Zomba, Malawi

University of Malawi

Zomba, Malawi

The University of Malawi is an educational institution established in 1964 and composed of five constituent colleges located in Zomba, Blantyre, and Lilongwe. Of the five colleges, the largest is Chancellor College in Zomba. The name of the school is abbreviated to UNIMA. It is part of the Malawian government educational system. The present Vice Chancellor is Professor John Kalenga Saka. Wikipedia.

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Agency: European Commission | Branch: FP7 | Program: CSA-CA | Phase: HEALTH.2010.3.4-3 | Award Amount: 2.19M | Year: 2011

This project will add new research training capacity at Sub Saharan African (SSA) universities, for health systems and services strengthening. The focus is doctoral and post doctoral training, institutional strengthening for education, financial and administrative research management, and South-South network building. Novel capacity building approaches will reduce brain-drain, be more climate friendly and encourage gender equity with south based training. Internet mounted downloadable modules in quantitative (e.g., epidemiology), qualitative (e.g., anthropology) and economic methods will support excellent interdisciplinary courses. Our EU and African partners have many successful previous collaborations, e.g., web based training modules; joint PhD degree with Uganda. Health systems strengthening is research intensive, incremental improvement to service delivery, implementation and evaluation. Therefore SSA countries need to grow their own health services and systems research (HSSR) capacity: interdisciplinary, rigorous and relevant. ARCADE-HSSR will support evidence informed service delivery by producing a stream of well trained young HSSR scientists, the next generation of health system leaders and researchers in SSA. Activities will be aimed at individuals, institutions and at the network. Makerere University(MU) and Stellenbosch University (SU) are two strong SSA universities with HSSR focus. They will act as hubs in a South-South network including MU, SU, and initially, Muhimbili (MUH) and Malawi (MA). Working with strong northern HSSR institutions (Karolinska Institute KI, Sussex University Institute for development Studies, IDS, and Norwegian Knowledge Centre for Health Services KS) this region-wide approach will draw skills, resources and students to a new south-south HSSR capacity development network. We will expand our unique north-south joint PhD degree programme (KI-MU: 20 Ugandan graduates), to south-south joint PhD degrees (MU-SU).

Agency: European Commission | Branch: H2020 | Program: RIA | Phase: WATER-5c-2015 | Award Amount: 3.57M | Year: 2016

The WHO estimates that in 2015 in Africa ~156 million people relied on untreated sources for their drinking water. WATERSPOUTT will design, develop, pilot and field-test a range of, sustainable point-of-use solar disinfection (SODIS) technologies that will provide affordable access to safe water to remote and vulnerable communities in Africa and elsewhere. These novel large-volume water treatment SODIS technologies will be developed in collaboration and consultation with the end-users, and include: 1. HARVESTED RAINWATER SODIS SYSTEMS for domestic and community use. (South Africa, Uganda). 2. TRANSPARENT 20L SODIS JERRYCANS. (Ethiopia) 3. COMBINED 20L SODIS/CERAMIC POT FILTRATION SYSTEMS. (Malawi) These are novel technologies that will create employment and economic benefits for citizens in both the EU and resource-poor nations. WATERSPOUTT will use social science strategies to: a. Build integrated understanding of the social, political & economic context of water use & needs of specific communities. b. Examine the effect of gender relations on uptake of SODIS technologies. c. Explore the relevant governance practices and decision-making capacity at local, national and international level that impact upon the use of integrated solar technologies for point-of-use drinking water treatment. d. Determine the feasibility & challenges faced at household, community, regional and national level for the adoption of integrated solar technologies for point-of-use drinking water treatment. WATERSPOUTT will transform access to safe drinking water through integrated social sciences, education & solar technologies, thus improving health, survival, societal well-being & economic growth in African developing countries. These goals will be achieved by completing health impact studies of these technologies among end-user communities in Africa. Many of the consortium team have worked for more than 15 years on SODIS research in collaboration with African partners.

Agency: European Commission | Branch: FP7 | Program: CP-FP-SICA | Phase: HEALTH.2010.3.4-1 | Award Amount: 3.94M | Year: 2011

