Introduction: By 2030, the non-communicable diseases (NCDs) are expected to overtake communicable, maternal, neonatal, and nutritional (CMNN) diseases combined as the leading cause of mortality in sub-Saharan Africa (SSA). With the increasing trend in NCDs, the NCD risk factors (NCDRF) need to be understood at local level in order to guide NCD risk mitigation efforts. Therefore, we provide a detailed analysis of some modifiable NCDRF and their determinants in Malawi using the 2017 Stepwise survey (STEPS). Methods: This is a secondary analysis of the Malawi 2017 STEPS. Data was analysed using frequencies, proportions, odds ratios (OR) and their associated 95% confidence intervals (95%CI). We fitted multiple logistic regression of the NCD risk factors on the explanatory variables using likelihood ratio test. The level of statistical significance was set at P< 0.05. Results: Of the 4187 persons, 9% were current smokers, 1% were taking alcohol, 16% had high salt intake, 64% had insufficient fruit intake, 21% had low physical activity, 25% had high blood sugar, and 11% had high blood pressure. Smoking odds increased with age but decreased with level of education. Females had lower odds of engaging in harmful alcohol use than males (AOR=0.04, 95%CI: 0.01-0.17, P<0.001). Females had lower odds of high salt uptake than the males (AOR=0.70, 95%CI: 0.58-0.84, P=0.0001). Persons in non-paid jobs had higher odds of salt uptake than those employed (AOR=1.70, 95%CI: 1.03-2.79, P=0.04). Females were 22% more likely to have insufficient fruit uptake compared to males (AOR=1.22, 95%CI: 1.06-1.41, P=0.007). Conclusion: The high prevalence of physical inactivity, high salt consumption, insufficient fruit intake, raised blood glucose and high relatively blood pressure calls for a sound public health approach. The Malawi Ministry of Health should devise multi-sectoral approaches that minimize exposure to modifiable NCD risk factors at population and individual levels.
Introduction: Although countries in sub-Sahara Africa (SSA) show progress in implementing various forms of health insurance, there is a dearth of information regarding health insurance in settings like Malawi. Therefore, we conducted this study to determine the uptake of health insurance and describe some of the factors associated with the prevailing uptake of health insurance in Malawi using the 2019-20 Multiple Indicator Cluster Survey (MICS). Methods: This was a secondary analysis of the 2019-20 MICS data. Data were analysed using frequencies and weighted percentages in Stata v.17. Furthermore, since the number of persons with health insurance is very small, we were unable to perform multivariate analysis. Results: A total of 205 (1%) of the 31259 had health insurance in Malawi in 2019-20. Of the 205 individuals that owned health insurance, 118 (47%) had health insurance through their employers while 39 (16%) had health insurance through mutual health organization or ccommunity-based. Men had higher uptake of health insurance than the women. The residents from urban areas were more likely to have a health insurance than those in the rural areas. Persons with media exposure were more likely to own health insurance as compared to their counterparts. There was increasing trend in the uptake of health insurance by wealth of the individual with the poorest being less likely to have health insurance compared to the richest. The persons with no education being least likely to have a health insurance while those with tertiary education were most likely to have health insurance. Conclusion: The uptake of health insurance in Malawi was extremely low. In order to increase the uptake of health insurance, there is need to increase insurance coverage amongst those in formal employment, consider minimizing the geographic, economic and demographic barriers in accessing the health insurance.
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