Implementing the Family-Led Care model for preterm and low birth weight newborns in Malawi: experience of healthcare workers

Background: Every Preemie­SCALE developed and piloted the Family-Led Care model, an innovative, locally developed model of care for preterm and low birth weight babies receiving kangaroo mother care. Aim: The aim of this study was to describe healthcare workers' experience using Family-Led Care. Setting: This study was conducted in five health facilities and their catchment areas in Balaka district, Malawi. Methods: The mixed-methods design, with two data collection periods, included record reviews, observations and questionnaires for facility staff and qualitative interviews with health workers of these facilities and their catchment areas. The total convenience sample comprised 123 health professionals, support staff and non-professional community health workers. Results: Facility-based staff generally had positive perceptions of Family-Led Care (83%). Knowledge and application-of-knowledge scores were 69% and 52%, respectively. A major change between the first and the second data periods was improvement in client record-keeping. Documentation of newborn vital signs increased from 62% to 92%. Themes emerging from the qualitative interview analysis were the following: benefits of Family-Led Care; activities supporting the implementation of Family-Led Care; own care practices; and families' reaction to and experience of Family-Led Care. Conclusion: This article reports improved quality of care through better documentation and better follow-up of preterm and low birth weight babies receiving kangaroo mother care according to the Family-Led Care model. Overall, health workers were positive about their involvement, and they reported positive reactions from families. Lessons learned have been incorporated into a universal Family-Led Care package that is available for adaptation by other countries

Cigarette Smoking Prevalence among School-Going Adolescents in Two African Capital Cities: Kampala Uganda and Lilongwe Malawi

Background: Non communicable diseases are a growing public health concern. Globally tobacco-related deaths surpass malaria deaths and yet developing countries' data are lacking. Objectives:To compare prevalence of tobacco use and exposure to tobacco and tobacco-related issues among adolescents in Kampala; Uganda and Lilongwe; Malawi. Methods: Cross sectional data from the Global Youth Tobacco Survey (GYTS) w used. Data were collected in 2001 in Lilongwe and in 2002 in Uganda using a standardized questionnaire tool.The study was aimed to enrolled schoolchildren aged 13-17 years. Results:The prevalence of tobacco smoking in Kampala and Lilongwe among adolescents was 5.6and 6.2(p 0.05) respectively. However; adolescents in Lilongwe were statistically significantly more likely to have ever smoked; use other tobacco products and perceived themselves as likely to initiate smoking in the coming year. Exposure to tobacco-related advertisements through billboards; newspapers and magazines was high in both settings. Conclu-sions : Adolescents are increasingly being exposed to tobacco and tobacco-related advertisements in Lilongwe; Malawi and Kampala; Uganda.There is need to enhance tobac-co prevention efforts in developing nations

School children's accessibility to insecticide-treated bednets in peri-urban Blantyre; Malawi

Malaria is a major cause of childhood morbidity and mortality in Malawi. Use of insecticide treated bed nets (ITNs) could reduce the burden of malaria. The objective of the study was to determine the general health status, and factors that influence reported access to ITNs among school children in a peri-urban area of Blantyre, Malawi. 454 school children participated in the study of which 253 (55.7%) were males and 201 (44.3%) females. Their mean age and range were 14 years (std. deviation, 1.4 years) and 10-19 years respectively. When asked about general health status questions, 263 (57.9%) reported ever having fallen ill while at school, 41.2% having ever came to school knowing they were unwell, and 40.7% of those that reported having fallen ill at school, categorized their illness as malaria. Regarding illness in the month preceding the study, 41.0% indicated that they had been ill. 40 (8.8%) participants reported that they were not allowed by their religious denominations to use medications when ill. 165 (36.3%) participants reported using bed nets themselves, 159 (35.0%) had a household member (other than parent) using nets and 254 (55.9%) had parent(s) sleeping under an ITN. Having someone in the household who uses an ITN was positively associated with ITN use while age of the participants was inversely associated with ITN access in the home. While more females (37.3%) reported using nets than males (35.6%), the difference was not statistically significant (p=0.7). It was concluded that many of the school children experience ill health in Ndirande, Malawi and malaria is perceived to be a common illness. While younger children seem to have higher access to ITNs, there seems to be no statistically significant gender differences in accessibility

Condom and sexual abstinence talk in the Malawi National Assembly

Background: Correct and consistent use of condoms has been reported as effective in the prevention of transmission of HIV.There have been many studies reporting on attitudes (perceptions) of communities on condoms and other aspects of HIV and AIDS and yet there is paucity of data on the perception towards condoms and abstinence by law makers. Objective:To determine perceptions of Members of Parliament in Malawi towards condoms. Methods: A qualitative study utilising parliamentary Hansards to describe the discussions about condoms and abstinence in the National Assembly 1999-2004. Content and discourse analyses were used. Results: In general; Members of Parliament had negative attitudes towards extra- and/or pre-marital sexual intercourse; condom promotion and use. Sexual abstinence amongst non-married persons was preferred as opposed to condom use. Condom use was not perceived as an effective way of controlling the spread of HIV. Some MPs though called for a change in mind-set so as to allow use of condoms in prisons; in order to prevent transmission of infection from prisoners to the general community once the prisoners were released. Conclusion:This study confirms that health interventions such as condoms are not perceived neutrally and may be construed as the enemy of society