Women empowerment and the current use of long acting and permanent contraceptive: Evidence from 2010 Malawi Demographic and Health Survey

Background Both contraceptive use and fertility rates are high fertility in Malawi. Status of women remains low and is believed to affect reproductive health decisions including use of Long Acting and Permanent Contraceptives Method (LAPCM). Objective This study seeks to examine the relationship between women empowerment and LAPCM. A measure of women’s empowerment is derived from the women’s responses to questions on the number of household decisions in which the respondent participates, employment status, type of earnings, women’s control over cash earnings and level of education. Methods The study is based on a sub sample of 5,948 married women from the 2010 Malawi Demographic and Health Survey. Data was analysed using descriptive statistics, Chi-square and multinomial logistic regression models (α=5%). Results The prevalence of current use of LAPCM was 20.0% and increases with increasing empowerment level (p<0.001). Mean age and empowerment score of women who are currently using LAPCM were 38.53±6.2 years and 6.80±2.9 respectively. Urban women (22.2%) were more currently using LAPCM than rural women (19.4%) p<0.001. Women who belong to Seven Day Adventists/Baptist were 1.51(C.I=1.058-2.153; p=0.023) more likely and Muslims were 0.58(C.I=0.410-0.809; p=0.001) less likely to currently use LAPCM than Catholic women. Being in the richest wealth quintile (OR=1.91; C.I=1.362-2.665; p<0.001) promotes current use of LAPCM than poorest. The likelihood of currently using LAPCM was higher among women who have access to FP programmes on media and increases consistently with increasing women empowerment level even when other potential confounding variables were used as control. Conclusion In Malawi, LAPCM is still underutilized and more than half of the women are not adequately empowered. Women empowerment, wealth quintile and access to FP programmes are key factors influencing the use of LAPCM. Programmes that address these determinants are urgently needed in Malawi.

A PRELIMINARY SURVEY OF ANIMAL HANDLING AND CULTURAL SLAUGHTER PRACTICES AMONG KENYAN COMMUNITIES: POTENTIAL INFLUENCE ON MEAT QUALITY

Kenya is composed of over 40 ethnic communities who practice varied methods of animal handling and slaughter. Socio-cultural and religious traditions have the potential to influence animal handling and slaughter practices. These influences have, however, not been documented in the literature as far as the author is aware. Also, the literature has documented the connection between the manner of animal treatment and meat quality, but this is rarely discussed in the literature in Kenya; this connection is important as it informs modern meat trade practices by Kenyans as they trade in the global arena. This survey aimed to mainly establish and document the animal slaughter practices among Kenyan communities, and, to also highlight any current provisions related to meeting modern animal welfare requirements, animal handling procedures in the meat trade and discuss their potential influence on meat quality available in commerce in Kenya. This preliminary study surveyed the slaughter practices among 10 different Kenyan communities through a semi-structured questionnaire, focus group discussions and individual interviews. The survey demonstrated that different Kenyan communities practice varied methods of animal slaughter depending on whether the animal being slaughtered is for public feasting, domestic consumption or commercial merchandizing. The Kenyan communities surveyed in this study depend mainly on males to slaughter livestock for females preparing it for domestic use using a number of instruments and methods. For small stock for domestic consumption, females may slaughter the animal except for Muslims whose males have to slaughter the animal with a special knife (a Khalef) according to Muslim rites to render it Halal. Large stock is invariably slaughtered by males irrespective of the community, and the manner of use of the carcass. Gender, age, religion, community and the size of the animal were the major determinants of the method of animal slaughter. The animal welfare issues highlighted in the survey and related to the handling and slaughter of livestock have important implications for meat quality during commercial merchandizing. There is an apparent need to provide education to herders, livestock handlers, employees and management in the livestock industry in Kenya on the relationship between animal welfare requirements, animal handling procedures and meat quality. Such awareness can potentially improve the quality and economic value of the meat available in commerce.

Community pharmacists’ understanding, attitudes, practice and perceived barriers related to providing pharmaceutical care: a questionnaire-based survey in Macao

Purpose: To explore the knowledge, attitudes, practice and perceived barriers of community pharmacists regarding provision of pharmaceutical care as well as provide recommendations on how to advance the service during the early stage of development in Macao. Methods: A questionnaire comprising 10 items was used to collect respondents’ demographic information and to evaluate their understanding of pharmaceutical care, attitude towards service provision, current practice and perceived barriers. Descriptive and comparative analysis of the results was conducted. Results: While 95 % of the participating pharmacists agreed that patients’ health was their primary responsibility, only 57 % believed that they can provide better pharmaceutical care in the future. The majority spent most of their work time counselling patients (90 %) and checking prescription (70 %). Only a small portion monitored adverse drug reaction and drug compliance (44 %), engaged in health screening or drug safety promotion (20 %) or maintained patient medication records (4 %). Insufficient communication with physicians (90 %), lack of time (79 %) and lack of physical space at the pharmacy (76 %) were considered the most significant barriers. Conclusion: A suboptimal level of pharmaceutical care is provided by pharmacists in Macao. Considering the barriers identified and integrating other country experiences, establishing an enabling atmosphere using policy and regulatory measures is the fundamental element for advancing pharmaceutical care by community pharmacists.