Thesis & Dissertations

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    Knowledge, attitude and practice of hypertensive clients about self-care home management at LCH (OPD II) medical clinic
    (2004-10) Kamwedo-Muyakha Maria Isabella
    A descriptive, quantitative and qualitative study was conducted at Kamuzu Central Hospital (OPD II) medical clinic. Experiences from the health workers at Kamuzu Central Hospital (KCH) had shown that the hypertensive clients lacked knowledge on the disease process hence clients do not know what actually happens in their bodies (Ozotiosauka, 2004). In this view, it was important to conduct a study whose purpose was to find out if hypertensive clients have got knowledge about how they can manage their condition at home. The study focused on knowledge, attitude, drug compliance and practice of hypertensive clients in the control of high blood pressure. Nursing literature in Malawi lacks information on the self-care home management for hypertensive clients. No such study has ever been conducted in Malawi. Orem's self-care model was used to guide the study with emphasis on self-care home management of hypertensive clients. Sample size of twenty clients was drawn from KCH Medical Clinic (OPD II) using a simple random sampling method. A pilot study was conducted at Likuni Hospital to ensure validity and reliability of the research instrument. Data was collected using an interview guide. Data was analysed manually using descriptive statistics and content analysis to describe qualitative data. Study findings revealed lack of adequate knowledge for hypertensive clients about the disease process and its cause, need for psychological support from health workers and also the usefulness of the medical clinic for the general public. Recommendations were made basing on the results, emphasizing the importance of the information, education and communication (IEC) to hypertensive clients and also establishment of other medical clinic services within the Central Region to cater for those clients living in other districts in order to promote health and maintain self-care management at home. In conclusion, we have seen that participants' lack of knowledge on the disease process was related to inadequate information, education and communication, low level of education and poor communication between clients and health workers.
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    The use of maternity waiting homes at Chiradzulu District Hospital, Southern Malawi
    (2016-04-01) Kadzuwa, Blessings Ridson
    The concept of maternity waiting home (MWH) was introduced at Chiradzulu District Hospital in 2012, in an effort to improve maternal and neonatal health in Chiradzulu District through the promotion of skilled attendance at birth in the district. Since then, no study has been conducted to examine the use of MWH at the district hospital. This comparative study was designed to examine the use of MWH at Chiradzulu District Hospital, Southern Malawi by identifying the characteristics of pregnant women who use MWH; identifying factors that influenced use of MWH; describing types of services offered at MWH, and comparing pregnancy outcomes of women who used MWH with those who did not use MWH. A comparative cross sectional study was conducted at Chiradzulu District Hospital, postnatal ward. Using a proportionate stratified random sampling method, a total 266 postnatal mothers were enrolled. The study had two strata-one stratum comprised mothers who used MWH and the other stratum comprised mothers who did not use MWH, but came direct from home to deliver at the district hospital. Systematic random sampling method was used to select the 133 participants in each stratum. Data collection was done using a well structured questionnaire through face to face interviews and review of participant’s records. Data was analysed quantitatively using SPSS version 16.0. Chi-square test at 5% level of significance was used to determine associations as well as to compare pregnancy outcomes between mothers who used MWH and those who did not use MWH. There was no significant difference in demographic attributes between mothers who used MWH and those who did not use MWH (P≥0.050). However, significant difference was identified on the following obstetric risk factors: malaria in pregnancy (p=0.030), severe anaemia in pregnancy (p=0.014), and breech presentation (p=0.042) between mothers who used MWH and those who did not use MWH. Furthermore, the study shows that there was no significant association between the utilisation of MWH and the pregnancy outcomes (p≥0.050). The only significant difference was on babies with very low Apgar score of 0-3 at five minutes (p=0.035); only one baby born to mothers who used MWH had severe asphyxia (Apgar score of ≤ 3) compared to seven babies born to mothers who did not use MWH. Although the results showed that MWH utilisation at Chiradzulu District Hospital, Southern Malawi did not significantly improve maternal and neonatal health outcomes; babies born to mothers who used MWH were more likely to survive the neonatal period.
