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Introduction: Clinical teaching is essential for undergraduate nursing and midwifery students. Registered nurses/midwives trained as preceptors (an experienced nursing/midwifery professional who teaches, supervises and serves as a role model for a student) , guide the students during clinical practices. Literature is scanty on the roles and experiences of the preceptors in Malawi. This study explored the roles and experiences of preceptors during clinical teaching of the students., Methods: A cross-sectional study utilising quantitative research design was conducted at four tertiary level hospitals; a mental hospital; one mission hospital and five district hospitals. A total of 87 preceptors completed a Clinical Preceptor Experience Evaluation Tool. Data were analysed using SPSS version 20 and descriptive statistics were computed. Analysis of variance (ANOVA) and post hoc analysis were used to determine and test significant differences., Results: The study revealed that respondents were confident in performing their preceptor role; with good level of experience and education qualification of BSc in Nursing. ANOVA and post hoc comparisons using the Tukey HSD test indicated that the role domain mean scores for the respondents with 4-5 years of post-registration experience (M = 6.61, SD = 0.36) was significantly different (p=0.02) with those with >9 years (M = 6.13, SD = 0.60). The results showed that respondents with 4 -5 years experience were more confident in their preceptorship role than those with >9 years., Conclusion: This study indicates the roles of preceptors in Malawi to involve facilitating students' clinical teaching and learning. It suggests that registered nurses/midwives with a BSc in Nursing are suitable preceptors to facilitate students' clinical teaching and learning. There is revelation that preceptors with more years of post-registration experience are less confident in their preceptorship role performance., (© 2021 The College of Medicine and the Medical Association of Malawi.)

Background: Maternal near-miss cases occur in larger numbers than maternal deaths hence they require comprehensive analysis when studied. However, there is scarcity of information on determinants of maternal near-miss cases in Malawi. Therefore, this study aimed at establishing the determinants of maternal near-miss cases at two selected central hospitals in Malawi., Methods: This was a case control study that utilized a quantitative approach. A random sample of 458 case files comprising maternal near-miss cases (161) and non-cases (297) was drawn using a ratio of 1:1.8. Data were analyzed using Stata 14 to generate descriptive statistics, Chi Square values to describe the data and determine associations among variables and logistic regression was conducted to determine the determinants of maternal near-miss., Results: We found significant differences between demographic characteristics (marital status, occupation, admission mode, means of transport and age) of maternal near-miss cases and the non-cases (P<0.05). Age and mode of birth were found to be significantly associated (P<0. 05) with maternal near-miss. Women aged 31-35 years were 3.14 times more likely to experience maternal near-miss [OR=3.14, 95% CI: 1.09, 9.02, p=0.03] compared to those aged less than 20 years. Furthermore, emergency caesarean [OR=4.08, 95% CI: 2.34, 7.09, p=0.001] and laparotomy for uterine rupture [OR=83.49, 95% CI: 10.49, 664.55, P=0.001] were significantly associated with maternal near-miss., Conclusion: Among pregnant women, health workers need to pay close attention to factors such as age and mode of birth for them to implement targeted maternal health services in order to reduce incidence of maternal near-miss cases., (© 2021 The College of Medicine and the Medical Association of Malawi.)

Background: Screening instruments for antenatal depression vary in performance. This study aimed at assessing the performance of a range of screening instruments in detecting depressive symptoms in antenatal clinics in Blantyre district, Malawi., Methods: A cross-sectional study was conducted to screen for depression among women attending 8 selected antenatal clinics in Blantyre district using 3-item screener, Edinburgh Postnatal Depression Scale (EPDS), Hopkins Symptoms Checklist-15 (HSCL-15), Self-Reporting Questionnaire (SRQ) and Pregnancy Risk Questionnaire (PRQ). The instruments were administered to a random sample of 480 pregnant women. Data were analysed using SPSS 22.0 testing for performance differences in proportions of screen positives and how screen positive results might differ by particular variables., Results: The prevalence estimates yielded by screening instruments ranged from 12.9% (SRQ) to 42.1% (3-item screener). There were no significant differences in prevalence estimates for EPDS, HSCL-15, PRQ and SRQ. There were performance differences in the proportions of screen positives with significant systematic differences between proportions of screen positives of PRQ and SRQ (p<.001), EPDS and HSCL-15 (p=.001), HSCL and PRQ (p<.001), and EPDS and SRQ (p<.001). Screen positive results on HSCL-15, PRQ, 3-item screener and EPDS were found to differ by variables such as "not being supported by partner" which resulted in respondents having ≥3 times chances to screen positive on these four instruments. The screen positive results on SRQ were found not to differ by age, education, employment status, marital status, setting, gestation and number of pregnancies., Conclusions: There were minimal variations in the performance of the EPDS, SRQ and HSCL-15 as standard public health screening instruments. However, systematic differences between proportions of screen positives exist and screen positive results from these instruments differed by demographics. It is important to validate screening instruments against a gold standard to ensure relevant clinical outcomes for pregnant women with depression.

Introduction: Therapeutic commitment of general nurses influences their provision of mental health care to clients. It is the general nurses' predisposition for working therapeutically with clients who have mental health problems (MHPs). In Malawi, general nurses are the majority of health care professionals who care for people living with HIV/AIDS (PLWHA) and they are expected to deal with the mental health problems of these patients. The provision of mental health care to PLWHA is vital because apart from the physical illnesses associated with the virus, these people are also affected by mental health problems. However, most general nurses, feel neither confident nor competent when dealing with the mental health problems of their clients in Malawi. This may negatively influence their therapeutic commitment in dealing with mental health problems of PLWHA. However, therapeutic commitment of general nurses in providing mental health care to PLWHA in Malawi remains unknown., Materials and Methods: The study used a quantitative descriptive survey design. a convenient sample comprising of 136 general nurses was used and data was collected using Mental Health Problems Perception Questionnaire. Permission to use the tool in this study was granted by Prof. Lauder. Ethical approval to conduct the study was granted by Ethics Committees at University of KwaZulu Natal and University of Malawi. Data were analysed using Statistical Package for Social Sciences version 15.0., Results: The study findings revealed that there is a linear relationship between general nurses' levels of knowledge and skills and their therapeutic commitment (r=.40, n=136, p<.05) to provide mental health care of PLWHA., Conclusion: This study suggests general nurses' levels of therapeutic commitment in dealing with MHPs of PLWHA vary and their levels of knowledge and skill to deal with MHPs influence their willingness to provide mental health care to PLWHA.