Charles Michelo

Charles Michelo
Harvest University Lusaka Zambia · Harvest Institute of Global Health Health (HIGH)

BSc., MBChB, MPH, MBA, PhD
Director, Harvest Research Institutes, School of Public Health, Harvest University, Lusaka, Zambia

About

196
Publications
48,495
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2,479
Citations
Additional affiliations
January 2010 - June 2016
University of Zambia
Position
  • Head of Department
January 2006 - December 2012
University of Bergen
August 2002 - December 2006
University of Bergen
Position
  • PhD

Publications

Publications (196)
Article
Full-text available
Background: The study examined the association between HIV infection and individual and neighbourhood-level socioeconomic factors in Zambia. Methods: We used multilevel mixed effects logistic regression to examine the association of individual and neighbourhood level variables on HIV prevalence based on data from the 2013-14 and 2018 Zambia Demo...
Article
Full-text available
Background: Human Immunodeficiency Virus (HIV) pandemic has become a serious public health concern worldwide. The prevalence of paediatric HIV infection is largely unknown in many countries in Sub-Saharan Africa (SSA). We aimed to determine the prevalence and predictors of HIV infection among under-5 years children in Muheza District, Tanzania. Met...
Article
Full-text available
Introduction This article aimed to analyse constructions of adolescents’ sexualities and sexual health and the consequences of these discourses for adolescents’ exercise of their sexual reproductive health and rights (SRHR) in rural Zambia. Methods Interpretative repertoires, which is rooted in discursive psychology was used to analyse data from p...
Preprint
Background The global burden of malaria has increased from 227 million cases in 2019 to 247 million cases in 2020. Indoor residual spraying (IRS) remains one of the most effective control strategies for malaria. The current study sought to measure the acceptability level and associated factors of indoor residual spraying. Methods A cross sectional...
Article
Full-text available
Plain language summary Adolescent pregnancy carries health and economic risks for the pregnant girl and her baby. However, many adolescent girls in Zambia become pregnant and this is partly due to social norms around fertility and marriage. Community dialogue meetings may be useful in order to discuss norms and beliefs around early pregnancy, marri...
Article
Full-text available
Background The burden of disease attributable to tobacco smoking and harmful alcohol consumption poses a major threat to sustainable development in most low- and middle-income countries. However, evidence on tobacco use and harmful alcohol consumption to inform context-specific interventions addressing these harmful social behaviours is limited in...
Article
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This editorial introduces the eleven papers in the special issue titled: The multiple lenses on the community health system: implications for research and action. Our editorial begins by describing the collaboration that led to the special issue, and then gives an overview of the contents of the special issue, which include two framing papers and n...
Article
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Background: Although provision of sanitary facilities in workplaces is an important issue, very few studies have been undertaken in this regard. Objective: This study assessed the provision of sanitary facilities for market traders and their perceptions of the provided facilities in Lusaka district Zambia. Methods: A cross-sectional study of w...
Article
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Background The Zambia Medicines Regulatory Authority (ZAMRA) piloted the implementation of Guidelines on Operating Health Shops in Zambia in 2016, with a view to making basic medicines more accessible to communities. The guidelines aim to transform ordinary drug shops into health shops, which are dispensing facilities permitted to sell a ZAMRA-pres...
Article
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There have been increased calls for low and middle-income countries to develop community health systems policies or strategies. However, emerging global guidance brackets the inherent complexity and contestation of policy development at the country level. This is explored through the case of Zambia’s 5-year Community Health Strategy (CH Strategy),...
Article
Background: Surgery for hydrocele is commonly promoted as part of morbidity management and disability prevention (MMDP) services for lymphatic filariasis (LF). However, uptake of these surgeries has been suboptimal owing to several community level barriers that have triggered mistrust in such services. This study aimed at documenting mechanisms of...
Article
Full-text available
Background: Adolescents face significant barriers to access and utilization of sexual and reproductive health services in many low-income settings, which in turn may be associated with adverse consequences such as early pregnancy, sexually transmitted infections, unsafe abortion and mortality. There is evidence suggesting that limited access to se...
