Malawi Dissertations
The Malawi Longitudinal Study of Families and Health (MLSFH) is one of very few long-standing publicly-available longitudinal cohort studies in a sub-Saharan African (SSA) context. It provides a rare record of more than a decade of demographic, socioeconomic and health conditions in one of the world’s poorest countries. With data collection rounds in 1998, 2001, 2004, 2006, 2008, 2010, 2012+2013, and forthcoming through 2020, for up to 4,000 individuals, the MLSFH permits researchers to investigate the multiple influences that contribute to HIV risks in sexual partnerships, the variety of ways that people manage risk within and outside of marriage, the possible effects of HIV prevention policies and programs, and the mechanisms through which poor rural individuals, families, households, and communities cope with the impacts of high morbidity and mortality that are often—but not always—related to HIV/AIDS. Graduate students in the Demography Ph.D. program offered via the Graduate Group in Demography and housed at the Population Studies Center at the University of Pennsylvania as well as graduate students working with MLSFH researchers at other institutions occasionally write dissertations on Malawi that are subsequently included in this series.
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Publication Changes in HIV/AIDS Knowledge, Attitudes and Behaviors in Malawi(2014-01-01) Fedor, TheresaThe three chapters of this dissertation collectively assess how HIV/AIDS knowledge, attitudes are behaviors are changing in Malawi. The first chapter assesses how married individuals use knowledge of HIV status to make behavioral changes to reduce HIV risk or make decisions about divorce. Instrumental variable models controlling for selection into HIV testing are estimated using data from the Malawi Longitudinal Study of Families and Health (MLSFH). Results indicate that knowledge of HIV status does not affect chances of divorce but does reduce the number of reported sexual partners among HIV-positive respondents, and increases reported condom use with spouses for both HIV-negative and HIV-positive respondents. The goals of the second and third chapters are to dig beneath behavior itself and look at how potential behavioral changes are motivated, as well as how basic HIV knowledge has changed. Chapter 2 examines ways that HIV prevention efforts may have changed beliefs and attitudes towards HIV risk and HIV prevention, in particular attitudes towards a woman's right to protect against HIV risk. Using MLSFH data, I compare participants and non-participants in a program providing extensive HIV counseling and testing. Results suggest that participants are more likely to believe that women have the right to take steps to protect themselves from HIV risk, are less likely to be extremely worried about HIV infection, and are more likely to think condom use is an acceptable means of protection against HIV. Chapter 3 explores how individuals update knowledge of HIV/AIDS transmission and prevention over time in Malawi. HIV knowledge uptake could potentially be different according to an individual's age, the time frame in which an individual was born, or could be changing predominately over time for all individuals (age, period or cohort). Using Demographic and Health Surveys Data for Malawi in cross-classified random effect age-period-cohort models, I find that period effects dominate over cohort or age effects, meaning that knowledge of effective HIV prevention tactics has increased most strongly over time, net of age and birth cohort effects.Publication Essays on Family Structure and Marriage in Sub-Saharan Africa(2013-01-01) Chae, SophiaThe three essays in this dissertation examine issues related to family structure and marriage in Sub-Saharan Africa. The first two essays explore how family structures influence children's outcomes. The third essay focuses on the data quality of marriage histories collected in a longitudinal survey. The first essay examines whether the timing and type of orphanhood is associated with early sexual debut and early marriage among 12-19-year-old adolescents in Burkina Faso, Ghana, Malawi, and Uganda. I also test whether education mediates orphans' risk of early sexual initiation and early marriage. Discrete-time event history models suggest that female double orphans, regardless of timing of orphanhood, have greater odds of early sexual debut than do nonorphans. Education explains little of their increased risk. In contrast, male orphans of any type reveal no increased vulnerability to early sexual debut. Uganda is the only country where female orphans, specifically double orphans and those who are paternal orphans before age 10, have greater odds of early marriage, with education accounting for a small portion of the risk. The second essay investigates the relationship between parental divorce and children's schooling in rural Malawi. Child fixed effects regression models are used to control for unobserved heterogeneity