Sam Phiri
Datos Biográficos
| ID | 6782840 |
|---|---|
| NOMBRE | Sam Phiri |
| NOMBRES | Sam |
| APELLIDO | Phiri |
| FIRMA | PHIRI S |
| AFILIACIONES | Lighthouse Trust |
| ORCID | 0000-0002-9372-212X |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 27 |
| TOTAL DE CITAS | 0 |
| TOTAL COMO AUTOR | 27 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2010 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 0 |
Implementation strategies to increase Malawian health care workers’ knowledge about and self-efficacy to recommend HPV vaccination
Health workers’ recommendation of HPV vaccination is a highly effective evidence-based intervention for increasing the uptake of this important cancer prevention tool. In Malawi, as in many countries, HPV vaccine uptake is low. In preparation for an implementation science study using an intervention optimization design, we pilot tested two implementation strategies aimed at increasing Malawian health workers’knowledge and self-efficacy to counsel…
Contraceptive method continuation among a prospective cohort study of Malawian women on antiretroviral treatment initiating the Levonorgestrel Implant or the Depot Medroxyprogesterone Acetate Injectab…
Limited prospective data exist for long-term hormonal contraceptive continuation rates among women living with HIV. We conducted a prospective cohort study of women living with HIV in Lilongwe, Malawi from 2017 to 2021 and evaluated their contraceptive method continuation and ART regimens. Participants initiating either depot medroxyprogesterone acetate (DMPA) injection or levonorgestrel (LNG) implant were followed every 24 weeks for up to 192 we…
Barriers to viral suppression in children aged 9 years or younger on dolutegravir-based antiretroviral therapy in Malawi, a mixed-methods study
After the transition to pediatric dolutegravir-based regimens, viral load (VL) suppression among children with HIV (CWH) in Malawi has remained suboptimal. This mixed-methods study assessed factors associated with high VL among young CWH on dolutegravir-based antiretroviral therapy (ART) and explored adherence barriers from primary-caregiver and healthcare worker perspectives. Between April-July 2023, we performed an unmatched case-control study …
Health care needs survey to improve preparedness of community outreach clinics after severe flooding in Mulanje district, Malawi
Due to the rising impact of climate change, Malawi has increasingly experienced extreme weather events in the last decade, including flooding that resulted in large-scale displacement of vulnerable populations. In response, the Ministry of Health and partners set up outreach clinics at camps for displaced persons. However, little is known about health care needs of the affected populations. We conducted a cross-sectional survey among individuals …
Intimate partner violence among HIV index case testing clients in Malawi, a mixed-methods study
While its prevalence in sub-Saharan Africa is high, intimate partner violence (IPV) is rarely reported during routine index case testing (ICT) services in Malawi. We retrospectively explored the occurrence of IPV in a large, PEPFAR-supported HIV care and treatment program, among people with HIV (PWH) who had previously accessed ICT services. Between July-August 2022, we enrolled PWH aged ≥18 years, at 15 health facilities, who had received ICT se…
Healthcare provider and health system leader perspectives on barriers to hypertension care in Malawi
BACKGROUND: Malawi has a significant burden of hypertension, including for people with HIV. The World Health Organization recommends integrated HIV-hypertension care, but such integration is not widely implemented in resource-constrained settings. OBJECTIVE: This study explored barriers to hypertension care in Malawi from the perspectives of healthcare providers and health system leaders. METHODS: We conducted a qualitative study of providers and…
Factors associated with cervical cancer screening
These results suggest promising areas for interventions aiming to increase cervical cancer screening in these contexts: encouraging health workers to discuss screening with eligible women, leveraging women's peers who have been affected by cervical cancer, and promoting screening during other preventive health services
Stakeholder priorities for ART initiation and early retention strategies in Malawi
New or returning antiretroviral therapy (ART) clients are largely ineligible for differentiated service delivery (DSD) models. These clients are at increased risk of treatment interruption and may benefit from flexible care models, but stakeholder buy-in may limit progress on interventions for this population. We qualitatively explored stakeholder perceptions and decision-making criteria for scaling DSD models for new or returning ART clients in …
