Health Policy and Planning Assignment

This assignment focuses on health policy and planning within the context of Malawi. Students are expected to analyze various research studies exploring decentralization of antiretroviral therapy, maternal health outcomes, newborn care practices, women's perceptions of healthcare quality, and methodological approaches used in these studies. The analysis should highlight key findings, implications for policy and practice, and potential areas for further research.

Dissertation briefing

ABSTRACT
Around the world, there are different type of developments that are taking in place. With
the advancement in technology people are able to develop their knowledge and understanding
towards different areas. However, there are places were government are not able to deliver with
proper services. There are places were people do not have proper knowledge and understanding
related with health and the change that has taken place around the world. Another set of issues is
related with ineffective food security and due to this, adults and children are getting negatively
affected in relation with their growth. In this present research Zomba district is taken in to
consideration. This district is located at Southern Malwi. More specifically, there are about 230
persons per Km2, in this 52.6% are below 18 years. Present report is about resilient system which
has the capacity to respond positively to change, maintaining or improving function; this
includes monitoring, anticipating and managing known risks and vulnerabilities to existing
shocks and stresses while being able to address uncertainties in the future. This research aims at
assessing the impact of resilience building programmes on food security in the southern Malawi
at zomba district.

Table of Contents
ABSTRACT.....................................................................................................................................2
BACKGROUND INFORMATION................................................................................................1
Framework of analysis.....................................................................................................................4
Challenges anticipated.....................................................................................................................5
Limitation of the planned work........................................................................................................5
List of proposed chapters.................................................................................................................6
Expected Results..............................................................................................................................6
Gantt Chart.......................................................................................................................................6
REFERENCES................................................................................................................................9

