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https://www.readbyqxmd.com/read/29165644/-the-money-can-be-a-motivator-to-me-a-little-but-mostly-pbf-just-helps-me-to-do-better-in-my-job-an-exploration-of-the-motivational-mechanisms-of-performance-based-financing-for-health-workers-in-malawi
#1
Julia Lohmann, Danielle Wilhelm, Christabel Kambala, Stephan Brenner, Adamson S Muula, Manuela De Allegri
Performance-based financing (PBF) is assumed to improve health care delivery by motivating health workers to enhance their work performance. However, the exact motivational mechanisms through which PBF is assumed to produce such changes are poorly understood to date. Although PBF is increasingly recognized as a complex health systems intervention, its motivational effect for individual health workers is still often reduced to financial 'carrots and sticks' in the literature and discourse. Aiming to contribute to the development of a more comprehensive understanding of the motivational mechanisms, we explored how PBF impacted health worker motivation in the context of the Malawian Results-based Financing for Maternal and Newborn Health (RBF4MNH) Initiative...
November 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29165225/prevalence-of-asymptomatic-parasitemia-and-gametocytemia-in-hiv-infected-children-on-differing-antiretroviral-therapy
#2
Charlotte V Hobbs, Erin E Gabriel, Portia Kamthunzi, Gerald Tegha, Jean Tauzie, Yonghua Li, Tiina Ilmet, Elena Artimovich, Jillian Neal, Ted Hall, Sunil Parikh, Brian Kirmse, Patrick Jean-Philippe, Jingyang Chen, William R Prescott, Paul Palumbo, Patrick E Duffy, William Borkowsky, For The P S Study Team
Laboratory data and prior pediatric reports indicate that HIV protease inhibitor (PI)-based antiretroviral therapy (ARV) kills gametocytes and reduces rates of gametocytemia, but not asymptomatic parasitemia, in a high malaria-transmission area. To determine whether ARV regimen impacts these rates in areas with less-intense malaria transmission, we compared asymptomatic parasitemia and gametocytemia rates in HIV-infected children by ARV regimen in Lilongwe, Malawi, an area of low-to-moderate transmission intensity...
November 20, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29163934/determinants-of-integrated-management-of-childhood-illness-imci-non-severe-pneumonia-classification-and-care-in-malawi-health-facilities-analysis-of-a-national-facility-census
#3
Emily White Johansson, Humphreys Nsona, Liliana Carvajal-Aguirre, Agbessi Amouzou, Helena Hildenwall
Background: Research shows inadequate Integrated Management of Childhood Illness (IMCI)-pneumonia care in various low-income settings but evidence is largely from small-scale studies with limited evidence of patient-, provider- and facility-levels determinants of IMCI non-severe pneumonia classification and its management. Methods: The Malawi Service Provision Assessment 2013-2014 included 3149 outpatients aged 2-59 months with completed observations, interviews and re-examinations...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29162065/from-policy-to-practice-exploring-the-implementation-of-antiretroviral-therapy-access-and-retention-policies-between-2013-and-2016-in-six-sub-saharan-african-countries
#4
Julie Ambia, Jenny Renju, Alison Wringe, Jim Todd, Eveline Geubbels, Jessica Nakiyingi-Miiro, Mark Urassa, Tom Lutalo, Amelia C Crampin, Daniel Kwaro, Catherine Kyobutungi, Natsayi Chimbindi, F Xavier Gomez-Olive, Malebogo Tlhajoane, Brian Njamwea, Basia Zaba, Paul Mee
BACKGROUND: Understanding the implementation of 2013 World Health Organization (WHO) consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection at the facility level provides important lessons for the roll-out of future HIV policies. METHODS: A national policy review was conducted in six sub-Saharan African countries to map the inclusion of the 2013 WHO HIV treatment recommendations. Twenty indicators of policy adoption were selected to measure ART access (n = 12) and retention (n = 8)...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29158996/anterior-posterior-gene-expression-differences-in-three-lake-malawi-cichlid-fishes-with-variation-in-body-stripe-orientation
#5
Ehsan Pashay Ahi, Kristina M Sefc
Morphological differentiation among closely related species provides opportunities to study mechanisms shaping natural phenotypic variation. Here, we address variation in the orientation of melanin-colored body stripes in three cichlid species of the tribe Haplochromini. Melanochromis auratus displays a common pattern of dark, straight horizontal body stripes, whereas in Aristochromis christyi and Buccochromis rhoadesii, oblique stripes extend from the anterior dorsal to the posterior mid-lateral trunk. We first validated a stably reference gene, and then, investigated the chromatophore distribution in the skin by assessing the expression levels of the iridophore and melanophore marker genes, ltk and slc24a5, respectively, as well as pmel, a melanophore pigmentation marker gene...
