http://hdl.handle.net/123456789/874 2026-04-13T15:54:51Z http://hdl.handle.net/123456789/1001 Communication Factors Influencing Antiretroviral Therapy Non-Adherence Among Test And Start Clients In Zomba District, Malawi Nantchito, Adson Victor Malawi adopted test-and-start approach for initiating HIV diagnosed clients on antiretroviral therapy (ART) in HIV management in 2016. Despite notable improvements in ART coverage, adherence still remains suboptimal. A cross sectional convergent parallel mixed methods study was conducted amongst 325 test and start clients and 68 health workers and expert clients in Zomba District, to assess communication factors contributing to non- adherence. Quantitative data were collected using a structured questionnaire. Qualitative data was collected using topic guides for FGDs, KIIs and IDIs. Logistic regression was used in quantitative data analysis to test associations. Thematic analysis was used to analyse qualitative data. Despite lack of quantitative evidence that communication factors influence adherence, qualitative results showed that they in fact do. The following intra-personal factors had potential to influence nonadherence: lack of knowledge about test and start, hearing about test and start for first time at hospital, health feeling, denial and negative attitude towards test and start. Interpersonal communication factors such as disclosure, poor quality counselling, not freely talking about ART had potential to influence non-adherence. Only one factor, follow up calls by health worker, was significantly associated with adherence (OR=1.787, 95% C.I:1.410-2.513). Social cultural factors such as poverty and prolonged time spent at health facility potentially influence non-adherence. Long distance to health facility did not influence non-adherence but rather encouraged privacy of clients. Communication about test-and-start should begin at community level. For effective adherence, other media of communication such as radio, television and posters, should also be emphasized in communicating ART test and start messages. Health workers should ensure that clients are well educated on the importance of test and start prior to ART initiation. A system to follow up ART clients with missed scheduled appointments should be strengthened to enhance adherence. A Thesis Submitted to the Department of Language and Communication, Faculty of Education and Media Studies, in Partial Fulfillment of the Requirements for a Master of Arts Degree in Health and Behaviour Change Communication (MHBCC) 2021-06-01T00:00:00Z http://hdl.handle.net/123456789/991 An Assessment Of Malawian Smallholder Farmers’ Readiness To Start Using Fee-Paying Digital Media For Extension Service Delivery Mulomole, Augustine Sinforiano Digital media for extension service delivery are currently being utilized by smallholder farmers in Malawi, at subsidized rates. Digital extension service delivery in Malawi has for a long time, been championed using subsidies from the donor agencies such as the Government of Flanders, the World Food Programme (WFP), the United States Agency for International Development (USAID) and GIZ. Currently, three institutions in Malawi are running the farmers’ call centre: Farm Radio Trust (FRT), the Agriculture Commodity Exchange (ACE), and Airtel Malawi. Malawi’s annual budget, however, depends on foreign aid, which accounts for around a quarter of the annual income. Since donor support has not been very steady, funding for extension service delivery in Malawi continues to dwindle, as evidenced by the annual budgetary allocation vote no. 190 for the Ministry of Agriculture, which has been getting smaller every financial year. The dwindling funding for the extension service delivery in Malawi is a signal that indicates the need to start seeking funding from other sources. This study, therefore, was motivated by this general donor fatigue which could hit the extension service delivery in Malawi, specifically digital extension. A sample of 782 smallholder farmers that were already exposed to digital media for extension service in Nkanakhothi Extension Planning Area (EPA) in Kasungu district in central Malawi, and Malosa EPA in Zomba district in southern Malawi, participated in this quantitative study by completing a closed-ended questionnaire. The descriptive method of data analysis was conducted, using IBM® SPSS® statistics version 22. Farmers reported higher levels of awareness about the existence, usage and knowledge about the benefits they got from using the digital media for extension services, their capacity to access agricultural content using the digital platforms, and their readiness to start using fee paying digital media for extension services. A Pearson correlation coefficient was computed to assess the linear relationship among the variables of awareness, knowledge and capacity, with readiness as a dependent variable in the study, and it found that there was a significant positive correlation between the capacity of the farmers and their readiness to start accessing agricultural content using fee-paying digital media. The main findings of the study, therefore, were that farmers in Malawi were ready for the introduction of fee-paying digital extension services, with those having enough financial capacity indicating more readiness and willingness than those with less capacity. A Dissertation Submitted to the Department of Journalism and Media Studies, Faculty of Education and Media Studies, in Partial Fulfillment of the Requirements for the Award of the Master of Arts degree in Media Studies. 