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"Rap Music and the Youth in Malawi: Reppin' the Flames" by Ken Lipenga Jr. is a book that explores the influence of hip-hop on youth culture in Malawi, one of the poorest countries in the world. The author discusses the spread of hip-hop in African countries, focusing on the popularity of MCing or rapping. The book also examines the use of language in Malawian rap, including the use of local languages and English. It delves into how rappers address specific topics in their music, such as politics, alcohol, and community. The book concludes on a hopeful note, suggesting that hip-hop's popularity in Malawi will continue to grow. [Extracted from the article]

In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi's APL. Two hundred and ninety-six persons with disabilities participated in a rapid Assistive Technology Assessment (rATA) survey. Six focus group discussions (FGDs) with people with various types of disabilities were conducted. The rATA questionnaire and FGDs collected data on assistive products (APs) participants used, APs they needed and the challenges they experienced. Data collection was done in six districts spread across the three regions in Malawi. All age groups were included in the survey. Persons with disabilities aged less than 18 participated but went with their guardians. All persons who participated in this study provided consent. Survey and FGDs results were presented at an APL consensus meeting with policymakers, service providers, disabled peoples' organizations and development partners in the disability sector. Based on the results and further discussions, a consensus was reached on the priority APs for Malawi. More than a third of respondents used wheelchairs (32%), followed by auxiliary crutches (25%), walking sticks (13%), reading glasses (11%), prosthesis (10%), elbow crutches (9%) and orthosis (8%). There is also a high demand for products such as pull-up underwear (incontinence products) (79%), hearing aids (70%), reading glasses (59%) and diapers (63%). After intensive discussions during a consensus meeting, an agreement was reached on the 22 priority APs for Malawi. There is a wide range of APs being used by people with different functional limitations in Malawi. There is also a demand for APs that are not readily available. When developing an APL, the list should include products in use, those in demand, and those recommended by service providers. Following the development of the priority assistive products list (APL) by WHO, member states should develop their own contextually based APL. The development of the APL should be based on research evidence. All key stakeholders including persons with disabilities and other functional limitations, government, and development partners should participate in this process. The APL should be part of the national health system or community services. The Department of Disability and Elderly Affairs in the Ministry of Gender, Community Development, being the Government of Malawi line ministry coordinating disability issues participated actively in this study including inviting participants in the stakeholders' validation workshop. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the topic?: Mental health‐related problems in pregnancy are now becoming a global health concern. However, most studies have reported that midwives are unable to assess and support maternal mothers due to poor preservice education. The findings of these studies needed to be explored further from the available literature to address the gap. What does the paper add to existing knowledge?: The paper has identified maternal mental health core competencies and innovative clinical teaching strategies that nurse educators can utilize when supporting students theoretically and during clinical practice so that students should be adequately prepared for maternal mental health practice.Challenges and recommendations for clinical teaching were also identified. However, there are still gaps in the literature related to the effectiveness of teaching strategies to promote competence acquisition in maternal mental health. What are the implications for education?: The study results can be used by nurse educators to develop effective clinical teaching practices in maternal mental health care. The findings can be used in the development of best clinical teaching guidelines for maternal or perinatal mental health to be used by nurse educators for the undergraduate midwifery training programmes. Introduction: Maternal mental health problems are commonly experienced by women; however, they are usually not adequately recognized and treated by midwives in Malawi. Evidence suggests poor preservice education by nursing colleges which affects the development of essential maternal mental health competencies. Aim: The aim of the study was to review existing evidence on clinical teaching practices by nurse educators in teaching student midwives maternal mental health care. Method: Integrative review method was used, and various databases were searched. Out of 1768 articles, 27 research articles met the inclusion criteria. The critical appraisal skills programme checklist tools were used to assess data quality. Thematic analysis was done by comparing, grouping and integrating data. Results: Six themes emerged, namely: core maternal mental health competencies, professional regulation, interactive teaching strategies, collaborative partnerships, capacity building and shortage of resources. Discussion: Clinical teaching is an important aspect of midwifery education. Utilizing student‐centred teaching approaches helps students acquire competencies in maternal mental health care. Further research is required to identify the effectiveness of the clinical teaching methods. The Implication to Practice: The study results can assist nurse educators to provide comprehensive clinical teaching practices in maternal mental health care which will aid in the development of maternal mental health competencies among student midwives. [ABSTRACT FROM AUTHOR]

In the histories of both colonial and postcolonial Malawi, there have been cases of religious-related violence, both in its physical and non-physical forms. Such cases have led to the deaths of the "perpetrators" of violence and 'innocent' believers, destruction of property, prison detentions, and even the forced removal of citizens from the country. This paper analyzes two case studies, one in which private citizens perpetrated the violence, led by a preacher called John Chilembwe, of the Providence Industrial Mission (PIM), challenging British colonial authorities during the second decade of the twentieth century. In the second case, the focus is on the independent Malawi government, which used violence against members of the Jehovah's Witness (JW) religious sect from the early 1960s to the early 1990s, owing to the Witnesses' disassociation from the demands of the secular state. Using data primarily drawn from various archives and other published studies, this paper argues that the use of 'religious-based violence' is not just a domain 'reserved' for those experiencing oppression, exclusion, and marginalization. Rather, authoritarian governments, like the one that emerged in postcolonial Malawi and other parts of Africa, also resorted to using 'religious-based violence' to serve as a tool for eliminating 'non-conforming' religious sects and organizations. In doing so, this paper contributes to the various fields of scholarship, including the relationship between religion and violence in modern Africa and the dynamics and operations of the state in both colonial and postcolonial Africa. [ABSTRACT FROM AUTHOR]

Candidate debates are increasingly organized during elections in democracies and electoral autocracies. How do debates impact partisan divisions and preferences in these contexts? One theoretical perspective suggests that debates should amplify these preferences and divisions, while another implies debates should attenuate them. This paper evaluates these expectations by studying presidential debates organized during Malawi's May 2019 elections. With an experiment and national panel survey, the paper provides evidence consistent with attenuation: debate watchers were substantially more likely to vote across partisan lines (cross-party voting), became more favorable toward out-partisan candidates, and became less favorable toward co-partisans. Suggestive evidence on causal mechanisms shows that these effects were driven by policy persuasion and debates' impact on perceptions of the candidates' policies and qualities. Results advance debates about information processing, campaign effects, and voting behavior in new democracies and electoral autocracies, and have implications for electoral institutions' impact on partisan divisions. [ABSTRACT FROM AUTHOR]

Agricultural markets remain major issue downgrading root and tuber crop farmers who form the mainstream of the agricultural producers in Malawi. Recent evidence however reveals that orange‐fleshed sweet potato (OFSP) (Ipomea batatas) is currently being sold in produce markets along with the non‐orange varieties, sometimes in differentiated form in Malawi. The main objective of this study was to examine factors affecting market participation of sweet potato farmers in southern region of Malawi. Using a double‐hurdle model, this paper analyzed both the factors affecting farmer decision to participate and the extent/intensity of participation in market. The first tier of the double hurdle focused on decision to participate in the market using probit model and the second tier addressed factors affecting intensity of participation using truncated normal regression model. The paper used data collected from 360 farmers in southern districts of Malawi. Out of 360, 146 farmers had grown OFSP in the season preceding the survey. Double hurdle results indicate that farm size, output, age of a farmer (household head), and early maturing trait significantly determined decision to participate in the market. Further, results on intensity of participation indicate that access to market training, farm size, asset value, and output positively determined the intensity and negatively determined by distance to main market and gender of a farmer (household head). Based on the research findings, higher output levels and early maturing trait were found to increase smallholder farmer market participation. It is therefore recommended that strategies aimed at increasing household capacity to produce surplus produce through market tailored extension messages and productivity enhancement technologies could be highly effective in fostering smallholders' participation in commercial markets. Again, enhanced capacity building of research institutions to breed sweet potato varieties based on market demand is pivotal for increased market participation. Furthermore, research suggests that improving smallholder farmers' access to market price information, asset value, and farm size can help increase their intensity in the market. Therefore, it is critical for policymakers to holistically comprehend these socioeconomic factors in order to address the issue of smallholder farm households' decisions about market participation and the degree to which they participate. Core Ideas: Orange fleshed sweet potato is currently being sold along with non‐orange varieties, sometimes in differentiated.Decision to participate in market is significantly influenced by output, farm size, age early maturing attribute.Market intensity is determined by access to training, distance to market, farm size, gender, asset value and output.Breeding programs should integrate both sensory and agronomic traits such as early maturity and good taste. [ABSTRACT FROM AUTHOR]