Assessing the Implementation Fidelity of a Patient-Centered, Combination Adherence Strategy to Support HIV Antiretroviral Therapy and Pre-Exposure Prophylaxis Adherence During Pregnancy and Breastfeed…
Barriers and facilitators of a large clinical trial on prevention of HIV transmission through breastfeeding in Lusaka, Zambia
This study provides new elements to better understand the reduced HIV transmission with the PROMISE-EPI intervention. It also highlights potential gaps between the package proposed in the trial and what can be applied in less controlled, 'real life' settings
Preferences for Hypertension Care in Malawi
Hypertension is the most common non-communicable disease diagnosed among people in sub-Saharan Africa. However, little is known about client preferences for hypertension care. We performed a discrete choice experiment in Malawi among people with hypertension, with and without HIV. Participants were asked to select between two care scenarios, each with six attributes: distance, waiting time, provider friendliness, individual or group care, antihyp…
Depression, Alcohol Use, and Sexual Behaviors by HIV Infection Stage and Diagnosis Timing Among STI Clinic Patients in Lilongwe, Malawi
Burnout and depression
Health care workers (HCWs) in eastern Africa experience high levels of burnout and depression, and this may be exacerbated during the COVID-19 pandemic due to anxiety and increased work pressure. We assessed the prevalence of burnout, depression and associated factors among Malawian HCWs who provided HIV care during the COVID-19 pandemic. From April-May 2021, between the second and third COVID-19 waves in Malawi, we randomly selected HCWs from 32…
Provider-led community antiretroviral therapy distribution in Malawi
Background Outcomes of community antiretroviral therapy (ART) distribution (CAD), in which provider–led ART teams deliver integrated HIV services at health posts in communities, have been mixed in sub-Saharan African countries. CAD outcomes and costs relative to facility-based care have not been reported from Malawi. Methods We performed a retrospective cohort study in two Malawian districts (Lilongwe and Chikwawa districts), comparing CAD with f…
Acceptability of a Combination Adherence Strategy to Support HIV Antiretroviral Therapy and Pre-exposure Prophylaxis Adherence During Pregnancy and Breastfeeding in Malawi
Triple Benefit
We conducted a programmatic, observational cohort study with mother-infant pairs (MIPs) enrolled in prevention-of-mother-to-child-transmission (PMTCT) programs in Malawi to assess the feasibility and potential HIV-related benefits of integrating Early Childhood Development (ECD) services into PMTCT programs. Six health facilities were included in the intervention. We offered ECD counseling from the WHO/UNICEF Care for Child Development package in…
Reorienting Primary Health Care Services for Non-Communicable Diseases
Despite positive NCD policies in recent years, majority of Sub-Saharan African (SSA) health systems are inadequately prepared to deliver comprehensive first-line care for NCDs. Primary health care (PHC) settings in countries like Malawi and Zambia could be a doorway to effectively manage NCDs by moving away from delivering only episodic care to providing an integrated approach over time. As part of a collaborative health system strengthening proj…
Deadly”, “fierce”, “shameful”
We propose the "life-course" as a useful concept for studies on masculinity, HIV and stigma. Considering gendered constructions of "respectable" midlife-older age vis-à-vis younger age, and how they influence stigma as well as uptake and adherence to ART might lead to more targeted services for men that build on "transformative masculinities
Service Use and Resilience among Adolescents Living with HIV in Blantyre, Malawi
Adolescent centred-approaches have the potential to enhance resilience promoting resources and outcomes. A multi-sectoral approach to service use and provision is critical to inform adolescent intervention programs and wellbeing
Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi
The patients interviewed in this study preferred the NCAP approach to the facility-based model of care because it saved them money on transport, reduced waiting-times, and allowed for a more thorough consultation, while continuing to provide quality HIV care. However, when considering a community-level DMOC approach, certain factors - including staff transportation and workload - must be taken into consideration and purposefully planned
