- ItemRestrictedThe perception of adolescent toward parent to child communication on sexual reproductive health issues(Kamuzu University of Health Sciences, 2022-08-17) Banda, MirriumThis study will explore the perceptions of adolescents in the Salima district on parent-child communication about Sexual and Reproductive Health Issues. Communication on SRH issues between parents and children hardly occurs even though parents live and spend most of the time with their children. Lack of openness when discussing SRH issues between parents and adolescents is associated with risky sexual practices that are detrimental to adolescents' health and well-being. Problem statement Intergeneration discussion on sexual reproductive health issues is regarded as taboo in most African countries, Malawi inclusive. It is believed that it predisposes adolescents to early sexual debut. Nevertheless, for adolescents to be able to enhance their sexual life positively as they grow they need to be adequately informed on issues of SRH by their parents. Failing which, adolescents get information from the wrong sources and this has led to exposure to several health risks including sexually transmitted infections, HIV and AIDS, unwanted teenage pregnancy, unsafe induced abortion, and low education attainment Broad Objective The broad objective of the study is to explore adolescents’ perception in Salima District on parent-tochild communication on sexual reproductive health issues Specific Objectives The objectives of the study are: 1) To explore how the adolescent perceives parent-to-child communication. 2) To understand the sexual reproductive health topics that the adolescents perceive important to discuss with parents. 3) To describe the perceived communication strategies used during parent-to-child communication in homes. 4) To explore the perceived challenges of parent to child communication on sexual and reproductive health issues Methodology This study will be a descriptive qualitative study to be carried out in Salima district(Malawi). Salima has purposively been selected because it is one of the districts in Malawi with high rate of teenage pregnancy. According to Malawi Demographic Health Survey (MDHS) (2015-16), teenage pregnancy rate for Salima is below the national average rate 26% and 29% respectively. However, Salima district has high rate of teenage pregnancy as compared to the average rate of central region which is at 25% (MDHS 2015-16). The study will involve adolescents aged 12-19 years. This age group is considered mature and can provide precise information. Data will be collected through in-depth interviews with twenty participants using an interview guide. All interviews will be sound recorded, transcribed verbatim, and will be analyzed manually. Ethical approval will be obtained from College of Medicine Research and Ethics committee. The institutional clearance has been granted from the Director of Health and Social Services for Salima District Hospital. Expected Findings The study will establish if communication on sexual reproductive health issues between parent and their adolescents do/don’t occur. This will help to close the communication gap between parents and their adolescents on sexual reproductive health issues. Parents/families will understand their role and the importance of parent-to-child communication on sexual reproductive health issues. In addition, the expected findings will also help the policymakers, programme managers, decision makers and advocators to revise or inform the development process of health intervention to address adolescent sexual reproductive health in the light of HIV and AIDS prevention. Dissemination of findings The findings of this study will be presented to the College of Medicine Research and Ethics Committee and the Ministry of Health through Salima District Health Office from where the data will be collected. The study finding will be published in respectable peer-reviewed journals and presented at the conference.
- ItemRestrictedSmall at birth: associations with health and development in late adolescence in rural Malawi, version 1.0(Kamuzu University of Health Sciences, 2022-07-26) Ashorn, Ulla Dr.Type of research study: A prospective observational birth cohort study, built on a randomised controlled trial of maternal antibiotic and antimalarial treatment during pregnancy. Problem: There is scarce literature on child and adolescent outcomes of individuals born preterm or small for gestational age. We intend to provide information on their growth and development trajectories till late adolescence, body composition, cardiovascular and mental health in a population cohort of children followed up from pregnancy and now in late adolescence. We will also be able to evaluate whether gains in and related traits caused by maternal antibiotic and antimalarial treatment are sustained at this age. All these analyses may eventually guide the design and targeting of public health interventions aimed at supporting healthy growth and development. Objectives and primary outcomes: Overall objective of the study is to examine whether there is an effect of being born preterm or small for gestational age (SGA) or of the antibiotic and antimalarial intervention which their mothers received during pregnancy child and adolescent growth and development outcomes. The specific objectives are: 1. To describe and analyse the key interrelated outcomes related to adolescents’ health, functional reserve and ability to thrive in rural Mangochi; 2. To assess how preterm birth and being born small for gestational age predict these outcomes; 3. To assess the effects of maternal antibiotic/antimalarial intervention during pregnancy on these outcomes. Methodology: This will be a study of adolescents from the Lungwena area, rural Mangochi District in Malawi. The subjects have participated in a longitudinal cohort study since their fetal period. In the proposed study, we will invite the participants for a visit to study clinic and conduct anthropometric measurements, measure their body composition and blood pressure, physical activity, fitness and cognitive and motor abilities and administer standardised tests and questionnaires in the form of interviews. We expect to reach approximately 800 participants. Expected findings and their dissemination: We expect to produce information on growth and development trajectories till late adolescence, body composition and cardiovascular and mental health. Results from the study will be disseminated locally (at Mangochi District Hospital), nationally (Kamuzu University of Health Sciences, Ministry of Health, Kamuzu University of Health Sciences Research and Ethics Committee) and in international meetings and journals.