Obstetrical and abdominal emergencies, and trauma, much of it affecting children, represent a major and neglected part of Africas burden of disease. Countries cannot train and retain sufficient specialist surgeons (doctors) to address these priorities. We propose a surgical training intervention targeted at Clinical officers (COs), who are trained non-physician clinicians that form the backbone of Africas district hospital services. Lacking medical degrees, COs have fewer opportunities for emigration. Surgical training of non-clinician physicians has been tried and reportedly worked well in African countries. It has never been rigorously evaluated, nor been subject to economic and population impact assessments. Two different 2 year training models are proposed: district hospital in-service training in Malawi and centralised training in Zambia. Before-and-after and randomized controlled trial evaluations are planned. The latter is the strongest study design for evaluating an intervention. Outcomes will include direct health benefits to patients, including morbidity and mortality averted; improved provider knowledge, skills and performance; direct (surgical) and indirect (management and other services) improvements in district hospital performance. Cost-effectiveness analyses and population impact assessments will be conducted. Clinical Officer training has for long been a feasible and acceptable model to African national policy makers; and COST-Africa has already elicited high level expressions of support. There will be an ongoing interaction with national stakeholders in both countries to ensure attractive career paths, salaries and retention strategies are in place for the graduates. A proven model for training and retaining a new cadre of non-physician surgical officers has the potential to provide a standard of life-saving surgical care often denied to African populations; tackle major rural:urban inequities; and transform district hospital care. Without such a resource, Africa has no hope of reaching MDG 5 on maternal mortality; and reduced hope for MDG 4 on childhood mortality.

Agency: European Commission | Branch: H2020 | Program: RIA | Phase: SC1-PM-21-2016 | Award Amount: 6.00M | Year: 2017

In sub-Saharan Africa 95% of the population has no access to surgical services. In this region surgery a proven and often life-saving intervention is only accessible to urban populations, with only one surgeon per 2.5 million people in rural areas. Emerging evidence demonstrates that major surgery can be undertaken safely and effectively at district hospitals, making it accessible to otherwise neglected rural populations. Objectives: Guided by a health systems-strengthening framework and a comprehensive programme of research, Scaling up Safe Surgery for District and Rural Populations in Africa will scale up the delivery of accessible, elective and emergency surgery at district hospitals to national level programmes in three African countries: Malawi, Zambia and Tanzania. How objectives will be achieved: SURG-Africa is a tested intervention, drawing lessons from two large-scale successful interventions coordinated by members of this SURG-Africa consortium (one FP7 EC funded) that have trained and supervised non-physician clinicians to deliver essential and emergency surgery in four African countries. Platformed on comprehensive surgical systems analyses, it will put in place national surgical information systems; and will test innovative interventions for making specialist supervision of district surgery feasible and affordable. Epidemiological, economics and implementation research will evaluate impact, and provide evidence for policymakers. SURG-Africa directly addresses all aspects of Topic SC1-PM-21-2016: Implementation research for scaling- up of evidence based innovations and good practice in Europe and low and middle-income countries. The results will be transferable and scalable national surgical systems models, with implications for national budget factored in, for making safe surgical services accessible, equitable and sustainable in Africa, especially for women in rural areas.

Agency: European Commission | Branch: H2020 | Program: RIA | Phase: ICT-39-2015 | Award Amount: 2.00M | Year: 2015

mHealth4Afrika is a collaborative research project that addresses maternal and newborn healthcare delivery, a key requirement of end-user communities in developing countries, and priority area in both the 2015 Millennium Development Goals and Post-2015 Sustainable Development Goals. Aligned with Horizon 2020 Societal Challenges, mHealth4Afrika will research and evaluate the potential impact of co-designing an open source, multilingual mHealth platform on the quality of community based maternal and newborn healthcare delivery in Southern Africa (Malawi, South Africa), East Africa (Kenya) and Horn of Africa (Ethiopia). Research and innovation actors from three European and four African countries will engage with local end-user communities (i.e. representatives of parents and local community leaders, Ministry of Health, healthcare professionals and volunteers, health oriented NGOs). Based on this User-centred Design, Living Labs, Collaborative Open Innovation based approach, the consortium will integrate and adapt Multilingual electronic health records to store patient history, associated tests and test results; Sensors to capture the results of a range of standardised tests for expectant and lactating mothers, unborn babies and infants; Analytical and visualisation tools to facilitate the interpretation and monitoring of the patient results; and Multi-lingual and multimodal mobile interfaces leveraging visualisation and speech synthesis to address literacy deficits and digitise data gathering through electronic forms. By focusing on accessibility, usability and integrated training, this will facilitate urban, rural and deep rural healthcare workers to adopt and use a comprehensive system that integrates quality community based healthcare delivery with telemedicine. The expected outcome is a multi-region proof of concept that can make a significant contribution in accelerating exploitation of mHealth across Africa.

