3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Health risk assessment of lead exposure to children in Blantyre, Malawi(2016) Utembe, Wells RobertAlthough lead (Pb) is highly toxic, exposure to Pb has not been studied in Malawi. The aims of this study were therefore to: 1. Determine the levels of Pb from different sources of exposure such as food, water, and soil/house dust to predict the levels of Pb in blood (BPb) using the Integrated Exposure Uptake Biokinetic (IEUBK) model. 2. Measure the levels of BPb and compare to those predicted from the IEUBK model as an indication for its applicability in Malawi. 3. To relate the measured and predicted BPb levels as well as the prevalence of high BPb to potential health effects using the WHO and CDC guidelines. 4. Assess burden of disease using WHO spreadsheets. 5. Identify additional sources and risk factors for exposure to Pb in children in Malawi to assist the policy makers to reduce exposure to lead. In this cross-sectional study 152 children, aged 1-6 years, were recruited. To determine sources of exposure, children’s toys, domestic paints, foods, house dust, playground soil and water were collected and analyzed for Pb. A Pb exposure risk assessment questionnaire was also administered to identify potential risk factors and a 7-day food frequency questionnaire was used to collect information on food consumption. For measured BPb levels, venous blood was collected and analysed. Logistic regression was performed in STATA to evaluate the relationship between risk factors and high BPb (BPb ≥ 5 μg/dl). The comparisons between predicted and measured blood lead showed that the IEUBK model may be used provided that the bioavailability values for lead from different sources are available as well as the food consumption rates are provided for Malawi.. There was also a high prevalence (71.7%) of high BPb that is expected to result in 8.38 cases of mild mental retardation per 1000 children aged less than five years. From the identified risk factors, only areas of residence has correlated to prevalence of high BPb in statistically significant manner (p = 0.013). It can therefore be concluded that IEUBK model may be used for Malawi, that a significant proportion of children in Blantyre are exposed to levels of lead that are detrimental to their health and that exposure to lead in Blantyre require urgent intervention measures.Item The extent and risk factors for transactional sex among young people, in urban informal settlements in Blantyre, Malawi(2015-09-08) Longwe, Monica BrendaIntroduction: Studies across Sub-Sahara have established transactional sex as one of the of the keys factors contributing to young people’s risk of HIV infection. However, there are few studies that have explored the dynamics of transactional sex among young people in Malawi. The aim of this study was to investigate the extent of, and risk factors associated with transactional sex among (in and out of school) young men and women of ages 18 – 23 years in urban informal settlements in Blantyre, Malawi. Methods: This was a secondary analysis of data from a cross-sectional study conducted in 2013 on sexual risk-taking among young people aged 18 – 23 years in urban informal settlements in the city of Blantyre, Malawi. The analysis was restricted to sexually active young men and women (those respondents who reported ever having sexual intercourse in the primary study). Bivariate and multivariate analyses were conducted to detect associations between socio-demographic factors (i.e. age, socio-economic status, relationship status and education, as well as behavioral factors (i.e. sexual debut, number of partners, age disparity with sexual partner, coercive sex and alcohol consumption), and transactional sex. Results: The majority (60.06%) of the study population reported involvement in transactional sex. Stratified by sex, 67.10% of young men had ever given cash or material goods in order to get sex, and 53.45% of young women had ever received cash or material goods in exchange for sex. Half (50.75%) of the transactional sex reported was in exchange for cash and consumption/lifestyle goods and from this, over half of the young women (58.67%) reported receiving consumption and lifestyle goods in exchange for sex, and slightly over a quarter (26.32%) of the young men reported giving survival needs in exchange for sex. Among men, household structure (AOR 2.07, 95% CI 1.37 – 3.13) and severe food insecurity (AOR 1.67, 95% CI 1.05 – 2.67) emerged as important socio-demographic predictors of transactional sex, and number of sexual partners (AOR 2.67, 95% CI 1.78 – 4.08) and age disparity (AOR 0.34, 95% CI 0.21 – 0.57) were shown to be the behavioral factors that influence giving cash/material goods for sex. Among young women, only age at sexual debut (AOR 2.07, 95% CI 1.37 – 3.13) and number of sexual partners (AOR 3.02, 95% CI 1.65 – 5.52), were significantly associated with receiving cash or goods in exchange for sex. Conclusions: Overall, the study findings show that transactional