BACKGROUND INFORMATION
Between 2003 and 2013, disasters caused by natural hazards caused USD 1.5 trillion in
damages worldwide (FAO 2015). In developing countries alone, estimated damages from these
disasters amounted to about USD 550 billion and affected 2 billion people. Such disasters
undermine national economic growth and development goals, as well as the growth and
sustainable development of the agriculture sector (Landes, van Lettow and Bedell, 2012).
Despite this, there is as of yet little clear understanding of the extent and nature of the economic
impact of disasters on the agriculture and food security sectors. Alongside providing
humanitarian assistance to the affected population, humanitarian actors are in recent times also
giving significant focus on preparedness and recovery initiatives. Given the relatively recent
emergence of the concept of resilience within the humanitarian and wider development
community, there is scarcity of robust, verifiable evidence of the impact these programmes
seeking to build resilience are having on the targeted populations (Zimba, Kinney and Nyasulu,
2012). One major milestone in achieving resilience at a significant scale is the ability to measure
its outcomes at the household, community and national levels. Much as it is believed that
resilience building programmes contribute significantly towards the shift from food insecurity to
sustained food security, empirical evidence is needed that illustrates what factors consistently
contribute to resilience, to what types of shocks and in what contexts. While various models for
measuring resilience are currently under development, not much evidence has been provided to
quantify how resilience building programmes changes the lives of the targeted populations
(Chan, Mateyu and van Lettow, 2010). This is partly due to the fact that resilience is inherently
difficult to measure. Nonetheless, such information is critical for assessing the relative potential
of different approaches to building resilience in the face of recurring shocks.
Nutrition and Resilience concepts are strongly interlinked: nutrition is both an input to
and an outcome of strengthened resilience. Previous analyses of fragility and programming
experience suggest throughout the Malawi's district Zomba strongly suggest that programming
intended to enhance resilience is most necessary and appropriate where the following factors are
present: chronic vulnerability to food insecurity, and recurrent exposure to livelihood shocks and
stresses. There is a long history of poor nutrition to children's at Malawi. Lack of nutrition also
has long term effect over health. With this respect, it includes memory deficiencies, stunted
height and limited developmental delays (Landes, van Lettow and Schouten, 2012). Main reason
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for micronutrient and malnutrition deficiencies are commonly found in Malawi and the main
reasons behind this is insecurity of food, lack of rain, that causes low agricultural production and
burden of poverty.
“A resilient system has the capacity to respond positively to change, maintaining or improving
function; this includes monitoring, anticipating and managing known risks and vulnerabilities to
existing shocks and stresses while being able to address uncertainties in the future. Change and
responses may be incremental or transformational.” Disaster resilience has been described as
both an outcome and process. Practices focused on outcome are have tended to adopt top down
approaches and the process involves supporting the capacity of individuals to adapt through
assets and resources. At the Zomba District, there are different type of disasters occurred and that
has raised issues and it becomes difficult to survive in that region by the local people. In spite of
disaster, there are various other type of problems that are faced by people due to which a healthy
and normal life is difficult for the local people. One of the issues is related with the agriculture as
people are not able to get proper nutrition food. In order to overcome the problem of nutrition,
there are various communities that are helpful to develop people so that they will be able to
reduce the negative issues and problems related with health. More than 200 million children
under the age of 5 are continuously suffering from nutrition deficiencies and malnutrition-al
problems caused due to There is a program called early childhood development (ECD) which is
started by Save the Children aims at providing child with proper nutritious food and educating
families so that avoid the procedures that affects the health in negative manner. These service are
provided at CBCC (community-based childcare centers) and this community is helpful enough to
raise the parental and community involvement (Callaghan-Koru, Nonyane and Baqui, 2013). In
this context, parents and children are provided with nutritious meal that cooked and it is provided
to parents and same procedure is being followed by parent at homes and they provided child with
nutritious food. Further, due to early childhood development, there are different type of issues
that are being faced. In this context, one of the main issue is related with reduced life span. The
average life span that is expected is getting reduced and the main cause of this problem is due to
non healthy food that is consumed by children at Malawi.
Around the world, specially in rural areas there are different type of issues that they face.
In this context, the issues are related with market volatility, climatic changes, political unrest.
With this respect, with the increase in concept of resilience, it used in order to make development
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in which they focus on developing building, so that they will be able to make improvement in the
living condition of people. This way people are transformed to adapt and to cope up with the face
of stressors and shocks. When considering the area of food and security, there are number of
issues and problems. Food is prepared when there is proper rainfall and cultivation which is not
there at this region. At Malawi there is low rainfall and it important to make them training so that
they make use of the rain fall they get and make effective cultivation. Low rainfall can be
determined as one of the main challenge as it slows down the harvesting process (Kumbani,
Chirwa and Bjune, 2012). Another set of aspect that is considered is saving and storing of food.
Save the Children also make sure that all the people are provided with proper training so that
they will be able to store food. For this disaster risk reduction an food security aims at scaling up
enhancing the resilience of livelihoods against threats and emergencies to ensure the food and
nutrition service of vulnerable farmers, fishers, herders, foresters and other at risk groups.
Aim:
“To assess the impact of resilience building programmes on food security in the southern Malawi
zomba district”
Objectives:
 To quantify the magnitude of resilience programs being implemented SC in southern
Malawi zomba district
 To understand the food security trends of the targeted populations in the southern Malawi