2017: PeerJ
https://www.readbyqxmd.com/read/29157288/development-of-a-framework-to-improve-the-utilisation-of-malaria-research-for-policy-development-in-malawi
#6
Chikondi Mwendera, Christiaan de Jager, Herbert Longwe, Charles Hongoro, Kamija Phiri, Clifford M Mutero
BACKGROUND: The existing gap between research evidence and public health practice has attributed to the unmet Millennium Development Goals in Africa and consequently, has stimulated the development of frameworks to enhance knowledge translation. These efforts aim at maximising health research utilisation in policy and practice to address the world's disease burdens, including malaria. This study aimed at developing a contextual framework to improve the utilisation of malaria research for policy development in Malawi...
November 21, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/29157284/malaria-control-in-rural-malawi-implementing-peer-health-education-for-behaviour-change
#7
Tumaini Malenga, Alinune Nathanael Kabaghe, Lucinda Manda-Taylor, Asante Kadama, Robert S McCann, Kamija Samuel Phiri, Michèle van Vugt, Henk van den Berg
BACKGROUND: Interventions to reduce malaria burden are effective if communities use them appropriately and consistently. Several tools have been suggested to promote uptake and use of malaria control interventions. Community workshops on malaria, using the 'Health Animator' approach, are a potential behaviour change strategy for malaria control. The strategy aims to influence a change in mind-set of vulnerable populations to encourage self-reliance, using community volunteers known as Health Animators...
November 20, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29155891/the-burden-of-gynecomastia-among-men-on-antiretroviral-therapy-in-zomba-malawi
#8
Victor Singano, Alemayehu Amberbir, Daniela Garone, Christopher Kandionamaso, Jack Msonko, Monique van Lettow, Kondwani Kalima, Yamikani Mataka, Gift Kawalazira, Gabriel Mateyu, Aunex Kwekwesa, Alfred Matengeni, Joep J van Oosterhout
BACKGROUND: Many Africans who are on life-saving ART face challenges from a variety of toxicities. After the introduction of a standardized first-line efavirenz-containing ART regimen, reports of gynecomastia appeared in Malawian popular media, however data on the prevalence and risk factors of gynecomastia from Africa are lacking. METHODS: We conducted a cross-sectional study in males ≥18 years registered on ART at the HIV clinic in Zomba Central Hospital. Men who reported to have ever experienced breast or nipple enlargement received a standard questionnaire and underwent physical examination...
2017: PloS One
https://www.readbyqxmd.com/read/29151197/impact-of-the-dapivirine-vaginal-ring-on-sexual-experiences-and-intimate-partnerships-of-women-in-an-hiv-prevention-clinical-trial-managing-ring-detection-and-hot-sex
#9
Nicole D Laborde, Elizabeth Pleasants, Krishnaveni Reddy, Millicent Atujuna, Teopista Nakyanzi, Miria Chitukuta, Sarita Naidoo, Thesla Palanee-Phillips, Jared M Baeten, Elizabeth T Montgomery
Vaginally-inserted HIV prevention methods have been reported to impact the sexual experience for women and their partners, and hence impacts acceptability of and adherence to the method. We analyzed in-depth interviews and focus group discussions about participants' sexual experiences while wearing the ring, collected during the MTN-020/ASPIRE phase 3 safety and effectiveness trial of a dapivirine vaginal ring for HIV prevention in Malawi, South Africa, Uganda, and Zimbabwe. Most women reported that partners did not feel the ring during sex, however, women felt they had to manage their partners' interaction with or reaction to the ring...
November 18, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/29149905/the-kusamala-program-for-primary-caregivers-of-children-6-59-months-of-age-hospitalized-with-severe-acute-malnutrition-in-malawi-study-protocol-for-a-cluster-randomized-controlled-trial
#10
Allison I Daniel, Meta van den Heuvel, Wieger P Voskuijl, Melissa Gladstone, Mike Bwanali, Isabel Potani, Celine Bourdon, Jenala Njirammadzi, Robert H J Bandsma
BACKGROUND: Severe acute malnutrition (SAM) is associated with high mortality rates and impairments in growth and development in children that do survive. There are complex nutritional, health, and behavioural risk factors involving severely malnourished children and their primary caregivers, requiring integrated intervention approaches. METHODS: A cluster-randomized controlled trial at the Queen Elizabeth Central Hospital in Blantyre, Malawi will be conducted to evaluate the effectiveness of a 4-day hospital-based intervention programme directed at primary caregivers...
