Adamson S Muula
Biographic Data
| ID | 304729 |
|---|---|
| NAME | Adamson S Muula |
| GIVEN NAMES | Adamson S |
| FAMILY NAME | Muula |
| SIGNATURE | MUULA A S |
| AFFILIATIONS | University of Malawi |
| ORCID | 0000-0003-4412-9773 |
| VERIFIED | Yes |
| TOTAL WORKS | 51 |
| TOTAL CITATIONS | 48 |
| AUTHOR COUNT | 51 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2003 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 4 |
Stakeholder perspectives on adolescent sexual and reproductive health and rights in Malawi: Barriers, incentives, and opportunities for reform
Social norms, institutional weaknesses, and gaps between policy commitments and implementation in Malawi continue to pose significant barriers to adolescents' realisation of their sexual and reproductive health and rights (SRHR). Early marriage, gender-based violence, and limited access to contraception and comprehensive sexuality education (CSE) undermine adolescents' wellbeing and future opportunities. This qualitative study examines how actor …
Schools of public health as a cornerstone for pandemic preparedness and response: The Africa Covid-19 experience
Global implementation research capacity building to address cardiovascular disease: An assessment of efforts in eight countries
Cardiovascular diseases are the leading causes of morbidity and mortality worldwide, but implementation of evidence-based interventions for risk factors such as hypertension is lacking, particularly in low and middle income countries (LMICs). Building implementation research capacity in LMICs is required to overcome this gap. Members of the Global Research on Implementation and Translation Science (GRIT) Consortium have been collaborating in rece…
Uptake of diabetic retinopathy screening at a secondary level facility in Malawi
Diabetic retinopathy (DR) is a common microvascular complication of long-standing diabetes mellitus (DM). DR screening is a cost-effective intervention for preventing blindness from DR. We conducted a cross-sectional study to investigate the uptake and the predictors of uptake of annual DR screening in an opportunistic DR screening programme at a secondary-level diabetes clinic in Southern Malawi. Consecutive patients were interviewed using a str…
Quality of life among type 2 diabetes mellitus patients at Kamuzu Central Hospital in Lilongwe, Malawi: A mixed-methods study
Type II diabetes mellitus (T2DM) significantly impacts quality of life (QoL) yet data among these patients in Malawi are lacking. This study was conducted to assess QoL among patients with T2DM. A mixed-method cross-section study was conducted at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Data collection was done using a modified diabetes quality of life (MDQoL)-17 questionnaire for quantitative data while in-depth interviews and diary meth…
Exploring culturally-preferred communication approaches for increased uptake of voluntary medical male circumcision (VMMC) services in rural Malawi
The study concluded that community engagement and interpersonal communication which provide room for real-time feedback in any communicative event are the most preferred communication interventions for VMMC services among Yaos and Chewas
Implementation Determinants of Zimbabwe National Occupational Safety and Health Policy in Willowvale Industrial Area, Zimbabwe
Zimbabwe introduced the National Occupational Safety and Health Policy (ZNOSHP) in August 2014 with the vision and mission to eliminate occupational accidents, injuries, diseases, and fatalities and to promote Occupational Safety and Health (OSH). This study was therefore aimed at exploring the individual- and organizational-level determinants of ZNOSHP's implementation. Data were collected from 309 workers in the Willowvale industrial area in Ha…
How equitable is health spending on curative services and institutional delivery in Malawi? Evidence from a quasi-longitudinal benefit incidence analysis
Through its free healthcare policy, Malawi has reduced socioeconomic inequality in health spending over time, but some challenges still need to be addressed to achieve a truly egalitarian health system. Our findings indicate a need to increase public funding for the health sector to ensure access to care and financial protection
Love in the time of HIV: How beliefs about externalities impact health behavior
Experience of and factors associated with violence against sexual and gender minorities in nine African countries: A cross-sectional study
Sexual and gender minorities in Eastern and Southern Africa experience high levels of violence. Sexual orientation and gender identity need to be recognised as risk factors for violence in national and regional law and policy frameworks. States should follow the African Commission Resolution 275 and provide protection against violence based on real or perceived sexual orientation or gender identity
Protocol for a Case-Control Study to Investigate the Association of Pellagra With Isoniazid Exposure During Tuberculosis Preventive Treatment Scale-Up in Malawi
Background: Pellagra is caused by niacin (vitamin B3) deficiency and manifested by a distinctive dermatitis. Isoniazid is critical for treating tuberculosis globally and is a component of most regimens to prevent tuberculosis. Isoniazid may contribute to pellagra by disrupting intracellular niacin synthesis. In 2017, Malawian clinicians recognized a high incidence of pellagra-like rashes after scale-up of isoniazid preventive treatment (IPT) to p…