Article
Full-text available
Background The burden of child under-nutrition still remains a global challenge, with greater severity being faced by low- and middle-income countries, despite the strategies in the Sustainable Development Goals (SDGs). Globally, malnutrition is the one of the most important risk factors associated with illness and death, affecting hundreds of mill...
Article
Full-text available
Background: The Scanning Ears for Child Health (SEARCH) system is a biometric patient identification tool which uses a pattern recognition algorithm to translate an image of the ear into a unique identifier. If integrated into an electronic medical records (EMR) system, it would provide a patient identification solution that replaces unreliable pap...
Conference Paper
Full-text available
Background This study estimated the prevalence of curable sexually transmitted and reproductive tract infections (STIs/RTIs) among pregnant women attending antenatal care (ANC) in rural Zambia and evaluated the effectiveness of syndromic management of STIs/RTIs versus reference-standard laboratory diagnoses. Methods This was an observational cross...
Conference Paper
Full-text available
Background Malaria and curable sexually transmitted and reproductive tract infections (STIs/RTIs) are important causes of adverse birth outcomes. HIV has been associated with STIs/RTIs and malaria infection. The study objectives were to estimate the prevalence of malaria and STIs/RTIs and to identify risk factors for infection in rural Zambia. Met...
Article
Background Adolescent fertility is a global health and sustainable development indicator, and requires robust information systems for priority setting and decision-making to control. Evidence-based decision making for health stresses the use of scientific objective data and methodologies, which typically sieve out the more contextually understood s...
Preprint
Full-text available
Background: The burden of disease attributable to tobacco smoking and harmful alcohol consumption poses a major threat to sustainable development in most low- and middle-income countries. However, evidence on tobacco use and harmful alcohol consumption to inform context-specific interventions addressing these harmful social behaviours is limited in...
Article
Full-text available
Background Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia. Methods A qualit...
Preprint
Full-text available
Objective With the spread of COVID-19 to most low-and middle- income countries, global concerns arise on how to respond to the pandemic. We seek to highlight the early response to COVID-19 of Tanzania, Uganda and Zambia and draw lessons on how community actors could be engaged in the global efforts to prevent its spread and resurgence. This is envi...
Article
Full-text available
Introduction. Globally, there is a growing concern over antimicrobial resistance (AMR) which is currently estimated to account for more than 700,000 deaths per year worldwide. AMR undermines the management of infectious diseases in general especially in pregnancy where significant bacteriuria continues to be a serious cause of maternal and perinata...
Article
Full-text available
Background This study estimated the prevalence of curable sexually transmitted and reproductive tract infections (STIs/RTIs) among pregnant women attending antenatal care (ANC) in rural Zambia, evaluated the effectiveness of syndromic management of STIs/RTIs versus reference-standard laboratory diagnoses, and identified determinants of curable STIs...
Article
Full-text available
Background Morbidity management and disability prevention (MMDP) services are essential for the management of chronic stages of lymphatic filariasis (LF) infection. However, there is limited information on health beliefs and health seeking behavior towards MMDP services for LF in endemic regions of Zambia. This study sought to document health belie...
Preprint
Full-text available
Introduction: This article aimed to analyse constructions of adolescents’ sexualities and sexual health and the consequences of these discourses for adolescents’ exercise of their sexual reproductive health and rights (SRHR) in rural Zambia. Methods: We analysed data from photo-elicitations interviews and focus group discussions with 25 adolescents...
Article
Full-text available
Background The World Health Organization recommends the provision of intermittent preventive treatment during pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) at 4-week intervals from gestational week 13 to delivery in areas of moderate to high malaria transmission intensity. However, the effect of IPTp-SP has been compromised in some areas due...
Article
Sexually transmitted infections have remained a public health problem mainly in the developing world, where the burden of HIV is also high. Effects of sexually transmitted infections can be devastating and have also been shown to enhance transmission of HIV. The risk of transmission depends on the type of infection, whether it presents with an ulce...
Article
Full-text available
Background Maternal iodine deficiency is one of the common causes of morbidity and mortality during pregnancy. Maternal iodine deficiency during pregnancy is associated with a number of adverse outcomes such as abortion, stillbirth, congenital anomalies, perinatal mortality and irreversible mental retardation. A study conducted in Zambia among preg...