November 17, 2017: Trials
https://www.readbyqxmd.com/read/29147893/high-elective-surgery-cancellation-rate-in-malawi-primarily-due-to-infrastructural-limitations
#11
Meghan Prin, Jessica Eaton, Onias Mtalimanja, Anthony Charles
BACKGROUND: The provision of safe and timely surgical care is essential to global health care. Low- and middle-income countries have a disproportionate share of the global surgical disease burden and struggle to provide care with the given resources. Surgery cancellation worldwide occurs for many reasons, which are likely to differ between high-income and low-income settings. We sought to evaluate the proportion of elective surgery that is cancelled and the associated reasons for cancellation at a tertiary hospital in Malawi...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29147054/service-readiness-of-health-facilities-in-bangladesh-haiti-kenya-malawi-namibia-nepal-rwanda-senegal-uganda-and-the-united-republic-of-tanzania
#12
Hannah H Leslie, Donna Spiegelman, Xin Zhou, Margaret E Kruk
Objective: To evaluate the service readiness of health facilities in Bangladesh, Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Uganda and the United Republic of Tanzania. Methods: Using existing data from service provision assessments of the health systems of the 10 study countries, we calculated a service readiness index for each of 8443 health facilities. This index represents the percentage availability of 50 items that the World Health Organization considers essential for providing health care...
November 1, 2017: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/29145143/biodegradation-of-polystyrene-wastes-in-yellow-mealworms-larvae-of-tenebrio-molitor-linnaeus-factors-affecting-biodegradation-rates-and-the-ability-of-polystyrene-fed-larvae-to-complete-their-life-cycle
#13
Shan-Shan Yang, Anja Malawi Brandon, James Christopher Andrew Flanagan, Jun Yang, Daliang Ning, Shen-Yang Cai, Han-Qing Fan, Zhi-Yue Wang, Jie Ren, Eric Benbow, Nan-Qi Ren, Robert M Waymouth, Jizhong Zhou, Craig S Criddle, Wei-Min Wu
Commercial production of polystyrene (PS) -a persistent plastic that is not biodegradable at appreciable rates in most environments-has led to its accumulation as a major contaminant of land, rivers, lakes, and oceans. Recently, however, an environment was identified in which PS is susceptible to rapid biodegradation: the larval gut of Tenebrio molitor Linnaeus (yellow mealworms). In this study, we evaluate PS degradation capabilities of a previously untested strain of T. molitor and assess its survival and PS biodegradation rates for a range of conditions (two simulated food wastes, three temperatures, seven PS waste types)...
October 23, 2017: Chemosphere
https://www.readbyqxmd.com/read/29143624/randomized-controlled-pilot-of-a-group-antenatal-care-model-and-the-sociodemographic-factors-associated-with-pregnancy-related-empowerment-in-sub-saharan-africa
#14
Crystal L Patil, Carrie S Klima, Sebalda C Leshabari, Alana D Steffen, Heather Pauls, Molly McGown, Kathleen F Norr
BACKGROUND: The links between empowerment and a number of health-related outcomes in sub-Saharan Africa have been documented, but empowerment related to pregnancy is under-investigated. Antenatal care (ANC) is the entry point into the healthcare system for most women, so it is important to understand how ANC affects aspects of women's sense of control over their pregnancy. We compare pregnancy-related empowerment for women randomly assigned to the standard of care versus CenteringPregnancy-based group ANC (intervention) in two sub-Saharan countries, Malawi and Tanzania...
