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Biomedical subjects

Adamson S Muula

Publications and source records attributed to Adamson S Muula.

At least 19 recordsLinked to original sources
PubMed2006

Tobacco use among high school students in a remote district of Arua, Uganda.

INTRODUCTION: Tobacco smoking is a risk factor for several non-communicable public health problems including cancer, ischaemic heart disease and chronic obstructive airways disease. The prevalence of smoking among adolescents and the associated environment deserve attention. METHODS: A cross-sectional descriptive study was carried out in 2001 to determine the prevalence of tobacco smoking, exposure to advertisements, environmental tobacco smoke exposure, deterrents from smoking and perception about smoking among high school students in a remote district of Arua, north-western Uganda. RESULTS: In total 1528 high school students participated in the study of which 21.9% were current smokers and 33.1% had ever used tobacco products. When the data were stratified according to sex, 81/452 (17.9%) females and 337/871 (38.7%) males had ever smoked (p <0.05). With regard to current smoking, defined as having smoked at least once in the past 30 days, 12.2% of females (55/452) and 25.5% males were current smokers. Approximately one-tenth perceived themselves as likely to initiate smoking within the next 12 months. Just under half (47.3%) were exposed to environmental (passive) smoking in the home and 19.4% of current smokers usually smoked at home. Approximately 60% of smokers had obtained tobacco from grocery stores and they had never been prevented because of their age. Media exposure to tobacco advertisements was high. CONCLUSION: Many young people in Arua, Uganda, were current smokers and exposed to environments that seemed to facilitate uptake of tobacco smoking and other tobacco use. This could be explained in part, by the fact that the district relies heavily on tobacco farming and exposure to facilitating environments is common. A concerted public health response is urgently required that will effectively alter the home and societal environment so as to discourage uptake of tobacco use by young people.

Adolescent↗
PubMed2006

The financial losses from the migration of nurses from Malawi.

BACKGROUND: The migration of health professionals trained in Africa to developed nations has compromised health systems in the African region. The financial losses from the investment in training due to the migration from the developing nations are hardly known. METHODS: The cost of training a health professional was estimated by including fees for primary, secondary and tertiary education. Accepted derivation of formula as used in economic analysis was used to estimate the lost investment. RESULTS: The total cost of training an enrolled nurse-midwife from primary school through nurse-midwifery training in Malawi was estimated as US$ 9,329.53. For a degree nurse-midwife, the total cost was US$ 31,726.26. For each enrolled nurse-midwife that migrates out of Malawi, the country loses between US$ 71,081.76 and US$ 7.5 million at bank interest rates of 7% and 25% per annum for 30 years respectively. For a degree nurse-midwife, the lost investment ranges from US$ 241,508 to US$ 25.6 million at 7% and 25% interest rate per annum for 30 years respectively. CONCLUSION: Developing countries are losing significant amounts of money through lost investment of health care professionals who emigrate. There is need to quantify the amount of remittances that developing nations get in return from those who migrate.

Journal Article↗
PubMed2006

How are health professionals earning their living in Malawi?

BACKGROUND: The migration of health professionals from southern Africa to developed nations is negatively affecting the delivery of health care services in the source countries. Oftentimes however, it is the reasons for the out-migration that have been described in the literature. The work and domestic situations of those health professionals continuing to serve in their posts have not been adequately studied. METHODS: The present study utilized a qualitative data collection and analysis method. This was achieved through focus group discussions and in-depth interviews with health professionals and administrators to determine the challenges they face and the coping systems they resort to and the perceptions towards those coping methods. RESULTS: Health professionals identified the following as some of the challenges there faced: inequitable and poor remuneration, overwhelming responsibilities with limited resources, lack of a stimulating work environment, inadequate supervision, poor access to continued professionals training, limited career progression, lack of transparent recruitment and discriminatory remuneration. When asked what kept them still working in Malawi when the pressures to emigrate were there, the following were some of the ways the health professionals mentioned as useful for earning extra income to support their families: working in rural areas where life was perceived to be cheaper, working closer to home village so as to run farms, stealing drugs from health facilities, having more than one job, running small to medium scale businesses. Health professionals would also minimize expenditure by missing meals and walking to work. CONCLUSION: Many health professionals in Malawi experience overly challenging environments. In order to survive some are involved in ethically and legally questionable activities such as receiving "gifts" from patients and pilfering drugs. The efforts by the Malawi government and the international community to retain health workers in Malawi are recognized. There is however need to evaluate of these human resources-retaining measures are having the desired effects.

Attitude of Health Personnel↗
PubMed2006

Condom and sexual abstinence talk in the Malawi National Assembly.

BACKGROUND: Correct and consistent use of condoms has been reported as effective in the prevention of transmission of HIV. There have been many studies reporting on attitudes (perceptions) of communities on condoms and other aspects of HIV and AIDS and yet there is paucity of data on the perception towards condoms and abstinence by law makers. OBJECTIVE: To determine perceptions of Members of Parliament in Malawi towards condoms. METHODS: A qualitative study utilising parliamentary Hansards to describe the discussions about condoms and abstinence in the National Assembly 1999-2004. Content and discourse analyses were used. RESULTS: In general, Members of Parliament had negative attitudes towards extra- and/or pre-marital sexual intercourse, condom promotion and use. Sexual abstinence amongst non-married persons was preferred as opposed to condom use. Condom use was not perceived as an effective way of controlling the spread of HIV. Some MPs though called for a change in mind-set so as to allow use of condoms in prisons, in order to prevent transmission of infection from prisoners to the general community once the prisoners were released. CONCLUSION: This study confirms that health interventions such as condoms are not perceived neutrally and may be construed as the enemy of society.

Adult↗
PubMed2006

Nationality and country of training of medical doctors in Malawi.

BACKGROUND: There is growing interest in the migration of doctors from Africa to developed nations. Little attention has been made in understanding the flow of doctors into African countries. OBJECTIVE: To describe the nationality, country of primary qualification as a doctor and specialties of doctors registered in Malawi in 2003. METHODS: Review of Medical Council of Malawi 2003 register and University of Malawi-College of Medicine graduation records. RESULTS: There were 252 doctors registered by the Medical Council of Malawi (MCM) of whom 51.2% were Malawian and 48.8% non-Malawian. 35.7% of the doctors had obtained their primary education in Malawi, 17.5% from the UK, 9.9% other African countries and 8.7% from other African countries. There were 72 specialists of whom 23 were Malawian nationals and 49 were non-Malawians. CONCLUSIONS: There is almost an equal distribution of national and non-national doctors in Malawi. However, among specialists, non-national far out-number Malawians by over two and a half times. While the brain drain of doctors from developing nations to developed nations has received interest, there is need also to explore the migration of doctors into resource-poor countries such as Malawi.

Career Choice↗