- ItemRestrictedThe impact of natural disasters among adolescent girls on their menstrual hygiene management in Mulanje district(Kamuzu University of Health Sciences, 2022-05-09) Chizule, HildaType of study: The study design for this study is qualitative, which will employ an explorative approach. A qualitative study will be conducted with men, women, boys and girls in the Mulanje district. The investigator will explore the beliefs, taboos associated with menstruation, materials and disposal areas used during a natural disaster, the role of men and boys in MHM during natural disasters and inclusive approaches to shelter and settlements initiatives for MHM in emergencies/natural disasters. The problem: Malawi faces natural disasters periodically. The most related are weather-related shocks, for instance, floods, i.e., Cyclone Idai Cyclone Ana. The Cyclone idai developed in Mozambique and it brought strong winds and caused severe flooding in Madagascar, Mozambique, Malawi and Zimbabwe. In Malawi, it affected 13 districts, including the Mulanje district and two cities in the southern region and two districts in the central region of Malawi. The flooding affected the mental health, social-economical, livelihoods, infrastructure and even death. Women and girls face challenges accessing the bathrooms and toilets when they dislocate to camps during natural disasters. Lack of Menstrual Hygiene Management (MHM) inclusive shelters for settlement hinders girls’ privacy and safety. The inadequacy of facilities and material, i.e. buckets for girls to bath, wash and take care of themselves when menstruating, is worrisome. There are no drying areas of their sanitary materials and drainage systems at the camping sites. In a quest to bring solutions towards MHM, humanitarian agencies, nongovernmental organizations (NGOs) and government focus mainly on technical solutions limited to the distribution of sanitary pads and provision of water. The beliefs and taboos associated with menstruation continue to affect how girls and women manage menstruation. In addition to that women and girls lack support from men and boys especially in patriarchal societies. Boys engage in period teasing whilst men inadequately support the women and girls in allocation of finances to buy sanitary products, hence a need for males to become advocates for MHM alongside women. Study objectives: The study's main objective is to explore the impact of natural disasters on the menstrual hygiene management of adolescent girls and women in Mulanje. The specific objectives include 1) To identify the material used and disposal practices for adolescent girls as in regards to the MHM during natural disasters, 2) To describe the role of Men and Boys in MHM during natural disasters/ Emergencies 3) To explore beliefs, attitudes, taboos and practices associated with MHM during natural disasters and 4) To describe inclusive approaches to shelter and settlements initiatives for MHM in emergencies/natural disasters when natural disasters occur. Methodology: The investigator will employ focus group discussion (FGDs) with boys, girls, and women and men. Key informant interviews (KII) will be conducted with disaster and youth officers,mother group members and chiefs. The investigator will focus on the structural issues (social and environmental, policy, interventions issues), beliefs, attitudes, taboos and practices associated with MHM during natural disasters. A multi-stage sampling technique will be employed to develop clusters depending on the geographical location of the participants. A purposive sampling approach will follow to select the Traditional Authorities (TAs) to be part of the study. The structural vulnerability conceptual framework will help the investigator think more clearly, critically, and practically about how social structures, local hierarchies, and external and internal environmental factors affect girls’ menstrual management. There will be 16 FDGs and 6 KII. The total sample size is 102 (28men, 26women, 24boys and 24girls). The investigator will hire experienced 6 research assistants (3 female, 3male). The research assistants will participate in data collection tools, transcription, and analysis. Data collection tools have been developed in Chichewa and English. The data will be analyzed by Nvivo data package, which uses thematic data analysis. Expected findings and dissemination This study will provide evidence-based information on responding to MHM and planning other programme initiatives during emergencies. The findings will be disseminated to various stakeholders to integrate the information into their disaster response plans. Presentation of findings will be made to Mulanje district health office, public health departmental college meetings, College of Medicine Research Ethics Committee (COMREC), District Executive committee (DEC) and finally at the community level in Mulanje.