Introduction: Programme Science (PS) and community‐led monitoring (CLM) intersect in unexpected and promising ways. This commentary examines a CLM initiative in Malawi and South Africa to highlight the crucial role of CLM in bolstering the PS framework. By leveraging data sources often overlooked by conventional research and evaluation approaches, CLM emerges as a pivotal element in enhancing programme effectiveness. This paper delineates the fundamental principles of CLM, presents programme outcomes derived from CLM methodologies and contextualizes these findings within the broader framework of PS. Discussion: The Citizen Science Project implements CLM continuously at 33 health facilities: 14 in Malawi (eight in Kasungu District and six in Dedza District), and 19 in South Africa (all in the West Rand District), representing a total catchment area of 989,848 people. Monitoring indicators are developed in an iterative process with community groups. The indicators are unique to each country, but both focus on the uptake of health services (quantitative) and barriers to access (qualitative). Monthly clinic records surveys capture 34 indicators in Malawi and 20 in South Africa and are supplemented by qualitative interviews with care recipients and healthcare workers. Qualitative interviews provide additional granularity and help confirm and explain the more macro trends in service coverage as described in quantitative data. The resulting data analysis reveals key themes that help stakeholders and decision‐makers to solve problems collaboratively. Noteworthy outcomes include a substantial increase in multi‐month dispensing of antiretroviral therapy (ART) during COVID‐19 (from 6% to 31%) with a subsequent recovery surpassing of HIV service benchmarks in Malawi post‐pandemic. Conclusions: While quantifying direct impact remains challenging due to the project's design, CLM proves to be a robust methodology that generates credible data and produces impactful outcomes. Its potential extends beyond the health sector, empowering community leadership and fostering interventions aligned with community needs. As CLM continues to evolve, its integration into PS promises to improve relevance, quality and impact across diverse disciplines. [ABSTRACT FROM AUTHOR]

Landslide event inventories are one of the most critical datasets to increase knowledge on landslide occurrences. However, they are rarely available in various regions, especially in countries of the Global South. This study aims to generate rainfall-induced landslide event inventories and define the rainfall thresholds responsible for landslide occurrence at the national scale of Malawi, Africa. We mainly followed a three-step methodology to generate landslide inventories. First, we went through media reports to identify documented landslide events. Second, we used Sentinel-2 images to identify possible areas affected by landslides using automated change detection algorithms based on vegetation indices. Third, we manually went through optical images provided by Planet Lab and Google Earth and mapped landslides via visual image interpretation. Overall, we mapped 27 rainfall-induced landslide inventories between 2003 and 2022, with a total of 4709 individual landslides. We then analysed the Malawian terrain and identified two different landscape clusters (i.e. Cluster 1 and Cluster 2) showing similar morphometric and climatic conditions. Ultimately, we calculated the rainfall threshold for each landscape cluster. The minimum rainfall amounts responsible for landsliding correspond to 66 mm/two-day and 51 mm/day in Clusters 1 and 2, respectively. In this context, our paper not only presents and shares the first national-scale, digital rainfall-induced landslide event inventory database of Malawi but also suitable rainfall thresholds to be potentially exploited for a national scale landslide early warning system. A similar framework could be applied to generate landslide inventories for other data scarce regions. [ABSTRACT FROM AUTHOR]

Globally, rural conditions are in states of change. They are often highly vulnerable to climate and environmental change, extreme weather events, conflict, socio-economic changes, inequalities, and demographic changes. These changes are putting stress on rural areas, which rely upon agriculture and natural resources for their livelihoods and are often the foundation of national economies. Communication for development (C4D) has played an important role in addressing these challenges. Its thinking is broadly consistent with rural development goals—indeed, the roots of C4D come in part from rural development and agricultural extension. Communication for development (C4D) was defined by the World Congress on Communication for Development as "...a social process based on dialogue using a broad range of tools and methods. It also seeks change at different levels, including listening, building trust, sharing knowledge and skills, building policies, debating, and learning for sustained and meaningful change. It is not public relations or corporate communications". However, after decades of action to address these interrelated rural development challenges, much remains to be done. This paper critically considers the following: What does inclusive rural development mean now, in light of environmental change, and how does this affect the conceptualisation and practice of C4D? This was done by using three countries as case studies: Malawi, Ukraine, and the Philippines. Each of these countries represented contrasting challenges and opportunities for rural development and environmental change, with lessons from their experiences shedding insight into the communication for development thinking. [ABSTRACT FROM AUTHOR]

This paper proposes a new approach to monitoring farmer prices in low-income developing countries. This crowdsourcing approach involves broadcasting radio jingles inviting farmers to report the prices and locations at which they sold their crops to a toll-free call centre, with weekly prizes to incentivize reporting. An application to Malawi illustrates the feasibility of this approach in a setting where internet connectivity is limited but mobile phone coverage is reasonable. The majority of farmers reporting sold to assemblers or small traders and received substantially less than official minimum farm gate prices. Non-parametric analysis shows that farmer prices vary according to bargaining power and sales volume but not by distance to the point of sale. These findings may be explained by the fragmented and monopsonistic nature of food markets in Malawi, and farmers' mode of transport to the point of sale. [ABSTRACT FROM AUTHOR]

Summary: Although wildlife management models across the world have since the early 1980s shifted from top-down fortress conservation to different labels of people-friendly community-based conservation, their outcomes remain contested. This paper explores how, and in whose interests, approaches to wildlife conservation in Malawi have been reconfigured from fortress conservation to market–community collaborative management. Based on qualitative field data, we demonstrate how varying levels of community participation in the processes of wildlife conservation transformed the identities and interests of powerful groups of people regarding wildlife conservation in the Majete Wildlife Reserve. We highlight how commodification and monetarization of wildlife conservation served the interests of the emergent powerful groups whilst marginalizing those of the weak. The work indicates how new community identities with regard to wildlife conservation mask the power hegemonies that dictate mechanisms of inclusion and exclusion regarding natural resource use. [ABSTRACT FROM AUTHOR]

In sub-Saharan Africa, water insecurity is intertwined with gender and sociocultural norms. While extensive scholarship exists on gender-water relations in the region, it predominantly focuses on women's roles and responsibilities, seldom considering the role of masculinities. This paper examines masculinities, gender relations, and women's embodied experiences of water insecurity. It situates women's embodied experiences of water insecurity within household and community masculinities. The study was conducted in Lilongwe, Malawi, and data were drawn from interviews, focus groups, observations, and household surveys. The findings advance the gender-water literature in at least three significant ways. First, they demonstrate how gendered labour underpins women's embodied experiences of water insecurity. Second, they show that women's decisions and strategies for coping with water insecurity are themselves an embodied consequence of water insecurity. Finally, they illuminate how men's perceptions and constructions of masculinity, expressed through marital expectations of femininity, shape women's embodied experiences of water insecurity. Together, the findings reveal intricate intersections between masculinities, gender relations, and women's everyday embodied experiences of water insecurity, validating the body as a significant site of geographic inquiry. [ABSTRACT FROM AUTHOR]

Background: Health research is typically disseminated through peer-reviewed journals and academic forums. However, evidence suggests limited exploration of alternative communication methods for effective knowledge dissemination. Objectives: This study aimed to determine the extent to which policymakers in Malawi consult health researchers while translating their knowledge. This study aimed to determine the postresearch endeavours of Malawian health researchers to incorporate research findings into policy and decision making. Method: Conducted at Kamuzu University of Health Sciences (KUHeS), this cross-sectional study employed a 5-point Likert scale survey to collect data from researchers, offering a snapshot view without indicating temporal changes or causality. Results: Researchers rarely created suggestions, take-home messages, or actionable instructions for use by health officials. They seldom give users access to a searchable database of papers, studies, and syntheses that summarise recommendations for policymakers in the field of health. They seldom send reprints of papers from scientific publications to decisionmakers. Few researchers have created summaries of articles or systematic reviews for health officials’ use. Conclusion: Traditional channels, such as journals and conferences, dominate the dissemination of health research. However, limited evidence suggests the need for broader communication strategies. The current landscape lacks effective products and methods, urging researchers to produce accessible formats with clear, key messages to address policy questions. Contribution: Researchers should develop research products in compelling formats by using clear key messages. The summarised evidence should answer important policy questions. Researchers should involve the media to communicate their research outputs. [ABSTRACT FROM AUTHOR]

In this paper, Indigenous and local understandings of the role of storytelling for children (nthanu) are contrasted with the didactic understandings of children's stories that permeate the formal education frameworks of Malawi; frameworks which are deeply entangled in a colonial and (post)colonial history. For Chitonga speakers, the majority of whom live in rural communities along the northern lakeshore of Malawi, nthanu form a crucial part of what might be considered 'education' – as core components in the construction of the social-self, these oral stories play a critical role in the onto-epistemological formation of the young person. This storytelling is seen as marginalised by formal school systems. Through thick ethnographic material, the paper shows how people who are part of the ethno-linguistic group of the Tonga understand the role of story-telling for children as creating ontological notions of what it means to be human, to live in this world, and the sociality of being human that is seen as necessary for living a good life. In an examination of villagers' fears about the disappearance of their stories, the paper locates the tensions between the literacy-oriented use of stories in formal schooling and the socio-ontological importance ascribed to stories in local learning modalities. [ABSTRACT FROM AUTHOR]

