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- 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, 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 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 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 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.