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Recent Submissions
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Assessing factors affecting the utilisation of long-acting reversible family planning methods among the female youths at Kawale Health Centre
(Kamuzu University of Health Sciences, 2023-06-21) Verona Mpasi; Laness Chigona; Lesina Banda; Julius Jenya
Type of Research Study
This is a cross-section study using a quantitative approach.
The problem (to be studied)
The problem to be studied is the under utilization of long-acting reversible contraceptives among
female youths aged 18 to 24 at Kawale Health Centre, hence the need to assess the factors affecting
the utilization of long-acting reversible contraceptives.
The Objectives
The following are the objectives of the study; to assess the level of knowledge on the available
contraceptive methods among female youths accessing family planning services, to assess
utilization of long-acting reversible contraceptive methods by female youth accessing family
planning and to identify barriers affecting female youth on utilization of long-acting reversible
contraceptive methods.
Methodology
The study will be conducted at Kawale Health Centre in Lilongwe district on female youths aged
18 to 24. The data will be analyzed using the statistical package for social sciences (SPSS) version
23. The findings will be studied and compared with different correspondents and the conclusion
will be made.
Expected findings and their dissemination
The results of the data collected will be presented in pie charts, histograms, line graphs, and tables
for easy analysis and understanding. Copies of the dissertation will be distributed to the Head of
the Community Health Nursing Department, the College of Medicine Research and Ethics
Committee, the Head of the Department of Basic Studies, the College library, the Lilongwe district
health office, and Kawale Health Centre.
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NESTmw_final_nid_2019_2023
(Malaria Alert Centre, 2019-08-01) Nest360
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Neonatal Inpatient Dataset - Bwaila District Hospital
(Malaria Alert Centre, 2023-01-17) Nest360
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An assessment of the factors contributing to increase cases of abortion among women of reproduction age, Mzimba
(Kamuzu University of Health Sciences, 2023-01-11) Kaipa, Audrino; Khasu, Bridget; Makwinja, Abigail; Gotta, Godfrey
Introduction: Abortion continues to be a burden in both developing and developed countries.
Global and regional studies show that factors like knowledge, finances and religion have great
impact on abortion. In Malawi abortion cases accounts for 18.2% of all gynaecology conditions
among women of reproductive age and is the most common cause of infertility in women.
Despite increased access to family planning method and integrated post abortion care services,
cases are still rising each and every year.
Aim: This study aims at assessing factors associated with abortion among women of
reproductive age at Mzimba District Hospital. The specific objectives are: to discover the
influence of marital status on abortion among women, to explore knowledge of abortion of
women of reproductive age, to examine financial status of women of reproductive age, to
compare influence of religion on women’s belief to keep pregnancy or not.
Methodology: Cross sectional research design will be used to assess the factors associated with
increased cases of abortion in Mzima, Malawi. A sample size of 50 will be used during data
collection. Data will be analysed using SPSS version 23.
Expected findings: We expect that women will have little knowledge on abortion, women of
low income level will have high rate of abortion and women of strong religious belief will have
low abortion rate.
Dissemination: The results from the research findings will be printed and disseminated during
dissemination seminar to be held at College of Medicine. Both hardcopies and soft copies will be sent to Kamuzu University of Health Sciences library. We will arrange a meeting with female surgical ward health care workers at Mzimba District Hospital to give feedback of the research findings to incorporate them in their interventions including health education and counselling given to the women
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Sexually Transmitted Infection (STI) in Pregnancy and Adverse Birth Outcomes; A Case-control Study
(Kamuzu University of Health Sciences, 2023-01-19) Freyner, Bridget
Type of Research Study:
A cross-sectional survey and nested case-control study.
The problem: Sexually transmitted infections (STIs) are associated with increased rates of
preterm birth, stillbirth and low birth weight (LBW). In Malawi STIs are diagnosed by syndromic
ascertainment which has poor sensitivity in antenatal mothers. The prevalence of these
diseases in the antenatal period and their contribution to adverse birth outcomes are not
known in Malawi. This is critical as they are highly modifiable.
This study will be done as part of the DIPLOMATIC collaboration. Through the COMREC
approved TUDA study (P06/19/2714), the DIPLOMATIC collaboration has established midwife
capacity in antenatal ultrasound for the determination of gestational age at Queen Elizabeth
Central Hospital (QECH). This platform will be utilised in the current study to accurately
ascertain the outcomes of prematurity and low birth weight. The DIPLOMATIC group is
committed to the implementation of evidence-based practices with the aim of reducing preterm
birth, stillbirth and neonatal mortality in Malawi and Zambia.
