Browsing by Author "Kumwenda, Moses"

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    An assessment of gender and intersectionality in disease exposure, care seeking behaviour and treatment pathways in malaria prevention and control in Kenya and Malawi: a case of Migori county and Chikwawa district
    (2022-04-13) Kumwenda, Moses
    Type of study This project will adopt a longitudinal study design with embedded mixed methods to allow for translational research and long-term in-depth exploration. This study design will be a multidisciplinary integration among basic, clinical, practice, population, and policy-based research enabled by a multidisciplinary team of clinical and social scientists. Problem The burden of malaria persists despite the ongoing prevention and control interventions over the last two decades with the different malaria endemic and epidemic zones being strategically targeted with a view to eradicate this infectious disease. In Kenya and Malawi, malaria remains a major cause of morbidity and mortality with more than 70 percent of the population at risk of the disease. Kenya has four main malaria epidemiological zones with diversity in risk and intervention determined largely by altitude, rainfall patterns, and temperature, as well as the prevalence of malaria. Further, access to and uptake of health services for prevention and treatment knowledge of malaria and health outcomes experienced throughout the life course are influenced by the foregoing life stratifiers often overlooked in intervention programmes and policies. Objectives Main objective The aim of the study is to assess the gender and intersectionality of exposure to mosquito bites, care seeking and treatment pathways for Malaria in Migori County, Kenya when compared to Chikwawa district in southern Malawi Specific objectives 1. To assess the intersection between the risk of exposure to mosquito bites with gender and other social determinants (sex, age, occupation, level of education/class, place of residence (urban/rural), and religion) of Malaria. 2. To describe how gender power relations, the prevailing gendered social inequalities, and the culturally dominant constructions of masculinity and femininity intersect with each other in shaping people’s understanding of ill-health and influence Malaria health seeking behaviours. 3. To audit Malaria programme delivery and Malaria control interventions including research and access to Malaria and disease management services using the intersectional gender lens. 4. To identify the gender dimensions in Malaria programme delivery and control interventions in the emerging COVID-19 pandemic context. 13-The study will be conducted in Migori County, Kenya and Chikwawa district in Malawi to target health facilities and community members to explore gender and intersectionality of malaria etiology, health and health seeking and treatment pathways and inform the specific study objectives. The research will employ participatory , qualitative and quantitative methods to explore gender and intersectionality of malaria etiology, health seeking and treatment pathways. This study will be carried out in two phases: Phase one - the formative phase and will entail mainly the document reviews and piloting of the study tools and; Phase Two - mixed methods studies, the longitudinal comparative approach will include quantitative and qualitative studies to assess malaria etiology, health and health seeking and treatment pathways through a gender and intersectionality lens. Expected findings and dissemination The research protocol will be published after all ethical approvals have been received. Findings from the study will be presented through community engagement mechanisms such as community engagement meetings and science cafe’s. Advocacy work through various mechanisms at county and national level based on the findings of the study will be conducted. Results will be shared with the wider scientific community through presentations at national and international conferences, and through open-access peer-reviewed journal publications. In addition, we can submit the report of our findings to COMRE and national open data platform.
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    Developing “U=U” communication messages targeting HIV discordant couples in Malawi: Establishing evidence on feasibility and acceptability
    (2022-07-20) Kumwenda, Moses
    This research will employ a mixed-methods approach combining qualitative and quantitative approaches to develop and pilot “Undetectable = Untransmittable” in short “U=U” communication materials that could be delivered through ANC clinics in Blantyre, Malawi. The problem There is a gap in evidence on the availability of “U=U” communication materials in Malawi and information on how HIV sero-discordant couples who are expecting a baby can manage their HIV status to minimise the probability of transmitting HIV virus to the partner or the infant. This gap needs to be filled to enable policy makers and implementers in Malawi to make informed choices on how “U=U” communication material can be integrated within the ANC care and HIV programme in Malawi. The Objectives The broad aim is to develop contextually relevant TasP messaging materials that emphasise “U=U” information targeting HIV discordant couples. The specific objectives are to: 1. To explore understanding of TasP and “U=U” among HIV-discordant couples and recipients of ART care. 2. To develop culturally relevant communication materials that optimise user comprehension of “U=U” concepts targeting HIV sero-discordant heterosexual couples . 3. To test the acceptability of the developed “U=U” messages targeting HIV discordant couples. Methodology20-Jul-2022 ACCEPT ‘U=U’ Study - PROTOCOL Version 3.0: 15/04/2021 Page 5 of 36 This is a mixed-methods study that will develop and pilot “U=U” communication materials delivered through ANC clinics of Bangwe, Limbe, Madziabango and Mpemba Health Centres antenatal clinic in Blantyre, Malawi. Focus group discussion and key informant interviews will be done during the formative qualitative investigation. Three stakeholder participatory workshop and cognitive interviews will be used during the “U=U” communication material development stage. A Phase 2 exploratory trial will be done at Bangwe, Limbe, Madziabango and Mpemba Health Centres to test the feasibility and acceptability of the developed “U=U” communication materials. Expected findings and dissemination Expected results from this study include well developed and contextualised “U=U” messages, and outcomes following a pilot test of the application of “U=U” messages within primary health care context in Malawi. The results of this research will be used to guide the formation of national and international policies. Findings will be circulated to the College of Medicine Research and Ethics Committee, the Health Sciences Research Committee and the University Research and Publication Committee. Results will also be distributed to global health policy makers, nationally to the Malawian government, including HTS technical working group. Research findings will be published in journals and presented at conference.s
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    Values and preferences for Covid-19 self-testing in low and middle income countries: A qualitative study in Malawi
    (Kamuzu University of Health Sciences, 2021-09-21) Kumwenda, Moses
    The type of research study This is a qualitative inquiry that has been nested in a multi-site, mixed-methods study comprised of two components: a cross-sectional survey and a qualitative inquiry. Malawi participates in the qualitative inquiry only. The problem Malawi is currently implementing a study on the feasibility of self-sampling and self-testing for SARS-COV-2 under the leadership of the Foundation for Innovative New Diagnostics (FIND) in collaboration with the Helse Nord TB Initiative in the College of Medicine of the Kamuzu University of Health Sciences (KUHES) . No study within the Malawian context have explored the values and preferences of COVID-19 self-testing. Populations' views and perceptions are crucial in leading the discussion around the safest strategies for implementing COVID-19 self-testing. Furthermore, light has to be shed on the different sociocultural specificities that may hinder or accelerate the widespread use of COVID-19 self-testing.