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The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study
The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy
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in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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Malawi is a landlocked country with a surface area of 118,484 km2. Administratively, the country is divided into three regions, namely the Northern, Central and Southern regions. The country has 28 districts, which are further divided into traditional authorities (TA) ruled by chiefs. The TAs are su
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b-divided into villages, which form the smallest administrative units. The Village Development Committees (VDCs) under the TAs are responsible for development activities. Politically, each district is divided into constituencies that are represented by Members of Parliament (MPs) in the National Assembly for purposes of legislations. Constituencies are further divided into wards which are represented by a ward councillor at district assembly.
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Only 10 per cent of households have electricity. Less than one half (46 per cent) of the households use basic sanitation facilities. Three in every four of the household population had basic drinking water services. More than one third of under-5 Malawian children (boys 39 per cent than girls 32 per
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cent) suffer from stunting with related health issues that can include cognitive impairment.
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In 2008 the Ministry of Health and Social Services (MOHSS) commissioned a national health and social service system review which found that although some progress has been made in primary health care, provision of health services did not go beyond the health facilities, irrespective of the fast dist
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ances between the Health facilities and community. The review then recommended that health services should be extended in a structured manner to communities through the establishment of paid health workers.
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The RTA covered UNICEF’s response to COVID-19 from March 2020 – when WHO declared the disease a pandemic – until January 2021. Further, the RTA applied a broad and cross-cutting lens to all 21 UNICEF county offices across the region, focusing on six case study countries: Kenya, Madagascar, Nam
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ibia, Somalia, South Africa and Uganda.
In addition to a Regional Analysis Report, the RTA produced six deep-dive reports with findings and lessons specific to the six case study countries mentioned above – all of which can be accessed through the drop-down listing on this page.
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In the initial chapters, you will find different approaches that describe how to support job creation for entrepreneurs or employees who live with disabilities. The interventions are often initiated by the readiness to find and pick the right opportunities, such as an engaged entrepreneur or an open
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-minded TVET school. Opportunities are good, a strategy, which enables to work for an inclusive environment that creates many more opportunities, is better
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750,000 people are estimated to be food insecure. This number may magnify as households continue to recover from impacts of COVID-19.
Over 63% of household surveys were responded to by female heads and 37.5% of the Key informant respondents were women. Women and children continue to be more dispr
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oportionally affected by the drought than men.
Communities continue to develop negative coping strategies as drought conditions persist.
Increase in nomadic and cross border population movements. Over 1,792 Angolan nationals were repatriated from Namibia in January 2022 whilst others remain integrated in the Namibian communities.
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BMC Pregnancy Childbirth 2022 Apr 5;22(1):284. doi: 10.1186/s12884-022-04619-w. Adolescent reproductive health is still a challenge in Low and Middle Income Come Countries (LMICs). However, the reasons for the inability of most pregnant adolescent girls to access and utilize maternal and child heal
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th information (MCHI) are not well-documented. This is despite the policy guidelines promoting the provision of this necessary information to pregnant adolescents in order to prepare them for delivery. This provision is one of the strategies envisaged to improve their attendance of ANC visits and their maternal and child health.
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BMJ Open Quality 2017;6:e000145. doi:10.1136/
bmjoq-2017-000145Although there are many evidence-based practices that reduce the risk of maternal and neonatal mortality around the time of birth, there remains a gap between what is known and the care received. This knowdo gap is a source of preventab
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le maternal and perinatal deaths and is the focus of improvement efforts in many countries. Following an increase in perinatal and maternal deaths, Gobabis District Hospital initiated a quality improvement (QI) initiative to increase adherence to these WHO Safe Childbirth Checklist (SCC)-targeted essential birth practices.
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Int J Tuberc Lung Dis. 2019 Jul 1;23(7):858–864.Namibia ranks among the 30 high TB burden countries worldwide. Here, we report results of the second nationwide anti-TB drug resistance survey. To assess the prevalence and trends of multidrug-resistant TB (MDR-TB) in Namibia.
From 2014 to 2015, pat
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ients with presumptive TB in all regions of Namibia had sputum subjected to mycobacterial culture and phenotypic drug susceptibility testing (DST) for rifampicin, isoniazid, ethambutol and streptomycin if positive on smear microscopy and/or Xpert MTB/RIF.
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Namibia has, for many years, had a strong legislative and policy framework for the protection of children. These policies and laws have been developed through the combined expertise of those working in the field of child protection who have ensured Namibia has a robust legal framework that is in li
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ne with international best practices.