Background: Sub-Saharan Africa is the region with the highest under-five mortality rate globally. Child healthcare decisions should be based on rigorously developed evidence-informed guidelines. The Global Evidence, Local Adaptation (GELA) project is enhancing capacity to use global research to develop locally relevant guidelines for newborn and child health in South Africa (SA), Malawi, and Nigeria. The first step in this process was to identify national priorities for newborn and child health guideline development, and this paper describes our approach. Methods: We followed a good practice method for priority setting, including stakeholder engagement, online priority setting surveys and consensus meetings, conducted separately in South Africa, Malawi and Nigeria. We established national Steering Groups (SG), comprising 10–13 members representing government, academia, and other stakeholders, identified through existing contacts and references, who helped prioritise initial topics identified by research teams and oversaw the process. Various stakeholders were consulted via online surveys to rate the importance of topics, with results informing consensus meetings with SGs where final priority topics were agreed. Results: Based on survey results, nine, 10 and 11 topics were identified in SA, Malawi, and Nigeria respectively, which informed consensus meetings. Through voting and discussion within meetings, and further engagement after the meetings, the top three priority topics were identified in each country. In SA, the topics concerned anemia prevention in infants and young children and post-discharge support for caregivers of preterm and LBW babies. In Malawi, they focused on enteral nutrition in critically ill children, diagnosis of childhood cancers in the community, and caring for neonates. In Nigeria, the topics focused on identifying pre-eclampsia in the community, hand hygiene compliance to prevent infections, and enteral nutrition for LBW and preterm infants. Conclusions: Through dynamic and iterative stakeholder engagement, we identified three priority topics for guideline development on newborn and child health in SA, Malawi and Nigeria. Topics were specific to contexts, with no overlap, which highlights the importance of contextualised priority setting as well as of the relationships with key decisionmakers who help define the priorities. [ABSTRACT FROM AUTHOR]

Background: Data on SARS-CoV-2 infection in pregnancy and infancy has accumulated throughout the course of the pandemic, though evidence regarding asymptomatic SARS-CoV-2 infection and adverse birth outcomes are scarce. Limited information is available from countries in sub-Saharan Africa (SSA). The pregnant woman and infant COVID in Africa study (PeriCOVID Africa) is a South-South-North partnership involving hospitals and health centres in five countries: Malawi, Uganda, Mozambique, The Gambia, and Kenya. The study leveraged data from three ongoing prospective cohort studies: Preparing for Group B Streptococcal Vaccines (GBS PREPARE), SARS-CoV-2 infection and COVID-19 in women and their infants in Kampala and Mukono (COMAC) and Pregnancy Care Integrating Translational Science Everywhere (PRECISE). In this paper we describe the seroepidemiology of SARS-CoV-2 infection in pregnant women enrolled in sites in Uganda and Malawi, and the impact of SARS-CoV-2 infection on pregnancy and infant outcomes. Outcome: Seroprevalence of SARS-CoV-2 antibodies in maternal blood, reported as the proportion of seropositive women by study site and wave of COVID-19 within each country. Methods: The PeriCOVID study was a prospective mother-infant cohort study that recruited pregnant women at any gestation antenatally or on the day of delivery. Maternal and cord blood samples were tested for SARS-CoV-2 antibodies using Wantai and Euroimmune ELISA. In periCOVID Uganda and Malawi nose and throat swabs for SARS-Cov-2 RT-PCR were obtained. Results: In total, 1379 women were enrolled, giving birth to 1387 infants. Overall, 63% of pregnant women had a SARS-CoV-2 positive serology. Over subsequent waves (delta and omicron), in the absence of vaccination, seropositivity rose from 20% to over 80%. The placental transfer GMR was 1.7, indicating active placental transfer of anti-spike IgG. There was no association between SARS-CoV-2 antibody positivity and adverse pregnancy or infancy outcomes. [ABSTRACT FROM AUTHOR]

Farmers' low adoption rate of improved common bean varieties is the root cause of other challenges that stakeholders in Malawi's common bean value chain face in marketing, seed production, processing, and consumption. As a result, it is ideal to address the issue of low uptake by encouraging farmers to adopt improved varieties to make more significant contributions to the common bean value chain. The study's main objective was to assess the impact of multi-stakeholder platforms (MSPs) and farmers' attitudes on the uptake of improved common bean varieties. According to the findings of the KAP survey, there is a correlation between farmers' knowledge, attitude, and uptake of improved common bean varieties. Using a probit model, the paper discovered that farmers in the project area's intervention site had a 25% higher probability of uptake than farmers in the counterfactual site. Farmer households that were members of MSPs were more likely to participate than farmer households that were not members of any MSP. Meanwhile, farmers who were negative or neutral about the accessibility and affordability of improved common bean varieties were less likely to uptake them than those who were positive. According to the findings, farmers with a neutral attitude toward the yield potential of the improved common bean varieties had a lower probability of uptake than farmers with a positive attitude. Therefore, the study recommends MSP-based initiatives as one way to promote the uptake of improved common bean varieties. [ABSTRACT FROM AUTHOR]

Background: The best chance of eradicating the COVID-19 pandemic lies in a successful vaccination campaign against the virus. There is still hesitancy among some of the Malawians over the use of COVID-19 vaccines that are readily available. This review's objective was to currently analyze COVID-19 vaccination hesitancy among Malawians. Methods: This scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. An electronic database search was performed using CINAHL, OVID Medline, PubMed, and Google Scholar for studies published between January 1, 2020, and July 10, 2023, on the topic of reluctance toward COVID-19 vaccine in Malawi. A review of the journal titles and abstracts was performed to establish a match within the selection criteria. Based on the parameters of interest, this paper included publications that explicitly mentioned COVID-19 vaccine hesitancy in Malawi. Results: A total of seven articles were identified as meeting the inclusion criteria. Some of the eligible Malawian population's poor response to COVID-19 vaccination was due to hesitancy. Misinformation is primarily to blame for COVID-19 vaccine reluctance. COVID-19 vaccines are viewed as dangerous or intended to cause harm such as the myth that the COVID-19 vaccine would cause infertility, severe disability, and even death. The review revealed that some people choose not to receive vaccines due to religious convictions and beliefs. Some individuals also think that getting the COVID-19 vaccine could result in receiving a triple-six (666) mark from the devil. There were also reports that the COVID-19 vaccination is being considered experimental and ineffective. Conclusions: The Malawi government should focus on fear and misinformation regarding COVID-19 vaccination campaigns, using interventions, motivational interviews, and individual sensitization. Traditional, religious, and youth-led organizations should provide practical information on COVID-19 vaccine safety and efficacy. [ABSTRACT FROM AUTHOR]

Background: Lymphatic filariasis (LF) is a parasitic disease transmitted by mosquitoes, causing severe pain, disfiguring, and disabling clinical conditions such as lymphoedema and hydrocoele. LF is a global public health problem affecting 72 countries, primarily in Africa and Asia. Since 2000, the World Health Organization (WHO) has led the Global Programme to Eliminate Lymphatic Filariasis (GPELF) to support all endemic regions. This paper focuses on the achievements of the Malawi LF Elimination Programme between 2000 and 2020 to eliminate LF as a public health problem, making it the second sub-Saharan country to receive validation from the WHO. Methodology/principal findings: The Malawi LF Programme addressed the widespread prevalence of LF infection and disease across the country, using the recommended WHO GPELF strategies and operational research initiatives in collaboration with key national and international partners. First, to stop the spread of infection (i.e., interrupt transmission) and reduce the circulating filarial antigen prevalence from as high as 74.4% to below the critical threshold of 1–2% prevalence, mass drug administration (MDA) using a two-drug regime was implemented at high coverage rates (>65%) of the total population, with supplementary interventions from other programmes (e.g., malaria vector control). The decline in prevalence was monitored and confirmed over time using several impact assessment and post-treatment surveillance tools including the standard sentinel site, spot check, and transmission assessment surveys and alternative integrated, hotspot, and easy-access group surveys. Second, to alleviate suffering of the affected populations (i.e., control morbidity) the morbidity management and disability prevention (MMDP) package of care was implemented. Specifically, clinical case estimates were obtained via house-to-house patient searching activities; health personnel and patients were trained in self-care protocols for lymphoedema and/or referrals to hospitals for hydrocoele surgery; and the readiness and quality of treatment and services were assessed with new survey tools. Conclusions: Malawi's elimination of LF will ensure that future generations are not infected and suffer from the disfiguring and disabling disease. However, it will be critical that the Malawi LF Elimination programme remains vigilant, focussing on post-elimination surveillance and MMDP implementation and integration into routine health systems to support long-term sustainability and ongoing success. Summary: Lymphatic filariasis, also known as elephantiasis, is a disabling, disfiguring, and painful disease caused by a parasite that infected mosquitoes transmit to millions of people worldwide. Since 2000, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) has supported endemic countries such as Malawi in south-eastern Africa, to eliminate the disease as a public health problem. The Malawi National LF Elimination Programme has worked tirelessly over the past two decades to implement the GPELF recommended strategies to interrupt the transmission with a two-drug regime, and to alleviate suffering in patients with lymphoedema and/or hydrocoele through morbidity management and disability prevention. Additionally, the LF Programme has collaborated with national and international stakeholders to implement a range of supplementary operational research projects to address outstanding knowledge gaps and programmatic barriers. In 2020, the World Health Organisation validated that Malawi had successfully eliminated LF as a public health problem, making it the second country in sub-Saharan Africa to achieve this, which is remarkable given that Malawi previously had very high infection rates. The LF Programme now remains vigilant, putting its efforts towards post-elimination surveillance and the continued implementation of care for patients with chronic conditions. Malawi's elimination of LF will ensure that future generations are not affected by this devastating disease. [ABSTRACT FROM AUTHOR]

