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Free cervical cancer screening services are provided in Malawi’s public healthcare institutionssince 1999. Few women aged 42 and older, utilise these services. Cervical cancer continues to be a major cause of morbidity and mortality among this group of women. Structured interviews were conducted with 381 women who attended three healthcare centers in Blantyre and semi-structured interviews with 14 nurse/midwives working at the same centers. The results for both phases arepresented within the Health Belief Model’s constructs. Phase 1 revealed that women had low levels of perceived susceptibility to cervical cancer. Although the interviewed women perceived cervical cancer to be a serious condition, they did not regard themselves to be at risk of suffering from cervical cancer. Knowledge that cervical cancer screening could detect this cancer at an early stage, embarrassment, stigma, social support, financial costs, traditional practices and available sources of information, influenced women’s intentions to be screened for cervical cancer. In phase 2, the nurse/midwives indicated that Malawian women lacked information about cervical cancer, available screening tests and the purpose of such screening.These women perceived cervical canceras being incurable and linked to witchcraft. Women’s utilisation of cervical screening services was hampered by barriers relating to healthcare institutions, women themselves and nurse/midwives. Local radio and television broadcasts, friends and nurse/midwives motivated individual women to use these screening services.Women preferred receiving information about cervical cancer screening during community activities. Health education should be intensified, nurse/midwives should be more empathetic, clinic days and hours should be extended. Misconceptions should be addressed and more service providers should be trained. This would enable more Malawian women to use cervical screening services, enhancing early detection and treatment of cervical cancer and reducing the morbidity and mortality statistics related to this condition in Malawi. / Health Studies / D. Litt. et Phil. (Health Studies)

A quantitative, descriptive, explorative survey was conducted to explore and describe factors contributing to underutilisation of HIV testing services among tuberculosis patients and clients in Malawi. Sampled were 282 participants attending an outpatient clinic. A self administered questionnaire was used. The findings revealed that 80.5% of the respondents perceived themselves susceptible to HIV infection, 55% believed there were negative consequences of HIV Testing and Counselling (HTC), 87.6% perceived HTC had benefits, most of the respondents (76.8%) mentioned the benefit of knowing the HIV status helping one to plan life, 65% believed in themselves, that they could accept and undergo HIV testing with ease. The study recommends that all HTC providers be thoroughly trained in knowledge and skills to offer services with confidentiality and avoid stigma and discrimination of those found HIV positive. The importance and benefits of HTC should be emphasised in all behaviour communication messages / Health Studies / M.A. (Public Health)

Free cervical cancer screening services are provided in Malawi’s public healthcare institutionssince 1999. Few women aged 42 and older, utilise these services. Cervical cancer continues to be a major cause of morbidity and mortality among this group of women. Structured interviews were conducted with 381 women who attended three healthcare centers in Blantyre and semi-structured interviews with 14 nurse/midwives working at the same centers. The results for both phases arepresented within the Health Belief Model’s constructs. Phase 1 revealed that women had low levels of perceived susceptibility to cervical cancer. Although the interviewed women perceived cervical cancer to be a serious condition, they did not regard themselves to be at risk of suffering from cervical cancer. Knowledge that cervical cancer screening could detect this cancer at an early stage, embarrassment, stigma, social support, financial costs, traditional practices and available sources of information, influenced women’s intentions to be screened for cervical cancer. In phase 2, the nurse/midwives indicated that Malawian women lacked information about cervical cancer, available screening tests and the purpose of such screening.These women perceived cervical canceras being incurable and linked to witchcraft. Women’s utilisation of cervical screening services was hampered by barriers relating to healthcare institutions, women themselves and nurse/midwives. Local radio and television broadcasts, friends and nurse/midwives motivated individual women to use these screening services.Women preferred receiving information about cervical cancer screening during community activities. Health education should be intensified, nurse/midwives should be more empathetic, clinic days and hours should be extended. Misconceptions should be addressed and more service providers should be trained. This would enable more Malawian women to use cervical screening services, enhancing early detection and treatment of cervical cancer and reducing the morbidity and mortality statistics related to this condition in Malawi. / Health Studies / D. Litt. et Phil. (Health Studies)

A quantitative, descriptive, explorative survey was conducted to explore and describe factors contributing to underutilisation of HIV testing services among tuberculosis patients and clients in Malawi. Sampled were 282 participants attending an outpatient clinic. A self administered questionnaire was used. The findings revealed that 80.5% of the respondents perceived themselves susceptible to HIV infection, 55% believed there were negative consequences of HIV Testing and Counselling (HTC), 87.6% perceived HTC had benefits, most of the respondents (76.8%) mentioned the benefit of knowing the HIV status helping one to plan life, 65% believed in themselves, that they could accept and undergo HIV testing with ease. The study recommends that all HTC providers be thoroughly trained in knowledge and skills to offer services with confidentiality and avoid stigma and discrimination of those found HIV positive. The importance and benefits of HTC should be emphasised in all behaviour communication messages / Health Studies / M.A. (Public Health)