2024-04-01T00:00:00Z http://hdl.handle.net/123456789/986 An Evaluation Of The “Ndife Otsogola” Voluntary Medical Male Circumcision (Vmmc) Communication Brand In Relation To Vmmc Uptake In Dowa, Malawi Phiri, Alvin Chidothi Since the Human Immune Deficiency Virus (HIV) was discovered in Malawi in 1985 it has continued to spread within different sub groups in the country. To curb the spread, there have been a number of interventions including Voluntary Male Medical Circumcision (VMMC). In order to popularize the procedure, branding of VMMC intervention was done using the “NDIFE OTSOGOLA” logo. Since the branding was done, the effectiveness of the brand has not been evaluated. This qualitative study was aimed at evaluating the brand’s influence on the uptake of VMMC in traditionally non-circumcising rural areas like in Dowa district which started providing VMMC services in 2012. Theory of Planned Behavior (TpB) constructs were used to develop data collection tools. Interviews were done with purposely sampled 34 respondents using In Depth Interviews, and 29 respondents using two Focus Group Discussions in three selected health facilities’ catchment areas. The interviews were tape recorded, transcribed and coded according to themes. The analysis revealed that awareness levels of the brand was very low although the brand had been in existence for seven years by the time of the study. The brand could not be recalled by over three quarters of the participants. The small portion able to recall mentioned that the brand informs them of the availability of VMMC services in the district and it was meant to assist them make an informed choice. Most women mentioned that they were reminded that they would be protected from developing cervical cancer in future. The majority also mentioned that the brand could play a part in decision making processes, promote readiness and motivate target groups to go for VMMC if they are exposed to it constantly. Despite some positive perceptions and attitudes towards VMMC among males and females, there still remained some pockets of negative perceptions and misunderstandings affecting uptake of VMMC services in the district arising from cultural norms. The findings also showed that peers could be an important influence in motivating men to seek VMMC services in rural areas. The study recommends that Health Workers in the district should ensure that the community members are constantly exposed to the brand on VMMC, and that visibility of the brand should be enhanced by using a mix of channels, not just the Health Office branded vehicle and posters as was the case at the time of the study to improve uptake of VMMC services in the district. A theses in partial fulfillment of the requirements for the award of a degree of Master Of Arts In Health And Behaviour Change Communication 2004-01-13T00:00:00Z http://hdl.handle.net/123456789/952 Students’ perception towards the introduction of Open and Distance learning in technical Colleges in Malawi Nothale-Liwambano, Ptricia The study was conducted to assess students’ perceptions towards the introduction of Open and Distance Learning (ODL) as a mode of teaching and learning in technical colleges. Using questionnaires which were administered at Soche, Nasawa and Lilongwe technical colleges. Data were collected from three random selected technical colleges. A total of 90 questionnaires were sent and 71 were returned. Students were selected through simple and systematic random sampling techniques. Data gathered from closed ended questions were tabulated into Statistical Package for Social Scientist (SPSS). Data gathered from open ended survey questions were categorised and brought up themes and sub themes. The key findings revealed that students perceive ODL as an alternative educational mode in technical colleges. Students perceived face-to-face contact as an important element in the teaching and learning process. However, they showed a positive perception towards ODL because of its flexibility in terms of time, space, pace and geographical location of students. These findings give insight to TEVETA and other open and distance learning institutions to take into consideration the possibility of offering technical courses through ODL or including ODL as a mode of delivery in technical colleges in order to increase access to technical and vocational education. In addition, scholars in the field of technical and vocational education may carry out further research in technical colleges to establish whether other colleges have the similar perception about ODL if introduced in technical colleges. A Thesis submitted to the Department of Technical Education, Faculty of Education and Media studies, in partial fulfilment of the requirements for the degree of Master of Technical and Vocational Education 2017-03-01T00:00:00Z