zomba district
 To analyze the understanding of resilience building by different stakeholders and
beneficiaries To recommend way through which health related issues can be solved.
Research Questions:
 What are the magnitude of resilience programs being implemented SC in southern
Malawi zomba district ?
 What are the food security trends of the targeted populations in the southern Malawi
zomba district ?
 What is the understanding of resilience building by different stakeholders and
beneficiaries ?
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Framework of analysis
This a part of dissertation that enables to provide the research clear understanding about
the type of analysis and framework that will be followed through which the current research can
be conducted in an effective manner. Below given are the different steps that will be followed:
Research design: This is helpful enough to assess the materials, figures and facts that will
be selected in conducting the research. In this context, it includes correlation, exploratory, case
study, analytical, descriptive, etc. (Flood, 2010). As per the present research, investigator has
made use of descriptive research design that is helpful to collect the information and facts that
makes to explain the existing phenomenon. Further, it also assesses to conduct the structure for
questionnaire which enables to focus over the information and data.
Research philosophy: It enables to determine the way with the help of which data will be
collected or gathered and examined. These are of two different terms through which it is denoted
and they are doxology and epistemology. Further, this is of two type which are positivism and
interpretivism (af Wåhlberg, 2012). Among these two, positivism is applied as it helps to provide
flexible research framework. In addition to this, it also helps the researcher have confidence over
the data that is being collected.
Research approach: These are of two types and they are deductive and inductive.
Inductive research approach is applied when the nature of research is of qualitative. On the other
hand, for quantitative nature of research, investigator make use of deductive approach. Among
these two inductive research is considered as the qualitative is the nature of current research.
This will help to determined the perception of responded and they will be helpful enough to
come up with and appropriate outcome.
Sampling: The areas of research to be collected is from Malawi and it is difficult to
conduct the research of large population. As per the research, the respondents will be parents
who will be aspected question that will help to come up with an appropriate outcome for the
research. Further, random sampling method will be used to select the most suitable sample.
Further, the sample will be collected from parents and for this purpose, the sample size will be
20. Questionnaire will be developed in order to get proper information.
Data collection: There are two different method with the help of which data is collected.
In this context, it includes primary and secondary methods. Among these two, research will
make use of both methods. In order to collect primary information, questionnaire will be made in
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which al the those questions will be included that covers the research objectives. On the other
hand, secondary information will be collected with the help of books, articles, journals, online
websites, etc. (Dickinson, Freiberg and Barnes, 2011). Both these methods will enable to gather
adequate information though which the research can be conduct in an effective manner.
Data analysis: When data collected, then it is also important to present it effectively and
efficiently. It is difficult yo understand the information and form it into a meaningful source. For
this purpose, research will make use of thematic as it is helpful enough to present the information
effectively and efficiently. With the help of thematics, investigator is able make use of graphs,
tables, etc. and these are helpful to make the viewers understand the data collected.
Challenges anticipated
In order to conduct the research, there are different type f issues that are being faced by
the researcher. In this content, below given are the changes faced in conducting the research:
Communication: In order to collect information, it is essential to make sure that all the
respondents are provided with proper information so that they will be able to understand the
importance and provide their valuable information. Perception of people will help to know the
impact of health and the services that are reaching them. Further, majority of people at Malawi
are not literate and so that questionnaire included in the questionnaires had to be told and then
the response has to be take. This is a type of challenge that will be faced in conducting the
research.
Reaching out respondents: It is important to make proper understand about the type of
information that is being collected so that they will provide adequate information for the same.
Limitation of the planned work
There are different type of limitations that are faced in the research and they are as
follows:
Cost: High cost s involve in order to reach out all the respondents and to gather
appropriate information. It becomes a type of limitation when the cost is not appropriate. In order
to list out the activities, it requires cost to be set out for each of the activity and if it is not done,
then it has negative impact over the research to complete.
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Time: To make all the respondents understand about the questions involved in
questionnaire will consume time and there is a speculated time period planned and if it is nt
properly managed, then the time period will exceed.
List of proposed chapters
There are different type of chapter that will be involved and they are as followed:
Chapter 1: Introduction- It provides proper overview of the research and the objectives
and aim that will be covered. It provides detailed description about the study.
Chapter 2: Literature review- Critical analysis take place and it is based on the objectives
that are being set. It provides proper information and knowledge on the topic selected.
Chapter 3: Research methodology- Different techniques and methods are included that
enables to conduct the research in effective manner.
Chapter 4: Data analysis and findings- It demonstrates the data collected by the
researcher that is gathered from primary and secondary sources.
Chapter 5: Conclusion and recommendation- From the research conduct, it enables to
come up with appropriate conclusion and recommendation.
Expected Results
This study is expected to contribute towards understanding of the impact that resilience
programmes have regarding improving the food security situation of the households in disaster
prone areas of zomba district southern Malawi. The study will also assist in profiling of
resilience building activities in zomba district.
Gantt Chart
Activity Week
1
Week
2
Week
3
Week
4
Week
5
Week
6
Week
7
Week
8
Week
9
Week
10
Writing
Research
Proposal
Reading
various
literature
6

