Protocols

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Browsing Protocols by Subject "Research Subject Categories::SOCIAL SCIENCES"

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    Enhancing pathways from agriculture-to-nutrition
    (Kamuzu University of Health Sciences, 2021-12-03) Kalumikiza, Zione
    Study TitleType of research study: Women’s empowerment in nutrition and maternal nutrition outcomes: examination of linkages and identification of strategies for optimising outcomes among beneficiaries of a feeding trial in a rural agro-based community in Malawi The proposed study is a cross-survey that determines associations between Women’s empowerment and maternal nutrition outcomes in a rural Malawian community. Consensus exists that addressing malnutrition, a problem of public health significance in Malawi, will require a combination of both nutrition specific and sensitive interventions. Women’s empowerment, alone, or through the agriculture impact pathway, has generated considerable interest within various sectors, nutrition inclusive, despite limited evidence of its impacts on nutrition. The proposed study to be conducted in Kasungu District under Wimbe Traditional Authority, involves research to this effect. Problem: The nature, strength, and direction of associations between women’s empowerment and nutrition outcomes seems to vary widely and is ambiguous. No local research has assessed comprehensively associations between women’s empowerment and maternal nutrition or attempted to measure women’s empowerment in the realm of nutrition. Using a measure closely related to nutrition, the proposed study will provide data on the status of women’s empowerment and propose actions to facilitate nutrition empowerment and outcomes. This ambiguity largely stems from differences in the measures used for women’s empowerment. This is further compounded by a lack of local data in the field to inform actions. No research in Malawi has attempted to measure women’s empowerment in the realm of nutrition or assessed comprehensively associations between women’s empowerment and maternal nutrition. This study, therefore, will not only add to the body of knowledge in the relevant fields, but will generate evidence with policy and programmatic implications. proposes research which can support and guide national strategies and policies in these dimensions. Objectives: Broadly, the study seeks to identify strategies for optimising maternal nutrition outcomesdetermine the status of nutritional empowerment among women of reproductive age in a rural Malawian community using a novel index, the Women’s Empowerment in Nutrition Index (WENI) and assess its associations with nutrition outcomes. Specific study objectives are; (i) to determine the level and extent to whichstatus of nutritional women are empowered in nutrition using a novel index,empowerment in the study population the Women’s Empowerment in Nutrition Index (WENI); (ii) to measure determine associations between the WENI and the Body Mass Index (BMI), Mid Upper Arm Circumference, and, dietary diversity of women in the study area; (iii) to examine assess the effect of provision of a staple food (maize flour) on dietary diversity, and intakes of energy, protein, iron and folate; and, (iv) to examine assess changes in dietary quality (diversity) among the WRA 2 years after participation in a feeding trial. Methodology: The study combines a cross sectional survey designed to collect and measure status of women’s empowerment in nutrition and its associations with maternal nutrition outcomes, and, secondary analysis of data from an intervention study, the “Alleviating Hidden Hunger with Agronomy (AHHA)” conducted within the Geo Nutrition project (reference: P.05/18/2393). The analysis of the AHHA data will measure changes in diversity and intakes of energy, protein, iron, and folate following receipt of a staple food (maize flour). The changes in diversity over time will also be assessed to see to what extent benefits, if any, are sustained over time. For the WENI survey, face-to-face interviews will be conducted with women who participated in the AHHA study (n=180), guided by a semi-structured interviewer administered questionnaire. Microsoft Excel, IBM SPSS Statistics version 25, will be used in the data entry and analyses phase respectively. In addition to general descriptive statistics, Fischer’s LSD test and the Dunnett’s test will be used to examine assess changes in nutrient intakes. To test for associations between women’s empowerment in nutrition and nutrition outcomes, chi-square analyses will be used. Multivariate logistic regression will be employed to identify specific empowerment domains closely related to nutrition outcomes. This study is part of a Doctoral Research for Ms Zione Kalumikiza. Expected Findings and Dissemination. The study is expected to measure the level of women’s empowerment in nutrition and identify areas of disempowerment, which provides a basis for the type of interventions needed to improve nutrition and health of women in similar contexts. By investigating associations between women’s empowerment in nutrition and maternal nutrition outcomes, the study helps to understand the extent to which the empowerment index (WENI) can be used as a predictor of nutritional status hence its application in both nutrition programming and assessments. Variations are expected in empowerment across the different domains with most participants demonstrating empowerment in the knowledge domain as opposed to resources and control domains. This is largely because women are the main targets for nutrition education and are less often provided with resource support or linkages to institutions. In addition, rural communities often favour males on control of resources. Overall, this study will identify specific areas of disempowerment and provide a basis for the type of interventions needed to improve nutrition and health of women in similar contexts. It will further help to understand the extent to which the empowerment index (WENI) can be used as a predictor of nutritional status hence its application in both nutrition programming and assessments. We further test the influence of empowerment in a single domain-dimension (food/maize flour provision) and hope this generates evidence for informing the design of similar nutrition-sensitive interventions for better impact. Finally, the study will explore whether dietary changes resulting from the AHHA intervention are sustained over time. Taken together, this study will identify barriers to nutrition empowerment and thus propose actions to facilitate nutrition empowerment and outcomes. The study, therefore, will not only add to the body of knowledge about nutrition and empowerment, but generate evidence with policy and programmatic implications. Study findings will be presented to the scientific community through publications in peer reviewed journals and presentations at national and international conferences. The Kasungu local council and concerned Traditional Authority will also be presented with key findings from this research. A copy of the thesis and all published work from this study will be shared with the College of Medicine Library, the College of Medicine Research Ethics Committee, and other relevant committees in line with requirements by the College of Medicine.
