The aim of this study was to describe the clients' satisfaction with Primary Health Care (PHC) Services in Lilongwe Health District with regard to client involvement in health care delivery and the accessibility of PHC services. It was hoped that the information generated would be used in the evaluation of PHC Services in Lilongwe. A quantitative and qualitative research was done using an outcome analysis evaluation design. The study utilised Kawale and Chiwamba Health Centres and their catchment population. Systematic random sampling was used for the clients making use of the health centres, convenience sampling for those not using the health centres and purposive sampling for the focus group participants. Quantitative data was collected using self-administered questionnaires while qualitative data was collected using an interview guide in focus group sessions. Quantitative data was analysed using SPSS and percentages and frequencies were calculated while qualitative data was analysed through a template style of analysis. The findings of the study revealed that in both Health Centres Clients were satisfied with some aspects of PHC such as, cultural accessibility, health education and listening abilities of health workers but there was still some evidence of dissatisfaction, and misunderstanding of the concept of Community Involvement in Health care delivery. This calls for a need to reorient communities on PHC delivery and what it means. / Thesis (M.N.)-University of Natal, Durban, 2004.

Participation in development is not a new concept as over the years, facilitators of development have realized that meaningful development can only be achieved when the people concerned take part in decision making and implementation of activities affecting them. This study was done to examine the extent to which child participation is being achieved in a development programme area, facilitated by World Vision Malawi, a Non Governmental Organization. The study was done in Chata Area development programme (ADP) located in T/A Chimutu in Lilongwe district. Children are defined as any person below the age 18. The study used mixed methods approach in which quantitative and qualitative approaches were used. Through random and purposive sampling, 110 children and 105 adults were interviewed using a questionnaire. Focus group discussions and key informant interviews were also done to supplement information collected through the questionnaires. Analysis of the quantitative data collected was done using Scientific Package for Social Scientists (SPSS) tool while the qualitative data was analyzed manually using common themes that emerged from the findings. The findings of the study show that despite the many development activities in Chata area participation of children has been limited. Adults look down upon children as a minority group which cannot meaningfully participate in development activities. Furthermore, the study found such factors as cultural and traditional practices, gender, level of education and other household characteristics to be the major barriers to children‟s participating in development activities. Surprisingly, the findings further indicate that much as the programme has been engaged in advocacy activities, these have focused more on creating awareness on child protection only rather than child participation. The study argues that if children will have to sustain the development gains in communities such as Chata, then they equally need to participate in the development process to enhance their future capacities in related development activities. On the overall, therefore, the study recommends that there is a need to create awareness on the adults to change attitude when they look at children and begin to create room for children to participate in the development process in an age appropriate manner. There is a need to create systems and structures that will enable children be included in the decision making process while building their capacity and self esteem. / Development Studies / M.A. (Development Studies)

Participation in development is not a new concept as over the years, facilitators of development have realized that meaningful development can only be achieved when the people concerned take part in decision making and implementation of activities affecting them. This study was done to examine the extent to which child participation is being achieved in a development programme area, facilitated by World Vision Malawi, a Non Governmental Organization. The study was done in Chata Area development programme (ADP) located in T/A Chimutu in Lilongwe district. Children are defined as any person below the age 18. The study used mixed methods approach in which quantitative and qualitative approaches were used. Through random and purposive sampling, 110 children and 105 adults were interviewed using a questionnaire. Focus group discussions and key informant interviews were also done to supplement information collected through the questionnaires. Analysis of the quantitative data collected was done using Scientific Package for Social Scientists (SPSS) tool while the qualitative data was analyzed manually using common themes that emerged from the findings. The findings of the study show that despite the many development activities in Chata area participation of children has been limited. Adults look down upon children as a minority group which cannot meaningfully participate in development activities. Furthermore, the study found such factors as cultural and traditional practices, gender, level of education and other household characteristics to be the major barriers to children‟s participating in development activities. Surprisingly, the findings further indicate that much as the programme has been engaged in advocacy activities, these have focused more on creating awareness on child protection only rather than child participation. The study argues that if children will have to sustain the development gains in communities such as Chata, then they equally need to participate in the development process to enhance their future capacities in related development activities. On the overall, therefore, the study recommends that there is a need to create awareness on the adults to change attitude when they look at children and begin to create room for children to participate in the development process in an age appropriate manner. There is a need to create systems and structures that will enable children be included in the decision making process while building their capacity and self esteem. / Development Studies / M.A. (Development Studies)

The government of Malawi established the community based childcare (CBCC) programme with the aim of addressing early childhood problems and achieve national development in the long run. The CBCC programme, as one of the approaches to early childhood development (ECD), is guided by the national early childhood development policy. It promotes some practices that somehow deviate from the traditional childcare ways that communities have always known. Experience has shown that programmes that have elements of conflict with commonly held beliefs are bound to meet with resistance in society. The study employed a mini survey, focus group discussion, observation and document review to understand how the CBCC childcare practices in Malili intersect with commonly held beliefs about childcare as well as how they reflect on the national ECD policy. The study also focused on understanding the perceptions of community members on the CBCC programme. The study revealed that while some aspects of CBCC delivery conform to commonly held beliefs about childcare in the area under study, others diverge from such beliefs. Such convergence and divergence appear to be in line with the propositions of transformalist globalisation theory- one of the perspectives adopted for the study. The study also found that care practices at CBCC are not a true reflection of the national ECD policy as community members’ perceptions, poor community participation, poverty and lack of caregiver training in ECD contribute towards poor quality of care in CBCC, contrary to what is defined in the national ECD policy. The study also found that while both CBCC caregivers and sampled community members perceived the quality of care at the centers as poor, caregivers had a more positive perception towards the CBCC than community members. The study indicated that CBCC are centres of desperation for low economic status communities. Findings from the research have revealed that cultural values and commonly held beliefs, and exposure to new knowledge through globalisation play a role in determining childcare practices as well as perceptions towards them. In this sense the study has indicated that meanings that communities attach to development interventions influence their actions and perceptions towards it.