Finalizin
g the
aims and
objective
s
Draft
literature
review
Collect
secondar
y data
Analyze
secondar
y data
Develop
research
approach
Draft
research
methodol
ogy
Develop
questionn
aire
Arrange
the
interview
Conduct
the
interview
Accumul
7

ate the
data
Draft
Findings
Analyze
data
Complete
remainin
g
chapters
Submit it
to tutor
and
await for
feedback
Revise
the draft
Print and
bind
Submit
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REFERENCES
Books and Journals
Landes, M., van Lettow, M. and Bedell, R. A., 2012. Mortality and health outcomes of HIV-
exposed and unexposed children in a PMTCT cohort in Malawi. PloS one. 7(10).
pp.e47337.
Zimba, E., Kinney, M. V. and Nyasulu, D., 2012. Newborn survival in Malawi: a decade of
change and future implications. Health policy and planning. 27(suppl 3). pp.iii88-iii103.
Chan, A. K., Mateyu, G. and van Lettow, M., 2010. Outcome assessment of decentralization of
antiretroviral therapy provision in a rural district of Malawi using an integrated primary
care model. Tropical Medicine & International Health, 15(s1), pp.90-97.
Landes, M., van Lettow, M.and Schouten, E., 2012. Mortality and health outcomes in HIV-
infected and HIV-uninfected mothers at 18–20 months postpartum in Zomba District,
Malawi. PLoS One. 7(9). pp.e44396.
Callaghan-Koru, J. A., Nonyane, B. A. and Baqui, A. H., 2013. Contribution of community-
based newborn health promotion to reducing inequities in healthy newborn care practices
and knowledge: evidence of improvement from a three-district pilot program in
Malawi. BMC Public Health. 13(1). pp.1052.
Kumbani, L. C., Chirwa, E. and Bjune, G., 2012. Do Malawian women critically assess the
quality of care? A qualitative study on women’s perceptions of perinatal care at a district
hospital in Malawi. Reproductive health. 9(1). pp.30.
Flood, A., 2010. Understanding phenomenology: Anne Flood looks at the theory and methods
involved in phenomenological research. Nurse researcher. 17(2). pp.7-15.
af Wåhlberg, A., 2012. Driver behaviour and accident research methodology: unresolved
problems. Ashgate Publishing, Ltd..
Dickinson, D. K., Freiberg, J. B. and Barnes, E. M., 2011. Why are so few interventions really
effective? A call for fine-grained research methodology. Handbook of early literacy
research. 3. pp.337-357.
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APPENDIX
Questionnaire
Name: __________
Age: ________
Gender: _________
1. Do you agree that you life has a meaning?
 Yes
 No
 Not sure
2. Do you have positive thinking attitude?
 Yes
 No
 Not sure
3. Do you feel that you can direct your life?
 Yes
 No
 Not sure
4. Do you agree that the food you consume is nutritions?
 Strongly Agree
 Agree
 Neutral
 Disagree
 Strongly Disagree
5. Do you think that you can solve the challenges that you facer in life?
 Yes
 No
 Not sure
6. Do you share or express your emotions with friend or family members?
 Yes
 No
 Not sure
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7. Do you find time for meditating your daily life?
 Yes
 No
8. Do you take initiates to achieve goals for your life?
 Yes
 No
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