Guided by the World Health Organization quality of life (WHOQOL) framework, this systematic review aimed to examine evidence about the prevalence and severity of QOL-related health problems and their influencing factors in Sub-Saharan Africa (SSA). We identified eligible publications in English language from PubMed, Cumulative Index of Nursing and Allied Health Literature Plus with Full Text, Embase, APA PsycInfo, Scopus, and African Index Medicus databases. We included quantitative descriptive studies that measured overall and subdomains of QOL as the outcome in adult patients/survivors with cancer in SSA. Twenty-six descriptive cross-sectional studies (27 papers) that were conducted since 1988 in different SSA countries among patients with various types of cancer met our inclusion criteria. We found inconsistencies in how the prevalence and severity of QOL-related health problems have been researched and reported across studies, which complicated comparing findings and drawing conclusions. The most common factors that influenced the overall and subdomains of QOL included coping; internal and external locus of control; symptoms and symptom management; and religious beliefs and religious care. Demographics (e.g., age and marital status), cancer-related factors (cancer stage and type of treatment), and social determinants of health (e.g., education, access to information and resources, financial distress, and urban vs rural residency) also impacted QOL and its subdomains. Our findings indicate the significant need for recognizing and managing QOL-related problems for cancer patients and caregivers in SSA. Research needs to use culturally adapted, standardized assessment tools and analysis approaches to better understand the QOL challenges this population faces. Comprehensive supportive care is needed to address the complex QOL issues in resource-limited SSA.

This paper aims to illuminate how serodiscordant couples were informed by their own and other's bodies in their experience of HIV/ AIDS information. The lived body is the contact we have with the world. Our knowledge about others is through their bodies. In addition, illness is experienced first through the lived body. Therefore, when doctors want to learn about the illness, they extract information from the lived body. In this study, we investigated how serodiscordant couples experience HIV and AIDS information in Malawi. In-depth interviews were conducted in the homes of twenty-one serodiscordant couples and three individuals who had separated from their partners. Participants for the study were selected purposively. Data analysis was carried out using Max van Manen's phenomenological approach to generate descriptions and interpretations of the couples' experiences of HIV and AIDS information. The study found that the life-world is the overarching context of experiencing HIV and AIDS information and identified five structures of the life-world of serodiscordant couples: lived body, lived space, lived others, lived time, and spirituality. HIV and AIDS are first experienced through the lived body, and bodies were informational within the lived spaces. Thus, this research contributes to the study of HIV and AIDS information by revealing the lived body as an important source. It also identifies that the body can be an ambiguous source, since HIV and AIDS information available from the lived body may be ignored or misinterpreted by the serodiscordant couples and by those they interact with.

Background: Perinatal depression causes significant burden to women and their families during the perinatal period. However, there is no reliable national prevalence data on perinatal depression in Malawi.Aim: This systematic review aimed at establishing the pooled prevalence of perinatal depression.Setting: The study setting is Malawi.Methods: Two reviewers conducted the search, selection, quality evaluation and data abstraction. Appropriate terms were used to search the CINAHL, PsychINFO, PubMed and ScienceDirect databases. The relevance and the quality of the studies were assessed. The prevalence of prenatal depression was pooled using a random-effects model, which was used to synthesise the data.Results: The review included a total of eight articles of fair and good quality. This review found a pooled prevalence of antenatal depression of 17.1% (95.0% confidence interval [CI]: 12.5–22.2) and postnatal depression of 19.8% (95.0% CI: 4.6–42.1) with an overall pooled prevalence of perinatal depression of 18.9% (95.0% CI: 14.5–23.8).Conclusion: This systematic review provided a pooled prevalence of perinatal depression which may be used in the absence of national prevalence data on perinatal depression.Contribution: This systematic review found a high a pooled prevalence of perinatal depression in Malawi suggesting that mental health should be a key component of maternal health programmes, policies and activities in the local setting.

Background Obstetric fistula (OF) is a birth complication that largely affects women in developing countries. The women suffer constant incontinence, shame, social segregation, and health problems. Reconstructive surgery can usually repair OF, and enable women to reintegrate back into their communities. However, physically repair does not necessarily result in emotional recovery. Our objective was to explore women’s experiences of social support during the twelve months following a first time OF repair. Methods An evidence synthesis was performed based on a systematic search of literature published between 2008 and October 2019 in PubMed, Medline and CINAHL databases using keywords “Obstetric Fistula”, "vesicovaginal fistula", "vesicovaginal", “Fistula”, and “Social Support”. Inclusion criteria were primary peer reviewed articles addressing one or more study objectives, in English, on OF support, regardless of location. Two reviewers independently assessed eligibility of the studies and extracted the data. Disagreement between the reviewers were resolved by a third reviewer. Results The search resulted in 212 articles, of which 15 were included in this review. The analysis of the studies was guided by Berkman’s Model. The model suggests that there is a link between social resources, social support and disease. We found that support was either internal or external. Internal support constituted self-efficacy resulting into strengthened internal locus of control. Externally, women were supported by friends and family with material and financial resources. They were also supported with education opportunities, and business start-up capital. Our review also identified the need to support women with information about OF. Most women who were successfully integrated into their communities supported other women suffering from OF. Conclusions Social networks make a significant contribution to emotional and psychological recovery of women after a successful OF surgical repair. Social networks were also found to be detrimental to emotional and psychological recovery of women. Most women were abandoned and not supported by their husbands. Only constructive surgery is not enough as OF treatment. Women need supportive and well organised social networks for them to make full recovery after OF repair.