The purpose of this 2-year study was to investigate Malawian teacher educators' perspectives and dispositions toward teaching about ecological sustainability issues in Malawi, a developing country in sub-Sahara Africa. This study was embedded in a larger theoretical framework of investigating earth systems science through the understanding of nature–knowledge–culture systems from local, place-based perspectives. Specifically, we were interested in learning more about eco-justice issues that are related to environmental degradation in Malawi and the potential role of inquiry-oriented pedagogies in addressing these issues. In a science methods course, the African educators' views on deforestation and teaching about ecological sustainability were explored within the context of the local environment and culture. Teachers participated in inquiry pedagogies designed to promote the sharing of perspectives related to the connections between culture and ecological degradation. Strategies encouraging dialogue and reflection included role-playing, class discussions, curriculum development activities, teaching experiences with children, and field trips to a nature preserve. Data were analyzed from postcolonial and critical pedagogy of place theoretical perspectives to better understand the hybridization of viewpoints influenced by both Western and indigenous science and the political hegemonies that impact sustainable living in Malawi. Findings suggested that the colonial legacy of Malawi continues to impact the ecological sustainability issue of deforestation. Inquiry-oriented pedagogies and connections to indigenous science were embraced by the Malawian educators as a means to involve children in investigation, decision making, and ownership of critical environmental issues. © 2006 Wiley Periodicals, Inc. Sci Ed90:660–680, 2006 [ABSTRACT FROM AUTHOR]

Background: Fewer than 1 in 20 people on the African continent in need of palliative care receive it. Malawi is a low-income country in sub-Saharan Africa that has yet to achieve advanced palliative care integration accompanied by unrestricted access to pain and symptom relieving palliative medicines. This paper studied the impact of Malawi's Waterloo Coalition Initiative (WCI) – a local project promoting palliative care integration through service development, staff training, and increased service access. Methods: Interdisciplinary health professionals at 13 hospitals in southern Malawi were provided robust palliative care training over a 10-month period. We used a cross-sectional evaluation to measure palliative care integration based on 11 consensus-based indicators over a one-year period. Results: 92% of hospitals made significant progress in all 11 indicators. Specifically, there was a 69% increase in the number of dedicated palliative care rooms/clinics, a total of 253 staff trained across all hospitals (a 220% increase in the region), substantive increases in the number of patients receiving or assessed for palliative care, and the number of hospitals that maintained access to morphine or other opioid analgesics while increasing the proportion of referrals to hospice or other palliative care programs. Conclusion: Palliative care is a component of universal health coverage and Sustainable Development Goal 3. The WCI has made tremendous strides in establishing and integrating palliative care services in Malawi with notable progress across 11 project indicators, demonstrating that increased palliative care access is possible in severely resource-constrained settings through sustained models of partnership at the local level. [ABSTRACT FROM AUTHOR]

Background: Health information management (HIM) is at the core of health organisations, providing essential information. In Malawi, there is a substantial deficit of qualified personnel, specifically health information managers, who can properly manage health information in electronic and paper-based formats. The nation has no higher education institution offering an academic programme in HIM. Objective: To investigate the need for HIM professionals in Malawi government health facilities, to determine the kinds of data managed by data users; competencies of HIM workers and challenges associated with the current HIM system. Method: A cross-sectional research design was adopted, with a qualitative approach to gather data from data users and key informants, using two focused interview guides. Data were collected from 13 participants from 6 government health facilities representing the primary, secondary and tertiary healthcare delivery levels. Data were analysed thematically. Results: Data users handled a diverse range of data, the majority having moderate skills in HIM. Both data users and key informants reported experiencing challenges in dealing with the existing HIM system. Findings also revealed key challenges associated with the absence, or inadequacy, of a well-trained HIM professional workforce in Malawi health facilities. Conclusion: Introducing a training programme in HIM would improve data management in health facilities in Malawi. Well-managed data would improve the delivery of health care services. [ABSTRACT FROM AUTHOR]

Recently, the environmental problem has become a global issue. The air to fuel ratio (AFR) in the combustion of thermal power plants directly influences pollutants and thermal efficiency. A research result was published showing that the AFR control performance of thermal power plants can be improved through supplementary control using dynamic matrix control (DMC). However, online optimization of DMC needs an extra computer server in implementation. This paper proposes a practical AFR control with one-step ahead control which does not use online optimization and can be implemented directly in existing distributed control system (DCS) of thermal power plants. Closed-loop transfer function models at three operating points are independently developed offline. Then, an online transfer function using interpolation of offline models is applied at each sampling step. A simple one-step ahead control with online transfer function is applied as a supplementary control of AFR. Simulations with two different type power plants, a 600 MW oil-fired drum-type power plant and a 1000 MW ultra supercritical (USC) coal-fired once-through type power plant, are performed to show the effectiveness of the proposed control structure. Simulation results show that the proposed supplementary control can effectively improve the conventional AFR control performance of power plants. [ABSTRACT FROM AUTHOR]

People with psychosis in Malawi have very limited access to timely assessment and evidence-based care, leading to a long duration of untreated psychosis and persistent disability. Most people with psychosis in the country consult traditional or religious healers. Stigmatising attitudes are common and services have limited capacity, particularly in rural areas. This paper, focusing on pathways to care for psychosis in Malawi, is based on the Wellcome Trust Psychosis Flagship Report on the Landscape of Mental Health Services for Psychosis in Malawi. Its purpose is to inform Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE), a longitudinal study that aims to build on existing services to develop sustainable psychosis detection systems and management pathways to promote recovery. [ABSTRACT FROM AUTHOR]

In Malawi, there is a cadre of mid-level health workers called clinical officers (COs) who undertake duties conventionally performed by medical doctors in the wake of an acute shortage of the latter. This paper argues that excessive workload and long hours of work are psychosocial hazards at public hospitals in Malawi that contribute to occupational stress (OS) and burnout among COs. The study from which this paper is derived adopted a qualitative research design with a case study as a research strategy. The study was conducted at four district hospitals and one central hospital, which are state-owned in Malawi. This paper argues, firstly, that before the COVID-19 pandemic, COs experienced OS and burnout due to excessive workloads and long hours of work at public hospitals. Secondly, the COVID-19 pandemic aggravated the problem of excessive workloads and long hours of work at public hospitals. Thirdly, OS and burnout among COs are associated with various impacts that can be categorised as psychological consequences and physical consequences. The psychological and physical consequences of OS and burnout are manifestations of poor quality of life among COs, which ultimately negatively affects public health. Finally, this paper recommends formulating and implementing comprehensive occupational safety and health (OSH) policies at public hospitals. Among others, these OSH policies should provide frameworks for regularly assessing the impact of OSH hazards on the mental health of hospital staff and then informing the development of appropriate measures for mitigation. [ABSTRACT FROM AUTHOR]

This paper reports the findings of a study on information literacy (IL) skills and competencies of nursing students at the Kamuzu University of Health Sciences in Malawi. This study adopted a cross-sectional descriptive design. The population for this study was nursing students of Kamuzu University of Health Sciences. Quantitative and qualitative data were collected through an online questionnaire that contained closed- and open-ended questions. Quantitative data were analysed using descriptive statistics in the form of charts, graphs, and relative frequencies. Qualitative data, on the other hand, were analysed using thematic analysis. The findings revealed that nursing students received several IL programme offerings that included on-campus IL sessions organised by the library, curriculumembedded IL programmes, and library instructional sessions. The findings further indicate that most students used Google as their primary source of information, while library subscription databases were minimally used. Besides wanting to learn the citation and referencing styles and how to avoid plagiarism, students wanted to learn how to find and evaluate information. The respondents recommended that IL skills be embedded in the nursing curriculum to make them more effective. This paper provides lessons to health-related institutions that may be planning on revamping their IL programme offerings to make them more relevant to students. The current study advocates for a more systematic approach in which IL should be part of the curriculum developed and offered by librarians in collaboration with faculty members. [ABSTRACT FROM AUTHOR]