Intended and unintended effects: Community perspectives on a performance-based financing programme in Malawi
Background: Several performance-based financing (PBF) evaluations have been undertaken in low-income countries, yet few have examined community perspectives of care amid PBF programme implementation. We assessed community members' perspectives of Support for Service Delivery Integration - Performance-Based Incentives ('SSDI-PBI'), a PBF intervention in Malawi, and explored some of the unintended effects that emerged amid implementation. Methods: …
Quantifying the cost of in-kind contributions to a multidonor-funded health research capacity-building programme: The case of the Consortium for Advanced Research Training in Africa
INTRODUCTION: There are significant investments in health research capacity development in the 'global-south'. The monetary value of contributions from institutions running these programmes is not known. METHODS: Using the Consortium for Advanced Research Training in Africa (CARTA) as a case study we estimate in-kind contributions made by consortium members. We measured unpaid hours of labour contributed by consortium members and converted this t…
The cost-effectiveness of using results-based financing to reduce maternal and perinatal mortality in Malawi
INTRODUCTION: Results-based financing (RBF) is being promoted to increase coverage and quality of maternal and perinatal healthcare in sub-Saharan Africa (SSA) countries. Evidence on the cost-effectiveness of RBF is limited. We assessed the cost-effectiveness within the context of an RBF intervention, including performance-based financing and conditional cash transfers, in rural Malawi. METHODS: We used a decision tree model to estimate expected …
Effective supervision of doctoral students in public and population health in Africa: Carta supervisors’ experiences, challenges and perceived opportunities
The quality and success of postgraduate education largely rely on effective supervision. Since its inception in 2008, the Consortium for Advanced Research Training in Africa (CARTA) has been at the forefront of providing training to both students and supervisors in the field of public and population health. However, there are few studies on supervisors' perceptions on effective doctoral supervision. We used a mostly descriptive study design to re…
The Impact of Behaviour Change Intervention [Bci] on Adolescent Hiv Risk Reduction in Selected Schools in Northern Malawi
The impact of Behaviour Change Intervention (BCI) on adolescent HIV risk reduction in selected schools in Northren Malawi
Introduction: We conducted a study to explore the impact of adolescent exposure to HIV and AIDS behaviour change Interventions (BCI) on their HIV risk reduction and sexual behaviour change in some selected secondary schools in the district of Mzimba, district of Nkhata Bay and Mzuzu city in Northern Malawi. Methods: We used mixed methods in a descriptive survey design triangulating both quantitative and qualitative approaches, with questionnaires…
Response to the commentary “to the bone”
Presenting process data - even in the absence of outcome data - supports a timely understanding of new, complex programs.•Seminal frameworks guided this research, but our emphasis on moderators was guided by data rather than frameworks.•Complexity here refers to a gap between what seemed feasible (early on) vs. what ultimately was feasible (mid-intervention)
Exploiting the emergent nature of mixed methods designs: Insights from a mixed methods impact evaluation in Malawi
The application of mixed methods in Health Policy and Systems Research (HPSR) has expanded remarkably. Nevertheless, a recent review has highlighted how many mixed methods studies do not conceptualize the quantitative and the qualitative component as part of a single research effort, failing to make use of integrated approaches to data collection and analysis. More specifically, current mixed methods studies rarely rely on emergent designs as a s…
“I wanted a skeleton … they brought a prince”: A qualitative investigation of factors mediating the implementation of a Performance Based Incentive program in Malawi
While several evaluations have examined the extent to which performance based financing (PBF) programs induce changes in the quantity and quality of health services provided, less is known about the process of implementing PBF. We conducted a process evaluation of a PBF intervention in Malawi that focused on understanding moderators of program implementation. Informed by a seminal theory of implementation, we first created a timeline and taxonomy…
The money can be a motivator, to me a little, but mostly PBF just helps me to do better in my job.’ An exploration of the motivational mechanisms of performance-based financing for health workers in M…
Performance-based financing (PBF) is assumed to improve health care delivery by motivating health workers to enhance their work performance. However, the exact motivational mechanisms through which PBF is assumed to produce such changes are poorly understood to date. Although PBF is increasingly recognized as a complex health systems intervention, its motivational effect for individual health workers is still often reduced to financial 'carrots a…