The aim of this study was to identify factors affecting facility-based delivery with the purpose of developing a framework for the promotion of facility-based delivery among women living in rural Ethiopia. Explanatory mixed methods design, comprising of four phases-the descriptive (quantitative), explorative (qualitative), meta-inference and development phases was employed. The quantitative phase was conducted first using a structured questionnaire to identify the variables influencing facility-based delivery care seeking behaviour. A sample of 389 responses were used for data analysis using Structural Equation Modeling. The quantitative phase conducted next to explain the determinants that contributed to influencing facility-based delivery care seeking behaviour. Sixteen participants who were involved the first phase were involved in the follow-up second phase. As illustrated by the results of the study, the majority of women in the study areas continued to deliver at home, putting themselves at risk of dying from pregnancy related causes. As highlighted by the key findings from the quantitative and qualitative data of this study, the most influential factors in predicting and explaining delivery care seeking behaviour are response efficacy, attitude, subjective norm, and perceived behavioural control which are shaped by mothers’ confidence in the outcome, quality of care, interpersonal relations with family members, willingness to conform, access to services, and their decision making power. The way these findings emphasized the factors attitude, subjective norm and perceived behavioural control were consistent with the Theory of Planned Behaviour, while the significance of response efficacy was in line with Protection Motivation Theory. The study developed a framework to help promote facility-based delivery among mothers living in rural Ethiopia. / Health Studies / D. Litt. et Phil. (Health Studies)

Cervical cancer remains the main source of mortality among women around the world. It is a burden in developing countries and generally recognized through the complications of the advanced stages. The aim of this study was to investigate the utilisation of cervical cancer screening services among women living with HIV in Hawassa in order to develop a strategy to enhance cervical cancer screening service utilisation among this population in Ethiopia. A quantitative approach with a cross-sectional study design was used in this study. The data were collected using a standard structured questionnaire from 309 women living with HIV attending health care facilities in Hawassa city Administration. Statistical Package for Social Sciences version 25 software was used to analyse data. The results are presented based on the Health belief Model’s construct. The result revealed a low utilisation of cervical cancer screening services. Knowledge and perception of cervical cancer and cervical cancer screening service were also low. The main reason for being not screened was feeling healthy, lack of awareness, and embarrassment. Knowledge of cervical cancer was affected by factors such as knowing someone with cervical cancer, educational status, and monthly income. The finding indicated that utilisation of screenings could be determined by composite knowledge, perceived susceptibility to cervical cancer, duration on Highly Active Anti-Retroviral Treatment and willingness to be screened. The findings of this study, findings from the literature review and relevant legislation guided the researcher to develop a strategy to enhance cervical cancer screening service utilisation among women living with HIV Ethiopia. Relevant recommendations were put forward to promote utilisation of strategy and also for future research. The utilisation of the developed strategy may improve the uptake of screening for cervical cancer, improve early diagnosis and treatment of cervical malignant growth, and decrease mortality among women living with HIV in Hawassa city organization. / Health Studies / Ph. D. (Public Health)

Text in English / This study aimed at exploring Barriers to compliance with exclusive breastfeeding and timely introduction of complementary feeding practices in Ofla District, Tigray Region in Ethiopia. A quantitative exploratory descriptive study was conducted to explore and describe the barriers that restrict mothers /caregivers to comply with exclusive breast feeding practice until six months and with introduction of solid, semi-solid and soft foods at six months in Ofla District. Data were collected using structured questionnaire, from a total of 112 samples of which 75 mothers and care givers with children aged 0-5 months and 38 children aged 6-8 months participated. The data were entered into a computer and analysed though the Statistical Package for Social Sciences (SPSS) software. The findings revealed that there are barriers related Doer mothers and Non-Doer mothers perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, cues for actions, perceived social acceptability and positive and negative attitudes towards exclusive breastfeeding and initiation of complementary feeding. On the other hand, the participant’s perception of both groups with regard to perception of Divine (God’s) Will on two child feeding practices was insignificantly the same. Both groups perceived that children could get sometimes malnourished because of spiritual or supernatural causes. / Health Studies / M.A. (Public Health)

Text in English / This study aimed at exploring Barriers to compliance with exclusive breastfeeding and timely introduction of complementary feeding practices in Ofla District, Tigray Region in Ethiopia. A quantitative exploratory descriptive study was conducted to explore and describe the barriers that restrict mothers /caregivers to comply with exclusive breast feeding practice until six months and with introduction of solid, semi-solid and soft foods at six months in Ofla District. Data were collected using structured questionnaire, from a total of 112 samples of which 75 mothers and care givers with children aged 0-5 months and 38 children aged 6-8 months participated. The data were entered into a computer and analysed though the Statistical Package for Social Sciences (SPSS) software. The findings revealed that there are barriers related Doer mothers and Non-Doer mothers perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, cues for actions, perceived social acceptability and positive and negative attitudes towards exclusive breastfeeding and initiation of complementary feeding. On the other hand, the participant’s perception of both groups with regard to perception of Divine (God’s) Will on two child feeding practices was insignificantly the same. Both groups perceived that children could get sometimes malnourished because of spiritual or supernatural causes. / Health Studies / M.A. (Public Health)