Aim: To determine the contribution of sexually transmitted infections (STI) in the antenatal
period to adverse birth outcomes at QECH
Primary objectives:
1. To determine the prevalence of STIs (N. gonorrhea, C. trachomatis, M. genitalium, T.
vaginalis, T. pallidum, Herpes Simplex Virus and HIV in women who attend QECH for
delivery of their infants.
2. To determine the attributable fraction of adverse birth outcomes at QECH with a
confirmed diagnosis of at least one STI in the peripartum period.
Secondary objectives:
1. To generate pilot data on the clinical outcomes of mother-infant pairs co-infected with
HIV and any other STI
2. To evaluate the accuracy of the syndromic approach to the diagnosis of STIs in
pregnancy compared to gold standard laboratory diagnostics.
3. To determine the coverage of antenatal diagnosis, treatment and partner notification
and treatment of STIs.
4. To determine the role of rapid point of care tests (POCT) for the differentiation of
early versus latent gestational syphilis and the diagnosis and management of
congenital syphilis.
5. To generate pilot data on the role of vaginal microbial composition in preterm birth
and mother to child transmission of HIV.
Methodology: A cross-sectional survey and nested case-control study of pregnant women,
recruited at delivery will be done at Queen Elizabeth Central Hospital, Blantyre, Malawi. A
composite case definition for adverse birth outcome will include all stillborn, preterm, low birth
weight (LBW) infants or infants admitted to NICU within 24 hours of birth. Each case will be
matched with a mother of a healthy term infant. Multiplex PCR will be done on vaginal swabs
in cases and controls to screen for all common STIs (N. gonorrhea, C. trachomatis, M.
genitalium, T. vaginalis, T. pallidum, Herpes Simplex Virus) and HIV and syphilis status will
be determined on maternal and infant serum. There is a planned sub-group analysis by HIV
sero-status. We will recruit 650 cases and 650 controls to give 80% power to detect a 50%
difference between groups, α=0.05 and allow prevalence estimates for each STI with +/-5%
margin of error margin of error.
Expected Findings: This study will provide prevalence data for curable STIs among postpartum
women and assess their contribution to adverse birth outcomes. In addition, this study
will provide information on the burden of neonatal disease in newborns exposed to STIs in the
pre- and peri-partum period.
Dissemination: Research findings will be shared with health care workers at QECH and with
participants with the help of the MLW science communication team. Data will be shared with
the Malawi College of Medicine and Malawi College of Medicine Research Ethics Committee,
Malawi Ministry of Health and published in peer reviewed publications. Data collected at
QECH will be presented as standalone findings in conferences and peer-reviewed
publications locally and shared with relevant clinicians and policy makers.
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Assessing Women’s Perception towards Cervical Cancer Screening at Mponela Rural Hospital, Dowa
(2023-01-11) Kawale Chiphangwi, Florence
STUDY DESIGN: This will be descriptive qualitative research study, assessing women’s
perception towards cervical cancer screening at Mponela rural hospital.
INTRODUCTION/BACKGROUND: Cervical cancer is listed among the top gynaecologic
cancers worldwide. It is ranked fourteenth among all cancers and fourth-ranked cancer among
women worldwide. It is estimated that 85% of all cervical cancer deaths occur in developing
countries. Malawi has the highest cervical cancer mortality rate in the world with 51.5 death
per 100. 000 deaths per year. This is seven times the global rate, and double the rate in Eastern
Africa. A call for cervical cancer elimination has been made and Malawi has adopted cervical
cancer elimination strategies, which among them is cervical cancer screening.
PROBLEM STATEMENT: Despite the available cervical cancer screening strategies that
have been put in place in Malawi, and specifically Mponela Rural Hospital, cervical cancer
screening rate still remains low. Currently only 4% of women in Mponela have accessed
cervical cancer screening, against the 80% national target for cervical cancer screening. No
studies have been done to establish the communities’ perceptions of cervical cancer and
cervical cancer screening at Mponela Rural Hospital. Therefore the aim of this study is to assess
the women’s perceptions towards cervical cancer screening
STUDY OBJECTIVES: This study aims at assessing the women’s perceptions towards
cervical cancer screening at Mponela Rural Hospital.
SPECIFIC OBECTIVES
1. To assess women’s knowledge on cervical cancer
2. To explore women’s belief towards cervical cancer screening
3. To assess the barriers and facilitators to cervical cancer screening
4. To identify strategies that can promote cervical cancer screening
METHODOLOGY: A descriptive qualitative research design using in-depth interviews to 30
women aged between 25 and 64 years of age who have never undergone cervical cancer
screening at Mponela Rural Hospital. Eligible women waiting for other services, and have
never had cervical cancer screening will be selected purposefully. In-depth interview will be
done using a semi structured thematic interview guide to deeply explore women’s perceptions
on cervical cancer screening. The instrument will be tested at Mtengowanthenga Mission
Hospital, and trustworthiness of the instrument will be determined.
