicine and highly active antiretroviral therapy among people living with AIDS in Lunzu, sub-urban of Blantyre in Malawi. Using purposive sampling, 30 participants were drawn from the Chisomo PLWHA support group. The sample comprised of 27 female and 3 males. Pilot study was conducted at Chisenjere AIDS support group in the same location. Permission to conduct the study was sought from relevant authorities and in addition, participants were requested to give informed consent. Data was collected using face to face interview with the participant using the semi-structured questionnaire as a data collection tool and guide. Analysis of the data was done using both SPSS 17 computer package and content analysis. The results were communicated to nursing faculty of Kamuzu college of Nursing, NAMPHAM secretariat, and the Blantyre District Health Officer. The study has found that 63% of AIDS support group members combine traditional medicine and antiretroviral therapy without the knowledge of the health care provider. Uncertified immune boosters and herbs are the most used traditional medicine by clients. Drug side effects and chronic nature of AIDS are some of predictors to the use of traditional medicine. It is recommended that traditional medicine policy be developed to protect the public form some potentially harmful medicine. Finally, more research is needed to explore the efficacy and safety of some the traditional medicines being used by AIDS clients.
Open Access
Contributing factors to maternal complications during Labour and delivery at Traditional Birth Attendants (TBAs) IN Nkhotakota
(Kamuzu University of Health Sciences, 2008-11-30) Seven, Faith, Violet
This study aimed at exploring contributing factors to maternal complications during labour and delivery at T BAs in Nkhotakota. Maternal complications are one of the 1 causes of maternal death in Malawi. The study employed a qualitative research design. The setting was Nkhotakota District Hospital and TBAs clinics. The sites were chosen to represent other T BAs clinics and the hospital as a referral site for complicated maternal cases. Purposive sampling was used. A total of fifteen participants were recruited in the study of which ten were women who developed complications at T BAs and five were trained 1 and practicing T BAs. Semi structured questionnaires were used to collect data. Data was analysed manually using content analysis. The findings of the study have revealed that maternal complications at TBAs is a result of an interplay of several factors such as delay in decision making both by T BAs and husbands of clients, unsafe practices during labour and delivery, dirty environment, poverty and long distance to reach the health facility. It is therefore important to address the challenges met by T BAs and weaknesses of T BAs considering that the access to acceptable, professional, modern health care services for all pregnant women is still not met and the fact that T BAs represent the only source available for maternity care to many developing country women including Malawi.
Open Access
Contributing factors to recurrent cases of smear positive Tuberculosis.
(Kamuzu University of Health Sciences, 2002-07-05) Lwesha, Victoria Mayamingie
Tuberculosis is a leading cause of death among adults in Malawi and the single type that is giving many problems is smear positive Tuberculosis. This type of Tuberculosis needs adequate treatment with ant TB drugs for the required period. Many patients are readmitted into the hospital with recurrent smear positive Tuberculosis and this give problems to the health care system as it calls for retreatment. The purpose of this study was to assess and evaluate the contributing factors to recurrent cases of smear positive Tuberculosis. The study specifically aimed at exploring how supervision of patients is done at hospital, health center and guardian level, identifying problems that hinder effective treatment of smear positive Tuberculosis and exploring suggestions from health workers patients and guardians on how to improve treatment and supervision of patients with smear positive Tuberculosis. A descriptive research design was used and the study involved 30 subjects who consisted of health workers, patients and guardians. The study was conducted at Bottom hospital and area 25-health center. An interview guide was used to collect data from patients and health workers and a question guide was used for focus group discussions to collect data from guardians. Data was analysed manually to determine frequency distributions and responses from focus group discussions were categorized and subjected to descriptive statistics of content analysis. The study findings indicated lack of adequate knowledge by patients and guardians on TB disease and principles of treatment as one of the main contributing factor to recurrent cases of smear positive TB. The results also indicated lack of adequate supervision and adequate follow up of defaulters due to lack of human and material resources as other contributing factors. Poor social economic status of the patients and guardians, poor relationship between clients and health workers and long period of treatment featured as the other major contributing factors to recurrent cases of smear Positive Tuberculosis. If health planers and health workers do not address these areas, the hospitals will continue registering increased numbers of Smear Positive Tuberculosis.
