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This study aimed to explore explanatory models and treatment practices for mental illness/ bio-psycho-social disability by traditional healers in Blantyre, Malawi. The study adopted an exploratory design using qualitative methods. In-depth interviews and focus group discussions were used to collect data. It was conducted in Blantyre, a district in southern Malawi. Participants were traditional healers practising in the district. Purposive sampling was used to select the study sample. In total, ten indepth interviews and two focus group discussions were conducted. The sample was determined based on data saturation. Thematic analysis was used to analyse the data aided by Nvivo 12. Four themes were identified in the data: presentation of a person with mental illness; types of mental illness; causes of mental illness; and management modalities. The findings show that although traditional healers are capable of recognizing mental illnesses, it is patients exhibiting significant behavioural disturbances that are mostly identified. Supernatural attributions and management dominated. Mistrust of the allopathic health system also exists among the healers. [ABSTRACT FROM AUTHOR]

Higher education has often been targeted for criticism with regard to its lack of relevance when seeking to address the harsh realities of poor health, poverty and conflict in African countries. African universities have been seen as producing Western-influenced graduates who become an elite out of touch with their own indigenous worldview. In order to maintain the connection between higher education in Africa and the African worldview and philosophy, thus enhancing the relevance of university education, this paper argues that there is a need to promote the revisiting of our African identities in the courses on offer. By way of illustration, the paper examines an aspect of medical tertiary education at the University of Malawi, College of Medicine: in particular, how the course entitled "Social and Behavioral Dynamics" has evolved over the past 10 years in an effort to embrace an African worldview and philosophy in the undergraduate medical program, with the goal of producing graduates sensitized to the worldviews of the indigenous populations they will serve, and able to enrich the global context by bringing to it uniquely African perspectives.

Used semi-structured interviews to investigate foster parents' qualitative experiences with the Malawi government family foster care structure. Found that cultural factors influenced family foster care, from caregivers' decision to foster children to their determination not to disclose to children that they were fostered; social and economic factors also played role, particularly with regard to some shortcomings in service delivery. (EV)

Mental, neurological and substance use (MNS) disorders are a leading, but neglected, cause of morbidity and mortality in sub-Saharan Africa. The treatment gap for MNS is vast with only 10% of people with MNS disorders in low-income countries accessing evidence-based treatments. Reasons for this include low awareness of the burden of MNS disorders and limited evidence to support development, adaptation and implementation of effective and feasible treatments. The overall goal of the African Mental Health Research Initiative (AMARI) is to build an African-led network of MNS researchers in Ethiopia, Malawi, South Africa and Zimbabwe, who are equipped to lead high quality mental health research programs that meet the needs of their countries, and to establish a sustainable career pipeline for these researchers with an emphasis on integrating MNS research into existing programs such as HIV/AIDS. This paper describes the process leading to the development of AMARI's objectives through a theory of change workshop, successes and challenges that have been faced by the consortium in the last 4 years, and the future role that AMARI could play in further building MNS research capacity by brining on board more institutions from low- and middle-income countries with an emphasis on developing an evidence-based training curriculum and a research-driven care service. [ABSTRACT FROM AUTHOR]

Community engagement to protect and empower participating individuals and communities is an ethical requirement in research. There is however limited evidence on effectiveness or relevance of some of the approaches used to improve ethical practice. We conducted a study to understand the rationale, relevance and benefits of community engagement in health research. This paper draws from this wider study and focuses on factors that shaped Community Advisory Group (CAG) members' selection processes and functions in Malawi. A qualitative research design was used; two participatory workshops were conducted with CAG members to understand their roles in research. Workshop findings were triangulated with insights from ethnographic field notes, key informant interviews with stakeholders, focus group discussions with community members and document reviews. Data were coded manually and thematic content analysis was used to identify main issues. Results have shown that democratic selection of CAG members presented challenges in both urban and rural settings. We also noted that CAG members perceived their role as a form of employment which potentially led to ineffective representation of community interests. We conclude that democratic voting is not enough to ensure effective representation of community's interests of ethical relevance. CAG members' abilities to understand research ethics, identify potential harms to community and communicate feedback to researchers is critical to optimise engagement of lay community and avoid tokenistic engagement. [ABSTRACT FROM AUTHOR]

