A peer group intervention implemented by community volunteers increased HIV prevention knowledge.

Background: HIV prevention knowledge levels are low in sub-Saharan Africa. In our efficacy study, the Mzake ndi Mzake (Friend-to-Friend; hereafter Mzake) 6-session peer group intervention, delivered by health workers, improved HIV prevention knowledge and other outcomes in Malawi. To expand HIV prevention approaches, this implementation study tested whether the intervention remained effective when implemented by trained community volunteers.

Status of information, education, and communication as perceived by clients receiving antenatal care at Chiradzulu District Hospital in Malawi.

Background: Information, education, and communication is a strategy to spread awareness through communication channels to a target audience to achieve a desired positive result. Women are supposed to receive information, education, and communication at each contact with the health worker during antenatal care. In Malawi, information, education, and communication for antenatal care is inadequate despite high antenatal care coverage.

Systematic mapping on availability, extent and distribution of mental health research in Malawi.

Background: Mental health research is essential in the implementation of evidence-based interventions. This can be impeded by unavailability or limited access to local evidence in low- and middle-income countries (LMICs) such as Malawi.

Aim: The aim of this systematic mapping was to describe the availability, extent and distribution of mental health research conducted in Malawi.

Experiential Training Workshops for Group Antenatal Care in Malawi.

The positive effects of the CenteringPregnancy group antenatal care (ANC) model on perinatal outcomes in the United States has led to its adaptation and implementation in many low- and middle-income countries. Facilitative discussions are a core component of this group ANC model. Facilitator training lays a critical foundation for delivery of this paradigm-shifting model as practitioners learn to adapt their approach to health education from didactive to facilitative.

Acceptability and feasibility of a screening protocol for antenatal depression (SPADe) in Blantyre District, Malawi.

Background: Depression is one of the most common perinatal mental health problems that affect pregnant women. Antenatal depression can adversely affect the well-being of the pregnant woman and her foetus. Depression is rarely detected by midwives due to the unavailability of relevant screening instruments in Malawi.

Experiences of health care workers' on interprofessional collaborative practice at Mzuzu Central and Ntcheu District hospitals.

Background: Interprofessional collaborative practice (ICP) is a new approach to delivery of health care. It is the practice which happens when healthcare providers work together with different professionals such as nurse/midwives, medical officers towards a common goal to improve patient outcomes.There is no evidence on healthcare workers' experiences on ICP in Malawi and a study on healthcare workers experiences would provide insight towards ICP.

The roles and experiences of preceptors in clinical teaching of undergraduate nursing and midwifery students in Malawi.

Introduction: Clinical teaching is essential for undergraduate nursing and midwifery students. Registered nurses/midwives trained as preceptors , guide the students during clinical practices. Literature is scanty on the roles and experiences of the preceptors in Malawi.

Experiences of nurse managers and practitioners on implementation of an evidence-based practice intervention.

Background: An evidence based practice (EBP) research project was undertaken to implement EBP interventions utilising the Iowa model in order to build the capacity of the nurses in using research evidence to improve decision making and quality care.

Aim: Exploring and understanding the experiences of nurse managers and practitioners who participated in the EBP change project.

Setting: The study was conducted in the intensive care unit (ICU) of a tertiary hospital in Lilongwe district in Malawi.

"Youth Photovoice": Promoting Youth-Driven Community Changes for HIV Prevention in Rural Malawi.

To meet the Joint United Nations Programme on HIV/AIDS global goal of no new HIV infections by 2030, it is imperative to reduce new infections among youth. Youth Photovoice was a 10-month, participatory, community-action research project developed to engage rural Malawi youth in an HIV prevention project focused on community-level outcomes. In this study, we describe how participants in Youth Photovoice engaged adults and community leaders to implement action plans, as well as the community and individual changes that occurred as a result of these collaborative efforts.

Healthcare workers' perceptions on collaborative capacity at a Referral Hospital in Malawi.

Background: Lack of collaborative capacity results in provision of fragmented health services that do not meet the needs of patients. Collaborative capacity refers to the extent to which providers have influence over other healthcare workers' decision-making, and can be assessed by measuring perceptions of task interdependence, quality of interaction and collaborative influence. However, each healthcare worker may present differing perceptions that can influence their ability to collaborate effectively during provision of care.

Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi.

Background: Depression is often underdiagnosed by treating health professionals. This is a situation in Malawi where there is no routine screening of depression at antenatal clinics. Recently, a Screening Protocol for Antenatal Depression (SPADe) that can be used by midwives to screen for antenatal depression was developed in Blantyre District.

Knowledge deficit on health promotion activities during pregnancy: the case for adolescent pregnant women at Chiladzulu District, Malawi.

Background: Adolescent pregnancy is a public health concern in Malawi as it is associated with high risks of adverse pregnancy outcomes. Almost 29% of adolescent women aged 15-19 years are already mothers and adolescent fertility rate is also high estimated at 136 per 1000 women. Therefore, the aim of the study was to explore knowledge of pregnant adolescents on importance of antenatal care and health promotion during pregnancy.

An effectiveness-implementation hybrid type 1 trial assessing the impact of group versus individual antenatal care on maternal and infant outcomes in Malawi.