How does performance-based financing affect health workers' intrinsic motivation? A Self-Determination Theory-based mixed-methods study in Malawi
Effects of adolescent exposure to behaviour change interventions on their HIV risk reduction in Northern Malawi: A Situation Analysis
Understanding adolescents' translation of HIV and AIDS-related behaviour change interventions (BCI) knowledge and skills into expected behavioural outcomes helps us appreciate behaviour change dynamics among young people and informs evidence-based programming. We explored the effects of adolescents' exposure to BCI on their HIV risk reduction in selected schools in Nkhatabay and Mzimba districts and Mzuzu city in Northern Malawi. The study used q…
Specialty training for the retention of Malawian doctors: A cost-effectiveness analysis
The use of specialty training to retain doctors in Malawi: A discrete choice experiment
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not …
Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa: Avoiding the Pitfalls and Dangers, Capitalizing on the Opportunities
We describe a number of pitfalls that may occur with the push to rapidly expand access to antiretroviral therapy in sub-Saharan Africa. These include undesirable opportunity costs, the fragmentation of health systems, worsening health care inequities, and poor and unsustained treatment outcomes. On the other hand, AIDS “treatment activism” provides an opportunity to catalyze comprehensive health systems development and reduce health care inequiti…
The money can be a motivator, to me a little, but mostly PBF just helps me to do better in my job.’ An exploration of the motivational mechanisms of performance-based financing for health workers in M…
Performance-based financing (PBF) is assumed to improve health care delivery by motivating health workers to enhance their work performance. However, the exact motivational mechanisms through which PBF is assumed to produce such changes are poorly understood to date. Although PBF is increasingly recognized as a complex health systems intervention, its motivational effect for individual health workers is still often reduced to financial 'carrots a…
How does performance-based financing affect health workers' intrinsic motivation? A Self-Determination Theory-based mixed-methods study in Malawi
Gender, Gays and Gain: The Sexualised Politics of Donor Aid in Malawi
Many Malawian politicians have exploited religious and cultural discourses, encouraging the discourse of the 'God-fearing Malawi nation' while also acknowledging the country as a secular state. This discourse -which most recently underwent further development in the early 1980s when Christians and Muslims, funded by donor money, accelerated their evangelical drives in the context of a one-party Malawi - resonates with a patriarchal, conservative …
An inquiry into the uneven distribution of women's HIV infection in rural Malawi
Ecological comparisons in sub-Saharan Africa show that HIV prevalence is lower where men are generally circumcised than where they are not. Randomized controlled trials have found a 50-60% reduction in HIV acquisition for newly circumcised men. Yet in Malawi, HIV prevalence is highest in several districts in the Southern Region, where men are commonly circumcised. We draw upon a population-based sample of ever-married women to explore this unexpe…
The use of specialty training to retain doctors in Malawi: A discrete choice experiment
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not …
Joint spatial modelling of common morbidities of childhood fever and diarrhoea in Malawi
Specialty training for the retention of Malawian doctors: A cost-effectiveness analysis
Gender differences in university students' HIV/Aids-related knowledge and sexual behaviours in Malawi: A Pilot Study
A cross-sectional study was conducted among first-year university students in Malawi to determine distributions of HIV/AIDS-related knowledge, and sexual behaviours. A total of 314 (199 male and 115 female) students were eligible to participate, and of these 221 (70.4%) participated in the survey. Generally, levels of HIV/AIDS-related knowledge were similar between sexes. Overall, 68.9% of students of both sexes felt that they knew enough about H…
Love in the time of HIV: How beliefs about externalities impact health behavior
An assessment of sex work in Swaziland: Barriers to and opportunities for HIV prevention among sex workers
The HIV situation in virtually all southern African countries is a generalised epidemic. Despite the fact that almost all adult age and social groups have high HIV prevalence estimates, sex workers are disproportionally affected, with prevalence estimates higher than the general population. In a qualitative study of 61 male and female sex workers in Swaziland, we found that while poverty drove many into sex work, others reported motivations of pl…
Prevalence and social correlates of sexual intercourse among schoolgoing adolescents in Namibia
Adolescent sexuality is an important public health issue, as it affects risk to contract HIV and other sexually transmitted infections. The assessment of prevalence of sexual intercourse among adolescents is of public health significance, as it may guide policies and programmes aimed at reducing the transmission of sexually transmitted infections among this age group. This cross-sectional study using standardised methodology was conducted to asse…