Cognitive health is an important dimension of well-being in older ages, but few studies have investigated the demography of cognitive health in sub-Saharan Africa's (SSA) growing population of mature adults (= persons age 45+). We use data from the Malawi Longitudinal Study of Families and Health (MLSFH) to document the age and gender patterns of cognitive health, the contextual and life-course correlates of poor cognitive health, and the understudied linkages between cognitive and physical/mental well-being. Surprisingly, the age-pattern of decline in cognitive health is broadly similar to that observed in the U.S. We also find that women have substantially worse cognitive health than men, and experience a steeper age-gradient in cognitive ability. Strong social ties and exposure to socially complex environments are associated with higher cognitive health, as is higher socioeconomic status. Poor cognitive health is associated with adverse social and economic well-being outcomes such as less nutrition intake, lower income, and reduced work efforts even in this subsistence agriculture context. Lower levels of cognitive health are also strongly associated with increased levels of depression and anxiety, and are associated with worse physical health measured through both self-reports and physical performance. Our findings suggest that cognition plays a key-but understudied-role in shaping late-life well-being in low-income populations., Competing Interests: Conflict of Interest Statement. The authors declare no competing interests, the funders had no role in the design of the study, the analysis of the data, or the decision to present the results.

The article has discusses the successes and challenges of implementing a dynamic street children's program in Mzuzu Malawi--using a developmental life-course framework blending psychodynamic approaches, risk-factor approaches, and strain and control theories of crime and delinquency. The framework has helped the programme implementation team consider not only the phase and stage of the child's development in their provision of care, but also the influence that early childhood dynamics of parent-child, 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.

Unlabelled: Patient satisfaction is an individual's state of being content with the care provided in the health system. It is important for reproductive health care providers to get feedback from women regarding satisfaction with reproductive health services. There is a dearth of knowledge about patient satisfaction in Malawi., Aim: The specific objective of the study was to determine the extent to which women are satisfied with the care they receive when they come to deliver at the Queen Elizabeth Central Hospital maternity unit., Methods: A cross sectional study of postpartum women using interviewer administered semi-structured questionnaires was conducted between November 2008 and May 2009. The questionnaires captured mainly quantitative data., Results: 1562 women were interviewed. Most women were housewives (79%) who were referred from Health Centres within the city. Ninety five percent delivered a live baby. The majority of women (97.3%) were satisfied with the care they received from admission through labour and delivery and the immediate postpartum period. Most women cited doctors' and nurses' reviews (65%) as what they liked most about the care they received during their stay in the unit. Most women expected to receive efficient and definitive care. The women's knowledge on patient's rights was extremely low (16%) and equally very few women were offered an opportunity to give an opinion regarding their care by the doctors and nurses in the maternity unit., Conclusion: Most women who deliver at the hospital are satisfied with the care offered. This satisfaction is mainly due to the frequent reviews of patients by nurses and doctors in the unit. There is a great need to educate both the population of women served and the health workers that serve them on patient's rights.

It is widely recognised that human behaviour change is a key element in the fight against HIV/AIDS. The reality of the situation however is that the current approaches to instigating sexual behaviour change appear to have borne little fruit. This paper shall argue that in the fight against HIV/AIDS, a fundamental error is made in the numerous outreach programmes that exist within Malawi and elsewhere. This error is grounded in the assumptions that are made about how persons respond to the messages garnered to the control of the disease. Until this mistaken assumption is addressed, it is argued that no serious headway shall be made in the control of this disease, which threatens the very fabric of the Malawi nation.