Mbeye N.M.,University of Malawi
Tropical medicine & international health : TM & IH | Year: 2014

Cotrimoxazole prophylactic treatment (CPT) prevents opportunistic infections in HIV-infected or HIV-exposed children, but estimates of the effectiveness in preventing malaria vary. We reviewed studies that examined the effect of CPT on incidence of malaria in children in sub-Saharan Africa. We searched PubMed and EMBASE for randomised controlled trials (RCTs) and cohort studies on the effect of CPT on incidence of malaria and mortality in children and extracted data on the prevalence of sulphadoxine-pyrimethamine resistance-conferring point mutations. Incidence rate ratios (IRR) from individual studies were combined using random effects meta-analysis; confounder-adjusted estimates were used for cohort studies. The importance of resistance was examined in meta-regression analyses. Three RCTs and four cohort studies with 5039 children (1692 HIV-exposed; 2800 HIV-uninfected; 1486 HIV-infected) were included. Children on CPT were less likely to develop clinical malaria episodes than those without prophylaxis (combined IRR 0.37, 95% confidence interval: 0.21-0.66), but there was substantial between-study heterogeneity (I-squared = 94%, P < 0.001). The protective efficacy of CPT was highest in an RCT from Mali, where the prevalence of antifolate resistant plasmodia was low. In meta-regression analyses, there was some evidence that the efficacy of CPT declined with increasing levels of resistance. Mortality was reduced with CPT in an RCT from Zambia, but not in a cohort study from Côte d'Ivoire. Cotrimoxazole prophylactic treatment reduces incidence of malaria and mortality in children in sub-Saharan Africa, but study designs, settings and results were heterogeneous. CPT appears to be beneficial for HIV-infected and HIV-exposed as well as HIV-uninfected children. © 2014 John Wiley & Sons Ltd.

Kaunda C.S.,University of Malawi
Renewable and Sustainable Energy Reviews | Year: 2013

Sustainable energy is required for any national development. This paper has reviewed and documented energy situation and small-scale hydropower potential and application status in Malawi. The country's energy sector is dominated by traditional forms of biomass. Level of modern forms of energy supply is low. In particular, electricity supply is unreliable and small in capacity. Decentralised energy supply systems like small-scale hydropower are some of the recommended energy projects for developing countries. The paper adds knowledge on small-scale hydropower in Malawi. The study has reviewed Government reports and other documents. Informants were also consulted. Information from documents and informants was confirmed through site visits. The analysis of the small-scale hydropower potential sites indicates that the country has considerable potential for decentralised hydropower generation, which if fully exploited, can contribute to the country's electricity and power supply especially for rural electrification. Most of the identified potential sites are located in the northern parts of the country. From the information on the assessed sites, a proven potential of 7.6 MW can be harnessed. An inventory of small-scale hydropower systems shows there is an installed capacity of 5.8 MW with most of the plants not functioning due to various reasons. Challenges and opportunities towards popularisation of the technology have been identified and discussed. © 2013 Elsevier Ltd.

Agency: GTR | Branch: NERC | Program: | Phase: Research Grant | Award Amount: 41.47K | Year: 2015

Central and Southern Africa (C&SA) exemplifies the issues that FCFA aims to address: a complex mix of remote and regional climate drivers that challenge conventional climate model simulations, high levels of poorly simulated multi-year climate variability, an extremely low level of investment in climate science relative even to other parts of Africa but particularly West Africa; high physical and socio-economic exposure to climate that projections indicate may become drier and more variable in the future; and low adaptive capacity resulting in decision-making and medium-term planning that is inhibited by significant political, institutional and economic barriers. Meanwhile economic growth and significant infrastructure planning is taking place within C&SA in the absence of adequate climate information. Deficient understanding of many key climate features in C&SA is one barrier to the integration of climate information into decision-making. UMFULA will provide a step-change in climate science in C&SA. Our objectives include: (i) fundamental research into key climate processes over C&SA and how these are dealt with in models; (ii) a process-based evaluation to determine how models invoke change and whether that change is credible; (iii) production of novel climate products (Work Packages WP1-2) encompassing convection permitting and very high resolution (c4 km) ocean-atmosphere coupled simulations that will reveal processes of high impact events and as yet unexplored complexities of the climate change signal. We will also focus on neglected but critical elements of the circulation such as the links between C&SA and the role of local features including the Angolan Low, Botswana anticyclone, Angola/Benguela Frontal Zone, and the Seychelles-Chagos thermocline ridge. Based on this research and through co-production with stakeholders we will generate improved and streamlined climate information for decision-makers (WP3). We will use a deliberative and participatory methodology to test findings from FCFA pillars 1 and 2 with stakeholders based on deep engagement in two contrasting case studies: the Rufiji river basin in Tanzania, and sub-national decision-making in Malawi. They are carefully selected as exemplars of multi-sector, multi-stakeholder, and multi-scale decision situations which can be compared for transferable lessons on the effective use of climate services. In-depth understanding of decision-making contexts, including political economy, theories of institutional change, and individual motivation from behavioural sciences will inform how to tailor and target climate projections for most effective use (WP4). The case study areas (WP5-6) will test these findings through a co-produced framework of C&SA-appropriate decision-making under climate uncertainty to identify robust climate services-informed intervention pathways (portfolios of policies and investments that could work well over a broad range of climatic and socio-economic futures). Our Capstone Work Package (WP7), and major outcome, will be the synthesis of best decision-making models and appraisal methods that are transferable in the African context and enable effective use of climate information in medium-term decision-making. The seven UMFULA Work Packages cut across the three FCFA pillars to ensure maximum complementarity and integration. We are a consortium with world-leading expertise in climate science, decision science and adaptation research and practice, together with stakeholder networks and strong, long-standing relationships in C&SA. We comprise 5 UK and 13 African institutions.

