Malawian parents' perceptions of physical activity and child development: a qualitative study.

BACKGROUND: In scientific studies, physical activity is measured by the amount of bodily movement, but lay perceptions of physical activity might be different. Parental influence is important for the development of children's physical activity behaviour, and parental perceptions of facilitators of physical activity are context specific. We aimed to investigate how parents of young Malawian children conceptualize physical activity in childhood, situate it in child development and understand its facilitators. METHODS: We used convenience sampling to identify parents of young children from different socio-economic backgrounds and age groups in semi-rural area of Malawi. We conducted in-depth interviews with 16 parents, a focus group discussion with six parents and key informant interviews with two nurses in Malawi. Six of the participants were fathers. We analysed the data with conventional qualitative content analysis by inductive approach. RESULTS: The parents emphasized practical skills, education and proper behaviour as goals for their children. They viewed activity as encompassing both mental and physical qualities and they perceived it as a positive attribute of children. The parents discussed skills acquisition, social competence, health and bodily movement as signs for being active. As facilitators of physical activity the parents mentioned balanced diet, good health and stimulation. The main concerns of the parents in regard to facilitators of physical activity and good child development were the availability of food and the child being healthy. CONCLUSIONS: Malawian parents' concept of children's physical activity is more comprehensive than scientific definition and includes aspects of both physical and mental activity.

Is transcription of data on antiretroviral treatment from electronic to paper-based registers reliable in Malawi?

SETTING: Antiretroviral treatment (ART) clinics at one central hospital, three district hospitals and one mission hospital in the central and southern regions of Malawi. OBJECTIVE: To measure the extent of inaccuracies in the transcription of case registration and recorded deaths between electronic medical data (EMR) and paper registers. This was done to inform the Ministry of Health on the reliability of the paper-based system as backup in case of EMR failure. DESIGN: Retrospective analysis of routine programme data. RESULTS: A total of 31 763 registrations and 2922 deaths in the EMR were compared with those in the paper registers. In one hospital, up to 24% of overall case registrations were missing from the paper registers. At other sites, the differences were minor and included duplicate patients who should have been classified as 'transfer in' patients in the paper register. There were major differences in the number of registered deaths in two of the five facilities. CONCLUSION: There are varying degrees of agreement between the EMR and paper registers which compromise the use of the latter as a backup solution in case of EMR failure. The reasons for this unreliability and ways forward to address the problem are discussed.