World Health Organization - Malawi

ABSTRACTBackground and AimsAccess to healthcare services is a public health challenge worldwide. Although governments continue to channelscarce resources to enhance service provision, the World Health Organization estimates that about half the world's population lacks essential access. This global context underscores persistent gaps even where investments are made. Public health spending often fails to achieve its aim of helping poor and vulnerable people, creating a critical disconnect between resource allocation and actual service reach. This study examines inequality in public health spending and access to healthcare services in Zimbabwe.MethodsThe study achieves the objective using 2017 government health expenditure from the Ministry of Health and Child Care and data from the 2017 Prices, Income, Consumption, and Expenditure Survey. To ensure consistency between spending patterns and household experiences, the empirical model is based on the concentration index and re‐centered influence functions. The study estimates inequality in public health spending using the standard concentration index, while Erreygers concentration index measures the inequality in access to healthcare services. Oaxaca–Blinder‐RIF decomposition is also used to decompose the differences in the concentration index between urban and rural populations.ResultsThe results show that, on average, public health spending in Zimbabwe is pro‐poor for public clinics and pro‐rich for public hospitals. This divergence reflects how different tiers of the health system serve different socioeconomic groups. Despite benefits from government health spending, inequality in the availability and affordability remains a problem, with the affluent continuing to benefit from well‐resourced facilities. Affordability and availability of healthcare services are pro‐rich, much greater in urban than in rural areas. Moreover, the decomposition analysis highlighted that inequality in the affordability and availability between urban and rural populations is largely not explained by the traditional variables, suggesting the influence of deeper systemic and institutional factors.ConclusionZimbabwe needs to aim for universal health coverage, with good quality, affordable care for all, regardless of geographical location or socioeconomic status. Achieving this requires not only sustaining but strategically strengthening current efforts. There is room to improve and augment efforts to achieve universal health coverage without leaving anyone behind. Broader health financing mechanisms and infrastructure investments should be explored to bridge the gap in access to services. Policymakers should, therefore, improve resource allocations in the health sector to achieve equality in government spending and access to healthcare services, ensuring that investment translate into equitable health outcomes for all.

Tick-borne diseases (TBDs) pose a major hindrance to livestock production in countries with limitedresources. Effective prevention and management of TBDs require a thorough understanding of disease vectorsand pathogens. However, there is limited information on studies of bovine tick-borne pathogens (TBPs) using molecular methods in Malawi. This study aimed to detect TBPs of cattle populations in southern Malawi, which has the largest cattle population in the country. A total of 220 blood samples from apparently healthy cattle were collected in six districts, and werescreened for selected TBPs using polymerase chain reaction (PCR). The overall detection rate of TBPs was 72.3%. Among the detected pathogens, Babesia bigemina hadthe highest detection rate (34.5%), followed by Anaplasma marginale (23.2%), Anaplasma phagocytophilum(22.3%), Theileria taurotragi (22.3%), Theileria parva (15.5%),Anaplasma bovis (9.6%), Babesia bovis (7.3%),Theileria mutans (4.1%), and Babesia naoakii (2.7%). Among the positive samples, 64.2% were found to be co-infected with two or more TBPs, with the highest number of seven pathogens detected in a single sample. Thestudy documents the existence of A. phagocytophilum, B. bovis, and B. naoakii in Malawian cattle for the first time. The findings herein demonstrate a significant burden of TBPs on cattle in Malawi, which gives a challenge in combating TBDs. The high TBP burden, along with the high co-infection frequencies in Malawian cattle necessitates the urgency to implement effective control strategies to enhance cattle production in the country.

New approaches to generating knowledge are needed to achieve the UN Sustainable Development Goals (SDGs). Participatory action research (PAR) builds on and expands the scientific process through engagement of scientists (ecological, agricultural, and social) with stakeholders in a systematic manner. To illustrate iterative co‐learning cycles, we report on two decades of PAR in rural communities in Malawi. Novel findings include the expansion of agricultural diversity beyond agroforestry to meet farmer requirements while enhancing redundancy and supporting a broad range of functions. Insights from farmers facilitated identification of the value of intermediate growth habits (such as those of shrubs and vines) as “goldilocks” crop types that tighten nutrient cycles in mixed farming systems while providing multiple harvests of nutritious seeds and forage. This illustrates how PAR involves co‐design with stakeholders and learning by doing, to meet local needs and mediate trade‐offs, as well as generate knowledge that addresses SDGs.

