Search

Background: Increasingly many perinatally HIV-infected children are surviving through adolescence and adulthood as a result of improvements in the management of paediatric HIV infection, particularly the increased use of combination therapy. It is usually the parents or guardians of these children who are faced with the task of informing the child living with HIV about his or her positive status. However, many parents—particularly biological parents —find this disclosure process difficult to initiate, and this study explored some of the difficulties that these parents encounter.Objective: This study set out to explore potential factors that challenge parents and guardians when informing their perinatally HIV-infected child about the child’s HIV status.Design: This was a qualitative narrative study that employed in-depth interviews with parents or guardians of children perinatally infected with HIV. A total of 20 parents and guardians of children who attend the outpatient HIV clinic at the Baylor College of Medicine-Abbott Fund Children’s Clinical Centre of Excellence (COE) in Lilongwe, Malawi were interviewed. Of these, 14 were biological parents and six were guardians.Results: Guardians and parents expressed uneasiness and apprehension with the disclosure conversation, whether or not they had already told their child that he or she had HIV. Participants who had not told their children recounted that they had contemplated starting the conversation but could not gather enough courage to follow through with those thoughts. They cited the fear of robbing their child of the happiness of living without the knowledge of being positive, fear of making their own status known to more people, and fear of confrontation or creating enmity with their child as impediments to disclosing their child’s positive HIV status to him or her.Conclusions: It is apparent that guardians—more particularly biological parents—of children perinatally infected by HIV find it difficult to inform their children about their children’s HIV status. From this disempowered position, parents dread the disclosure of a positive HIV status to a child as a psychosocial process that has the potential to disturb a family’s previously established equilibrium with threats of stigmatization, marginalization, and parent-child conflict. This calls for strategies that could support parents to make disclosure to the child less challenging.

IntroductionThis qualitative and quantitative exploratory study was conducted to assess patients’/customers’ knowledge, beliefs and practices about antibiotics and other prescription only medication (POM) in 10 community pharmacies in Blantyre, Malawi.Method5 out of 10 pharmacies were selected by simple random sampling and 54 participants attending the selected pharmacies were interviewed.ResultsThe major antibiotic drugs frequently requested without a doctor’s prescription were Bactrim (Cotrimoxazole) and amoxicillin. Knowledge of these medicines was attributed to the patients’ previous medical conditions and doctor’s prescription. However this knowledge does not extend to understanding of proper therapeutic indications and dosage regimens for antibiotic therapy. The majority (30 out of 54 participants) did not know about the importance of completing a prescribed course of antibiotics. All 54 participants believed in the efficiancy of antibiotics.ConclusionStudy participants had wide range of knowledge about antibiotics and other POM from hospital, but the majority had limited knowledge regarding clinical indications and correct dosage schedules.

The article has discusses the successes and challenges of implementing adynamic street children’s program in Mzuzu Malawi – using a developmentallife-course framework blending psychodynamic approaches, risk-factorapproaches, and strain and control theories of crime and delinquency. Theframework has helped the programme implementation team consider notonly the phase and stage of the child’s development in their provision of care, but also the influence that early childhood dynamics of parentchild, parent-parent and child-parent-environment; life-events; peers and neighbourhoods have at each of the developmental stages of child and adolescent development, and how they can influence the child’s behaviour in both positive and negative ways. The article also discusses successes and suggests ways of addressing the identified challenges.