that could affect both parental divorce and children's schooling. Results suggest that children from divorced marriages have completed, on average, fewer grades of schooling than children from intact marriages. No differences in current school enrollment and schooling gap (among children currently in school) are found by parents' marriage status. The third essay measures the reliability of marriage histories collected in two waves of the Malawi Longitudinal Study of Families and Health. Multivariate regression analyses are used to examine the characteristics associated with misreporting marriages and dates of marriage. Paired and unpaired statistical tests assess whether marriage indicators are affected by misreporting. Results indicate that a significant proportion of marriages are underreported and that misreporting is not random. Several individual, marriage, and survey-related characteristics are associated with underreporting marriages and misreporting marriage dates. I also find that misreporting leads to biased marriage indicators.Publication Influences on Children's Human Capital in Rural Malawi(2013-01-01) Appiah-Yeboah, Shirley AfuaThe circumstances that characterize poor, rural communities in Malawi suggest that children's health-wealth gradient can vary from other settings. This dissertation begins with a description of the methods used to create a household wealth variable using assets data in the Malawi Longitudinal Study of Families and Health project. By using a fixed effects model to minimize omitted variable bias, I determine the influence of participating in a farm subsidy program on the levels of household wealth in 2004, 2006 and 2008. The results show that the program is positively associated with the wealth index score and this association is stronger when using lagged explanatory variables. This chapter demonstrates how asset data broadens the possibilities of wealth-poverty research that can be undertaken in poor settings. In the next chapter, I use the wealth index to identify a health-wealth gradient for children under 5 years, and I determine whether the gradient varies with age. I find that children in wealthier households have decreased risk of stunting but this is not significant until the oldest age groups (36-47 and 48-59 months). While there is no apparent health-wealth gradient across these ages, there is evidence of an emerging gradient as children get older. The final chapter explores the role of maternal social capital in children's schooling outcomes, using an index measure of women's membership in community groups and instrument variable analysis to address endogeneity concerns. I find that maternal social capital has a significant, positive association with primary school enrollment for younger children and primary school completion for older children. In contrast, maternal social capital has significant, negative association with school enrollment for older children. Maternal social capital is discussed within the context of government policies to improve enrollment and retention. Poor, rural children in Malawi face unique circumstances that have long-lasting implications. The findings across these chapters underscore the need for research that contextualizes and seeks to understand these specific challenges. If this can be achieved, Malawian children have a better chance in becoming healthier, productive adults.Publication The Production and Circulation of AIDS Knowledge in Malawi(2011-05-16) Biruk, CrystalAs the AIDS epidemic continues to spread across Africa, a demand for evidence produced by policy-relevant research means that expatriate-led research projects have become a fixture in highly infected countries. While many have drawn attention to the social and economic consequences of AIDS suffering, few have documented the everyday practices, contradictions and politics of producing AIDS-related knowledge in impoverished contexts. This study examines the ways in which AIDS survey research projects in Malawi produce new socialities and mobilities, generate new exclusions and inclusions and reconfigure expertise and evaluations of knowledge. Rather than focusing on a single knowledge community, the study follows AIDS knowledge itself as it is formulated and circulates through sites of production (the “field”), conversion and manipulation (the office) and consumption (conferences, journal articles or other forums). Drawing on twenty months of ethnographic fieldwork in 2005 and 2007-08 with case study research projects, researchers, fieldworkers, rural research participants and policy makers in Malawi, this study examines how actors’ positioning within the social field of “AIDS research” informs their stakes in research and analyzes the tactics they employ to achieve them. Central to the study is an illustration of how boundaries and differences (between people, knowledge and context) are produced and negotiated within interactions between actors with multiple and crisscrossing commitments, interests and ideas.