Tobacco control in developing countries
Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa: Avoiding the Pitfalls and Dangers, Capitalizing on the Opportunities
We describe a number of pitfalls that may occur with the push to rapidly expand access to antiretroviral therapy in sub-Saharan Africa. These include undesirable opportunity costs, the fragmentation of health systems, worsening health care inequities, and poor and unsustained treatment outcomes. On the other hand, AIDS “treatment activism” provides an opportunity to catalyze comprehensive health systems development and reduce health care inequiti…
Identification of beneficiaries of free anti-retroviral drugs in Malawi: A community consensus process
Malawi is a southeastern Africa country that has been heavily affected by the AIDS pandemic. It is estimated that about 170,000 people were in need of highly active antiretroviral therapy (HAART) for the treatment of AIDS in 2006. At the end of 2006, at least 55,000 people in Malawi were on HAART treatment, mostly through the free public sector program. At the time the program was being initiated, an ethical question needed to be answered in resp…
Correlates of current cigarette smoking among in-school adolescents in the Kurdistan region of Iraq
We suggest that public health interventions aimed to curb adolescent cigarette smoking should be designed, implemented and evaluated with due recognition to the factors that are associated with the habit
Prevalence and determinants of adolescent tobacco smoking in Addis Ababa, Ethiopia
Prevalence of smoking among adolescents in Ethiopia is lower than in many other African countries. There is however need to strengthen anti-tobacco messages especially among adolescents
Suicidal Ideation and Associated Factors Among School-Going Adolescents in Harare, Zimbabwe
This study determined the prevalence and associated factors of suicidal ideation among school-going adolescents in Harare, Zimbabwe. Data on 1970 respondents were obtained from a cross sectional study of the Global School-based health survey. Respondents were selected using a two-stage probability sampling technique. The prevalence of suicidal ideation was 21.6%. Males were less likely to have suicidal ideation than females (OR=0.70; 95% CI 0.54,…
Male Circumcision to Prevent HIV Transmission and Acquisition: What Else do We Need to Know
Correlates of current cigarette smoking among school-going adolescents in Punjab, India: Results from the Global Youth Tobacco Survey 2003
BACKGROUND: Smoking is a leading cause of morbidity and mortality globally. There is therefore need to identify relevant factors associated with smoking among adolescents in order to better tailor public health interventions aimed at preventing smoking. METHODS: We used data from the Global Youth Tobacco Survey (GYTS) conducted in 2003 in Punjab, India, on 2014 adolescents of whom 58.9% were males. We conducted a weighted logistic regression anal…
Antismoking messages and current cigarette smoking status in Somaliland: Results from the Global Youth Tobacco Survey 2004
A combination of school and home based antismoking interventions may be effective in controlling adolescent smoking in Somaliland
Factors associated with adolescent cigarette smoking in Greece: Results from a cross sectional study (Gyts Study)
Male gender, parental smoking, and having pocket-money > or = 16 Euros were independently associated with current smoking among Greek students. These findings could be taken into account in order to formulate a comprehensive anti-smoking strategy in Greece
Joint spatial modelling of common morbidities of childhood fever and diarrhoea in Malawi
Gender differences in university students' HIV/Aids-related knowledge and sexual behaviours in Malawi: A Pilot Study
A cross-sectional study was conducted among first-year university students in Malawi to determine distributions of HIV/AIDS-related knowledge, and sexual behaviours. A total of 314 (199 male and 115 female) students were eligible to participate, and of these 221 (70.4%) participated in the survey. Generally, levels of HIV/AIDS-related knowledge were similar between sexes. Overall, 68.9% of students of both sexes felt that they knew enough about H…
Prevalence and social correlates of sexual intercourse among schoolgoing adolescents in Namibia
Adolescent sexuality is an important public health issue, as it affects risk to contract HIV and other sexually transmitted infections. The assessment of prevalence of sexual intercourse among adolescents is of public health significance, as it may guide policies and programmes aimed at reducing the transmission of sexually transmitted infections among this age group. This cross-sectional study using standardised methodology was conducted to asse…
Socio-economic factors associated with delivery assisted by traditional birth attendants in Iraq, 2000
BACKGROUND: Traditional birth attendants (TBAs) are likely to deliver lower quality maternity care compared to professional health workers. It is important to characterize women who are assisted by TBAs in order to design interventions specific to such groups. We thus conducted a study to assess if socio-economic status and demographic factors are associated with having childbirth supervised by traditional birth attendants in Iraq. METHODS: Iraqi…
