In this mixed-methods implementation study, routine immunization and family planning services were integrated across health facilities and community sites across two rural districts in Malawi, Dowa and Ntchisi. The total number of women accessing family planning services during the study period increased by 14% while DPT immunization rates for children remained consistent. In interviews, parents and providers found the integration of family planning and immunization services to be feasible and beneficial, indicating a win-win for both services.
The use of antenatal care (ANC) services among pregnant adolescents in low- and middle-income countries, including tetanus toxoid vaccination, was lowest among women who lived in rural areas, had completed less education, and who were of poorer wealth quintiles.
In rural Malawi, even though medical care for cholera is free-of-charge in the public sector, more than half of families had to borrow money or sell livestock or other assets to compensate for the lost wages of patients or caregivers and other costs (such as for food and transportation) incurred as a result of an episode of cholera.
An analysis of the impact of rotavirus vaccine in 25 countries found that the rates of vaccination in all countries were highest and risk mortality lowest in the top two wealth quintile’s coverage. Countries differed in the relative inequities in these two underlying variables. Cost per DALYs averted in substantially greater in the higher quintiles. In all countries, the greatest potential vaccine benefit was in the poorest quintiles; however, reduced vaccination coverage lowered the projected vaccine benefit.
In a systematic literature review of studies in Africa, it was found that 25% of children who survived pneumococcal or Hib meningitis had neuropsychological deficits.
A systematic literature review analyzing data from 21 African countries revealed that bacterial meningitis is associated with high case fatality and frequent neurophysiological sequelae. Pneumococcal and Hib meningitis contribute to one third of disease related mortality. They also cause clinically evident sequalae in 25% of survivors prior to hospital discharge. The three main causes of bacterial meningitis- Haemophilus influenzae type B; Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are vaccine preventable, routine use of conjugate vaccines have potential for significant health and economic benefits.
Neuropsychological sequelae includes hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delays/impairment, and seizures.
In Malawi, in 17% of cases where children were admitted to the hospital, and in 9% of cases where children were treated as outpatients for diarrhea, household costs associated with treating that episode, exceeded monthly income in a significant number of cases. The costs were significant enough to push families from each income level below the national poverty line for the month in which the illness occurred.