Integrating family planning services into HIV care
BACKGROUND: Integrating family planning (FP) services into human immunodeficiency virus (HIV) clinical care helps improve access to contraceptives for women living with HIV. However, high patient volumes may limit providers' ability to counsel women about pregnancy risks and contraceptive options. OBJECTIVES: To assess trends in the use of contraceptive methods after implementing an electronic medical record (EMR) system with FP questions and det…
End of an era and the debacle of cross-border media building projects in Africa
In the 1990s following the collapse of the Berlin Wall in Germany and the death of Apartheid in South Africa, several cross-national initiatives were undertaken in Africa to strengthen the role of the media in nascent democracies. Some 30 years later, several of these initiatives are dead while the surviving ones are on the brink of folding. This discussion takes a critical historic synopsis by exploring the conjectural and chronological foundati…
Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women (‘Option B+’) in Malawi
OBJECTIVE: To explore the levels and determinants of loss to follow-up (LTF) under universal lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') in Malawi. DESIGN, SETTING, AND PARTICIPANTS: We examined retention in care, from the date of ART initiation up to 6 months, for women in the Option B+ program. We analysed nationwide facility-level data on women who started ART at 540 facilities (n = 21,939), as well…
Understanding reasons for treatment interruption amongst patients on antiretroviral therapy – A qualitative study at the Lighthouse Clinic, Lilongwe, Malawi
BACKGROUND: In recent years, scaling up of antiretroviral therapy (ART) in resource-limited settings moved impressively towards universal access. Along with these achievements, public health HIV programs are facing a number of challenges including the support of patients on lifelong therapy and the prevention of temporary/permanent loss of patients in care. Understanding reasons for treatment interruption (TI) can inform strategies for improving …
Timing of antiretroviral therapy and regimen for HIV-infected patients with tuberculosis
Implementation of the 2011 Malawi Integrated ART/PMTCT guidelines was associated with an overall increase in ART uptake among TB/HIV patients and with an increase in the number of patients initiating ART within two weeks of starting their TB treatment. However, the reduction in time between initiating TB treatment and starting ART was small suggesting that further measures must be implemented to facilitate ART uptake. Early enrolment in HIV care …
Sin obras prominentes en esta página.
Negotiating multiple barriers
Malawi is facing a severe HIV and AIDS epidemic with an estimated 12% of its population living with the virus. Health workers are on the front lines of the HIV epidemic and they face the risk of HIV infection in both their personal and professional lives. This mixed method study aimed to explore the enablers and barriers to HIV counselling and testing and antiretroviral therapy by health workers in Malawi. After qualitative data were collected th…
Incidence of Pregnancy Among Women Accessing Antiretroviral Therapy in Urban Malawi
Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women (‘Option B+’) in Malawi
OBJECTIVE: To explore the levels and determinants of loss to follow-up (LTF) under universal lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') in Malawi. DESIGN, SETTING, AND PARTICIPANTS: We examined retention in care, from the date of ART initiation up to 6 months, for women in the Option B+ program. We analysed nationwide facility-level data on women who started ART at 540 facilities (n = 21,939), as well…
Understanding reasons for treatment interruption amongst patients on antiretroviral therapy – A qualitative study at the Lighthouse Clinic, Lilongwe, Malawi
BACKGROUND: In recent years, scaling up of antiretroviral therapy (ART) in resource-limited settings moved impressively towards universal access. Along with these achievements, public health HIV programs are facing a number of challenges including the support of patients on lifelong therapy and the prevention of temporary/permanent loss of patients in care. Understanding reasons for treatment interruption (TI) can inform strategies for improving …
Timing of antiretroviral therapy and regimen for HIV-infected patients with tuberculosis
