Patients who are critically ill get often admitted to intensive care units (ICUs). The majority of these patients require support with their breathing and are thus connected to a mechanical ventilator. One aspect to consider in the mechanically ventilated patient is endotracheal tube cuff pressure (ETT) management. The management of ETT cuff pressure entails that nurses working in ICUs have the responsibility of ensuring that ETT cuff pressure is kept within normal range of 20-30 cmH20 for the safety of the patients in order to avoid complication of over and under inflation. Poor management of ETT cuff pressure places the mechanically ventilated patients under risk of tracheal injury. Tracheal injury may also be caused by over or under inflation of the ETT cuff. Over inflation of the ETT cuff can lead to the occlusion of capillaries lining the trachea at the cuff site, tracheal stenosis, and can also lead to the death of mucus membranes around the area, just to mention a few. On the other hand, under inflation of the ETT cuff, can lead to air leaks as well as aspiration of gastric contents into the tracheal tree. Therefore, in order to maintain ETT cuff pressure within normal ranges, evidence-based guidelines related to the management of ETT cuff pressure should be used. However, in Malawi the management of endotracheal tube cuff pressure in mechanically ventilated adult patients by nurses in ICUs is not well explored and it is not clear whether this practice is based on evidence-based guidelines. Furthermore, strategies on how to implement evidence-based guidelines in the ICU might not be known and poorly defined because of the complexity of the context. The study is therefore aimed at implementing and evaluating the effect of an evidence-based guideline on the management of ETT cuff pressure in mechanically ventilated adult patients by nurses in ICUs in Malawi using active (printed educational materials and monitoring visits) and passive (printed educational materials only) implementation strategies. The research study used a quantitative approach with multi-designs. Four phases were used in order to achieve the four objectives that were set. Phase one was the pre-test and used a survey design, two was the expert panel review of the evidence-based guideline, three was the implementation of the reviewed evidence-based guideline using a randomised controlled trial design and phase four was the post-test which used a survey design. The RCT included 25 participants from the control and 27 from the intervention group. Each group had three ICUs of which one in each group was from a private hospital and the other were government. Data collection in phases one and four was by a hand delivered pre-and post-questionnaire. In phase two the expert panel members with experience in critical care used the AGREE II Instrument to review the evidence-based guideline that was implemented. In order to gather data during the monitoring visits, the researcher recorded field notes. The applications that were developed by the University statistician consultant using visual basic applications in excel were used to analyse data. Two different implementation strategies were used to implement the evidence-based guideline. The control group used passive implementation strategy which was printed educational materials thus the evidence-based guideline and algorithm. The intervention group used both active and passive implementation strategies which was the printed educational materials thus the evidence-based guideline and algorithm plus monitoring visits by the researcher. In order to establish the effect of the implemented evidence-based guideline on the nursing care practice for the management of endotracheal tube cuff pressure an evaluative posttest survey was conducted in phase four of the research study. The results revealed that the majority of participants had gaps in both groups regarding nursing care practice for the management of endotracheal tube cuff pressure for the mechanically ventilated adult patients in the pretest but improved in the posttest. In the control group 52% had very low knowledge score, 16% had low score, 28% average, and 4% high score while in the category of very high score there was nobody. However, in the posttest those in the very low score were only 44% while the percentage in the low score remained 16%. There was an improvement in the average scores in the posttest such that only 44% were in this category. There was no one in the high and very high score in the pretest. On the other hand, in the intervention group, 78% had a very low score, 9% low score, and 13% were in the category of average score, while in the high and very high score category there was zero percent in the pretest. However, there was also an improvement in the posttest such that only 44% a very low knowledge score. But 19% had a low score, there were 37% in the average category and no one was in the high and very high score. Statistical analysis revealed that the results were not significantly different between and within groups. Improvements were observed in the two groups regarding the scientific knowledge scores for the nursing care practices in the posttest. Upon qualitative analysis of the data from the open-ended question, two main themes emerged thus the need for documentation of endotracheal tube cuff and the process of implementation the evidence-based guidelines. Sub themes such as lack of documentation; no part of routine care and monitoring not done at all were identified under the main theme of the need for documentation of ETT cuff pressure. The Guideline itself need to be clear; implementation strategies; follow up; incentives; supervision; incentives; time factor; resources or equipment required for successful implementation; nurses buy-in critical for the implementation; training detrimental to EBP implementation; nurses attitude crucial to implementation of EBGs and knowledge of nurses for guideline essential for the implementation were the sub themes identified under the main theme of the process of implementing the evidence-based guideline. All appropriate ethical considerations such as principles of autonomy and self-determination, confidentiality and anonymity, voluntary participation, right to receive treatment, informed consent, were adhered to throughout the research study. The research study was unique in nature because it was the first of its kind in Malawi and it contributed to the awareness of the recommended practice for management of endotracheal tube cuff pressure in the ICUs in the country by implementing an evidence-based guideline. The unique contribution of the study is that it is a challenge to implement evidence-based guideline in poor and resource constraint countries like Malawi.