Agency: European Commission | Branch: FP7 | Program: CP-FP-SICA | Phase: HEALTH.2010.3.4-2 | Award Amount: 3.46M | Year: 2011

Most African women face childbirth without access to skilled health workers when obstetric and neonatal emergencies arise. Providing and retaining skilled health workers is vital in attempts to save the 600,000 women and 7 million babies who die annually in Africa. In the modern world this tragedy is unacceptable and largely preventable. Education and training for health professionals is the key to improving healthcare for mothers and babies in Africa. Non-Physician Clinicians (NPCs) are an effective and retainable health solution for doctor-less rural and some urban areas of Africa. Task shifting to NPCs needs to be extended, enhanced, endorsed and supported by the healthcare community and will be the aim of Work Package 1 (WP1) and WP3. The project aims to develop, implement and evaluate clinical service improvement through clinical guidelines and pathways in WP2, structured education and clinical leadership training (WP3) and workforce development of NPCs and faculty (WP1, WP3). A key element will be continuing support for NPCs in the workplace using communications technology and mentorship from local and international physicians (WP1, WP3). All service improvements will be sustainable, scalable, cost-effective, transferrable and co-developed by professional partners in Africa. Bringing together key European and African partners with GE Healthcare to address the major issues of enhancing a sustainable healthcare workforce and enhancing appropriate training in the use of existing technologies should help to significantly reduce the loss of mothers and babies in Africa.

Agency: GTR | Branch: NERC | Program: | Phase: Research Grant | Award Amount: 339.68K | Year: 2012

[Proposal EE112/ K1396905] Predicting the impacts of global change on rural communities is increasingly challenging due to the accelerating pace of climate change and social and economic development. The combined demands of ensuring food, energy and water security have been described as a Perfect Storm by Prof Sir John Beddington, HM Governments Chief Scientific adviser. It is clear that food security will continue to remain a critical issue in developing countries due to the unpredictable nature of food chains and the effects of climate change. Food security in poor rural communities often relies significantly on flows of ecosystem services from natural environments. For millennia mankind has engaged in thinking and learning experiences which have shaped the processes underpinning the production of food and the management of land, addressing multiple factors and tradeoffs. However, many food production systems require intensive management and are prone to failure outside of the range of their optimal environmental conditions. Concerns are growing about the ability of current agricultural systems to support rising human populations without further degrading critical ecosystem services (such as water provisioning, pollination). During extreme events, such as drought, or other shocks or crises (environmental, social or economic), the dependence of rural communities on ecosystem services to meet their nutritional and livelihood needs often increases. This highlights the importance of minimising the impacts of agricultural systems on ecosystems and the services they provide. Strategies for coping with food insecurity may, in turn, have an impact on the capacity of ecosystems to deliver ecosystem services as the spatial and temporal nature of feedbacks between socio-economic and ecological systems can be complex. Addressing the sustainability of natural resource management and rural livelihoods requires integrated thinking across disciplines. The complex transformations which can, or have already occurred from natural forest to managed landscapes must be fully understood so that systems can be adopted which promote sustainable transformations and/or can mitigate any negative impacts. This proposal therefore brings together expertise in social sciences, economics, ecology, risk management, spatial planning, climate change and complexity sciences to design and integrate a suite of models and methods to analyse how dynamic stocks and flows of ecosystem services translate to local-level food security and nutritional health. The study will examine the multiple (and multi-directional) links between ecosystem services, food security and maternal and child health outcomes in poor rural communities, addressing three main themes: 1. Drivers, pressures and linkages between food security, nutritional health and ecosystem services; 2. Crises and tipping points: Past, present and future interactions between food insecurity and ecosystem services at the forest-agricultural interface; 3. The science-policy interface: How can we manage ecosystem services to reduce food insecurity and increase nutritional health? Analysis of household and intra-household nutritional status and assessment and mapping of ecosystem services at the relevant spatial scales will be conducted in sites in Colombia and Malawi, which are characterised by mosaics of forests and agricultural lands, to explore the trade-offs and tipping points associated with managing these dynamic landscapes under climate and socio-economic change. Powerful new models will predict how ecosystem services will be changed by drivers and pressures for human wellbeing and food security. This will allow risk management/mitigation models and strategies to be developed which can inform national and regional policy in order to maintain ecosystems and support human wellbeing.

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