Browsing by Author "Chipeta, Effie"

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    Exploring facilitators and barriers to blood collection and repeat donations in high and low performing districts/programs in Malawi
    (Kamuzu University of Health Sciences, 2021-03-17) Chipeta, Effie
    Type of Study The Malawi Blood Transfusion Services (MBTS) was established in 2003 to provide centralized and safer blood supplies. Since its inception, the quantity of blood units collected through MBTS and hospital blood banks had increased to 87,166 units in 2017 and all districts in Malawi contributed to collection efforts. However, despite this increase, Malawi remains with a 27% deficit in required blood supplies. So far there has been limited research to understand the facilitators and barriers to blood collection and factors associated with repeat donations in Malawi. Research into understanding the facilitators and barriers to first time donation and regular donation in Malawi are critical to the design and successful retention of programs that promote life-long donation. Objectives This study seeks to examine and factors associated with blood collection and repeat donations among low and high performing districts in Malawi. Specifically, the study seeks: a) To explore the barriers and facilitators to blood donation and repeat donations among blood donors in Malawi b) To explore strategies to enhance blood collection among voluntary non remunerated blood donors in schools c) To explore strategies for building a sustainable pool of blood donors post secondary school in Malawi. Study design and data collection methods The proposed research will use a cross-sectional, qualitative, descriptive design to examine a range of factors that influence blood donation and donor retention. The study will utilise qualitative data collection methods such as in depth interviews (IDIs), focus group discussions (FGDs) and key informant interviews (KIIs) to collect data from donors, non-donors, community leaders, policy makers, and program staff. Data management and analysis All KIIs, FGDs, and IDIs will be audio recorded, transcribed verbatim and translated into English by trained research assistants. Recordings and anonymized transcripts will be kept in passwordsecured computers. Data will be analysed using using qualitative thematic analysis using Atlas.ti software. Ethical considerations Covid-19 preventive measures/anonymity/confidentiality/permission/information sheet and consent will be applied and followed. Possible constraints We anticipate challenges in the recruitment of school based VNRBDs. Schools have been closed and it’s still not certain when schools will reopen. This might also affect the study timelines and logistical challenges if data collection spills over to the first quarter of 2021 which in Malawi is the rainy season. In addition, due to the Covid-19 restrictions and the need to observe the precautionary measures, it may be challenging to conduct ideal group discussions as well as face to face interviews. Results Dissemination Results will be presented according to the study objectives. These will be presented in research reports that outline methods used, key findings, and recommendations. Further dissemination of results will also occur through publication(s) in peer-reviewed journal(s) as well as presentations at seminars/conferences, stakeholder meetings and websites. A report will be provided to COMREC. The implications of this study The study will provide insights on how barriers and facilitators of blood donations and retention of blood donors which will help formulate strategies to improve blood supplies in Malawi.
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    Implementation research on the appropriateness, feasibility, acceptability, and effectiveness of delivery of comprehensive sexuality education to Young people with disabilities and young people living with HIV out-of-school.
    (Kamuzu University of Health Sciences, 2021-03-04) Chipeta, Effie
    Type of study: This is an implementation science research study that will employ different methods to test the appropriateness, feasibility, acceptability and effectiveness of approaches to train and support facilitators to deliver CSE in out-of-school settings to young people with disabilities (YPWDs) and young people living with HIV (YPLHIV) in Malawi. Background and rationale: In January 2018, six UN agencies launched a revised edition of the International technical guidance on sexuality education, which provides guidance on designing and delivering comprehensive sexuality education (CSE) to support young people’s (10-24 years) health and well-being. Through UNFPA HQ and regional offices, the 3-year initiative titled “Reaching those most left behind through CSE for out-of-school young people,” is being implemented in Malawi and other four countries. The program in Malawi focuses on delivering CSE in out-of-school contexts to young people with disabilities and young people living with HIV. Objectives: The overall objective of the implementation research is to determine whether the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling the facilitators to engage YPWD and YPLHIV, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. The specific objectives of the implementation research are: 1. To determine whether the activities used to train and support facilitators were appropriate for the delivery of comprehensive sexuality education to young people with disabilities and young people living with HIV. 2. To determine whether the plan for training and supporting the facilitators was feasible and whether it was implemented with fidelity. 3. To determine whether the training and support provided to the facilitators was effective in improving their competencies and attitudes. 4. To determine whether the facilitators: a. perceived that the training and support they received adequately enabled them to carry out their roles and responsibilities. b. effectively carried out their roles and responsibilities. 5. To determine whether the YPWD and YPLHIV: a. perceived the CSE as accessible, relevant, interesting, and useful. b. gained in terms of knowledge, attitudes, values, and skills related to sexuality and reproduction, and in terms of the use of relevant services. Methods: This is an implementation science research study that will employ different methods to test the appropriateness, feasibility, acceptability and effectiveness of training and supporting facilitators to deliver CSE in out-of-school settings to young people with disabilities and young people living with HIV in Malawi. Data will be collected at different time periods to measure and assess the implementation process and outcomes throughout the course of the intervention. We will use qualitative methods such as focus group discussions and in depth interviews and records review to measure the implementation processes and outcomes. Data management and analysis: The data will be secured. To ensure that the identities of participants are kept confidential, data will be anonymised and random identifiers will be generated for each file. The investigators will also go through audio files and transcripts to ensure quality. Quantitative data will also be cleaned. Qualitative data will be analysed using thematic content analysis approach while we will generate descriptive statistics with quantitative data. The qualitative and quantitative findings will be triangulated. By using various research methods (i.e. records review, qualitative interviews and quantitative data), we will eliminate some biases and shortcomings that may arise with using one method. Where necessary, qualitative data will provide explanations, justifications and validations to the findings from the quantitative data. Possible constraints: We anticipate no major constraints. However, due to the COVID-19 pandemic, study activities may be delayed or paused depending on the status of the pandemic. We will also adhere to all COVID-19 guidelines in conducting our research to ensure the safety of both researchers and study participants. Results To ensure that the research findings support efforts to improve CSE more generally, research findings will be disseminated through key stakeholders, peer reviewed journals, conferences and a copy will be sent to approving ethics committees (e.g. COMREC). Implications of the study: We anticipate that facilitators will become more competent in and more comfortable with delivering CSE in out-of-school settings to the targeted populations, that is, young people with disabilities and young people living with HIV. We anticipate that the facilitators will be acceptable to the young people and that delivery of the CSE will be feasible and more effective.