Article
Full-text available
In many settings, and perhaps especially in low-middle income countries, training institutions do not adequately prepare their students for the ethical challenges that confront them in professional life. We conducted a survey to assess the training needs in research ethics among the faculty at the University of Zambia, School of Medicine (UNZASoM)...
Article
Background Vitamin A (VA) deficiency (VAD) affects ∼19 million pregnant women worldwide. The extent of VAD in Zambian women of reproductive age is unknown owing to lack of survey inclusion or the use of static serum retinol concentrations, a low-sensitivity biomarker. Objectives This cross-sectional study employed isotopic techniques to determine...
Article
Full-text available
Background As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on a needs assessment conducted among health services organisations (HSOs) to understand postgraduate training needs and se...
Preprint
Full-text available
Background Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia. Methods A qualita...
Preprint
Full-text available
Background: Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia. Methods: A quali...
Article
Full-text available
Background: About 13 years since the introduction of antiretroviral therapy (ART) for children living with HIV (CLHIV) in Zambia, HIV/AIDS testing and treatment guidelines for children have evolved over the years with limited documentation of long-term trends in the numbers testing HIV positive and initiating ART. We examined trends in HIV testing...
Article
Full-text available
Background: Research conducted before the introduction of anti-retroviral therapy (ART), showed that the majority of children living with HIV (CLHIV) would die before their second birthday. In Zambia, ART was rolled out to the public health system in 2004 with subsequent improved survival in CLHIV. However, the survival rates of CLHIV on ART in Zam...
Article
Full-text available
Cryptosporidium spp. is one of the leading causes of diarrhoeal disease globally. In Zambia, the burden of Cryptosporidium infection in the general human population is unknown and factors associated with it are unclear. A study was conducted to determine the prevalence of Cryptosporidium spp. and identify factors associated with its infection among...
Preprint
Full-text available
Background: Evidently, socioeconomic factors are strongly associated with HIV infection, however, the pattern of association varies. Understanding how these factors influence HIV infection can help public health authorities design targeted comprehensive prevention strategies. Methods: We used multi-level logistic regression models to examine the a...
Preprint
Full-text available
Background Adolescents face significant barriers to access and utilization of sexual and reproductive health services in many low-income settings which in turn may be associated with adverse consequences such as early pregnancy, sexually transmitted infections and unsafe abortion and mortality. There is evidence suggesting that limited access to se...
Preprint
Full-text available
Background: Adolescents face significant barriers to access and utilization of sexual and reproductive health services in many low-income settings which in turn may be associated with adverse consequences such as early pregnancy, sexually transmitted infections and unsafe abortion and mortality. There is evidence suggesting that limited access to s...
Article
Full-text available
Background: Mother to child transmission of HIV (MTCT) is a global challenge affecting many countries especially in sub-Saharan Africa. In 2009 about 370,000 infants were infected with HIV mainly through MTCT and most of them in sub-Saharan Africa. We aimed to determine the effectiveness of Option B+ compared to other options in reducing rates of e...
Article
Full-text available
Introduction: Community-based sexual reproductive interventions are key in attaining universal health coverage for all by 2030, yet adolescents in many countries still lack health services that are responsive to their sexual reproductive health and rights' needs. As the first step of realist evaluation, this study provides a programme theory that...
Article
Full-text available
Background: Iron and Folic Acid are two of the micronutrients recommended for pregnant women to support optimal maternal outcomes with regard to preventing anaemia and foetal birth defects. It is difficult to establish if women provided with iron and folic acid supplementation in Zambia benefit from it and how well it is implemented. The overall o...
Preprint
Full-text available
Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on the needs assessment conducted to understand postgraduate training needs for three selected public health disciplines –...
Article
Adolescent health demands specific attention because adolescents have the lowest levels of health-care coverage of any age-group globally. The main objective as addressed in this article was to explore the lived experience of adolescent mothers and the services provided to them by community health assistants (CHAs) in rural Zambia. Because the numb...
Article
Full-text available
Background: One important ethical issue in randomised controlled trials (RCTs) is randomisation. Relatively little is known about how participating individuals and communities understand and perceive central aspects of randomisation such as equality, fairness, transparency and accountability in community-based trials. The aim of this study was to...