As organizations grow, so does the volume of records they produce when conducting their business with the resulting large customer base. Studies have established that all forms of organizations that do not have a well-coordinated records management system face a variety of risks and challenges that can collapse the business operations of these organizations. This qualitative study employs interview and observation guides to analyse records management practices at the Northern Region Water Board, a public organization in Malawi. Specifically, the study focuses on establishing records creation practices, records management strategies and the challenges that that affect records management. The study establishes that the institution creates both electronic and paper-based records. The electronic records are stored and preserved in a networked system called Enterprise Resource Planning; some are kept in free standing devices such as personal computers. Paper-based records are kept in files and folders locked in drawers and cabinets while some are kept on shelves. The institution faces four key challenges in managing its records namely, lack of management support, lack of records management skills, poor infrastructure and absence of formal policies, strategies and guidelines. [ABSTRACT FROM AUTHOR]

Background: Responsive and resilient strategies to reduce high rates of maternal and infant mortality and clinician shortages are needed in low- and middle-income countries (LMICs). Malawi has some of the highest maternal and infant mortality rates globally. Group healthcare is a service delivery model that integrates these strategies. Although primarily implemented during the prenatal period, its potential for improving both maternal and infant health outcomes during the postpartum period has not been realized. The purpose of this study was to adapt and co-design the prototype for an evidence-based group care model for the postpartum period using a human-centered design approach with key stakeholders in Malawi. Methods: We completed steps of a framework guiding the use of human-centered design: 1) define the problem and assemble a team; 2) gather information through evidence and inspiration; 3) synthesize; and 4) intervention design: guiding principles and ideation. Qualitative methods were used to complete steps 2–4. In-depth interviews (n = 24), and incubator sessions (n = 6) that employed free listing, pile sorting and ranking were completed with key stakeholders. Data analysis consisted of content analysis of interviews and framework analysis for incubator sessions to produce the integrated group postpartum and well-child care model prototype. The fifth step is detailed in a separate paper. Results: All stakeholders reported a desire to participate in and offer group care in the postpartum period. Stakeholders worked collaboratively to co-create the prototype that included a curriculum of health promotion topics and interactive activities and the service delivery structure. Health promotion topic priorities were hygiene, breastfeeding, family planning, nutrition, and mental health. The recommended schedule included 6 sessions corresponding with the child vaccination schedule over the 12-month postpartum period. Conclusions: Using a human-centered design approach to adapt an evidence-based group care model in an LMIC, specifically Malawi, is feasible and acceptable to key stakeholders and resulted in a prototype curriculum and practical strategies for clinic implementation. [ABSTRACT FROM AUTHOR]

This paper examines the politics and dynamics of the policy design and practical policy implementation realities of institutional transformation in a developing country context. The paper finds that there has been a mismatch between policy design templates of institutional transformation and the actual practice in terms of transformational implementation outcomes. Taking decentralisation reforms within the Ministry of Health in Malawi as a case study, the paper underscores that the contextual realities of institutional transformation in the country have been manifested by path dependence tendencies characterised by reproduction that takes shape in a contradictory fashion to the underlying institutional logics. The resultant policy of the reproduction and contradiction in terms of policy practice is institutional legitimacy crisis characterised by support from institutional entrepreneurs that are benefiting from positive feedback and increasing returns of the old institution, and challengers that regard the reproductions and contradictions as restrictive and mismatching institutional transformation design. [ABSTRACT FROM AUTHOR]

This paper analyses the causes, processes and systemic factors that have been central to Malawi's post-independence foreign policy and its implications for national development policy options between 1964 and 1993. The paper argues that Malawi's post-independence foreign policy and development direction were mainly adopted in reaction to the failure of Kamuzu Banda (the first president of Malawi) to win international support (at an Organisation of African Unity summit) for his quest to interact economically with more countries. From a historical institutionalist perspective, it can be argued that this rejection "carved out" a future foreign policy direction that was deliberately meant to "rebel" against the Organisation of African Unity's prescriptions. Subsequent development policies (for instance, maintaining ties with Israel and the apartheid South African regime) were actually more of an aftermath of this "carved-out" foreign policy direction. In other words, foreign policy dictated the development policy options. The findings are drawn from available documentary sources (new and old) and a review of existing literature. Through a re-examination of the existing evidence in the context of historical institutionalism, it provokes and recasts a new and fascinating debate on Malawi's post-independence foreign policy architecture. [ABSTRACT FROM AUTHOR]

Background: Even though evidence based practice (EBP) is being considered as a critical element in improving the quality of health services and achieving excellence in patient care, there is currently little knowledge of how EBP relates to nursing and midwifery in Malawi. This paper is a report of a study describing EBP knowledge, attitudes, and use of registered nurse-midwives practicing in central hospitals across Malawi. Methods: The descriptive, cross-sectional research design was conducted with a randomly selected sample of 183 nurse-midwives (response rate of 87.9%). The study used a paper version questionnaire to collect the data. The data were analysed using both descriptive and inferential statistics in the Statistical Product and Service Solutions version 23. Descriptive statistics were calculated to summarise overall knowledge levels, attitudes, and use of nurse-midwives as percentages based on their scores on the assessment scale (1 to 7 Likert scale) in the EBP questionnaire. Non-parametric Mann-Whitney and Kruskal-Wallis tests were carried out to compare evidence-based practice scores based on demographics. Pearson's correlation (r) and stepwise regression analysis were further performed to analyse the relationship between the knowledge, attitude and use of nurse-midwives on the overall EBP of nurse-midwives. Results: The average scores (mean±SD) of evidence-based practice amongst nurse-midwives were 78.7 ± 19.6 for attitude, 70.6 ± 15.1 for knowledge levels, 57.8 ± 23 for use, and 68.9 ± 14.2 for the overall EBP. Higher educational qualification was associated with higher scores in knowledge levels (P = 0.02). Research experience was associated with higher scores in nursing use (P = 0.005), and higher overall evidence-based practice were associated with both research experience (P = 0.035) and educational qualification (P = 0.004). Nurse-midwives attitude was affected by clinical experience (P = 0.006) and the hospital where nurse-midwives worked (P = 0.016). There was no significant difference in the EBP scores of nurse-midwives based on gender and/or their administrative roles in their respective central hospitals. Conclusion: It is important to develop the knowledge or skills of nurse midwives in order to enhance evidence-based practice amongst nurse-midwives in Malawian hospitals. The results can be used by nurse managers, nurse educators, policy makers at the Ministry of Health and Nurses and Midwives Council of Malawi to enhance implementation of EBP. [ABSTRACT FROM AUTHOR]

Background: Even though evidence based practice (EBP) is being considered as a critical element in improving the quality of health services and achieving excellence in patient care, there is currently little knowledge of how EBP relates to nursing and midwifery in Malawi. This paper is a report of a study describing EBP knowledge, attitudes, and use of registered nurse-midwives practicing in central hospitals across Malawi. Methods: The descriptive, cross-sectional research design was conducted with a randomly selected sample of 183 nurse-midwives (response rate of 87.9%). The study used a paper version questionnaire to collect the data. The data were analysed using both descriptive and inferential statistics in the Statistical Product and Service Solutions version 23. Descriptive statistics were calculated to summarise overall knowledge levels, attitudes, and use of nurse-midwives as percentages based on their scores on the assessment scale (1 to 7 Likert scale) in the EBP questionnaire. Non-parametric Mann-Whitney and Kruskal-Wallis tests were carried out to compare evidence-based practice scores based on demographics. Pearson's correlation (r) and stepwise regression analysis were further performed to analyse the relationship between the knowledge, attitude and use of nurse-midwives on the overall EBP of nurse-midwives. Results: The average scores (mean±SD) of evidence-based practice amongst nurse-midwives were 78.7 ± 19.6 for attitude, 70.6 ± 15.1 for knowledge levels, 57.8 ± 23 for use, and 68.9 ± 14.2 for the overall EBP. Higher educational qualification was associated with higher scores in knowledge levels (P = 0.02). Research experience was associated with higher scores in nursing use (P = 0.005), and higher overall evidence-based practice were associated with both research experience (P = 0.035) and educational qualification (P = 0.004). Nurse-midwives attitude was affected by clinical experience (P = 0.006) and the hospital where nurse-midwives worked (P = 0.016). There was no significant difference in the EBP scores of nurse-midwives based on gender and/or their administrative roles in their respective central hospitals. Conclusion: It is important to develop the knowledge or skills of nurse midwives in order to enhance evidence-based practice amongst nurse-midwives in Malawian hospitals. The results can be used by nurse managers, nurse educators, policy makers at the Ministry of Health and Nurses and Midwives Council of Malawi to enhance implementation of EBP. [ABSTRACT FROM AUTHOR]