The aim of the study was to investigate local community contributions to the existing Malawi College of Fisheries curriculum with a focus on Chambo fishery. Chambo fish (Oreochromis species) is the most favoured fish in Lake Malawi. Chambo catches have declined over the years. Responding to the declining catches, the Fisheries Department is engaged in a number of management options to address the issues. Most of these management options are governed by scientific recommendations and do not consider the socio-economic situation of the people who are dependent on fishery. This approach to fishery has influenced the Malawi College of Fisheries curriculum. The existing curriculum is product-centred, developed by a consultant. During the development of the curriculum, there was little consultation with the lecturers and no consultation with the local communities who are using the resource. The fishing communities have been fishing for a long time and have acquired knowledge, skills and experience worth investigating for its potential role in improving the existing curriculum. Through the use of interviews, focus group discussions and workshops with local communities local knowledge was identified for inclusion into the curriculum. A review of the existing curriculum revealed that it has primarily technical focus, grounded in the protection, control and management of the fish stocks, while the local knowledge has a practical focus based on existing practices and requiring an understanding of the sources of the issues. There is also more emphasis on a historical perspective and the context in which fishing practices take place at the moment. It was evident from the study that local communities have much of knowledge, skills and experience gained over the years of fishing , and if properly utilised, it can improve the MCF curriculum. I therefore recommend in this study that the curriculum be reviewed in order to integrate and draw on the local knowledge through a deliberative and participatory process between the local communities and the government so that it addresses the needs of the local communities and improves the training of the extension workers.

M.Tech. (Radiography) / Satisfied patients are recognized as an important outcome measure for evaluating the quality of medical care provided in a hospital setting. A satisfied patient is more likely to comply with instructions given and cooperate with medical staff during procedures such as special radiographic examinations in the radiography department. In Malawi, studies on patient satisfaction have mostly been confined to doctor – patient interaction and other aspects of the health care service. Very little research has been conducted to explore the experiences of patients undergoing special radiographic examinations. The purpose of this study was to explore the experiences of patients undergoing special radiographic examinations at Kamuzu Central Hospital. A qualitative, contextual, explorative, descriptive approach was used to collect data from patients undergoing special radiographic examinations at Kamuzu Central Hospital in Malawi. Focus group interviews were employed to collect data from the study participants. A total number of 15 patients took part in the study. A content analysis approach was used to analyze the views of the participants. The themes that emerged from the focus group data were: Concerns about delays from reception to receiving radiography results (Radiographs and report); Patients’ experiences with regards to the quality of patient care they received and Concerns about the hospital environment and resources in the radiography department. Guidelines have been proposed to address the themes identified.

Magister Legum - LLM / This research aimed to undertake an investigation into the question of whether after divorce, in the matrilineal customary law marriage in Malawi, women's rights are severely violated. The study showed causes of divorce, how proceedings are done, how issues of property are handled, how the issue of custody of children and maintenance are also handled. All this was weighed against the constitutional provisions and international law. / South Africa