EXPECTED FINDINGS: It is expected that women’s perceptions on cervical cancer
screening at Mponela Rural Hospital will be identified. This will help in establishing policies
and strategies that can help in increasing the uptake of cervical cancer screening.
ETHICAL CONSIDERATION: Prior to starting the study, approval of the study will be
sought from College of Medicine Research and Ethics Committee and permission will be
obtained from Dowa District Health Office research committee. Explanation about the search
study will be explained to the eligible women, and informed consent will be sought.
DATA ANALYSIS: Thematic data analysis will be used to describe and interpret the data, as
well as to select code and construct themes.
DISSEMINATION OF THE RESULTS: The results will be disseminated to College of
Medicine Research and Ethics Committee, Kamuzu University for Health Sciences, Dowa
District Health research committee as well as publishing in a nursing journal
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A Study of the Experience of Sexually Assaulted Pregnant Minors Who Seek Access to Abortion-Related Services Through the Kamuzu Central Hospital One- Stop Centre
(Kamuzu University of Health Sciences, 2023-01-11) Chipeta, Effie Dr.
Type of Study: An exploratory cross-sectional qualitative study aimed at examining the
experiences of pregnant minors who seek abortion-related care through the Kamuzu Central
Hospital (KCH) One Stop Centre (OSC).
Background: Girls and young women who have survived rape, defilement, and sexual assault are
at high risk of pregnancy. Research has shown that younger unmarried and economically
dependent women and girls who receive maternity care in various health facilities report having
become pregnant through rape and defilement. For girls aged between 12 and 19 years in
Malawi, the risks associated with pregnancy and abortion are high. Abortion is only legal in
Malawi when the pregnant woman’s life is in danger and obtaining an abortion, aside from this
one condition is punishable by 7-14 years’ imprisonment. Nevertheless, it does not stop abortion
from occurring. In an assault report presented by the KCH OSC for the period January-November
2021, cases of defilement, rape, physical assault, emotional assault, and followed by sodomy,
abduction, and early child marriages were reported, and there were cases of girls between the
ages of 11 and 19 whose sexual violation resulted in pregnancy. In terms of managing
pregnancies, the staff at the OSC counsel clients, and provide ante-natal care and delivery
services. However, clients who request termination are informed this service is not available
because it is illegal. It was also reported that there is a high demand for termination of pregnancy
services from girls and women whose pregnancies resulted from sexual violation.
Objectives: The overall goal of this research is to explore the experiences of pregnant minors
(aged 10-17 years) who seek abortion-related care. The specific objectives are to:
1. Assess the lived experiences of pregnant minors who have been refused access to safe
abortion.
2. Evaluate the impact of national laws on the health and well-being of the pregnant minors
denied access to safe abortion at the OSC
3. Examine policy/program level and community level stakeholders’ perceptions on the
relationship between hospital policies and practices on the provision of safe abortion to
minors and the legal framework.
Study design, population, sample size and sampling strategy: The study will use an exploratory
cross-sectional qualitative design to examine the experiences of pregnant minors who seek
abortion-related care. The proposed study will be conducted amongst pregnant and previously
minors (10-17 years) following sexual assault; parents/guardians of pregnant minors (10-17
years) recruited in the study; health service providers at the One Stop centre; and key
stakeholders. Thirty participants will take part in the study. Pregnant minors will be sampled
using a combination of purposive and snowballing methods while the rest of the population will
be sampled purposively to ensure rich data is collected.
Study Site, Study period and data collection: The study will be conducted in Lilongwe district
through the Kamuzu Central Hospital One Stop Centre. It is expected that this study will run fromDecember 2022 to March 2023. In-depth interviews, key informant interviews and semistructured
interviews will be used to collect data
Data management and analyses: Data collection and analysis will partly be done concurrently
and audio-recorded interviews will be translated and transcribed verbatim by trained
transcribers. Before analysis, transcripts will be anonymised. Data will be analyzed using
qualitative thematic analysis methods. The analysis will use a hybrid of the deductive and
inductive approach
Dissemination Plans: Initially, the study findings will be shared with Options Consultancy Services
Ltd. Subsequently, the study findings will be shared with the participating institutions such as the
KCH OSC, MOH-RHD and other key stakeholders. The study findings will also be disseminated to
wider audiences such as national, regional and global audiences. The study reports will also be
shared with the College of Medicine Research and Ethics Committee (COMREC, as required. The
results will also be presented at relevant regional and international conferences and published
in relevant peer-reviewed journals.