Implementation of the 2011 Malawi Integrated ART/PMTCT guidelines was associated with an overall increase in ART uptake among TB/HIV patients and with an increase in the number of patients initiating ART within two weeks of starting their TB treatment. However, the reduction in time between initiating TB treatment and starting ART was small suggesting that further measures must be implemented to facilitate ART uptake. Early enrolment in HIV care …
Integrating family planning services into HIV care
BACKGROUND: Integrating family planning (FP) services into human immunodeficiency virus (HIV) clinical care helps improve access to contraceptives for women living with HIV. However, high patient volumes may limit providers' ability to counsel women about pregnancy risks and contraceptive options. OBJECTIVES: To assess trends in the use of contraceptive methods after implementing an electronic medical record (EMR) system with FP questions and det…
End of an era and the debacle of cross-border media building projects in Africa
In the 1990s following the collapse of the Berlin Wall in Germany and the death of Apartheid in South Africa, several cross-national initiatives were undertaken in Africa to strengthen the role of the media in nascent democracies. Some 30 years later, several of these initiatives are dead while the surviving ones are on the brink of folding. This discussion takes a critical historic synopsis by exploring the conjectural and chronological foundati…
Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi
The patients interviewed in this study preferred the NCAP approach to the facility-based model of care because it saved them money on transport, reduced waiting-times, and allowed for a more thorough consultation, while continuing to provide quality HIV care. However, when considering a community-level DMOC approach, certain factors - including staff transportation and workload - must be taken into consideration and purposefully planned
Reorienting Primary Health Care Services for Non-Communicable Diseases
Despite positive NCD policies in recent years, majority of Sub-Saharan African (SSA) health systems are inadequately prepared to deliver comprehensive first-line care for NCDs. Primary health care (PHC) settings in countries like Malawi and Zambia could be a doorway to effectively manage NCDs by moving away from delivering only episodic care to providing an integrated approach over time. As part of a collaborative health system strengthening proj…
Deadly”, “fierce”, “shameful”
We propose the "life-course" as a useful concept for studies on masculinity, HIV and stigma. Considering gendered constructions of "respectable" midlife-older age vis-à-vis younger age, and how they influence stigma as well as uptake and adherence to ART might lead to more targeted services for men that build on "transformative masculinities
Service Use and Resilience among Adolescents Living with HIV in Blantyre, Malawi
Adolescent centred-approaches have the potential to enhance resilience promoting resources and outcomes. A multi-sectoral approach to service use and provision is critical to inform adolescent intervention programs and wellbeing
Depression, Alcohol Use, and Sexual Behaviors by HIV Infection Stage and Diagnosis Timing Among STI Clinic Patients in Lilongwe, Malawi
Burnout and depression
Health care workers (HCWs) in eastern Africa experience high levels of burnout and depression, and this may be exacerbated during the COVID-19 pandemic due to anxiety and increased work pressure. We assessed the prevalence of burnout, depression and associated factors among Malawian HCWs who provided HIV care during the COVID-19 pandemic. From April-May 2021, between the second and third COVID-19 waves in Malawi, we randomly selected HCWs from 32…
Provider-led community antiretroviral therapy distribution in Malawi
Background Outcomes of community antiretroviral therapy (ART) distribution (CAD), in which provider–led ART teams deliver integrated HIV services at health posts in communities, have been mixed in sub-Saharan African countries. CAD outcomes and costs relative to facility-based care have not been reported from Malawi. Methods We performed a retrospective cohort study in two Malawian districts (Lilongwe and Chikwawa districts), comparing CAD with f…
Acceptability of a Combination Adherence Strategy to Support HIV Antiretroviral Therapy and Pre-exposure Prophylaxis Adherence During Pregnancy and Breastfeeding in Malawi
Triple Benefit
We conducted a programmatic, observational cohort study with mother-infant pairs (MIPs) enrolled in prevention-of-mother-to-child-transmission (PMTCT) programs in Malawi to assess the feasibility and potential HIV-related benefits of integrating Early Childhood Development (ECD) services into PMTCT programs. Six health facilities were included in the intervention. We offered ECD counseling from the WHO/UNICEF Care for Child Development package in…