Background: The roles and functionality of technical working groups (TWGs) in the health sectors vary across countries, still they aim to support government and ministries in formulating evidence-informed recommendations for policies and facilitate dialogue and alignment of activities among stakeholders within the health sector. Thus, TWGs have a role in enhancing the functionality and effectiveness of the health system structure. However, in Malawi, the functionality of TWGs and how they utilize research evidence to contribute to decision-making is not monitored. This study sought to understand the TWGs' performance and functionality in enabling evidence-informed decision-making (EIDM) in Malawi's health sector. Methods: A cross-sectional descriptive qualitative study. Data were collected through interviews, documents review and observation of three TWG meetings. Qualitative data were analysed using a thematic approach. The WHO-UNICEF Joint Reporting Form (JRF) was used to guide the assessment of TWG functionality. Results: TWG functionality varied in the Ministry of Health (MoH) in Malawi. The reasons for those perceived to be functioning well included meeting frequently, diverse representation of members, and that their recommendations to MoH were usually considered when decisions were made. For the TWGs that were perceived as not functioning well, the main reasons included lack of funding, periodic meetings and discussions that needed to provide clear decisions on the actions to be taken. In addition, evidence was recognized as important in decision-making, and research was valued by decision-makers within the MoH. However, some of the TWGs lacked reliable mechanisms for generating, accessing and synthesizing research. They also needed more capacity to review and use the research to inform their decisions. Conclusions: TWGs are highly valued and play a critical role in strengthening EIDM within the MoH. Our paper highlights the complexity and barriers of TWG functionality in supporting pathways for health policy-making in Malawi. These results have implications for EIDM in the health sector. This suggests that the MoH should actively develop reliable interventions and evidence tools, strengthen capacity-building and increase funding for EIDM. [ABSTRACT FROM AUTHOR]

Background. The knowledge, attitudes and practices of people during the coronavirus pandemic is pivotal to uptake of recommended preventative strategies. Objective. This paper describes the Malawian knowledge, attitudes and practices related to coronavirus and associated public health measures. Methods. This was a multi-site cross-sectional survey where data was collected through personal one-on-one interviews in nine Malawian districts over 3 weeks (5-25 October 2020). 521 participants (>18 years) were enrolled to answer a questionnaire. Results. We found that all respondents were aware of the ongoing coronavirus pandemic with the majority using the Radio. 75% of participants displayed knowledge of all key symptoms of coronavirus-disease (cough, fever and shortness of breath) and additionally, the majority of participants (97%) knew enough to take some sort of intervention (calling a hotline or visiting the nearest hospital) if they developed symptoms. Participants also demonstrated a high perception of risk of coronavirus, where >60% believed to be susceptible to the coronavirus under the current preventative measures and > 50% believed they would die from infection. Communities displayed a high perceived effectiveness of all preventative measures, with "hand hygiene using soap and water" being perceived as effective by the majority of respondents. Although the majority of the participants (>80%) were willing to self-isolate at home, various barriers to home-isolation were raised which would ultimately influence their ability to do so. Conclusion. Baseline community psychosocial and behavioral information which influence the adoption of public health measures in Malawi has been highlighted alongside recommendations for best practices. [ABSTRACT FROM AUTHOR]

Starting from the observation that value chain research has informed much of agricultural development interventions in recent decades, this paper identifies five key challenges to current agricultural development policies in low- and middle-income countries (LMICs): access to finance, infrastructure, land tenure, local linkages and knowledge transfer. Based on this review, it is argued that recent theoretical advances in the global production network (GPN) approach can help to achieve a more holistic view of agricultural development policies than the more linear value chain research. In particular, three key concepts from the GPN approach are highlighted: mobilisation of regional assets, strategic coupling and territorial embeddedness. These key concepts are used to propose a framework called 'insight-out strategic coupling for smallholder integration', which builds on the concept of strategic coupling in GPN research and applies it as a development tool to agricultural production. Using an in-depth case study approach, the usefulness of this framework is tested by examining the experience of Malawi Mangoes, a company established to promote smallholder exports. Malawi Mangoes was initially funded by private equity, but despite a number of challenges along the way, was soon able to attract development funding and integrate smallholders from surrounding villages throughout-grower schemes. Analysis of the case shows both the usefulness of the framework and the lost potential in implementing agricultural development policy. The authors conclude that the framework is useful for linking current debates on agricultural development interventions, but that the findings of critical GPN research need to be taken into account when developing agricultural development interventions in order to respect the 'do no harm' principle. [ABSTRACT FROM AUTHOR]

In this paper, the authors reflect on public participation (PP) in environmental impact assessment (EIA) processes in Malawi, where EIA is implemented as Environmental and Social Impact Assessment (ESIA). Who is invited and who is actively contributing to PP meetings is explored. In this context, 12 ESIAs are examined, six from rural and six from urban areas. While PP principles ask for a balanced approach towards the inclusion of both interested and affected individuals and bodies, in the 12 projects, participants were mostly development and planning experts in urban projects and traditional leaders (chiefs) in rural projects. People without societal positions that were directly affected by developments only represented 15% of those being present in PP meetings. Based on these findings, the authors suggest that PP policy needs to be improved and enforced in order to allow ordinary people potentially directly affected by development to be better represented. [ABSTRACT FROM AUTHOR]

To address the data gap on efforts to assess use of assistive technology among children with disability in sub-Saharan Africa. Contribute towards efforts examining access to assistive technologies in sub-Saharan Africa. The paper uses data from the 2017 survey on Living conditions among persons with disabilities in Malawi and the 2015-16 Malawi Demographic and Health survey to address the objective of the study. The two datasets were statistically matched through random hot deck technique, by integrating the two datasets using randomly selected units from a subset of all available data donors. Results indicate that statistical matching technique produces a composite dataset with an uncertainty value of 2.2%. An accuracy assessment test of the technique also indicates that the marginal distribution of use of assistive technology in the composite dataset is similar to that of the donor dataset with an Overlap index value of close to 1 (Overlap = 0.997). The statistical matching procedure does enable generation of good data in data constrained contexts. In the current study, this approach enabled measurement of access to assistive products among children with disabilities, in situations where the variables of interest have not been jointly observed. Such a technique can be valuable in mining secondary data, the collection of which may have been funded from different sources and for different purposes. This is of significance for the efficient use of current and future data sets, allowing new questions to be asked and addressed by locally based researchers in poor settings. In resource-poor settings, the technique of statistical matching can be used to examine factors that predict the use of assistive technology among persons with disabilities. The statistical matching technique is of significance for the efficient use of current and future datasets, allowing new questions to be asked and addressed by locally based researchers. [ABSTRACT FROM AUTHOR]

The new coronavirus disease (COVID-19) has paralysed many sectors of human life, including economic, social-cultural and political processes. In the political arena, several countries have postponed elections due to the COVID-19 pandemic. Other countries, including Malawi, went ahead with their planned elections. Malawi held a presidential election at a time when the number of COVID-19 cases was increasing rapidly. In this paper, we assess the effect of the perceived risk of catching COVID-19 on willingness to vote in the Malawi presidential election that was held on 23 June 2020. Turn out in this election was ten percentage points lower than in the general elections that were held a year earlier. The paper draws on a nationally representative survey of adult Malawians (n = 1155). In our main analysis, we use instrumental variables to account for potential endogeneity. We find that nearly two thirds of Malawians thought that they were likely to catch COVID-19 at some point. Notwithstanding the COVID-19 risk, 86% of the country's citizens were willing to vote. Our analysis shows that an individual's perceived risk of catching COVID-19 is associated with a lower likelihood of voting (β = − 0.096; p < 0.05). This suggests that voter turnout in Malawi's fresh presidential election may have been highly affected by the perceived risk of catching COVID-19. The policy implication is that instituting and enforcing primary preventive measures may help reduce the perceived risk of catching COVID-19 and mitigate voter apathy. [ABSTRACT FROM AUTHOR]

