Khumbo Phiri
Biographic Data
| ID | 7726678 |
|---|---|
| NAME | Khumbo Phiri |
| GIVEN NAMES | Khumbo |
| FAMILY NAME | Phiri |
| SIGNATURE | PHIRI K |
| AFFILIATIONS | Partners In Health |
| ORCID | 0000-0001-9166-0749 |
| VERIFIED | Yes |
| TOTAL WORKS | 19 |
| TOTAL CITATIONS | 0 |
| AUTHOR COUNT | 19 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2020 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 0 |
Implementation of male-specific motivational interviewing in Malawi
INTRODUCTION: Treatment interruption (TI), defined as >28 days late for antiretroviral therapy appointment, is one of the greatest challenges in controlling southern African HIV epidemics. Negative client-provider interactions remain a major reason for TI and a barrier to return to care, especially for men. Motivational interviewing (MI) facilitates client-driven counselling and improves client-provider interactions by facilitating equitable, int…
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…
Access to HIV treatment during community-wide flooding
Community-wide flooding in high HIV-burdened districts affects continuity of HIV care, especially in resource-limited countries in sub-Saharan Africa. We explored the lived experiences of antiretroviral therapy (ART) clients and health care workers (HCWs) in Malawi to understand challenges and potential solutions for ART delivery during floods. This was a mixed methods study. In quantitative analysis, we used routine program data from Partners in…
‘You don’t need schooling—just take the pills and don’t stop.’
Research on chronic care management from other settings indicates that people’s formal education (e.g., primary, secondary, and tertiary schooling) may confer important cognitive skills and material resources to help them manage their chronic HIV care and treatment. However, recent population-level findings from southern and eastern Africa suggest no statistical relationship between education and chronic HIV care. To gain additional insight into …
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 …
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…
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…
Health care workers’ perceptions and bias toward men as HIV clients in Malawi and Mozambique
Men are underrepresented in HIV services throughout sub-Saharan Africa. Little is known about health care worker (HCW) perceptions of men as clients, which may directly affect the quality of care provided, and HCWs’ buy-in for male-specific interventions. Focus group discussions (FGDs) were conducted in 2016 with HCWs from 15 facilities across Malawi and Mozambique and were originally conducted to evaluate barriers to universal treatment (not HCW…
Understanding the Unique Barriers and Facilitators that Affect Men’s Initiation and Retention in HIV Care
Men in sub-Saharan Africa are underrepresented in antiretroviral therapy (ART) programs. Our secondary analysis of 40 in-depth interviews with Malawian men living with HIV examined barriers and facilitators for ART initiation versus retention. Interviewees included men who never initiated or initiated ART late (initiation respondents, n = 19); and men who initiated ART but were late for an appointment (retention respondents, n = 21). Transcribed …
Health behaviours and beliefs among Malawian adults taking antihypertensive medication and antiretroviral therapy
In order to understand HIV-positive Malawian adults' experiences with hypertension management, we conducted qualitative interviews with 30 hypertensive adults who were also taking antiretroviral therapy. These interviews regarding hypertension management behaviours and beliefs were audio-recorded, transcribed, translated into English, and coded in Atlas.ti. Despite acknowledging the dangers of hypertension and the benefits of medication, many res…
Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi
The parent trial is registered with ClinicalTrials.gov , NCT03271307 , and Pan African Clinical Trials, PACTR201711002697316
How HIV Clients Find Their Way Back to the ART Clinic
Retention in antiretroviral therapy (ART) services is critical to achieving positive health outcomes for individuals living with HIV, but accumulating evidence indicates that individuals are likely to miss ART appointments over time. Thus, it is important to understand why individuals miss appointments and how they re-engage in HIV care. We used in-depth interviews with 44 ART clients in Malawi who recently missed an ART appointment (> 14 days) b…
Optimizing Test and Treat in Malawi
Background: Test and Treat has been widely adopted throughout sub-Saharan Africa, whereby all HIV-positive individuals initiate antiretroviral therapy (ART) immediately upon diagnosis and continue for life. However, clients who feel healthy may delay ART initiation, despite being eligible under new treatment guidelines.Objective: We examined health care worker (HCW) perceptions and experiences on how feeling healthy positively or negatively influ…
