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Joseph Mfutso-Bengo

Joseph Mfutso-Bengo
Kamuzu University of Health Sciences-former Malawi-College of Medicine Blantyre Malawi · School of Global and Public Health (SOGAPH)

PhD, MA., Dipl. Phil.
Ethical decision-science, VEDMAP -Decision-making modelling APP, The role Ethics and values in priority setting,

About

110
Publications
87,164
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1,350
Citations
Additional affiliations
January 2001 - January 2014
University of Malawi
Position
  • I have been Head of Community Health for 10 years and deputy dean for post graduate. I Held the post of the chair of college of medicine research and ethics committee for six years. i was also the principal investigator for Wellcome Trust bioethics and anthropological research projects. I am also recipient of Fogarty Bioethics training grant, • European & Developing Countries Clinical Trials Partnership(ECDTP) research & IRB capacity building grants, • AMANET Ethics Review Committee capacity building Grant. I am Associate Editor for Oxford University journal on Public health Ethics and an editorial board member of Springer journal theoretical medicine and Bioethics. A ex- member of WHO International working group on Ethical Issues in Research and Surveillance. worked as an external expert to advise Pfizer funded Harvard University Multi-Regional ClinicalTrials Project. Worked as Ethics advisor to HIVrevention Trials Network. A recipient of American Government US National Institute of Health Special (NIH) Medal for dedication and excellence in data safety monitoring consultancy at NIH. 2005 An honour to be appointed by prestigious US Institute of Medicine of the National Academies -to be a external reviewer of a online book titled “On Scaling up Treatment for The Global AIDS Epidemic” http://books.nap.edu/books/0309092647/html/R1.html. Appointed an advisory board to John Hopkins University Forgarty Bioethics Program. One of the organisers of 2005 global forum for Bioethics in Blantyre -Malawi.
Description
  • I am working as a full professor of Bioethics and director of center of bioethics at College of Medicine -University of Malawi mahatma Gandhi Street private bag 360, BLANTYRE MALAWI
December 2001 - December 2014
College of Medicine-University of Malawi
Position
  • Professor of Bioethics
Description
  • We conduct anthropological and bioethics study funded by Wellcome Trust and EDCTP We offer masters degree in public health with specialization in research ethics and public health ethics