Open Access
Coping mechanisms against stigma for people living with HIV/AIDS in Balaka
(Kamuzu University of Health Sciences, 2008-11-30) Nyson, Chikondi
The study aimed to explore the coping mechanisms of PLWH against stigma in Balaka. Roy adaptation Model was adopted to guide the researcher in the research process. A qualitative research design was used with a sample size of 10 people both men and women to explore the coping mechanisms. The researcher used random sampling in the selection of the participants. A semi-structured interview guide was used for the purpose of data collection and the data was analysed through content analysis where three themes from the results were identified. These include; knowledge on positive living, forms of stigma and coping strategies e.g. rationalization, seeing oneself as ok, concentrating on other things, acceptance, turning to God, joining a group, disclosing, educating others, changing one's lifestyles and going for counselling. The identified coping strategies have been labelled action based strategies or emotion based coping strategies. Coping appears to be self taught in managing stigma.
Open Access
Deaf clients' experience in accessing health care services in Lilongwe urban
(Kamuzu University of Health Sciences, 2010-11-10) Sabola, Edison Wakale
The plight of the deaf patients in accessing the health care services has been a problem especially in the developing countries where proper structures and training of the health personnel on issues of communicating with the deaf patients is still a major challenge. Like any person who is able to hear properly, deaf clients have been experiencing communication problems and isolation by health care workers, as most of them find it difficult to obtain data from patients, as well as giving advice on how to use things like medication. Another concern comes on the issue of lack of privacy as some of the patients need interpreters to express the information to the health personnel. This has led to poor diagnosis being made on the clients leading to wrong prescription of treatment made to those patients. The purpose of this study was to identify the experiences as well as challenges faced by the deaf clients in accessing health services from the health personnel in Lilongwe Urban. A qualitative research design was used whereby a sample of 10 participants were selected randomly and interviewed using an interview guide, with the help of the certified sign language interpreter. Data was analyzed using content analysis.
Open Access
Effectiveness of standard case management of under-five children with pneumonia towards clients outcome at Kasungu district hospital.
(Kamuzu University of Health Sciences, 2009-12-08) Kudya, Mercy Shora
A quantitative study was designed to investigate the effectiveness of standard case management of pneumonia in under five children at Kasungu district hospital. The purpose of the study was to explore the effectiveness of the standard case management as a strategy. The objectives of the study were to assess the effectiveness and to describe the treatment results. Secondary data was used from clients files those that were admitted due to severe and very severe pneumonia from January to December 2008. Systematic sampling was used to sample 50 files from total files of 992 records of children once admitted with pneumonia from January to December 2008. The questionnaire was used to collect the information retrospectively. Data was analysed manually and findings were presented in graphs, pie charts, tables and percentages. The study has revealed that the standard case management is not effective as shown by increased number of deaths, out come unknown and 1 decreased number of those completed treatment. It has also revealed that participants were not checked vital signs on daily basis. The researcher recommends that health workers should be trained in standard case management and health talks to be targeted to parents or care givers of children of 2 -11 months old.
Open Access
The effectiveness of the nursing auxiliaries on the delivery of patient care at Queen Elizabeth Central Hospital (QECH) in Blantyre.
(Kamuzu University of Health Sciences, 2006-11-30) Msukwa, Pamela Monica
Health care provision has moved towards an approach to patient care that challenges the traditional role boundaries of health care workers. In nursing this has resulted in the delegation of 'nursing care' to the Nursing Auxiliaries. This study sought to evaluate the effectiveness of the Nursing Auxiliaries on the delivery of patient care. The research method was a qualitative, inductive approach. Data were gathered using in-depth interviews. These were conducted with eleven nurses who were Sister in-charges of different wards. Data were grouped, analysed, interpreted and summarized manually. Content analysis was done to classify the words into a few categories according to their importance. The findings of the study showed that from the qualified nurses' perspective, the nursing auxiliaries are not effective in the delivery of patient care. Some factors that would contribute to this have been discussed in themes that arose from the findings and these include supervision, poor working relationship, rote parameters and their influence on the delivery of patient care. Based on the findings there is need for ongoing monitoring and supervision of nursing auxiliaries work to maximize their contribution to patient care and to ensure quality standards, because professional roles in many health care systems are changing to meet increasing demands for care. There is also need for in service education and training for the qualified nurses on accountability and supervision of the nursing auxiliaries. This will make them better prepared for their role as supervisors. This in turn will result in effective delivery of patient care.
