1,721,153 research outputs found
Experience of and factors associated with violence against sexual and gender minorities in nine African countries: a cross-sectional study
Full text linkObjective
The objective of this research was to assess physical and sexual violence experienced by sexual and gender minorities in nine African countries, and to examine factors associated with violence.
Methods
We conducted an exploratory multi-country cross-sectional study among self-identifying sexual and gender minorities, using a survey tool available in paper and online. Participants were sampled through venue-based and web-based convenience sampling. We analysed data using descriptive statistics and logistic regression, with Stata15.
Findings
Of 3798 participants, 23% were gender minorities, 20% were living with HIV, and 18% had been coerced into marriage. Fifty-six per cent of all participants had experienced physical or sexual violence in their lifetime, and 29% in the past year. Gender minorities had experienced significantly higher levels of violence compared to cisgender (sexual minority) participants. The variable most strongly associated with having experienced violence was being coerced into marriage (AOR, 3.02), followed by people living nearby knowing about one’s sexual orientation and/or gender identity (AOR, 1.90) and living with HIV (AOR, 1.47).
Conclusion
Sexual and gender minorities in Eastern and Southern Africa experience high levels of violence. Sexual orientation and gender identity need to be recognised as risk factors for violence in national and regional law and policy frameworks. States should follow the African Commission Resolution 275 and provide protection against violence based on real or perceived sexual orientation or gender identity
Evaluating complex health financing interventions: using mixed methods to inform further implementation of a novel PBI intervention in rural Malawi
Full text linkBackground: Gaps remain in understanding how performance-based incentive (PBI) programs affect quality of care and service quantity, whether programs are cost effective and how programs could be tailored to meet client and provider needs while remaining operationally viable. In 2014, Malawi’s Ministry of Health launched the Service Delivery Integration-PBI (SSDI-PBI) program. The program is unique in that no portion of performance bonuses are paid to individual health workers, and it shifts responsibility for infrastructure and equipment procurement from facility staff to implementing partners. This protocol outlines an approach that analyzes processes and outcomes, considers expected and unexpected consequences of the program and frames the program’s outputs relative to its costs. Findings from this evaluation will inform the intended future scale-up of PBI in Malawi. Methods/design: This study employs a prospective controlled before-and-after triangulation design to assess effects of the PBI program by analyzing quantitative and qualitative data from intervention and control facilities. Guided by a theoretical framework, the evaluation consists of four main components: service provision, health worker motivation, implementation processes and costing. Quality and access outcomes are assessed along four dimensions: (1) structural elements (related to equipment, drugs, staff); (2) process elements (providers’ compliance with standards); (3) outputs (service utilization); (4) experiential elements (experiences of service delivery). The costing component includes costs related to start-up, ongoing management, and the cost of incentives themselves. The cost analysis considers costs incurred within the Ministry of Health, funders, and the implementing agency. The evaluation relies on primary data (including interviews and surveys) and secondary data (including costing and health management information system data). Discussion: Through the lens of a PBI program, we illustrate how complex interventions can be evaluated via not only primary, mixed-methods data collection, but also through a wealth of secondary data from program implementers (including monitoring, evaluation and financial data), and the health system (including service utilization and service readiness data). We also highlight the importance of crafting a theory and using theory to inform the nature of data collected. Finally, we highlight the need to be responsive to stakeholders in order to enhance a study’s relevance
Assessing some of the associations with perinatal mortality at Kamuzu central hospital in Lilongwe, Malawi
No full textIncludes bibliographical references.The study objectives were to: determine the prevalence of perinatal mortality (PNM) and causes of early neonatal deaths (ENNDs), describe socio-demographic factors of mothers with PNM and assess some of the associations with PNM at Kamuzu Central Hospital
Shortage of health workers in the Malawian public health services system: how do parliamentarians perceive the problem?
Full text linkThe quality and quantity of health care services delivered by the Malawi public health system is severely limited, due to, among other things the shortage of adequate numbers of trained health care workers. In order to suggest policy changes and implement corrective measures, there may be need to describe the perceptions of the legislature on how they perceive as the cause of the problem, which could be the solutions and an evaluation of those solution. In this paper, I present the finding from a qualitative study of Hansards (official verbatim record of parliamentary speeches) analysed by discourse analysis. Parliamentarians identified the shortage of health workers as resulting from death, retirement and brain drain to other countries mostly the UK, Saudi Arabia and South Africa. Training more health workers, training new but lower cadres of health workers not marketable to the outside world, improving the working conditions and remuneration of health workers are suggested as some of the solutions. Even without the brain drain of health workers to other countries, Malawi's health sector personnel numbers are not adequate to serve the needs of the country. Relying on training more health workers in the numbers normally produced from the prevailing training institutions is unlikely to remove the shortages. African Journal of Health Sciences Vol. 12(3-4) 2005: 101-10
What Should HIV/AIDS Be Called in Malawi?
No full textHIV/AIDS is the leading cause of morbidity and mortality in the southern African country of Malawi. At the largest referral health facility in Blantyre, the Queen Elizabeth Central Hospital, the majority of patients hospitalized in medical wards and up to a third of those in the maternity unit are infected with HIV. Many patients in the surgical wards also have HIV/AIDS. Health professionals in Blantyre, however, often choose not to write down the diagnosis of HIV or AIDS; rather, they prefer to use 'SGOT', 'ELISA' and 'spot test' to represent the HIV test, while 'immunosuppression', '\CD4 disease' and 'ARC' are preferred instead of 'AIDS'. It is possible that health professionals' belief that mentioning HIV and/or AIDS will harm patients is encouraging them to use these euphemisms. The use of less than exact terms to label HIV and AIDS may not be without cost. For instance, future attempts to conduct retrospective case study research may be hampered by this practice, which is not in accordance with the international classification of diseases. It is suggested that, although stigmatization and discrimination could be important driving factors in the use of cryptic language, it may be more worthy to fight discrimination and stigmatization head-on, rather than create avenues where these reactions may be perpetuated
Explaining the gender disparities in SARS-Cov 2 infection and Covid-19 Disease in Malawi
Full text linkGlobal Covid-19 data show that there is higher morbidity and mortality among males compared to females1-3. Why, is this the case, and what needs to be done to save lives? Alternatively is this a situation where the observed status is only good for reporting but not worth interventions
Serological Survey of Antibodies to Toxoplasma Gondii *
Full text linkToxoplasmosis is one of the most prevalent parasitic infections of man
and livestock, and its transmission has usually been attributed to
ingestion of undercooked or raw meat from infected livestock, with the
infection rate in those animals being an important risk predictor of
human disease, high in Iran and Ardabil State. During a study on this
public health problem, we tested serum samples from cattle, goats,
sheep and chicken from the State of Ardabil, Iran, for IgG antibodies
to Toxoplasma gondii by enzyme-linked immunosorbent assay (ELISA).
Antibodies to Toxoplasma gondii were found in 30% (60/200) of sheep,
15% (30/200) of goats and 9% (18/200) of cattle, and none were found in
chicken sera. Despite the differences in feeding habits of each
species, the rate of infection of the animals tested could be
attributed to livestock management methods, whose improvement could
reduce infection
To screen, or not to screen for SARS-Cov2
Full text linkOne of the trappings, if not a burden, to Editors-in-Chief (EIC) of many medical journals is that one is expected to write editorials. Thus attempting to speak from the Mount, the EIC has the opportunity to identify one or more issues they think is/are important for the readership at that time or had been in the past or for the future
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