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Optimizing Test and Treat in Malawi
Background: Test and Treat has been widely adopted throughout sub-Saharan Africa, whereby all HIV-positive individuals initiate antiretroviral therapy (ART) immediately upon diagnosis and continue for life. However, clients who feel healthy may delay ART initiation, despite being eligible under new treatment guidelines.Objective: We examined health care worker (HCW) perceptions and experiences on how feeling healthy positively or negatively influ…
Health behaviours and beliefs among Malawian adults taking antihypertensive medication and antiretroviral therapy
In order to understand HIV-positive Malawian adults' experiences with hypertension management, we conducted qualitative interviews with 30 hypertensive adults who were also taking antiretroviral therapy. These interviews regarding hypertension management behaviours and beliefs were audio-recorded, transcribed, translated into English, and coded in Atlas.ti. Despite acknowledging the dangers of hypertension and the benefits of medication, many res…
Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi
The parent trial is registered with ClinicalTrials.gov , NCT03271307 , and Pan African Clinical Trials, PACTR201711002697316
How HIV Clients Find Their Way Back to the ART Clinic
Retention in antiretroviral therapy (ART) services is critical to achieving positive health outcomes for individuals living with HIV, but accumulating evidence indicates that individuals are likely to miss ART appointments over time. Thus, it is important to understand why individuals miss appointments and how they re-engage in HIV care. We used in-depth interviews with 44 ART clients in Malawi who recently missed an ART appointment (> 14 days) b…
Understanding the Unique Barriers and Facilitators that Affect Men’s Initiation and Retention in HIV Care
Men in sub-Saharan Africa are underrepresented in antiretroviral therapy (ART) programs. Our secondary analysis of 40 in-depth interviews with Malawian men living with HIV examined barriers and facilitators for ART initiation versus retention. Interviewees included men who never initiated or initiated ART late (initiation respondents, n = 19); and men who initiated ART but were late for an appointment (retention respondents, n = 21). Transcribed …
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…
Health care workers’ perceptions and bias toward men as HIV clients in Malawi and Mozambique
Men are underrepresented in HIV services throughout sub-Saharan Africa. Little is known about health care worker (HCW) perceptions of men as clients, which may directly affect the quality of care provided, and HCWs’ buy-in for male-specific interventions. Focus group discussions (FGDs) were conducted in 2016 with HCWs from 15 facilities across Malawi and Mozambique and were originally conducted to evaluate barriers to universal treatment (not HCW…
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…
‘You don’t need schooling—just take the pills and don’t stop.’
Research on chronic care management from other settings indicates that people’s formal education (e.g., primary, secondary, and tertiary schooling) may confer important cognitive skills and material resources to help them manage their chronic HIV care and treatment. However, recent population-level findings from southern and eastern Africa suggest no statistical relationship between education and chronic HIV care. To gain additional insight into …
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 …
Implementation of male-specific motivational interviewing in Malawi
INTRODUCTION: Treatment interruption (TI), defined as >28 days late for antiretroviral therapy appointment, is one of the greatest challenges in controlling southern African HIV epidemics. Negative client-provider interactions remain a major reason for TI and a barrier to return to care, especially for men. Motivational interviewing (MI) facilitates client-driven counselling and improves client-provider interactions by facilitating equitable, int…
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…
Access to HIV treatment during community-wide flooding
Community-wide flooding in high HIV-burdened districts affects continuity of HIV care, especially in resource-limited countries in sub-Saharan Africa. We explored the lived experiences of antiretroviral therapy (ART) clients and health care workers (HCWs) in Malawi to understand challenges and potential solutions for ART delivery during floods. This was a mixed methods study. In quantitative analysis, we used routine program data from Partners in…
Medicine (14 works) · Family medicine (13 works) · HIV/AIDS Research and Interventions (12 works) · Nursing (11 works) · Health care (10 works) · Adolescent Sexual and Reproductive Health (8 works) · Public health (7 works) · Qualitative research (7 works) · Psychology (6 works) · Antiretroviral therapy (4 works)