This thesis aimed at measuring the economic costs of soil degradation and to determine factors that influence the incidence and extent of adoption of soil conservation technologies by smallholder farmers in Malawi. A dynamic optimisation model was used to derive and analyse the optimal conditions for soil resource extraction and use in Malawi, while a selective tobit model was used to simulate the two-step decision-making process of farmers with respect to adoption of soil conservation technologies. Soil degradation has long-term consequences and static models, which form the bulk of studies that have so far been carried out in Africa on this topic, do not account for the inter-temporal dimension of optimal resource management. To deal with this shortcoming, this thesis used an inter-temporal optimisation framework, which considers soil in a time-dependent resource extraction perspective. This thesis has demonstrated that soil degradation is causing an enormous reduction in the productive value of smallholder land in Malawi. Current user cost of soil quality based on current practices of smallholder farmers, which represents annual loss in productive value of land, was estimated to be US$21 per hectare. Based on this value and land area under smallholder agriculture in Malawi, economic costs of soil degradation among smallholder farmers were estimated to amount to 14 per cent of the agricultural GDP. If left unabated, soil degradation threatens not only the future of smallholder agriculture but also, economic growth prospects of the nation. Although not operating on the SS optimal path in terms of soil resource management, current practices show that smallholder farmers in Malawi still consider, to certain degree, the dynamic costs in soil resource use. Hence, there is no strong evidence to suggest that current trends in land degradation are due to an institution failure (i.e., smallholder farmers have private incentives to conserve their soil resource). A result that suggests presence of other factors, most likely market distortions, behind existing deviations of farmers' practices from dynamic optimum. Government's serious support of the input and output market reforms is important not only to make the markets work but also, to make smallholder agriculture a profitable enterprise. It is only when smallholder agriculture becomes profitable that farmers can seriously invest in the soil resource. Agricultural support programs such as "food for work" if extended to include soil conservation, could lead to substantial curtailment of soil erosion since farmers can invest their labour in their own gardens during the critical times of land preparation. The sensitivity analysis indicated that increasing the discount rate to' 5%, SS solutions were close to current practice solutions. This suggests that one reason smallholder farmers are exploiting the soil resource is because they have a higher time preference. The high levels of poverty, especially among the smallholder subsistence farmers in Malawi, entail that farming households are more concerned with their survival now than their future well being. The study estimated an optimal output of 1.5tonlha and nitrogen fertiliser rate of 49 kg/ha at SS. The fertiliser estimates are based on smallholder farming system that incorporates soil conservation. In one of the most detailed studies on nitrogen use efficiency in Malawi, Itimu (1997) indicated that with the incorporation of manure, nitrogen fertiliser use dropped from 60 to 30 kg/ha to produce about 2.5 tons of maize. Malawi uses area specific recommendations for fertiliser application. However, using "best bet" technologies, at least 35kgN/ha is recommended for smallholder farmers on average. The SS optimum fertiliser estimated in the current study was somehow higher due to the fact that an inter-temporal framework, which considered the dynamic costs of soil nutrient extraction, was used. Results from fertiliser recommendation trials may be reinforced if researchers consider the inter-temporal nature and dynamic costs associated with the use of soil. The selective tobit model results indicate that factors that influence smallholder farmers' decisions to adopt soil conservation technologies may not necessarily be the same factors that influence subsequent decision on levels of adoption. The implication of this finding is that different policy prescriptions on soil conservation should strictly be guided by the goals the government wants to achieve. With fertiliser prices being out of the reach of most smallholder farmers in Malawi, soil conservation is one of the reliable options available to reduce soil degradation. However, any policy aimed at improving adoption of soil conservation technologies among smallholder farmers would succeed only if the various needs of smallholder farmers at the two decision stages are properly identified and addressed. / Thesis (PhD (Agricultural Economics))--University of Pretoria, 2006. / Agricultural Economics, Extension and Rural Development / unrestricted

Literature and the cooperative movement in Malawi shows that the first cooperative was established in 1947. Since the economy of the country depends on agriculture, most cooperatives were strongly developed in the fields of agricultural production, and processing and marketing. The first coffee cooperative was registered in 1950, known as the Nchenachena Coffee Producers Cooperative Society. After Malawi 's independence in 1964, agricultural cooperatives were dissolved and government formed the Farmers Marketing Board (FMB) to take over all marketing activities of all crops, including coffee. The FMB was replaced by the Agricultural Development and Marketing Corporation (ADMARC) in 1967. After the dissolution of agricultural cooperatives, government saw the need for crop development and established Smallholder Coffee Authority in 1971. The Smallholder Coffee Authority worked up to 1999 when it collapsed because of administrative and financial problems. Due to the failure of the Smallholder Coffee Authority, the government of Malawi reintroduced agricultural cooperatives in 1999. Mzuzu Coffee Planters ' Cooperative Union was formed in 2006 following the re-introduction of cooperatives. The union is mandated to promote sustainable production, processing and marketing of Arabica coffee on behalf of the farmers. Since its inception, the output of coffee for export from the Mzuzu Coffee Planters Cooperative Union has increased from 156 tonnes in 2006 to over 400 tonnes in 2009. The increase in coffee exports was not by mere chance but a number of factors contributed to this success. The main reasons for this success were: • Strong prior relationship between the growers and the buyers • The uniqueness of the cooperative business model • The unique taste and quality of coffee grown • The introduction of a different approach to farming coffee Currently there is high demand for organic coffee and this could be a niche market that is not only rewarded with premium prices but also creates environmental friendly business. The union considers Fair Trade market as an alternative approach to conventional trade, aiming at improving the livelihoods of smallholder producers by improving payments, giving them fair prices and providing continuity in trading relationships.