November 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29142958/diagnostic-performance-of-a-saliva-urea-nitrogen-dipstick-to-detect-kidney-disease-in-malawi
#15
Rhys Evans, Viviane Calice-Silva, Jochen G Raimann, Ulla Hemmila, Alison Craik, Mwayi Mtekateka, Fergus Hamilton, Zuze Kawale, Hamish Dobbie, Gavin Dreyer, Nathan Levin, Peter Kotanko, Roberto Pecoits-Filho
Introduction: Kidney disease (KD), including acute kidney injury, is common, severe and leads to significant mortality in the developing world. However, simple tools to facilitate diagnosis and guide treatment are lacking. We studied the diagnostic performance of saliva urea nitrogen (SUN) measured by dipstick to diagnose KD in a low-resource setting. Methods: Medical admissions to a tertiary hospital in Malawi had serum creatinine tested at presentation; SUN was measured using a dipstick...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29142125/emergence-of-double-and-triple-gene-reassortant-g1p-8-rotaviruses-possessing-a-ds-1-like-backbone-post-rotavirus-vaccine-introduction-in-malawi
#16
Khuzwayo C Jere, Chrispin Chaguza, Naor Bar-Zeev, Jenna Lowe, Chikondi Peno, Benjamin Kumwenda, Osamu Nakagomi, Jacqueline E Tate, Umesh D Parashar, Robert S Heyderman, Neil French, Nigel A Cunliffe, Iturriza-Gomara Miren
To combat the high burden of rotavirus gastroenteritis, multiple African countries have introduced rotavirus vaccines into their childhood immunisation programmes. Malawi incorporated a G1P[8] rotavirus vaccine (Rotarix™) into its immunisation schedule in 2012. Utilising a surveillance platform of hospitalised rotavirus gastroenteritis cases, we examined the phylodynamics of G1P[8] rotavirus strains that circulated in Malawi before (1998 - 2012) and after (2013 - 2014) vaccine introduction. Analysis of whole genomes obtained through next generation sequencing revealed that all randomly-selected pre-vaccine G1P[8] strains sequenced (n=32) possessed a Wa-like genetic constellation, whereas post-vaccine G1P[8] strains (n=18) had a DS-1-like constellation...
November 15, 2017: Journal of Virology
https://www.readbyqxmd.com/read/29141763/pilot-study-of-the-addition-of-mass-treatment-for-malaria-to-existing-school-based-programs-to-treat-neglected-tropical-diseases
#17
Lauren M Cohee, Moses Chilombe, Andrew Ngwira, Samuel K Jemu, Don P Mathanga, Miriam K Laufer
Malaria and neglected tropical diseases (NTDs), including schistosomiasis and soil transmitted helminths, threaten the health of school aged in sub-Saharan Africa. Established school-based mass drug administration (MDA) programs are used to control NTDs. Recent clinical trials have shown benefit of mass treatment of malaria in schools. The potential of adding malaria treatment to existing NTD programs has not been thoroughly evaluated. We offered malaria treatment with artemether-lumefantrine during routine NTD MDA and developed peer education programs in two primary schools in southern Malawi...
November 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29141742/characterizing-the-last-latrine-nonowners-in-rural-malawi
#18
Jurgita Slekiene, Hans-Joachim Mosler
Open defecation is a public health problem worldwide. NGOs in developing countries use various approaches to increase latrine coverage, but for little-understood reasons, some of the population does not adopt latrine construction. The objective of our research was to uncover which of the factors predicting latrine construction are relevant to the last nonowners of latrines, termed laggards in the diffusion of innovations theory. In a cross-sectional study, quantitative face-to-face interviews were conducted in households in rural Malawi (N = 824) to assess the behavioral determinants of latrine construction, mental health, and leadership...
October 23, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29137678/disentangling-regional-trade-agreements-trade-flows-and-tobacco-affordability-in-sub-saharan-africa
#19
Adriana Appau, Jeffrey Drope, Ronald Labonté, Michal Stoklosa, Raphael Lencucha
BACKGROUND: In principle, trade and investment agreements are meant to boost economic growth. However, the removal of trade barriers and the provision of investment incentives to attract foreign direct investments may facilitate increased trade in and/or more efficient production of commodities considered harmful to health such as tobacco. We analyze existing evidence on trade and investment liberalization and its relationship to tobacco trade in Sub-Saharan African countries. METHODS: We compare tobacco trading patterns to foreign direct investments made by tobacco companies...
November 14, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29136117/cost-effectiveness-of-community-based-hiv-self-testing-in-blantyre-malawi
#20
Hendramoorthy Maheswaran, Aileen Clarke, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Stavros Petrou
Background: HIV self-testing (HIVST) is effective, with scale-up underway in sub-Saharan Africa. We assessed cost-effectiveness of adding HIVST to existing facility-based HIV testing and counselling (HTC) services. Both 2010 (initiate at CD4<350 cells/μl) and 2015 (initiate all) WHO guidelines for antiretroviral treatment (ART) were considered. Methods: A microsimulation model was developed that evaluated cost-effectiveness, from both health provider and societal perspectives, of an HIVST service implemented in a cluster-randomised trial (CRT) (ISRCTN02004005) in Malawi...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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