Anticipated challenges: Some of the actors such as service providers may feel uncomfortable
when asked questions about the provision of abortion services. The researcher also realizes the
sensitivity of the matter such that the minors may not be able to share their experiences. To
minimize this, we will inform the participants that participation in this study is voluntary and they
can stop participation at any time. Study staff will make every attempt to ensure a comfortable
and secure environment in which to interact with participants, and will be trained to protect
confidentiality.
Potential use of results: The findings of the research will contribute to understanding the impact
of laws and policies on the lives of minors who are pregnant due to sexual assault. It will also
contribute to clarifying the relationship between hospital practices in the provision of safe
abortion to minors and the legal framework. The Research will generate new evidence on barriers to safe abortion services access. This will reignite new discussions, raising the profile and visibility of the importance of legislative and policy reforms to address unsafe abortion.
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Characteristics and outcomes of HIV Patients starting ART in the era of routine screening for advanced HIV Disease at Lighthouse Trust, Lilongwe
(Kamuzu University of Health Sciences, 2023-01-11) Buleya, Shameem
Type of Research Study
This is a retrospective cohort study that will focus on exploring the characteristics and
outcomes of HIV patients starting ART in the era of routine screening for advanced HIV
diseases at Lighthouse Trust, Malawi.
Problem statement
The department of HIV/AIDS in Malawi implemented the Advanced HIV Disease (AHD)
package of care in 2018 to reduce deaths in People living with HIV (PLHIV). AHD
laboratory screening for tuberculosis and cryptococcal infection using CD4 count of ≤200
cells/ul as a cut-off point was since enforced on every newly HIV diagnosed client before
starting ART. However, it has been observed that despite the implementation of the AHD
package, there is limited data in Malawi on the proportion of people initiated on ART with
AHD and their specification on age segregation. Subsequently, the effect of CD4 screening
and testing for opportunistic infections on antiretroviral Treatment (ART) outcomes has not
been well described in Malawi. This study will address the knowledge gap on distribution of
AHD in people newly diagnosed with HIV will help program implementors introduce
approaches to reduce the prevalence of AHD in the general HIV population of PLHIV.
Objectives
The broad objective of the study is to describe the epidemiology of clients diagnosed with
AHD in the Era of Routine advanced HIV disease screening at Lighthouse Clinic- Lilongwe.
The specific objectives are:
i. To estimate the proportion of people with CD4 count of ≤200 cells/ul.
ii. To determine the demographic characteristics of people starting ART with CD4
count of ≤200 cells/ul.
iii. To assess the ART outcomes of clients diagnosed with AHD conditions at ART
initiation.
Methodology
This is a quantitative study of retrospective cohort design which will be conducted at
Lighthouse Trust, Lilongwe. The study population will include all HIV newly diagnosed
patients started ART at Lighthouse Trust from October 2020 to September 2021, with a CD4
count result before initiation. A suitable anonymized purposive sample of one-year initiations
will be selected from the Electronic Medical Records System (EMRS) and all study records
meeting the inclusion criteria. Secondary data will be collected from laboratory equipment,
registers and the lighthouse electronic medical record keeping system, which will be entered
in a tailored data collection tool (appendix A). Data will be analyzed through regression
analysis.
Expected Findings
The study expects to find the proportion of people starting ART with AHD using CD4 count
as a marker as well as WHO HIV clinical staging. It will assess the characteristics of
individuals presenting with AHD at initiation and their clinical outcomes over a year. For
instance, it is anticipated that males of older age groups (above 50 years) have higher risk of
developing AHD due to their poor health seeking behaviors. Patients who started ART with
existing AHD are expected to have poorer clinical outcomes; weight loss, elevated HIV Viral
Load copies at 6 months, and higher mortality rates than their counterparts with higher CD4
count.
Dissemination of results
Presentation of the outcomes shall be in tables, charts, and graphs, the research findings will
be presented to College of Medicine Research ethics Committee (COMREC) as well as
Lighthouse Trust clinic.
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Anti-Sexual Harassment Policy
(Kamuzu University of Health Sciences, 2022-06-01) Saidi, Alice Siyenunu
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Open, Distance and E-Learning (ODeL)
(Kamuzu University of Health Sciences, 2012-03-01) Kaponda, Mercy
The perception of adolescent toward parent to child communication on sexual reproductive health issues