Association between maternal use of traditional healer services and child vaccination coverage in Pont-Sonde, Haiti
We found that mother's use of traditional healer services was negatively associated with vaccination of Haitian children. Findings from this study underscore the potential to enlist the support of traditional healers in promoting child health by educating, mentoring them (the traditional healers) in supporting vaccination efforts
Current cigarette smoking among in-school American youth: Results from the 2004 National Youth Tobacco Survey
We found that White non-Hispanic adolescents were as likely to be current smokers as American Indians but more likely to be smokers than all other racial/ethnic groups. Older adolescents, increase amounts of pocket money, and perception that smoking was not harmful to health. The racial/ethnic differences in prevalence of smoking among America youth deserve particular exploration
Marriage, not Religion, is Associated with HIV Infection Among Women in Rural Malawi
Determinants of Exposure to Environmental Tobacco Smoke (ETS) among Non Smoking Adolescents (Aged 11-17 Years Old) in Greece: Results from the 2004-2005 Gyts Study
The aim of the study is to investigate the determinants of exposure to ETS among Greek adolescents aged 11-17 years old. The GYTS questionnaire was completed by 5,179 adolescents. About 3 in 4 responders (76.8%) were exposed to ETS at home, and 38.5% were exposed to ETS outside of the home. Gender, age group, parental and close friends smoking status were significant determinants of adolescent's exposure to ETS. The results of the study could be …
Current use of smokeless tobacco among adolescents in the Republic of Congo
Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of tobacco use. The teenagers environment at home, at school and at leisure must also be factored in order to prevent their uptake or maintenance of tobacco use
An assessment of sex work in Swaziland: Barriers to and opportunities for HIV prevention among sex workers
The HIV situation in virtually all southern African countries is a generalised epidemic. Despite the fact that almost all adult age and social groups have high HIV prevalence estimates, sex workers are disproportionally affected, with prevalence estimates higher than the general population. In a qualitative study of 61 male and female sex workers in Swaziland, we found that while poverty drove many into sex work, others reported motivations of pl…
An inquiry into the uneven distribution of women's HIV infection in rural Malawi
Ecological comparisons in sub-Saharan Africa show that HIV prevalence is lower where men are generally circumcised than where they are not. Randomized controlled trials have found a 50-60% reduction in HIV acquisition for newly circumcised men. Yet in Malawi, HIV prevalence is highest in several districts in the Southern Region, where men are commonly circumcised. We draw upon a population-based sample of ever-married women to explore this unexpe…
Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi
BACKGROUND: Despite the documented benefits of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) services, the uptake remains low in sub-Saharan Africa. The lack of male involvement (MI) may be one of the reasons for this. However, there are limited data on strategies for MI in PMTCT. OBJECTIVE: The objective of this study was to identify strategies that may promote MI in PMTCT services in antenatal care (AN…
Gender, Gays and Gain: The Sexualised Politics of Donor Aid in Malawi
Many Malawian politicians have exploited religious and cultural discourses, encouraging the discourse of the 'God-fearing Malawi nation' while also acknowledging the country as a secular state. This discourse -which most recently underwent further development in the early 1980s when Christians and Muslims, funded by donor money, accelerated their evangelical drives in the context of a one-party Malawi - resonates with a patriarchal, conservative …
Exploring the relevance of male involvement in the prevention of mother to child transmission of HIV services in Blantyre, Malawi
BACKGROUND: Male involvement (MI) in Prevention of mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services remains low despite the progress registered in the implementation of the PMTCT program. Male involvement in PMTCT is a fairly new concept in Malawi that has not been fully implemented within PMTCT service provision despite its inclusion in the PMTCT guidelines. One of the reasons for the limited MI is the lack of …
Stakeholders’ perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre, Malawi
The factors that may hinder or promote MI arise from different sources. The success of MI lies on recognizing sources of barriers and averting them. Factors that promote MI need to be implemented at different levels of health care
Medicine (45 works) · Environmental health (28 works) · Public health (19 works) · Nursing (18 works) · Population (17 works) · Psychology (17 works) · Family medicine (16 works) · Global Maternal and Child Health (15 works) · Political science (15 works) · Economics (14 works)