sex is a common practice among young men and women, and that both young and women exchange luxury or aspirational items more than survival items for sex. Among young men, household structure, food security, age at sexual debut, number of sexual partners and age differentials with sexual partner were associated with giving material goods or money for sex. Among women on the other hand, age at sexual debut and number of sexual partners were associated with receiving material goods or money in exchange with sex. These findings suggest that young people in poor urban settings engage in risky sexual behavior such as Transactional sex, and highlight the need for HIV prevention interventions to deliberately target this group. Programmers should consider designing interventions that suit the needs of the different gender groups. The study findings also highlight the importance of targeting young women with behavioral change interventions before sexual debut, and integrating transactional sex interventions with those focused on reduction of multiple sexual partnerships may have beneficial implications for transactional sex among young people in poor urban settings. Further research should explore the influence of materialist and consumeristic cultures on transactional sex among young people.Item Implementation of the performance management policy of the Malawi civil service(2014-03-18) Chidwala, Jevas JafaliImplementation of the performance management policy for the Malawi has been held back by a number of factors. There have been indications that suggest that there were some problems resulting in differential implementation of the policy by government’s ministries and departments. In this study the purpose was to find out the factors contributing to this non-implementation of the policy. The research question was; what factors are contributing to the implementation or non-implementation of the performance management policy for the Malawi Civil Service? The study used a qualitative research methodology and questionnaire administered interviews to collect data. The main findings from the study was that implementation of the policy was being hampered because of the complex nature of the public service, absence of follow ups and management support, lack of consultations and motivation factors. The conclusion drawn from the study is that the factors identified are manageable. Therefore, the Department of Public Service and Management and other concerned stakeholders can reflect on the issues revealed by this study, consult widely and put in place necessary mechanism that could ensure successful implementation not only of the performance management but other future polices as well.Item Citizen participation in local policy making in Malawi(2013-06-03) Malamulo, Terence CraylIn the last two decades, a number of discourses on democratic governance and development in the developing countries position citizen participation as a public accountability mechanism. Most countries have adopted decentralization governance reforms to enable local citizens to influence government policies and services. Literature on decentralization shows weak coherence on how public accountability works to achieve local development and democracy consolidation. Hence, the research study proposes a citizen participation model that should be used in investigating citizen based public accountability in policy making. The evaluation study intends to measure the extent to which citizen participation influences public accountability in local policy making in Malawi; using an evaluation framework based on the suggested citizen participation model. The evaluation investigated the influence of citizen participation in the making of the Lilongwe City Development Strategy (2009). It used qualitative research design and a case study of Ngwenya, a peri-urban area in Lilongwe City. The study used a clarificative evaluation approach. The study found that there is poor citizen participation to influence public accountability in local policy making in Malawi. The findings depict that the conceptualization of citizen participation model should underpin policy principles and associate laws to frame contextual base that helps decentralization benefits reach the local citizens. The report suggests that to improve public accountability through citizen participation primarily there should be: i) clear social, constitutional or political contracts between local government and citizens; ii) adherence to democratic governance; and iii) consistent alignment of programme implementation to assumed contexts in their design.Item A comparison of HIV status among women who visit antenatal clinics with those who do not.