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    Factors associated with adherence to feeding protocols in stabilization phase of severe acute malnutrition management: Kamuzu Central Hospital, Lilongwe
    (Kamuzu University of Health Sciences, 2021-11-11) Gaven, Wilfred
    A retrospective cohort study design utilizing quantitative method will be conducted. During the process, every fourth case file of 6 to 59 months old SAM children admitted in four years from 2017 to 2021 will be selected till 459 sample size is reached. Later those selected files will be reviewed. Severe acute malnutrition remains a global challenge affecting 16.6 million out of 238 million under-five malnourished children and thus representing 7% with a death rate of 5% annually. Most of SAM cases are highly prevalent in Asia, Sub-Saharan Africa and Haiti in Latin America because the nation was hit by cholera epidemics which led to economic collapse. Asia has 12 million SAM children and thus representing a larger morbidity and mortality rate compared to other regions. Malawi through the study done at Kamuzu Central Hospital showed 9.7% of 6 to 36 months old SAM children with a death rate of 10.1%. Despite Malawi having done a lot to review community-based management of acute malnutrition guidelines and training of health workers on the same, there are still increased deaths in children with SAM. Again, there is inadequate data on adherence to SAM treatment, hence the need to do the study. The study aims at assessing factors associated with level of adherence to feeding protocols of severely malnourished under-five years of age children at KCH. The specific objectives will be: to determine adherence level to feeding protocols in the stabilization phase, to establish association between shift times and adherence, to expose association between days of the week and adherence, to establish association between wards of admission and adherence and determine association between outcome and adherence. A retrospective cohort design will be used to review all 6 to 59 months SAM children case files from 2017 to 2021. KCH, a tertiary referral hospital in Lilongwe, the Capital of Malawi which serves patients from nine district hospitals in the Central Region, will be used. The pediatric ward will be the exact place to do the study. A systematic sampling will be done where every fourth [1740/459] case file will be selected till the sample size is reached. Data collection will be done by using data extraction sheet which has six sections A, B, C, D, E and F. The form has both dependent variables to define adherence and independent variables against which adherence will be quantified. Descriptive statistics will be used for socio-demographic and clinical characteristics of the patients. The level of adherence to feeding protocol will be calculated by using the measures of relative frequency. Univariable and multivariable logistic regression analysis will be used to assess the association between adherence and each independent variable. Association between prognosis and adherence level will be established by Chi-square/Fisher’s Exact test to find the proportion. Data will be presented in graphs, tables, stem and leaf formats. Expected findings will include: proportion of adherence level, the differences in association between levels of adherence and independent variables and the level of association between prognosis and adherence level. Dissemination will be through morning reports, conference presentation and journal publication. A copy of the dissertation will be sent to Kamuzu University of Health Sciences, COMREC, KCH and Malawi College of Health Sciences libraries for reference.
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    Supplementation tendencies of vitamin C and D among non-severe COVID-19 patients in Blantyre, Malawi
    (Kamuzu University of Health Sciences, 2021-11-21) Katundu, Kondwani
    Study Type: Retrospective cross-sectional quantitative study. Background: Low blood Vitamin C and D have been associated with the severity of Coronavirus disease 2019 (COVID-19). The practice of vitamin supplementation among individuals with non-severe COVID- 19 disease appears to be common, but the frequency and dose of these vitamins among this population group has not been well evaluated in Malawi. Study Objectives: This study aims to determine prevalence and dose of supplementation of the vitamin C and D among non-severe COVID-19 patients in Blantyre, Malawi. Methods: We will conduct a retrospective study in randomly selected recovered non-severe COVID-19 adults (n=150) in Blantyre, Malawi who had a COVID-19 infection between January and September 2021. We will acquire information on the frequency, dose and duration of vitamin C and D supplementation during an episode of the non-severe COVID-19. Sample-size: The sample size for the study will be 150 participants was calculated to detect at least 40% frequency use of vitamin C and D supplementation at a power of 80% and 95% confidence interval. Outcomes and definitions: Vitamin C and D supplementation will be considered as any pharmacological form of the vitamins taken orally or parenterally at least at one point during the sickness episode of nonsevere COVID-19 infection. The prevalence of supplementation, the mean dose and the duration of supplementation will be calculated. Expected findings and dissemination: We expect at least 50% use of vitamin C and D supplementation in individuals with non-severe COVID-19. The results once analysed will be published in an international scientific journal and will be presented both at local and regional or international conferences. Published results will also be submitted to the Malawi Liverpool Welcome Trust Clinical Research Programme, College of Medicine Research and Ethics Committee (COMREC), Kamuzu University of Health Sciences Library, Blantyre District Health and Social Services Office and Queen Elizabeth Central Hospital.