Open Access
Examine the use of condoms among the religious women and women involved in casual sex.
(Kamuzu University of Health Sciences, 2001-04-11) Makunje, Treza M.
This is a correlational study whose purpose was to determine condom use among religious women and those women involved in casual sex. It was also to determine the relationship between religion and condom use as well as the relationship between casual sex and condom use. A convenient sample of 263 women was used of which 68.10% were female bank workers. 31.9% were female college students (teaching and nursing students) in Lilongwe and Blantyre districts. Data collection was done using a questionnaire and data analysis was done on computer using a statistical package for social science (SPSS) for windows. Findings in general showed that relationship between religion and condom use was significant (P—. 0485) while the relationship between casual sex and condom use was insignificant (P=. 0695). Recommendations proposed include health authorities. Spiritual work and nurses to work hand in hand in the fight against HIV/AIDS by providing the right information pertaining to condom use to people hence preventing the spread of the disease.
Open Access
Experiences of HIV positive mothers who stop breast feeding at six months at Limbe clinic.
(Kamuzu University of Health Sciences, 2009-12-04) Mwenda, Wezi Longwe
The transmission of HIV from a mother to her child is one of the most tragic aspects of the HIV/AIDS pandemic. World Health Organization advocates for early cessation of breastfeeding by HIV infected mothers, followed by replacement feeds in order to prevent mother to child transmission of HIV. For most HIV infected mothers in developing countries, following this recommendation represents a big dilemma because of several factors. On one hand, health care providers expect mothers to abide by WHO's recommendations in order to reduce the risk of HIV transmission to their infants. On the other hand, PMTCT enrolled 11101hers go back home to a society where those recommendations are found to be practically, socially and culturally unacceptable and irrelevant. This study explored Experiences of HIV positive mothers who stop breastfeeding at six months. The aim was to find out what experiences these mothers go through, with a view of making recommendations that would help to improve PMTCT programmes, thereby empowering women in matters concerning HIV/AIDS and infant feeding choices. The study focused on mothers that enrolled in the Prevention of Mother To Child Transmission of HIV programs at Limbe health centre, in Blantyre district. Qualitative study design was used on a sample of ten participants, who were recruited using convenience sampling method. An interview guide was used as a data collection tool and data was analysed manually using content analysis. The study revealed that early cessation of breast feeding as a feeding option to PMTCT of HIV is the best choice that HIV positive mothers can make. However, these mothers face a lot of challenges in form of stigma, discrimination and dealing with inquisitive people. Lack of material and financial resources, babies crying a lot and frequently falling sick are also some of the challenges encountered in relation to the weaned children. The study also revealed the big role that health workers or counsellors played in facilitating early cessation for it to be a success in the studied population. Based on the findings, relevant recommendations were made to all stake holders like the community, health workers, spouses and family members, government, MOHP, donors, non-governmental organizations, research organizations and many more, with the aim of improving PMTCT strategies like early cessation.
Open Access
Experiences of serodiscordant couples towards sexual relationship at Queen Elizabeth Central Hospital.