Barriers and facilitators of a large clinical trial on prevention of HIV transmission through breastfeeding in Lusaka, Zambia
This study provides new elements to better understand the reduced HIV transmission with the PROMISE-EPI intervention. It also highlights potential gaps between the package proposed in the trial and what can be applied in less controlled, 'real life' settings
Preferences for Hypertension Care in Malawi
Hypertension is the most common non-communicable disease diagnosed among people in sub-Saharan Africa. However, little is known about client preferences for hypertension care. We performed a discrete choice experiment in Malawi among people with hypertension, with and without HIV. Participants were asked to select between two care scenarios, each with six attributes: distance, waiting time, provider friendliness, individual or group care, antihyp…
Barriers to viral suppression in children aged 9 years or younger on dolutegravir-based antiretroviral therapy in Malawi, a mixed-methods study
After the transition to pediatric dolutegravir-based regimens, viral load (VL) suppression among children with HIV (CWH) in Malawi has remained suboptimal. This mixed-methods study assessed factors associated with high VL among young CWH on dolutegravir-based antiretroviral therapy (ART) and explored adherence barriers from primary-caregiver and healthcare worker perspectives. Between April-July 2023, we performed an unmatched case-control study …
Health care needs survey to improve preparedness of community outreach clinics after severe flooding in Mulanje district, Malawi
Due to the rising impact of climate change, Malawi has increasingly experienced extreme weather events in the last decade, including flooding that resulted in large-scale displacement of vulnerable populations. In response, the Ministry of Health and partners set up outreach clinics at camps for displaced persons. However, little is known about health care needs of the affected populations. We conducted a cross-sectional survey among individuals …
Intimate partner violence among HIV index case testing clients in Malawi, a mixed-methods study
While its prevalence in sub-Saharan Africa is high, intimate partner violence (IPV) is rarely reported during routine index case testing (ICT) services in Malawi. We retrospectively explored the occurrence of IPV in a large, PEPFAR-supported HIV care and treatment program, among people with HIV (PWH) who had previously accessed ICT services. Between July-August 2022, we enrolled PWH aged ≥18 years, at 15 health facilities, who had received ICT se…
Healthcare provider and health system leader perspectives on barriers to hypertension care in Malawi
BACKGROUND: Malawi has a significant burden of hypertension, including for people with HIV. The World Health Organization recommends integrated HIV-hypertension care, but such integration is not widely implemented in resource-constrained settings. OBJECTIVE: This study explored barriers to hypertension care in Malawi from the perspectives of healthcare providers and health system leaders. METHODS: We conducted a qualitative study of providers and…
Factors associated with cervical cancer screening
These results suggest promising areas for interventions aiming to increase cervical cancer screening in these contexts: encouraging health workers to discuss screening with eligible women, leveraging women's peers who have been affected by cervical cancer, and promoting screening during other preventive health services
Stakeholder priorities for ART initiation and early retention strategies in Malawi
New or returning antiretroviral therapy (ART) clients are largely ineligible for differentiated service delivery (DSD) models. These clients are at increased risk of treatment interruption and may benefit from flexible care models, but stakeholder buy-in may limit progress on interventions for this population. We qualitatively explored stakeholder perceptions and decision-making criteria for scaling DSD models for new or returning ART clients in …
Assessing the Implementation Fidelity of a Patient-Centered, Combination Adherence Strategy to Support HIV Antiretroviral Therapy and Pre-Exposure Prophylaxis Adherence During Pregnancy and Breastfeed…
Medicine (22 obras) · HIV/AIDS Research and Interventions (19 obras) · Nursing (16 obras) · Family medicine (15 obras) · Public health (12 obras) · Adolescent Sexual and Reproductive Health (11 obras) · Environmental health (11 obras) · Population (10 obras) · Health care (9 obras) · Antiretroviral therapy (7 obras)