Policy Briefs from the EIPM Training Programme

  • Reducing Cervical Cancer Prevalence in Malawi July, 2016

    Cervical cancer is a major public health problem that kills approximately 250,000 women globally every year. It especially affects women in low-income countries. Low-income countries accounted for 370 000 out of a total of 466 000 cases that were estimated to occur in the world in 2000. It is the third most common cancer worldwide and the leading cause of cancer death among women. Malawi has the highest rate of cervical cancer worldwide, estimated at 75.9 per 100,000 population. It is the second common cancer overall (25.4 percent) of all cancers in the country and the most common (45.4 percent) cancer among women in Malawi. The high rates of cervical cancer are linked to high prevalence of Human Papiloma Virus (HPV) infection, HIV and a non-performing screening programme. This policy brief further discusses the epidemiology of cervical cancer, the policy options that hold the potential of reducing its prevalence and draws on these options to make recommendations.

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  • Decentralisation of HIV-Testing to reduce results turnaround time through the use of point-of-care HIV diagnostic devices July, 2016

    Access to antiretroviral therapy (ART) for children under 12 months in resource-limited countries is constrained by the unavailability of HIV-diagnostic devices that can perform DNA/Polymerase Chain Reaction (PCR) HIV tests at service delivery points. The Early Infant Diagnosis (EID) platforms in current use in Malawi have been found to be too complex to be placed at district level and do not qualify as a point-of-care test method. The devices are located in central hospitals and special laboratories, leading to long delays between sample collection, transportation to and from the referral molecular laboratory and interpretation of the results by the care provider. Consequently, the children identified as living with HIV have delayed access to ART due to delayed results and caregivers may be frustrated to have to continuously ask for these results. This policy brief makes an analysis of this issue and considers policy options that could mitigate the constraints of access to diagnostic devices. Its recommendations are drawn from this discussion of policy options.

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  • Ensuring effective transfer of competencies to local researchers working in international health research projects in Malawi July, 2016

    The sustainability of any gains made by research activities hitherto led by international research organisations requires the effective transfer of knowledge and skills to local research collaborators or partners. However, the state of affairs in many international health research projects in Malawi does not reflect this vision. Local researchers have little or no knowledge of how study samples are managed, i.e. how the samples are analysed, which tests are used, who really owns the samples and when the samples will be destroyed, among other considerations. To achieve this, the Ministry of Health (MoH) needs to ensure availability of well-drafted, implemented and monitored agreements between international research organisations and local collaborating research institutions. The continuity of programmes and full realisation of expected outcomes should be direct benefits of such meaningful collaborations. This policy brief analyses the policy options that can make skills transfer a reality and recommends appropriate policy actions.  

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  • How can drug pilferage be prevented in Malawi public hospitals July, 2016

    Drug pilferage has been considered as one of the contributing factors for shortage of drugs not only in Malawi, but also in other African countries. A report from the United States President’s Malaria Initiative (PMI) highlighted some of the ways through which malaria drugs are trans-continentally diverted in Africa to include illegal diversions that would occur when a genuine pharmaceutical commodity approved and intended to be used in a specific country is illegally intercepted and sold in another country. Drug pilferage can also occur during transportation from the supplier or manufactures to the national warehouse such as the Central Medical Stores. The drugs can either be stolen from the warehouses or during transportation to the health facilities. Drugs can also be pilfered from pharmacies and drug stores within the health facilities. Furthermore, the Minister of Health, Dr Kumpalume, disclosed that Malawi loses about MK5 billion (about USD7 million) of the MK17 billion (about USD24 million) drug budget to theft. This policy brief therefore delves into the issue of drug pilferage and analyses policy options that could curb its continued persistence. It also makes recommendations based on this analysis.

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  • How can Malawi increase the number of voluntary non-remunerated blood donors July, 2016

    Malawi has the smallest number of blood donors as a percentage of the total population when compared to others in the SADC region. About 77 percent of blood donors in Malawi are under the age of 25 while in countries that are doing better, about 70 percent of their donors are above the age of 25. The large proportion of blood donors below the age of 25 in Malawi partly explains why the country is failing to meet the target of 80, 000 units per year. One of the main reasons contributing to the adult population’s reluctance to donate blood has been attributed to superstitious beliefs and myths. Many people, mainly those with low literacy, believe that donating blood could make them lose their strength, manhood and sexual potency and reduce their lifespan. Other people also fear testing HIV positive. This policy brief also looks at other factors that have contributed to the low levels of voluntary non-remunerated blood donors, and makes a discussion of policy options that could right the issue. It then makes some recommendations based on this discussion.

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  • How should the Malawi Health Sector indicators be revised to align with current monitoring and evaluation needs? July, 2016

    An indicator is a measurable variable used as a representation of an associated factor or quantity. It provides evidence of the quality or standard of service. To monitor performance of the Health Sector in Malawi, Ministry of Health (MoH) formulated a Handbook of Health Indicators in 2003. The Handbook had 110 Health Management Information System (HMIS) indicators. It was formulated on the basis that it will be revised every five years to reflect emerging health problems, priorities, goals and targets of the health sector. However, 13 years later, the indicators have never been evaluated or revised. This policy brief takes a look at the current batch of health sector indicators, and discusses the policy options that could be put in place to update them. The brief also makes some recommendations based on this discussion.

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