(2009-03-06T07:50:48Z) Niwemahoro, CelineFor monitoring the spread of HIV epidemic, both national population-based surveys and antenatal clinics (ANC) are used. However, in all cases, there are potential biases. Bias associated with ANC data includes whether the pregnant women who attend public ANC are representative of all pregnant women. Reduced fertility among HIV-infected women, selection for sexual activity and under-representation of smaller rural sites in surveillance systems are other factors that may be source of biases (Boerma et al. 2003 & Walker et al. 2003). So, the question arising is how women who attend ANC could be representative of the general female population. Evidently, not all women become pregnant and not all pregnant women attend ANC. This research project has been designed to address those biases especially in Rwanda and Malawi. It focused on investigating the significance of this bias by doing a comparative analysis of sero prevalence between both those using ANC and those who do not. This study, therefore, intends to test whether women attending ANC may be representative to the general female population of both Rwanda and Malawi using respectively 2004 MDHS and 2005 RDHS. Using statistical techniques with the aid of STATA software program, univariate, bivariate and logistic regression (bivariate and multivariate) were performed for 11321 women in Rwanda and 11698 in Malawi aged between 15 and 49. However, among them, those who had live birth in last five years prior to the surveys were the most interested on in this study; that is especially, 5390 in Rwanda and 7304 in Malawi. Besides, HIV status of respondents was an important variable. Considering both women who had live birth and those who did not have live birth, I find that women who had live birth in Rwanda are 0.62 times less likely to be HIV positive and 0.48 times less likely to be infected for those who had live birth in Malawi. When controlling for women who had live birth, I find that in both countries women who use ANC are less likely to be infected compared to those who do not (0.53 times less likely in Rwanda and 0.58 times less likely in Malawi). Based on these findings, relying only on data from ANC may lead to biases in HIV prevalence estimates; particularly referring to 2004 MDHS and 2005RDHS. Besides, considering the level of significance of the difference between HIV status between those who use ANC and those who do not, I find that this is not identical in Rwanda (5% level of significance) and in Malawi (10% level of significance). Thus, these results suggest, briefly, that not only the degree of ANC data representativeness is changing depending on various stages of HIV epidemic as Fylkesnes said (1998), but also is affected by the amount of women who had live birth and their respective HIV status. In fact, this difference may be based on the fact that in Malawi, HIV prevalence is high compared to Rwanda and those who had live birth were in high percentage comparing to Rwanda.Item Citizenship Education in Malawi: A critique in defence of maximal citizenship(2006-11-03T08:00:06Z) Divala, Joseph JinjaThis dissertation analyses assumptions about citizenship education in Malawi since the reintroduction of multiparty democracy in 1993 and reveals a minimalist conception of citizenship. It asserts that Malawi’s historical and traditional context require concerted efforts towards participatory citizenship if democracy is to be strengthened and protected. Central to the discussion are conceptual distinctions between minimal and maximal citizenship alongside a discussion of concepts of freedom, human rights and development, which can be attributed to minimal and maximal conceptions of citizenship. The dissertation argues that deliberative and participatory forms of democracy, with their parallel notions of contestatory and republican freedoms and rights, are more attuned to creating an active and strong citizenship while at the same time developing a positive relationship between democratic participation and participation in local and national development, a relationship which representative approaches in Malawi seemingly disavow.Item The Political Crisis in Malawi: From Authoritarianism to Democracy(2006-03-22) Nsanja, Alinane R.The thesis is a contribution to the existing literature on the democratic process in Malawi with specific focus on two areas namely, the factors that led to the opening up of political space and the implementation of multiparty democracy. The thesis argues that multiparty democracy in Malawi, which transpired due to internal and external factors, had been perceived as the means of transforming the oppressive climate created by the Banda regime. However, despite three multiparty elections since the 1990s, the UDF government, which succeeded Banda, has failed to broaden the avenues for the consolidation of democracy in Malawi, leading to disillusionment among the people. Ten years of multiparty democracy have only resulted in the regression to the practices of the very regime it replaced. Currently Malawi is plagued with a lack of independent media, weak civil society, corruption among top government officials and a weak economy to mention a few. The thesis argues that this is because of the nature of the ruling class as well as the issue of ethnicity, which has resulted in the contestation of power.