(Kamuzu University of Health Sciences, 2011-07-14) Shella, Agnes Katazuka
INTRODUCTION HIV and AIDS is one of the greatest public health as well as social problems threatening the human race. Since the beginning of the epidemic, nearly 30 million people have died from AIDS-related causes. Malawi is among the list which has one of the highest national prevalence rates in the world. PURPOSE The purpose of this study was to explore experiences of serodiscordant couples towards sexual relationships. The study objectives were to describe feelings of serodiscondant couples towards sexual relationships, examine attitudes of the serodiscordant couples towards serodiscordant status and explore sexual practices of serodiscordant couples. METHODOLOGY In this study, the population of interest was serodiscordant couples who attend clinics to Johns Hopkins at Queen Elizabeth Central Hospital. The study was a qualitative design, data was collected through face to face interview using an interview guide. A sample of five couples to make 10 participants was interviewed in order to obtain data. Data collected was analysed using content analysis. Convenient method of sampling was used in this study. This study was conducted at Johns Hopkins Clinic within Queen Elizabeth Central Hospital in Blantyre. The result of the study showed that serodiscordant couples felt that frequent sex will facilitate HIV transmission and condom use reduces sexual arousal. Further analysis showed that condom was considered the most appropriate method which improves their sexual relationship. On the other hand the study noted that serodiscordant couples meet challenges like fear of HIV transmission, the need for child bearing and anxiety. This implies that there is need to intensify couple counseling which will solve psychological problems of serodiscordant couples.
Open Access
An Exploration of Attitudes and Perceptions of Traditional Birth Attendants on their New Roles
(Kamuzu University of Health Sciences, 2009-11-25) Mwale, Jere Hilda
This study is a qualitative study whose purpose was to explore the attitudes and perceptions of TBAs on their new roles. This study was conducted at Ekwendeni. Convenience sampling was used to select the participants from a population of 90 TBAs who were trained by Ekwendeni Mission Hospital. A sample •size of 23 TBAs was used. Data was collected using three Focus Group Discussions. Data analysis was done manually using Collaizi's method of content analysis. The study revealed that T BAs have knowledge of the changes in their role but have different views on the reasons for such changes. The study also found that despite having knowledge of the changes some TBAs still continue conducting deliveries. This study has concluded that there is minimal compliance to the TBAs changed roles. There is need for policy makers to revisit the policy and find other strategies of gradually replacing TBAs with Skilled attendants
Open Access
An exploration of nurse turnover at Malamulo Hospital in Thyolo District
(Kamuzu University of Health Sciences, 2014-01-16) Kamwiyo, Martha Kanchiputu
Nurse turnover is a serious problem in most health institutions which causes shortage of nurses which compromises client care and the institutions keep on employing new nurses now and again which is costly. This study explained what motivates employees and examines their level of job satisfaction, using Herzberg's hygiene factors and motivators. The study explored nurse turnover at Malamulo Hospital in Thyolo district in Malawi. A qualitative research was done at Malamulo Hospital in Thyolo District in Malawi to explore nurse turnover thus to find out why nurses leave the institution. Data was collected from a purposive sample of ten nurses who have worked for Malamulo Hospital for at least six Months and above. Herzberg's motivational theory was used to contextualize the research results. In terms of Herzberg•s motivational theory. the motivators that could influence nurse turnover were natural, real factors such as achievement, recognition, the work itself. responsibility; advancement and growth are related to job satisfaction. The hygiene factors that included company policy, supervision, and relationship with boss, work conditions, salary relationship with peers and working conditions are related to job dissatisfaction. A qualitative research was conducted at Malamulo hospital in Thyolo district to explore nurse turnover. Data was collected from a purposive sample of eight nurses and two key informants (Management members) through an in depth interview using semi-structured interview guide. The results showed that most nurses had incomplete job satisfaction because the Innovators were not present and some of the hygiene factors were neglected. Further the results show that the nurses themselves had problems related to the work itself and, the nurses' expectations were not met and some of the organizational cultural elements were causing dissatisfaction among nurses. Finally, strategies to be done by management to retain more nurses were discussed.
Open Access
Exploring factors contributing to underutilization of Mangochi facility based circumcision by the people of Michesi village, TA Mponda Mangochi.