Background: Sub-Saharan Africa has the world's highest rates of maternal and perinatal mortality and accounts for two-thirds of new HIV infections and 25% of preterm births. Antenatal care, as the entry point into the health system for many women, offers an opportunity to provide life-saving monitoring, health promotion, and health system linkages. Change is urgently needed, because potential benefits of antenatal care are not realized when pregnant women experience long wait times and short visits with inconsistent provisioning of essential services and minimal health promotion, especially for HIV prevention.

Developing Action Plans in Youth Photovoice to Address Community-Level HIV Risk in Rural Malawi.

Youth-driven approaches to HIV prevention can engage youth and improve health outcomes. Photovoice has been used to engage youth in identifying the assets and challenges in their communities. In sub-Saharan Africa, youth remain vulnerable to HIV infection.

A hybrid design testing a 3-step implementation model for community scale-up of an HIV prevention intervention in rural Malawi: study protocol.

Background: Scaling-up evidence-based behavior change interventions can make a major contribution to meeting the UNAIDS goal of no new HIV infections by 2030. We developed an evidence-based peer group intervention for HIV prevention and testing in Malawi that is ready for wider dissemination. Our innovative approach turns over ownership of implementation to rural communities.

Substance Use and Risky Sexual Behaviors Among Young Men Working at a Rural Roadside Market in Malawi.

Using an ecological model, we describe substance use and sexual risk behaviors of young male laborers at a roadside market in Malawi. Data included observations and interviews with 18 key market leaders and 15 laborers (ages 18-25 years). Alcohol, marijuana, and commercial sex workers (CSWs) were widely available.

Participation and diffusion effects of a peer-intervention for HIV prevention among adults in rural Malawi.

This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers.

HIV Risk Reduction Intervention for Rural Adolescents in Malawi.

Malawian adolescents are at risk for HIV infection. Using a quasi-experimental two group research design, we determined the efficacy of (MMKA) in enhancing 13-19 year old Malawian males' and females' HIV knowledge, attitude about HIV, self-efficacy for condom use and for safer sex, and HIV risk reduction behaviors. The regression analyses revealed that compared to their cohorts in the control community, the adolescents in the MMKA community had significantly better scores on the outcome variables.

Changes in clients' care ratings after HIV prevention training of hospital workers in Malawi.

Objective: To examine the changes in clients' health-care ratings before and after hospital workers received an HIV prevention intervention in Malawi, which increased the workers' personal and work-related HIV prevention knowledge, attitudes and preventive behaviors.

Design: Pre- and post-intervention client surveys.

Setting: A large urban referral hospital in Malawi.

Outcomes of an HIV prevention peer group intervention for rural adults in Malawi.

This study used a quasi-experimental design to evaluate a six-session peer group intervention for HIV prevention among rural adults in Malawi. Two rural districts were randomly assigned to intervention and control conditions. Independent random samples of community adults compared the districts at baseline and at 6 and 18 months postintervention.

Peer group intervention reduces personal HIV risk for Malawian health workers.

Purpose: To test a peer group intervention to address personal HIV prevention needs of rural health workers in Malawi.

Design: Using a quasi-experimental design, we compared district health workers in two districts of Malawi that were randomly assigned to either the intervention or delayed control condition. We used independent sample surveys at baseline, 15 months, and 30 months postintervention.

Process evaluation of HIV prevention peer groups in Malawi: a look inside the black box.

This paper reports the process evaluation of a peer group intervention for human immunodeficiency virus (HIV) prevention which had positive outcomes for three target groups in Malawi: rural adults, adolescents and urban hospital workers. The six-session intervention was delivered to small groups of 10-12 participants by 85 trained volunteer peer leaders working in pairs. A descriptive, observational mixed methods design was used with a convenience sample of 294 intervention sessions.

Improving universal precautions and client teaching for rural health workers: a peer-group intervention.

Health workers can contribute to HIV prevention by minimizing HIV transmission in health facilities and increasing client teaching. We offered a peer-group intervention for Malawian rural health workers to build their universal precautions and teaching skills. A quasi-experimental design using independent sample surveys and observations compared health workers in an intervention and delayed intervention control district at baseline and at 15 and 30 months post-intervention.

Impact of a peer-group intervention on occupation-related behaviors for urban hospital workers in Malawi.

Using a pre- and posttest design with no control group, the authors evaluated the impact of a peer-group intervention on work related knowledge and behavior for health workers at an urban hospital in Malawi. The authors surveyed unmatched random samples of health workers, observed workers on the job, and interviewed clients about hospital services at baseline and at 6 months after the intervention. Universal precautions knowledge, reported hand washing, and reported client teaching were significantly higher at the final evaluation.

Impacts of a peer-group intervention on HIV-related knowledge, attitudes, and personal behaviors for urban hospital workers in Malawi.

This report describes the effects of a peer-group intervention on Malawian urban hospital workers' HIV-related personal knowledge, attitudes, and behaviors. More than 850 clinical and nonclinical hospital workers received the intervention. Evaluation used independent surveys of a sample of workers at baseline (N = 366) and postintervention (N = 561).