Background: In recent years a growing number of manufacturers and medical abortion products have entered country markets and health systems, with varying degrees of quality and accessibility. An interplay of factors including pharmaceutical regulations, abortion laws, government policies and service delivery guidelines and provider's knowledge and practices influence the availability of medical abortion medicines. We assessed the availability of medical abortion in eight countries to increase understanding among policymakers of the need to improve availability and affordability of quality-assured medical abortion products at regional and national levels. Methods: Using a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines in Bangladesh, Liberia, Malawi, Nepal, Nigeria, Rwanda, Sierra Leone and South Africa between September 2019 and January 2020. Results: Registration of abortion medicines—misoprostol or a combination of mifepristone and misoprostol—was established in all countries assessed, except Rwanda. Mifepristone and misoprostol regimen for medical abortion was identified on the national essential medicines list/standard treatment guidelines for South Africa as well as in specific abortion care service and delivery guidelines for Bangladesh, Nepal, Nigeria, and Rwanda. In Liberia, Malawi, and Sierra Leone—countries with highly restrictive abortion laws and no abortion service delivery guidelines or training curricula—no government-supported training on medical abortion for public sector providers had occurred. Instead, training on medical abortion was either limited in scope to select private sector providers and pharmacists or prohibited. Community awareness activities on medical abortion have been limited in scope across the countries assessed and where abortion is broadly legal, most women do not know that it is an option. Conclusion: Understanding the factors that influence the availability of medical abortion medicines is important to support policymakers improve availability of these medicines. The landscape assessments documented that medical abortion commodities can be uniquely impacted by the laws, policies, values, and degree of restrictions placed on service delivery programs. Results of the assessments can guide actions to improve access. Plain Language Summary: Unsafe abortion is a leading cause of death and disability among women of reproductive age. Medical management of abortion with mifepristone and misoprostol pills, or just misoprostol, is a safe and effective way to end a pregnancy. Owing to an increase in the number of medical abortion products that have entered country health systems, we examined access to these medicines from supply to demand in selected countries. The overarching goal of the national landscape assessments was to produce evidence to support advocacy efforts and policymaking for improved access to quality medical abortion products that is appropriate to the needs of the country. This paper aims to describe key findings across eight country settings on the availability of medical abortion medicines and identify key opportunities to improve access to them across countries. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate metadata creation practices in a functional academic institution repository in Malawi, with a specific focus on the Lilongwe University of Agriculture and Natural Resources (LUANAR) library. Design/methodology/approach: The study used a qualitative approach with a case study design. The study adopted a case study strategy that focuses on the in-depth, holistic and in-context examination of one or more cases. The researcher used non-probability purposive sampling to include all three LUANAR Digital Repository (LDR) staff at LUANAR library because they were thought to be knowledgeable about the LDR metadata work. The three library staff members directly involved in repository metadata were investigated for the study. Data collection techniques used in a case study approach included semi-structuring face-to-face interviews and documentary analysis. Data from interviews and documentary reviews were manually analyzed and presented in thematic categories based on the study's objectives. Findings: Qualified Dublin Core (DC) was chosen by all participants as the only metadata structure scheme that they will use to create and implement metadata in the repository. DC application profile was the only scheme used to enforce uniform naming and capitalization conventions in the application of Qualified DC element definitions. The scheme, however, was discovered to be the Qualified DC default format in the DSpace system. All participants indicated that the Agricultural Organization of the United Nations Vocabulary is used. Participants highlighted that institutional repository system compatibility, the subject matter of the resources, resource types and staff expertise influenced the selection criteria for the metadata schemes. The repository policy had been developed but had yet to be adopted by the LUANAR management. Research limitations/implications: The current study was limited to LUANAR library. A wider study across public and private universities in Malawi is needed to ascertain the role of metadata policy, technical knowledge and metadata specialist institutional repositories. Practical implications: Metadata policy is to aid in the understanding of the data, ensuring that appropriate security measures are used to protect the data and for metadata harvesting purposes. Social implications: Academic libraries should lobby for management support towards metadata policy for institutional repositories. Originality/value: Very little is known about challenges affecting the growth of institutional repositories and standards adopted, including metadata harvesting. This paper bridges the gap in metadata standards for institutional repositories in developing countries. [ABSTRACT FROM AUTHOR]

The inaccessibility of modern energy in low-income countries (LIC), especially in the Sub-Saharan African (SSA) region, continues to be a problem in the 21st century. The lack of access to modern energy has led to an inability to implement developmental structures and initiatives. While considerable progress and successes have been realised in the last three decades with increased activities and global commitments from international governments and multinational agencies through electrification projects in the SSA region, SSA countries remain off-track in their efforts to achieve the UN Sustainable Development Goal (SDG) 7. This is mainly demonstrated in sparsely populated rural regions where the high cost of centralised power generation, poor transmission and distribution infrastructures and economic factors have been a major barrier to electricity expansion. Although the use of RES (i.e., decentralised or stand-alone systems) have been acknowledged by the International Energy Agency (IEA) to be the least expensive route to improving access, its impact has not been effectively demonstrated regionally. Decentralised RES use in SSA countries have not seen significant uptake and/or enjoyed long-term sustainability owing to a number of factors. Malawi, despite its significant hydropower resources and the favourable proximity of its inhabitants to grid infrastructures, still has one of the lowest levels of access to electricity globally, with 86% of the population having no access to electricity. The country provides a good case study to investigate factors limiting electricity access in SSA countries. This paper explores the main issues that have historically hindered the uptake and sustainable operation of decentralised RES in the country. Recommendations to facilitate a potential improvement in RES use as a pathway to improved universal energy access are then put forward. [ABSTRACT FROM AUTHOR]

To "theologize," that is, to engage in theological reasoning and exposition when composing oral, written, or multimodal discourse, has been applied continually in Africa ever since the Bible was first introduced to this continent. Whenever God's Word is conveyed in another language and cultural setting, the existential theological barrier must be broken as important scriptural notions and entire propositions must inevitably be reconceptualized semantically and frequently also reconfigured grammatically to be communicated. The focus of the present paper is the crucial activity of Bible translation and the various ways in which those involved in such a multifaceted endeavor always engage in theologizing, to one degree or another, while carrying out their work. This article focuses specifically on the New Testament Study Bible in Chichewa (2017 Bible Society of Malawi). The importance of preparing such locally contextualized, scripturally accurate, and linguistically idiomatic study Bibles is demonstrated through manifold exemplification to be an indispensable means of ensuring the theological vitality and dynamic growth of the Church in Africa. [ABSTRACT FROM AUTHOR]

Research suggests that extreme weather will increase and impact more and more people. This has led a growing number of governments to consider resettling vulnerable populations. Resettlement is a novel strategy to manage disasters. Due to the infancy of resettlement as a strategy to adapt to environmental change there is debate about the best approach. However, one area of agreement is that resettlement should be voluntary and participatory. Despite an extensive literature on participation and its future, there are still difficulties preventing participation occurring in practice. In-depth interviews about the resettlement decision were held with three flooding-impacted communities and stakeholders in government and non-governmental organisations (NGOs) in Malawi. The research shows how government and NGOs use sensitisation as a technique to determine the knowledge of those in flooding-vulnerable communities. The purpose of this paper is to analyse the way in which sensitisation can contribute to a participatory approach. Sensitisation is often spoken of as synonymous with education. This research finds that government and NGOs use sensitisation mainly as part of a one-way process of disseminating their perspective to communities, with little or no opportunity for community members to make their voices heard and for resettlement to be participatory. [ABSTRACT FROM AUTHOR]

Out-of-pocket health payments as a means of financing health services are a cause of concern among households in low and middle-income countries. They prevent households from accessing health care services, can disrupt households' living standards by reducing consumption of other basic needs and push households into poverty. Previous studies have reported geographical variations in impoverishing effects of out-of-pocket health payments. Yet, we know relatively little about spatial effects on impoverishing effects of health payments. This paper assesses the factors associated with impoverishing effects of health payments and quantifies the role of districts spatial effects on impoverishment in Malawi. The paper uses a cross sectional integrated household survey data collected from April 2016 to April 2017 among 12447 households in Malawi. Impoverishing effect of out-of-pocket health payments was calculated as the difference between poverty head count ratio before and after subtracting health payments from total household consumption expenditures. We assessed the factors associated with impoverishment and quantified the role of spatial effects using a spatial multilevel model. About 1.6% and 1.2% of the Malawian population were pushed below the national and international poverty line of US$1.90 respectively due health payments. We found significant spatial variations in impoverishment across districts with higher spatial residual effects clustering in central region districts. Higher socio-economic status (AOR=0.34, 95% CI=0.22-0.52) decreased the risk of impoverishment whereas hospitalizations (AOR=3.63, 95% CI 2.54-5.15), chronic illness (AOR=1.56, 95% CI=1.10-1.22), residency in rural area (AOR=2.03, 95% CI=1.07-4.26) increased the risk of impoverishment. Our study suggests the need to plan financial protection programs according to district specific needs and target the poor, residents of rural areas and those with chronic illnesses. Policy makers need to pay attention to the importance of spatial and neighborhood effects when designing financial protection programs and policies. [ABSTRACT FROM AUTHOR]

While there is growing awareness of the issue of food losses at the political level, official post-harvest loss data for informing policymaking and reporting on SDG Indicator 12.3.1. (a) Food Loss Index is scarce. Representative sample-based surveys are necessary to obtain information on on-farm losses at the country level, but due to the issue's complexity, a loss module covering several key questions is needed. One main strategy proposed by the 50x2030 Initiative for optimizing data collection is sub-sampling for some of the survey modules. This paper examines whether modelling approaches can be combined with sub-sampling to improve harvest and post-harvest loss estimates and allow for further sample and cost reduction. The paper first presents the loss models generated on four selected surveys conducted in Malawi, Zimbabwe, and Nigeria, which were built using the Classification and Regression Tree (CART) method. The performance of each model is assessed for different sizes of sub-samples to improve the sample-based estimates, either by model-based estimates or by model-based imputation. The research concludes that the model-based estimates improve the loss estimates of the sub-samples due to post-stratification implied in the CART method, whereby they can constitute a cost-effective complement to sub-sampling strategies, while model-based imputations should only be used on a reduced number of missing observations. The models perform best when the survey invests in obtaining more detailed on-farm loss data and considers some key variables identified as relevant for on-farm loss models. Sub-sampling allows for investment in more detailed questionnaires and some considerations are derived for its design. [ABSTRACT FROM AUTHOR]