(Kamuzu University of Health Sciences, 2010-11-24) Chipuwa, Bernadetta Kadziweni
This is a study on factors contributing to underutilization of Mangochi facility based circumcision. The aim of the study was to explore factors contributing to the underutilization of the service. A descriptive quantitative research design was used in the study. The study was conducted in the area of Michesi village TA Mponda in Mangochi district. Convenient sampling was used in selecting the study subjects. A sample of 30 men who were fathers or guardians whose children were circumcised traditionally in the past four years was used. A structured questionnaire was used as a data collection instrument. The data was analysed manually. The analysed data was displayed in percentages, figures and tables to enable the researcher draw the meaning from the collected data. Ethical consideration was ensured by obtaining permission for conducting the study from the relevant authorities from where the study will be conducted. Confidentiality and anonymity of the responses was ensured through the use of coded numbers rather than the names and by reporting the findings as group data rather than individual data. The results of the study was disseminated through research reports which was made available in the library of Kamuzu College of Nursing and copies were sent to the supervisor and head of basic studies. The findings revealed that demographic data of the subjects who are decision makers such as age, denomination and tribe influence the utilization of Mangochi facility based circumcision. It has also been noted that cultural beliefs and values and the distance from the facility to the community were the other influencing factors.
Open Access
Factors affecting patients' referral to Machinga District hospital from Chikweo, Namanja and Ntaja Health centres
(Kamuzu University of Health Sciences, 2010-11-11) Kandiyesa, Mary Collette
Patient referral from health centers is a very crucial intervention that helps to determine the organization of the health care delivery system. This qualitative study was conducted to assess factors affecting patients' referral to Machinga District Hospital from Chikweo, Namanja and Ntaja Health Centers. This was based on realization that statistics in the district is indicating high morbidity and mortality rate as compared to the whole nation. A convenient sample of ten respondents which included; a District Health Management Team member, clinicians and nurses was used. In-depth interviews with a question guide and a tape recorder were used to collect data. In order to ensure reliability of the data collection instruments, a pilot study was done at Lilongwe DHO and Lumbadzi Health Centre on three respondents. Issues such as determination of the existing referral system, knowledge of personnel on the importance of referral and factors affecting the referral system were explored. Data was analyzed manually using Grounded Theory and transcription of data from the tape recorder. Findings revealed that factors such as adequate psychosocial support, emergency care given to patients whilst awaiting referral transport, responsibility exercised by health workers, patient and guardians' positive attitude towards referral and effective radio communication enhance the referral system. Lack of proper referral policies and guidelines, shortage of human and material resource, lack of holistic care to patients indicate a gap which needs to be filled in order to improve the referral system. The study results also elicited implications of the study to the nursing discipline and highlighted areas for further study.
Open Access
Factors Associated with the Recurrence of Seizures in Epileptic Patients at Kamuzu Central Hospital
(Kamuzu University of Health Sciences, 2006-11-28) Bandawe, Violet Love
A quantitative study on factors associated with the recurrence of seizures in epileptic patients was conducted at Kamuzu Central Hospital Epileptic clinic. The purpose of the study was to identify factors that contribute to the recurrent attacks of seizures in epileptic patients. The study consisted of 30 epileptic patients who were seeking health care services at the epileptic clinic. Convenient sampling was used to identify participants of the study. Only those patients who were in a position to give consent on their own participated in the Thedata that was collected was analysed manually. The findings showed that emotional stresses, psychological stress, treatment noncompliance and treatment changes are the major contributing factors to the recurrence of seizures in epileptic patients. The study findings revealed that most of the epileptic patients do not continue with their education and this leads to lack of employment and financial problems. Furthermore the findings have shown that most of the epileptic patients do not know the drugs they are taking by names, but by physical appearance. The researcher recommends that nurses at the epileptic clinic should include education on the nature of the disease and the importance of treatment compliance to minimize all the misconceptions that people have on epilepsy. The researcher also recommends that parents and the people who take care of epileptic patients should be encouraged to send epileptic children to school, because epileptic patients can also do better in class and proceed with their studies. Finally the researcher recommends that all nurses responsible and the hospital authorities should ensure that there is continuous supply of drugs to the clinic to avoid unnecessary treatment changes in these patients.