Article
Full-text available
Background: Reproductive health problems such as HIV, unwanted pregnancy and unsafe abortion among adolescents are closely linked to insufficient knowledge about sexuality and reproduction and lack of access to contraceptives. Supported by international agencies, Zambia has introduced an ambitious nation-wide program for comprehensive sexuality ed...
Article
Full-text available
Corrigendum: Change co-author name to Stephen Maluka. Article abstract czz042: Priority setting within health systems has not led to accountable, fair and sustainable solutions to improving population health. Providers, users and other stakeholders each have their own health and service priorities based on selected evidence, own values, expertise...
Preprint
Full-text available
Background As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on the needs assessment conducted to understand postgraduate training needs for three selected public health disciplines –...
Preprint
Full-text available
Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on the needs assessment conducted to understand postgraduate training needs for three selected public health disciplines –...
Preprint
Full-text available
Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on a needs assessment conducted among health services organisations (HSOs) to understand postgraduate training needs and s...
Preprint
Full-text available
Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on a needs assessment conducted among health services organisations (HSOs) to understand postgraduate training needs and s...
Preprint
Full-text available
Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on a needs assessment conducted among health services organisations (HSOs) to understand postgraduate training needs and s...
Preprint
Full-text available
Background: As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on a needs assessment conducted among health services organisations (HSOs) to understand postgraduate training needs and s...
Article
Full-text available
Introduction: Although large scale public sector community health worker programs have been key in providing sexual and reproductive health (SRH) services in low- and middle-income countries, their integration process into community health systems is not well understood. This study aimed to identify the conditions and strategies through which Comm...
Article
Full-text available
Priority setting within health systems has not led to accountable, fair and sustainable solutions to improving population health. Providers, users and other stakeholders each have their own health and service priorities based on selected evidence, own values, expertise and preferences. Based on a historical account, this article analyses if contemp...
Article
Full-text available
In the original publication of this article [1], there are several errors. The original sentences and corrections are listed below:
Preprint
Full-text available
Background There are evidences of the association between socio-economic factors and HIV prevalence in Sub-Saharan Africa. However, there is dearth of information on such relationship in Tanzania. Here, we present data on the relationship between household’s socio-economic factors and HIV prevalence among under five-year children in Muheza district...
Article
Full-text available
Background The HIV epidemic remains a concern on the global health agenda, despite progress made in reducing incidence. Investigation of trends among young people is important for monitoring HIV incidence and informing programming. The study examined geographical and sub-population differences in HIV prevalence trends among young people aged 15–24...
Article
Full-text available
Background According to the World Health Organization (WHO), 1.24 million people die annually on the world’s roads, with 20-50 million sustaining non-fatal injuries. More than 85% (1.05 million) of the global deaths due to injuries occur in the developing world. Road traffic deaths and injuries are a major but neglected public health challenge that...
Article
Full-text available
Background Malaria is among the top causes of mortality and morbidity in Zambia. Efforts to control, prevent, and eliminate it have been intensified in the past two decades which has contributed to reductions in malaria prevalence and under-five mortality. However, there was a 21% upsurge in malaria prevalence between 2010 and 2015. Zambia is one o...
Article
Full-text available
Background: The SAFE strategy (surgery for trichiasis, antibiotics for active infection, facial cleanliness and environmental improvement) is the World Health Organization (WHO) recommended guideline for the elimination of blindness by trachoma by the year 2020. Objective: While evaluations on the implementation of the SAFE strategy have been done,...
Article
Full-text available
Insufficient dietary intake, micronutrient deficiencies, and infection may result in malnutrition. In Zambia, an estimated 14% of women are vitamin A-deficient, ~50% are anemic, 10% are underweight, and 23% are overweight/obese. A cross-sectional survey determined food and nutrient intakes of randomly selected Zambian women (n = 530) of reproductiv...
Article
Full-text available
Introduction The Zambian Termination of Pregnancy Act permits abortion on socio-economic grounds, but access to safe abortion services is limited and this constitutes a considerable problem for rights to sexual and reproductive health. The case of Zambia provides an opportunity to explore the relationship between a legal framework that permits abor...