Purpose: The anecdote of this paper is to bring the aid effectiveness debate to the sub-national level using the change in night lights as an alternative measure of economic activity. We observe non-robustness of results regarding the effects of aid types on development in antecedent literature to arise due to the effects of aid being treated as a unitary component. provoked by such insightful observation and literature deficiency we employed geocoded data to examine Causal links between the varying types of aid and local economic development in Malawi. Design/methodology/approach: The main objective of the empirical examination is to examine the distributional effects of distinct aid types in local towns in Malawi. For that purpose, the authors thus have a panel dataset for each aid type indicator. Allowing for fixed time and town effects, the baseline light density growth regression model to estimate the effectiveness of disentangled aid on night light intensity was accomplished by employing a spatial dynamic panel data (SDPD) approach with instrumentation. Thus, panel regressions were performed to investigate both conceptual and policy implications. Findings: Cross-city evidence shows that category aid type brings both negative and positive results depending on location within a country. There are cities and locations where certain aid type(s) does not matter whereas it matters most in some. This speaks to different levels of growth between different regions and cities in Malawi. As a result, we observe the size of the effect of distinct aid type(s) on economic activities to vary (increase/decrease) with the size of the location. Research limitations/implications: It may be interesting to generalize results from this study to a panel case over long periods of time using dynamic modelling with both threshold analysis and interaction effects Institutional factors need also to be includes in similar analyses. The authors leave this for a follow-up study. Second, the most immediate opportunity is application of the methodology to the other countries with geo-coded AidData. The authors expect to expand the analysis by taking into account other determinants of aid effectiveness at the local level, including the characteristics of donors and varieties of targeted development programmes. Practical implications: Results in some geographical locations and towns indicate that the authors do not have sufficient evidence to reject the null hypothesis of the research study at 5% level. However, other geographical locations like Zomba indicate that aid category has a significant bearing on local economic growth. Therefore, as opposed to unitary aid approaches, we recommend distribution of relevant disentangled growth-enhancing aid type to specific administrative regions but with a bias toward smaller socially and economically deprived regions and towns. Social implications: The unique insight from this study is that foreign aid-growth benefits are symmetric and skewed toward large towns. If such unbalance aid-growth benefits anomalies are not addressed in a transparent manner it has the possibilities of promoting interregional migration which from Nielsen et al. (2011) and Findley et al (2011)'s evidence might trigger regional tensions and violent armed conflicts. Thus, there is need for equitable distribution of social and economic developmental aid free from political or ethnic inclination but based on transparent needs assessment model(s). Locations where social and developmental aid types seem to have negative or no effect serves as a salient indicator of aid leakages due to rent seeking tendencies of bureaucrats or weak institutions which ultimately pose welfare burden on citizens. Originality/value: Apart from contributing to the extant literature on aid and economic growth, this paper relates to at least three other strands of research. First, the work partially answers a call by Minoiu and Reddy (2010), Schmid (2013) and Khomba and Trew (2019) for researchers to examine the growth effects of distinct aid types on local economic development. Second, the increase in aid volumes to Africa and the worsening of economic conditions has been the subject of considerable interest amongst development economists (e.g. Ravenhill, 1990; Lancaster, 1999; Easterly, 2003; Bräutigam and Knack, 2004 and Collier, 2006). This makes the use of a major aid recipient developing economy (Malawi) as a laboratory an anecdote. Third, use of disaggregated as opposed to unitary aid data with an African flavour. [ABSTRACT FROM AUTHOR]

Purpose: The anecdote of this paper is to bring the aid effectiveness debate to the sub-national level using the change in night lights as an alternative measure of economic activity. We observe non-robustness of results regarding the effects of aid types on development in antecedent literature to arise due to the effects of aid being treated as a unitary component. provoked by such insightful observation and literature deficiency we employed geocoded data to examine Causal links between the varying types of aid and local economic development in Malawi. Design/methodology/approach: The main objective of the empirical examination is to examine the distributional effects of distinct aid types in local towns in Malawi. For that purpose, the authors thus have a panel dataset for each aid type indicator. Allowing for fixed time and town effects, the baseline light density growth regression model to estimate the effectiveness of disentangled aid on night light intensity was accomplished by employing a spatial dynamic panel data (SDPD) approach with instrumentation. Thus, panel regressions were performed to investigate both conceptual and policy implications. Findings: Cross-city evidence shows that category aid type brings both negative and positive results depending on location within a country. There are cities and locations where certain aid type(s) does not matter whereas it matters most in some. This speaks to different levels of growth between different regions and cities in Malawi. As a result, we observe the size of the effect of distinct aid type(s) on economic activities to vary (increase/decrease) with the size of the location. Research limitations/implications: It may be interesting to generalize results from this study to a panel case over long periods of time using dynamic modelling with both threshold analysis and interaction effects Institutional factors need also to be includes in similar analyses. The authors leave this for a follow-up study. Second, the most immediate opportunity is application of the methodology to the other countries with geo-coded AidData. The authors expect to expand the analysis by taking into account other determinants of aid effectiveness at the local level, including the characteristics of donors and varieties of targeted development programmes. Practical implications: Results in some geographical locations and towns indicate that the authors do not have sufficient evidence to reject the null hypothesis of the research study at 5% level. However, other geographical locations like Zomba indicate that aid category has a significant bearing on local economic growth. Therefore, as opposed to unitary aid approaches, we recommend distribution of relevant disentangled growth-enhancing aid type to specific administrative regions but with a bias toward smaller socially and economically deprived regions and towns. Social implications: The unique insight from this study is that foreign aid-growth benefits are symmetric and skewed toward large towns. If such unbalance aid-growth benefits anomalies are not addressed in a transparent manner it has the possibilities of promoting interregional migration which from Nielsen et al. (2011) and Findley et al (2011)'s evidence might trigger regional tensions and violent armed conflicts. Thus, there is need for equitable distribution of social and economic developmental aid free from political or ethnic inclination but based on transparent needs assessment model(s). Locations where social and developmental aid types seem to have negative or no effect serves as a salient indicator of aid leakages due to rent seeking tendencies of bureaucrats or weak institutions which ultimately pose welfare burden on citizens. Originality/value: Apart from contributing to the extant literature on aid and economic growth, this paper relates to at least three other strands of research. First, the work partially answers a call by Minoiu and Reddy (2010), Schmid (2013) and Khomba and Trew (2019) for researchers to examine the growth effects of distinct aid types on local economic development. Second, the increase in aid volumes to Africa and the worsening of economic conditions has been the subject of considerable interest amongst development economists (e.g. Ravenhill, 1990; Lancaster, 1999; Easterly, 2003; Bräutigam and Knack, 2004 and Collier, 2006). This makes the use of a major aid recipient developing economy (Malawi) as a laboratory an anecdote. Third, use of disaggregated as opposed to unitary aid data with an African flavour. [ABSTRACT FROM AUTHOR]

Malawi has decentralised development planning structures to create a representative system of local government and a base for participatory democracy in development. This paper, which is based on data collected through literature review supplemented by key informant interviews interrogates the extent to which decentralisation has generated opportunities for increased women's participation and representation in local government development structures. The paper contends that although decentralisation has generated opportunities for increased women's participation, men's domination supported by systemic, institutional and patriarchal norms and weaknesses in the enforcement of policies complicate the situation. Therefore, pragmatic policies and actions must be pursued to improve women's participation at local and national levels. These should include the introduction of specific quotas in local government structures, building public awareness on gender perspective, enforcement of existing gender policies and concrete action which translates into women having a voice, power, and the capacity to organise and mobilise themselves. [ABSTRACT FROM AUTHOR]

The outbreak of World War II in 1939 altered the trajectory of food production in Malawi in the last two decades of colonialism. This paper examines the extent to which the World War II and the World Food Crisis that followed shaped peasants' food production in Malawi between 1939 and 1957. It argues that, while the war caused food shortages through the dislocation of labour and foodstuffs, it also altered the production of surplus foodstuffs. Despite its merits, the paper observes, however, that colonial campaign for the peasants to grow more foodstuffs was a 'marriage of convenience' rather than an attempt to improve the food welfare of the peasants. As soon as the food crisis ended, the colonial authority resorted to its old policy of prioritising on cash crops at the expense of food crops. This history sheds new light to rethink 'the second colonial occupation' thesis by arguing that colonial appropriation of African resources in the 1940s and 1950s was complex, dynamic and contested. Foodstuffs laid at the core of rural life such that the colonial state could hardly expropriate them or discourage their excessive production without challenges from the peasants. [ABSTRACT FROM AUTHOR]