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Access to safe and voluntary family planning is an inalienable human right that
cannot be denied. In 2022, UNFPA continued to work with Government and partners
to make this a reality in Namibia by providing strategic support to the national family
planning programme and ensuring universal access
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to quality services for all.
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Namibia recorded its first COVID-19 case on 14 March 2020, with cumulative cases reaching 15,773 and 118 deaths by 10 December 2020. Namibia has done relatively well to contain the outbreak.
However, positivity rates have shown a consistent increase above 5 percent in quarter 4 of 2020, necessitati
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ng renewed attention to surveillance and outbreak control in 2021.
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PLoS ONE 17(9): e0272444. https://doi.org/ 10.1371/journal.pone.0272444.
Based on the RE-AIM metrics, our results show that KMC is a feasible intervention that can improve neonatal outcomes among preterm infants in Zambia. The study findings show a promising, practical approach to scaling up KMC in
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Zambia.
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PLoS ONE 18(5): e0285031. https://doi.org/10.1371/journal.pone.0285031
The study aims to integrate HPV vaccination into routine care in adolescent HIV clinics. To achieve success, we will co-design a package of implementation strategies using a previously successful implementation research approach
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developed for cervical cancer prevention in LMICs: the Integrative Systems Praxis for Implementation Research (INSPIRE). INSPIRE is a novel, comprehensive approach to develop, implement, and evaluate implementation science efforts
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Malaria and HIV, two of the world’s most deadly diseases, are widespread, but their distribution overlaps greatly in sub-Saharan Africa. Consequently, malaria and HIV coinfection (MHC) is common in the region. In this paper, pertinent publications on the prevalence, impact, and treatment strategie
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s of MHC obtained by searching major electronic databases (PubMed, PubMed Central, Google Scholar, ScienceDirect, and Scopus) were reviewed, and it was found that the prevalence of MHC in SSA was 0.7%–47.5% overall. Prevalence was 0.7%–47.5% in nonpregnant adults, 1.2%–27.8% in children, and 0.94%–37% in pregnant women. MHC was associated with an increased frequency of clinical parasitemia and severe malaria, increased parasite and viral load, and impaired immunity to malaria in nonpregnant adults, children, and pregnant women, increased in placental malaria and related outcomes in pregnant women, and impaired antimalarial drug efficacy in nonpregnant adults and pregnant women. Although a few cases of adverse events have been reported in coinfected patients receiving antimalarial and antiretroviral drugs concurrently, available data are very limited and have not prompted major revision in treatment guidelines for both diseases. Artemisinin-based combination therapy and cotrimoxazole are currently the recommended drugs for treatment and prevention of malaria in HIV-infected children and adults. However, concurrent administration of cotrimoxazole and sulfadoxine–pyrimethamine in HIV-infected pregnant women is not recommended, because of high risk of sulfonamide toxicity. Further research is needed to enhance our understanding of the impact of malaria on HIV, drug–drug interactions in patients receiving antimalarials and antiretroviral drugs concomitantly, and the development of newer, safer, and more cost-effective drugs and vaccines to prevent malaria in HIV-infected pregnant women.
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The annual bulletin of the Mekong Malaria Elimination (MME) programme is a yearly report that reviews ongoing efforts to combat multidrug resistance and eliminate malaria in the 6 countries of the Greater Mekong subregion (GMS): Cambodia, China (Yunnan province), Lao People's Democratic Republic, My
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anmar, Thailand and Viet Nam.
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20 YEARS OF STRATEGIC HIV AND PUBLIC HEALTH DATA . beThe completion of the 6th South African National HIV Prevalence, Incidence and Behaviour Survey (SABSSM) report, coincides with the celebration of 30 years of democracy in South Africa; and marks 20 years of conducting nationally representative ho
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usehold-based surveys by the Human Sciences Research Council (HSRC), its collaborators and donors. Since its inception in 2002, the SABSSM series has emerged as one of the HSRC’s leading scientific contributions to the country’s HIV and AIDS response (1), providing essential data to monitor the HIV epidemic, the impact of the HIV program in South Africa, and to inform strategies for epidemic control in the National Strategic Plan for HIV, TB and STIs (NSP), now in its fifth edition. Using scientific evidence from SABSSM and other key sources, the NSP guides the country’s response, under the leadership of the South African AIDS Council (SANAC) and the National Department of Health (NDoH), with focus on equitable access to biomedical interventions, addressing the structural and social behavioural drivers of the epidemic, and targeting populations disproportionately affected by HIV; such as, black Africans, key populations and adolescent girls and young women (AGYW) aged 15–24 years (2).
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Inclusive Project Cycle Management