Crop yield is related to household food security and community resilience, especially in smallholder agricultural systems. As such, it is crucial to accurately estimate within-season yield in order to provide critical information for farm management and decision making. Therefore, the primary objective of this paper is to assess the most appropriate method, indices, and growth stage for predicting the groundnut yield in smallholder agricultural systems in northern Malawi. We have estimated the yield of groundnut in two smallholder farms using the observed yield and vegetation indices (VIs), which were derived from multitemporal PlanetScope satellite data. Simple linear, multiple linear (MLR), and random forest (RF) regressions were applied for the prediction. The leave-one-out cross-validation method was used to validate the models. The results showed that (i) of the modelling approaches, the RF model using the five most important variables (RF5) was the best approach for predicting the groundnut yield, with a coefficient of determination (R2) of 0.96 and a root mean square error (RMSE) of 0.29 kg/ha, followed by the MLR model (R2 = 0.84, RMSE = 0.84 kg/ha); in addition, (ii) the best within-season stage to accurately predict groundnut yield is during the R5/beginning seed stage. The RF5 model was used to estimate the yield for four different farms. The estimated yields were compared with the total reported yields from the farms. The results revealed that the RF5 model generally accurately estimated the groundnut yields, with the margins of error ranging between 0.85% and 11%. The errors are within the post-harvest loss margins in Malawi. The results indicate that the observed yield and VIs, which were derived from open-source remote sensing data, can be applied to estimate yield in order to facilitate farming and food security planning.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread across the globe and has affected the health of millions of people. During the pandemic, social media was the major source of information for isolated and anxious people. Infodemics is defined as "an overburden of information - some accurate and some not - that makes it hard for people to find trustworthy source and reliable guidance when they need it." Misinformation raised out of infodemics during COVID-19 created many serious issues regarding the prevention and treatment of COVID-19. With the help of available literature, we aimed to review the role of infodemic in relation to worsening of COVID-19 spread and vaccine utilization with possible preventable measures to control infodemic. Various social media platforms were a major source of infodemic. The active role of world agencies, narrative guidelines by the local authority, use of artificial intelligence (AI) by social media platforms and active participation of community and health care professionals can control infodemics effectively.

How to engage farmers that have limited formal education is at the foundation of environmentally-sound and equitable agricultural development. Yet there are few examples of curricula that support the co-development of knowledge with farmers. While transdisciplinary and participatory techniques are considered key components of agroecology, how to do so is rarely specified and few materials are available, especially those relevant to smallholder farmers with limited formal education in Sub-Saharan Africa. The few training materials that exist provide appropriate methods, such as compost making, but do not explain relationships and synergies between nutrition, social inequalities, climate change and agroecology. Some food sovereignty and agroecology courses aim at popular political education for those with more formal education. Here we describe the process of development of an innovative curriculum, which integrates agroecology, nutrition, climate change, gender and other dimensions of social equity across 2 weeks of training explicitly for smallholders in southern Africa with limited formal education. The curriculum is highly participatory; we use concepts in popular education, transformative and experiential-based learning, and theatre. It is also integrative; we link agroecology with climate change, human and soil nutrition, gender, and related components of social equity. Developed in partnership with Malawian farmers, community development experts and academics from fi ve countries, the curriculum was piloted with 520 smallholder farming households in Malawi and Tanzania, and evaluated using qualitative techniques. Clashes of language, cultural norms, and terminology were as great of a challenge as agreeing on and conveying technical information, to weave into a coherent whole. However, farmers who participated in the curriculum training demonstrated high interest, comprehension of material and interest in immediate application to their lives.

This article is based on the study that assessed the impact of climate change on food security and adaptation strategies among smallholder farmers in Salima district, Malawi. The research design deployed literature review and case study survey. A mixed approach of both qualitative and quantitative research methods was used for data collection and analysis. Findings revealed a felt slight increase in temperature. Rainfall seasonality changes (inter annual and intra variation) are suspected to lead to more frequent and intensified droughts and floods that affect four pillars of food security i.e., food availability, access, utilization and stability. Perceived climate change risks are based on smallholder farmers’ experience and knowledge of their local farming. Majority of smallholder farmers in the study areas depend on subsistence farming that is rainfed and vulnerable to seasonality changes. Farmers are taking adaptation measures to ensure food security that includes indigenous knowledge based on past experiences and adoption of climate smart modern technologies. Adaptation limiting factors include limited livelihoods-based capitals, knowledge and skills of climate smart agriculture. There is need for reforming agriculture extension services provided by government through formal integration of climate smart agriculture in policy linkages to smallholder farmers.