Improving wasting among children under-5 years in Malawi: The role of farm input subsidies.

Wasting among children under-5 years remains a public health problem in Malawi, despite the quest to improve food availability through Farm Input Subsidy Program (FISP). As such, the study examined the link between FISP and child wasting. Using Malawi Integrated Household Panel Surveys for 2013, 2016, and 2019, two-stage least squares approach was employed to run a Cobb Douglas production function and a correlated Random Effects (CRE) Model to account for endogeneity challenges and an unbalanced panel dataset. The study hypothesized the role of FISP to dietary diversity at the household level on child wasting [weight-for-height (WHZ)]. Based on the analysis, the study found that household access to FISP coupons was not a stand-alone predictor for low wasting among children under-5 years. However, increased maize production due to FISP coupon access significantly correlated with lower wasting likelihood incidences at the household level. Worth to note, that in 2015/16, households that had accessed FISP coupons and were in the central region had higher wasting probabilities among the children under-5 years in Malawi compared to other counterparts panels. This implies challenges to addressing wasting among children under-5 years- which can be attributed to higher redemption costs of the FISP coupon. Therefore, the current study suggests that input subsidies can improve the reduction of wasting among children under-5 years through specific pathways, among them, increased maize production and considering appropriate targeted approaches to ensure households access the inputs for sustained food availability, which in turn enhances improved the children under-5 years health dividends in Malawi.

Dietary consumption and its effect on nutrition outcome among under-five children in rural Malawi.

BACKGROUND: Despite remarkable progress in reducing under five mortalities in Malawi, a relative proportion of under nutrition among children still exist. OBJECTIVES: The study examines dietary consumption factors and their effect on under nutrition outcomes among children under five years' children in rural Malawi. METHODS: Using the 2015-16 Malawi Demographic and Health Survey, in which 4,150 children were reported of under nutrition statuses, the study used nested logistic regression models to estimate factors influencing the prevalence of under nutrition among children. RESULTS: Based on the results, exclusive breast feeding among children under five years, after controlling for parental socioeconomic factors, was found to reduce the levels of wasting (ODDS RATIO [OR] = 0.763; p < 0.05), underweight (OR = 0.548; p < 0.001) and stunting (OR = 0.709; p < 0.005). Furthermore, it was found that despite the perceived adequacy among women in accessing fruits and vegetables, carbohydrates and micro-nutrient supplements, their children under five years, still experiences public health challenges and suffers from wasting, underweight and stunting. CONCLUSION: There is need to implement extensive pro-rural under five nutritional and health educational advocacy using community-based approaches, targeting parents, emphasizing the significance of exclusive breast feeding and consistencies in giving dietary foods, if and only if the persistent public health challenges due to under nutrition among children under five years, is to be sustainably dealt with, in Malawi.

Women's perspectives on quality of maternal health care services in Malawi.

Despite promotion by many stakeholders to improve maternal health outcome in many developing countries including Malawi, many analysts agree that the utmost success in maternal health will arise if maternal health care services are an unparallel led source for women's health care solutions for any problem related to childbirth. Health advocates worldwide claim that even though maternal services are provided, women's utilization of such services has not been ascertained. The objective of this study was to explore women's perspectives on the quality of health care service delivery in Malawi. This article therefore investigates women's perspectives on the quality of maternal health care services in Malawi. We used six focus group discussions in six health facilities that were selected across Malawi. We found that erratic availability of medical resources and unethical practices among health workers adversely affected quality of maternal health care service delivery. We concluded that the expensive routine operational audits of medical resources and service delivery across health facilities are imperative if women's health outcomes are to be enhanced in Malawi.

Factors influencing women's utilization of public health care services during childbirth in Malawi Public health facility utilization.

BACKGROUND: Maternal mortality remains a public health challenge claiming many lives at the time of giving birth lives. However, there have been scanty studies investigating factors influencing women's use of public health facilities during childbirth. OBJECTIVE: The aim of the study was to explore the factors associated with women choice of public health facility during childbirth. METHODS: The study used 2010 Malawi Demographic Health Survey dataset and a binary logistics regression analysis to estimate the determinants influencing women's use of public health facilities at the time they give birth. RESULTS: Of 23020 women respondents, 8454(36.7%) chose to give birth in public health facilities. Multivariate analysis reported that frequency of antenatal care (ANC), birth order, women's education, wealth status and quality of care were the major predictors increasing women's choice to use public health facilities at childbirth. CONCLUSION: There is need to use multimedia approach to engage women on significance of utilizing public health facilities during childbirth and promote quality of care in facilities if their health outcome is to improve in Malawi.

Rural-urban differences in the use of postnatal care services in Malawi.

BACKGROUND: In Malawi, women's postpartum care services often remain underutilized despite the efforts of the government to promote the use of maternal healthcare. Consequently, maternal mortality and morbidity are persistently high. AIM: The aim of the study is to examine the factors associated with women's use of postpartum care services in urban areas as compared with the rural areas in Malawi. MATERIALS AND METHODS: The study used data from the 2010 Malawi Demographic and Health Survey. A two-staged approach was used in data analysis where the logistic regression and multinomial regression methods were used first to identify the determinants of use and second to classify the determinants associated with timing of women's use of postpartum care service in the country. RESULTS: Of the 13776 women that constituted the sample, 7018 (50.9%) reported to use postpartum care services. Caesarean delivery in both urban [odds ratio (OR)=3.98; 95% confidence interval (CI): 2.27- 6.98] and rural settings (OR=3.56; 95% CI: 2.91-4.36) greatly increased women's likelihood of using postpartum care. On the contrary, problems of availability of health services decreased women's likelihood of using postpartum care services in both urban (OR=0.75; 95% CI: 0.57-0.97) and rural settings (OR=0.87; 95% CI: 0.80-0.93). Furthermore, pregnancy complications, lower levels of women's education, difficulties in accessing available healthcare facilities and low media exposure were significantly associated with women's delay in using postpartum care services in rural Malawi compared with their counterparts who used the services within 24 h after childbirth. CONCLUSION: In both urban and rural settings, women's use of postnatal care services remains low. The influence of low socioeconomic and service quality factors was prominent in rural areas more than in urban areas. This information is significant for health policy stakeholders to understand ways which can be adopted in order to enhance the quality and the use of postnatal care services. Therefore, there is a need to promote women-centred and community-based awareness in order to enhance the use of postnatal care in urban and rural areas, if maternal health outcomes are to improve in Malawi.

Health Care Factors Influencing Teen Mothers' Use Of Contraceptives in Malawi.

OBJECTIVE: The study seeks to examine factors associated with teen mothers' use of modern contraceptives after giving birth. METHODS: The 2010 Malawi Demographic and Health Survey data was used to test the study objective. A sample of 12, 911 teen mothers aged between 10 and 18 years were extracted from 23, 020 women and were asked of contraceptive usage after first birth experiences, in which, a logistic regression model was employed to estimate correlates of contraceptive usage. RESULTS: The study found that 54.8% of the teen mothers are still at a risk of having a repeat teenage pregnancy due to their non-use of contraceptives. This implies that less than 50% of teen mothers use contraceptives after experiencing teen birth. It is noted that health care factors such as use of antenatal care, awareness of pregnancy complications, attainment of primary education and exposure to media predict teen mothers' use of modern contraceptives. CONCLUSION: Despite endeavours made by government to improve access to family planning, health care challenges still exist affecting women's use of contraceptives in Malawi. Ameliorating these health encounters call for wide-range approaches aimed at addressing teen birth comprehensively in order to prevent early motherhood and subsequently high fertility. FUNDING: None declared.