Purpose -The purpose of this paper is to look at the prospects and challenges of digitising library resources and building digital repositories in the University of Malawi Libraries. Design/methodology/approach -Data collected through online questions sent to college librarians, ICT director and systems administrator (Chancellor College and Bunda College) and assistant librarians or repository co-ordinators in the constituent colleges of the University of Malawi (UNIMA) coupled with technical reports on digital and institutional repository projects in the UNIMA Libraries. Findings -The results of the study have indicated that the UNIMA Libraries are digitising library resources and building digital repositories though the pace is very slow. Bandwidth has increased though accessibility of the resources is hampered by its inadequacy. The databases are frequently attacked by viruses and are locally available through intranet. Policy statements were not drawn for the projects, instead an insertion was done in the research and publications rules and regulations on copyright for theses and dissertations. The majority of the projects lack technical skills, especially running the systems in secure operating Linux-based system environments. Three of the five colleges adopted Greenstone, two adopted DSpace and one adopted Procite depending on the training received and the source of funding. The initial projects relied on external funding for their roll out. Practical implications -The study recommends that college librarians should lobby for training in ICT skills in order to sustain the projects. Funding for digital repositories should be included in the annual budget estimates of the college libraries. Librarians should draw policies specifically for digitisation of library resources, copyright and building of digital repositories in the UNIMA Libraries. ICT department should assist in migrating the repositories to Linux-based environments. Originality/value -There is little researched information on digitisation of library resources and building digital repositories in Malawi, yet there is quite a variety of rare information about the country. This research will add some information on the progress made in digitising Malawiana collection which has cultural heritage, educational and research value.

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.

Background Voluntary medical male circumcision (VMMC) is becoming more popular as an important HIV prevention strategy. Malawi, with a high HIV and AIDS prevalence rate of 8.8% and a low male circumcision prevalence rate of 28% in 2016, is one of the priority countries recommended for VMMC scale-up. This paper investigates the attitudes and key challenges to VMMC adoption in a traditionally circumcising community in Malawi where male circumcision is culturally significant. Methods A mixed design study using quantitative and qualitative data collection methods was carried out to determine the attitudes of 262 randomly selected males towards VMMC in a culturally circumcising community in Malawi. Statistical Package for the Social Sciences (SPSS) version 20 was used to analyse the quantitative data. To identify predictors of VMMC uptake, we used logistic regression analysis. To identify the themes, qualitative data were analysed using content analysis. Results The findings indicate that, while more males in this community prefer medical circumcision, traditional circumcision is still practised. Panic (63%) perceived surgical complications (31%), and cost (27%) in accessing VMMC services were some of the barriers to VMMC uptake. Age and culture were found to be statistically significant predictors of voluntary medical male circumcision in the logistic analysis. According to qualitative data analysis, the key challenges to VMMC uptake were the involvement of female health workers in the circumcision team and the incentives provided to traditional circumcisers. Conclusion According to the findings of this study, VMMC services should be provided in a culturally competent manner that respects and considers existing cultural beliefs and practices in the community. Coordination between local leaders and health workers should be encouraged so that VMMC services are provided in traditional settings, allowing for safe outcomes, and increasing VMMC uptake.

Purpose -The purpose of this paper is to look at adequacy or inadequacy of budgets for University of Malawi Libraries (UML) from financial years 2004 to 2009. Design/methodology/approach -A case study design was used to collect quantitative data. University budget estimate from

Purpose-The paper examines levels of health research evidence in health policies in Malawi. Design/Methodology/Approach-The study selected a typology of health policies in Malawi from 2002 to 2017. The study adopted the SPIRIT conceptual framework and assessed the levels of research evidence in health policy, systems and services research using the revised SAGE policy assessment tool. Documentary analysis was used to assess levels of health research evidence in health policies in Malawi. Findings-In 29 (96.7%) of the health policies, policy formulators including healthcare directors and managers used generic search engines such as Google or Google Scholar to look for heath research evidence. In 28 (93.3%) of the health policies they searched for grey literature and other government documents. In only 6 (20%) of the heath policy documents, they used academic literature in a form of journal articles and randomised controlled trials. No systematic reviews or policy briefs were consulted. Overall, in 23 (76.7%) of the health policy documents research evidence played a minimal role and had very little influence on the policy documents. Research limitations/implications-The empirical evidence in the health policy documents are limited due to insufficient research citation, low retrievability of health research evidence in the policy documents and biased selectivity of what constitutes health research evidence. Practical implications-The paper indicates that unfiltered information (data from policy evaluations and registries) constitutes majority of the research evidence in health policies both in health policy, systems and services research. The paper seeks to advocate for the use of filtered information (peer reviewed, clinical trials and data from systematic reviews) in formulating health policies. Originality/value-There is dearth of literature on the levels of health research evidence in health policy-making both in health policy, systems and services research. This study seeks to bridge the gap with empirical evidence from a developing country perspective.

Purpose -The aim of this paper is to determine the impact of the structural adjustment policies on library and information services in the University of Malawi Libraries. Design/methodology/approach -A case study methodology was adopted, and data -budget documents and various reports and technical papers -were collected. Findings -Findings show that libraries in this study were affected by the structural adjustment reforms. Budgets of the libraries increased but were affected by currency devaluations, unavailability of foreign exchange to pay for subscriptions and purchase books and this had negatively impacted on the provision of library and information services.Research limitations/implications -The study looks at implications of the structural adjustment policies in the five libraries in the University of Malawi, namely the Bunda College, Chancellor College, College of Medicine, Kamuzu College of Nursing and the Polytechnic only. However the results give a general picture of both academic and public libraries in Malawi. Practical implications -Libraries are encouraged to consider adopting UNESCO coupons to solve foreign exchange shortages for software and journal subscriptions as well as engage international publishers with local shops to circumvent paying for library purchases in foreign currency. Libraries are also encouraged to use the Malawi Library and Information Consortium (MALICO) for bargaining prices against ever escalating journal and book prices. Originality/value -The paper explores the impact of the structural adjustment polices in Malawi.

Purpose -The purpose of this paper is to look at effects of budgeting and financing of the University of Malawi Libraries (UML) on the provision of library and information services. Design/methodology/approach -A multi-case study methodological design approach was used, coupled with annual acquisition statistics and University Budget Estimates from 2003/2004 to 2010/2011 financial years. Interviews were conducted with library staff in all the five college libraries. Questionnaires were distributed to students and academic staff in the constituent colleges of the university.Findings -The results of the study have indicated that library and information resources in UML deteriorated despite increased material budgets. Most of the essential books were outdated and not found in UML libraries. Print periodicals were inconsistent and unsubscribed to. Most of the electronic journals were inaccessible and irrelevant to users' needs. Internet was slow due to low bandwidth. Indirectly, library and information services were negatively affected. Reference services in UML deteriorated. Compact Read Only Memory (CD-ROM) services were overtaken by users' preference for the internet, e-journals and online databases. Document delivery services were mostly disconnected because of non-payment of subscription fees. Current awareness services were choked by low levels of acquisitions. Low levels of acquisitions for local materials crippled exchange programme services. Interlibrary loan services were affected by inability to return loaned materials. Practical implications -The study recommends that college librarians should lobby for increased budgets for library and information resources. Donors should be approached to assist in paying for the internet and postage charges. Originality/value -Improved budgets for library and information resources will directly revamp library and information services. The services include reference services, current awareness, document delivery, interlibrary loans and exchange programmes.

Purpose -The purpose of this paper is to highlight the impact of strategic plans in the planning of information services and systems in the University of Malawi libraries.