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    Effects of flooding on mental health of victims in Mzuzu City, Malawi
    (2018-06-01) Mwafulirwa, Glory Wezi Sopera
    Floods caused by climate change have large social consequences for communities and individuals. The mental health effect of floods on victims in Malawi is not documented. A cross-sectional quantitative study was conducted in Mzuzu city to investigate the effect of the April 2016 flood on the victims. An interviewer administered structured questionnaire was used to interview conveniently sampled adults who were living in the affected areas. Data was analyzed by comparing mental health indicators before and after the floods, using Statistical Package for Social Sciences(SPSS). A total of 351 interviews were completed; 70.7% of the respondents were females. The proportion of participants who reported being happy, had injuries, were able to provide for their dependents, accessed health services and had a good appetite before and after the floods were found to be statistically significant as they decreased after the floods and had p<0.001. On average, signs and symptoms of mental illnesses such as depression and post-traumatic stress disorder (PTSD) were reported in 56% of respondents. 19.3% received no support like others who did in form of food, shelter and counseling. Of those that received support, 79.8% reported that the support received had no effect on their mental health. Hence 61.5% indicated they needed to be provided with housing; 37.3% indicated they needed loans; 1.14% indicated they needed counseling services, for their mental health to be at optimal level. Flood victims in Mzuzu city had mental health issues as they presented with symptoms of mental problems. Their mental health indicators such as mood, physical health and eating pattern diverted from the normal state. A comprehensive mental health assessment should be considered for flood victims and a policy incorporating comprehensive mental health services in managing disaster victims should be developed.
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    Factors that predispose nurses and midwives to biological occupational health hazards at Kamuzu Central Hospital in Malawi
    (2018-06-19) Gangata, Owen
    Nursing and midwifery personnel experience a higher rate of workplace hazards exposure than other health care workers because nurses perform more bedside procedures. Not much was known about the extent of exposure to biological health hazards among nurses and midwives and the preventive measures put in place to avoid or minimize this exposure in Malawi. The study aimed at investigating factors that predispose nurses and midwives to biological occupational health hazards. A quantitative approach was adopted using a descriptive cross-sectional design. A self- administered structured questionnaire was used to collect data from a random sample of 160 nurse midwives. Ethical approval was sought from the College of Medicine Research and Ethics Committee (COMREC) and permission to conduct the study was obtained from the Hospital Director of Kamuzu Central Hospital. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. The study was conducted from October 2016 to April 2017. The study has revealed that 93.42% of the respondents were exposed to biological occupational health hazards. The number one leading factor to predispose respondents to occupational hazards was inadequate personal protective equipment (98%, n = 158), followed by workload (97.5%, n = 156) and poor hand washing practices (93.75%, n = 150). The study findings imply that knowledge of infection prevention, good sanitation in the working environment, adequate workload and adherence to hand-washing practices have proven to be some of the significant preventive measures to biological hazard exposure. The study recommends provision of adequate personal protective equipment, frequent in-service trainings on occupational hazards to be conducted and ensuring adequate nurse – patient ratio.
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    Substance use among the youth at Chaminade Boys Secondary School in Karonga District, Malawi
    (2018-04-01) Mzumara, Lizzie Margaret
    The aim of this study was to describe the present situation of substance use the youth at Chaminade Boys Secondary School in Karonga district. Substance use among adolescents and the youth continues to be a major public health and socioeconomic problem worldwide. Substance use is harmful for the adolescents and it leads to decreased academic performance, increased risk of contracting Human Immunodeficiency Virus, other sexually transmitted infections and mental health related problems. A quantitative study was done utilising a cross sectional descriptive design. The study was conducted, guided by four specific objectives; to determine the extent of substance use among the youth, to investigate the commonly used substances among the youth, to investigate the factors that influence the youth to use substances and to determine the knowledge level of the youth on the consequences of substance use. The study took place at Chaminade Boys Secondary school. The target population were males 18 years and above in forms 1 to 4 at Chaminade Boys Secondary School in Karonga district, Malawi. The sample size was 144 respondents. Simple random sampling technique was used to select the study respondents. The self-reported semi- structured questionnaire was used as an instrument of data collection. Data was analysed using Statistical Package for Social Sciences (SPSS) software Version 20. The study results showed that the 52.8 % of the respondents were using substance and 47.2 % had never used substances. The most commonly used substances were cannabis sativa 69.4 % and alcohol 66.0 %. The results also showed that there was a strong positive association between reasons for substance use and religious affiliations. The association was found p=0.03 < 0.05. Substance use among the students was prevalent. Based on the above results the researcher suggests to initiate awareness and coordination program with nearest health facility. Hence, there is need for collaborative initiatives in developing intervention strategies that will reduce substance use among adolescents and the youth. Laws and policies that facilitate and reinforce parents and educators in controlling substance use among adolescents should be clearly be put in place and be implementable.