As leaders of small and medium enterprises (SMEs), strategic leaders are responsible for strategising, the approach to which is influenced by their cultural paradigm. The effects of this strategising are manifested in the day-to-day activities of these leaders. This study aims to build an understanding of the shared cultural assumptions of strategic leaders in agri-based processing SMEs and how these assumptions affect the strategising activities that are adopted when addressing critical incidents related to the internal integration and external adaptation of the SME. Using Strauss and Corbin‟s (1990) grounded theory method, this study develops a theory titled Conveniencing the Family in Business, which is induced from critical incidents. A sample of critical incidents was gathered from 44 qualitative interviews conducted with strategic leaders of various agri-based processing SMEs operating in Malawi. This study found that strategic leaders display persistent and stable pragmatic business survival mind sets, but dynamic cultural assumptions about relationships with organisation members. The cultural influence of these assumptions is manifested in two distinctive and alternative processes making up the theory of conveniencing the family in business. These are the humanising and commodifying of relationships with organisation members, and they are evident in hostile and friendly business environments, respectively. Humanising of relationships with all members of the organisation builds and capitalises on inclusive, organisation-wide social capital that secures the future of the business. On the other hand, commodifying of relationships with non-family organisation members weakens collective support, which becomes mainly dependent on family and friendship ties. Thus, commodifying of relationships serves to perpetuate the close integration of business activity and family requirements to ultimately convenience the family in business, and represents the desired modus operandi of strategic leaders. As strategic leaders of SMEs have not yet conceptualised this, providing them with the conceptual theory developed here may be helpful towards a consistent re-orientation of the internal organisational support in a way that does not exclude but rather harnesses the wider solidarity of organisation members. The process explained by this theory is iterative, dynamic and distinguishes patterns of relationships amongst organisation members, which either enhances or compromises their collective support for the leaders and the enterprise. This by implication affects the performance of the enterprise. The results of this study are discussed from the perspective of social exchange and social capital theory, thereby contributing to the understanding of the strategising activities of strategic leaders, as well as the processes of building or destroying social capital in this type of enterprise.

Women representation in management positions is described as a fundamental human right and an important means of fair democratic representation. This study intended to investigate the factors determining women upward mobility and their promotion to management positions. Included as variables were traditional gender roles, access to education and lack of mentoring and role models. The study followed the qualitative approach using snowball sampling and conducting semi structured interviews with ten Controlling Officers from different ministries and department of the Malawi Public Service to find out whether the variables under investigation indeed affect women upward mobility. Empirical evidence shows that traditional gender roles e.g. being mothers affect women upward mobility. Similarly, limited access to education is another factor that limits women access to managerial positions. Lack of mentoring and role models, especially where there are already few women at the top also affects women’s upward mobility. The study recommended that Malawi government should help women get scholarships that provide for their children. Furthermore, the government should provide flexible working hours especially for mothers. Women themselves should meet for a cup of tea where they can empower each other on the most important aspects of their job as chief executives; that is delivering a speech, making presentations and forming networks.

Rural communities in Malawi are experiencing adverse climatic hazards which are attributed to climate variability and change. The frequent events being experienced include floods, dry spells and seasonal droughts. Rural livelihoods are severely affected because of their sensitivity to these phenomena. The research has analyzed community-based coping and adaptation strategies for sustainable livelihoods among the rural poor in Kaunda village, T/A Simlemba in Kasungu district, Malawi. The research data was collected from groups of male and female participants which also included a group of traditional leaders living in the area. The study used Participatory Rural Appraisal (PRA) methods such as Focus Group Discussions using the associated tools of resource mapping, transect walks, timelines and livelihood ranking to collect the data. The research findings have revealed that the major climate events experienced in Kaunda village are seasonal droughts and dry spells which have significantly impacted agriculture as a major livelihood activity in Malawi. The study has also revealed the community-based coping and adaptation strategies employed by the people. Recommendations made in this study have highlighted the need to support vulnerable rural communities with resilient and secure livelihoods.

The youth are generally in the peripheral of most development endeavors. This research dealt with factors influencing financial sustainability of youth enterprises funded under the Youth Enterprise Development Fund in Karonga, a district in the Northern Region of Malawi. The study was conducted through a descriptive and analytical survey. Data was collected using questionnaires, interviews and Focus Group Discussions. Questionnaires were analyzed and presented using graphs and in form of percentages. Findings from the questionnaires, interviews and FGDs were analyzed for content and presented in narrative form according to the thematic areas in relation to the variables. This research has revealed that repayment rates of YEDF beneficiary enterprises in the district are at 31 percent and that those that have finished paying back the loans stand at 15 percent. The research shows that political influence and inadequate capacity building skills in business management are some of the major reasons for the low repayment of the YEDF loans. The leaders and members in most groups had no prior experience and capacity for running a business. The challenges have negatively affected the revolving nature of the fund. The study recommends that YEDF should be independent of political influence, group members be given more training to enable them understand key business and financial management skills and, strengthening monitoring and evaluation of these groups by the YEDF officers.