http://hdl.handle.net/123456789/875 Articles available 2026-04-13T16:00:06Z 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/123456789/986 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