Publications

Publications (110)
Preprint
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The Thanzi La Mawa (TLM) study aims to enhance understanding of healthcare delivery and resource allocation in Malawi by capturing real-world data across a range of health facilities. To inform the Thanzi La Onse (TLO) model, which is the first comprehensive health system model developed for any country, this study uses a cross-sectional, mixed-met...
Preprint
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Development assistance for health (DAH) to Malawi will likely decrease as a fraction of GDP in the next few decades. Given the country's significant reliance on DAH for the delivery of its healthcare services, estimating the impact that this could have on health projections for the country is particularly urgent. We use the Malawi-specific, individ...
Preprint
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Objective Huge investments in HIV, TB, and malaria (HTM) control in Malawi have greatly reduced disease burden. However, the joint impact of these services across multiple health domains and the health system resources required to deliver them are not fully understood. Methods An integrated epidemiological and health system model was used to assess...
Article
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An efficient allocation of limited resources in low-income settings offers the opportunity to improve population-health outcomes given the available health system capacity. Efforts to achieve this are often framed through the lens of “health benefits packages” (HBPs), which seek to establish which services the public healthcare system should includ...
Article
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Background To make the best use of health resources, it is crucial to understand the healthcare needs of a population—including how needs will evolve and respond to changing epidemiological context and patient behaviour—and how this compares to the capabilities to deliver healthcare with the existing workforce. Existing approaches to planning eithe...
Article
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Background The Coronavirus disease-2019 (COVID-19) vaccines were rolled out in many countries; however, sub-optimal COVID-19 vaccine uptake remains a major public health concern globally. This study aimed at assessing the factors that affected the uptake, hesitancy, and resistance of the COVID-19 vaccine among university undergraduate students in M...
Preprint
Full-text available
Background: To make the best use of health resources, it is crucial to understand the healthcare needs of a population – including how needs will evolve and respond to changing epidemiological context and patient behaviour – and how this compares to the capabilities to deliver healthcare with the existing workforce. Existing approaches to planning...
Article
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Despite making remarkable strides in improving health outcomes, Malawi faces concerns about sustaining the progress achieved due to limited fiscal space and donor dependency. The imperative for efficient health spending becomes evident, necessitating strategic allocation of resources to areas with the greatest impact on mortality and morbidity. Hea...
Article
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Objectives. Preterm infants are at risk of hypothermia. This study described the available infant warming devices (IWDs) and explored the barriers and facilitators to their implementation in neonates in Malawi. Methods. A qualitative descriptive study was conducted among 19 health care workers in Malawi from January to March 2020. All interviews we...
Preprint
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Despite improvements in maternal and perinatal health in Malawi, morbidity and mortality remain high, partially due to gaps in the coverage and quality of health services. We developed an individual-based simulation model of maternal and perinatal health and healthcare in Malawi, situated in a ‘whole-health system, all-disease’ framework. We consid...
Preprint
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Background Decisions need to be made in all healthcare systems about the allocation of available resources with the aim of improving population health. Evidence is needed for these decisions, which can have enormous consequences for population health, especially in lower-income settings. Methods We address this need using an individual-based simul...
Article
Malawi has high unmet need for contraception with a costed national plan to increase contraception use. Estimating how such investments might impact future population size in Malawi can help policymakers understand effects and value of policies to increase contraception uptake. We developed a new model of contraception and pregnancy using individua...
Article
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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 prevailin...
Article
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Background Research ethics is intertwined with and depends on building robust and responsive research governance systems alongside researchers. Globally there has been substantial investment in agriculture, nutrition, and health (ANH) research motivated by the need to improve health outcomes, such as micronutrient deficiencies in Sub-Saharan Africa...
Article
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Objective The objective of this study was to assess the feasibility and acceptability of institutionalizing Health Technology Assessment (HTA) in Malawi. Methods This study employed a document review and qualitative research methods, to understand the status of HTA in Malawi. This was complemented by a review of the status and nature of HTA instit...
Article
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The existence and availability of evidence on its own does not guarantee that the evidence will be demanded and used by decision and policy makers. Decision and policy-makers, especially in low-income settings, often confront ethical dilemmas about determining the best available evidence and its utilization. This dilemma can be in the form of confl...
Article
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Background In 2007 WHO and UNAIDS recommended communication interventions as a key strategy for creating demand for Voluntary Medical Male Circumcision (VMMC) in Southern Africa. In Malawi, VMMC communication interventions, implemented by health communication agencies, have effectively raised awareness of services. However, high awareness of VMMC h...
Article
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Equitable access and utilization of the COVID-19 vaccine is the main exit strategy from the pandemic. This paper used proceedings from the Second Extraordinary Think-Tank conference, which was held by the Health Economics and Policy Unit at the Kamuzu University of Health Sciences in collaboration with the Malawi Ministry of Health, complemented by...
Article
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Environmental surveillance of rivers and wastewater for SARS-CoV-2 detection has been explored as an innovative way to surveil the pandemic. This study estimated the economic costs of conducting wastewater-based environmental surveillance for SARS-CoV-2 to inform decision making if countries consider continuing these efforts. We estimated the cost...
Article
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AimMalawi officially launched Voluntary Male Medical Circumcision (VMMC) in 2012 after the 2007 joint WHO /UNAIDSrecommendation that VMMC be a key HIV prevention strategy for Sub-Sahara African region. Malawi data, however, contradicted thefindings of three randomized studies conducted in Uganda, Kenya and South Africa between 2005 and 2007. While...
Article
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Background Road traffic injuries are a significant cause of death and disability globally. However, in some countries the exact health burden caused by road traffic injuries is unknown. In Malawi, there is no central reporting mechanism for road traffic injuries and so the exact extent of the health burden caused by road traffic injuries is hard to...
Article
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Health technology assessment (HTA) offers a set of analytical tools to support health systems' decisions about resource allocation. Although there is increasing interest in these tools across the world, including in some middle-income countries, they remain rarely used in low-income countries (LICs). In general, the focus of HTA is narrow, mostly l...
Preprint
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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...
Preprint
Full-text available
Background In 2007 WHO and UNAIDS recommended communication interventions as a key strategy for creating demand for Voluntary Medical Male Circumcision (VMMC) in Southern Africa. In Malawi, VMMC communication interventions, implemented by health communication agencies, have effectively raised awareness of services. Ironically, high awareness of VMM...
Article
Full-text available
This special communication discusses the current legal and ethical requirements for informed consent to medical treatment of adults in Malawi. It analyzes the scope of the laws and code of ethics on professional discipline, including criminal privilege for surgeries and clarifies when insufficient disclosures entitle patients to compensation under...
Article
Introduction By 2030, the noncommunicable diseases (NCDs) are expected to overtake communicable, maternal, neonatal, and nutritional diseases combined as the leading cause of mortality in sub-Saharan Africa. With the increasing trend in NCDs, the NCD risk factors (NCDRF) need to be understood at local level to guide NCD risk mitigation efforts. The...
Article
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Background Severe neonatal jaundice can result in long term morbidities and mortality when left untreated. Phototherapy is the main-stay intervention for treating moderate jaundice and for prevention of the development of severe jaundice. However, in resource-limited health care settings, phototherapy has been inconsistently used. The objective of...
Preprint
Full-text available
Background Road traffic injuries are a significant cause of death and disability globally. However, in some countries the exact health burden caused by road traffic injuries is unknown. In Malawi, there is no central reporting mechanism for road traffic injuries and so the exact extent of the health burden caused by road traffic injuries is hard to...
Preprint
Full-text available
The existence and availability of evidence on its own does not guarantee that the evidence will be demanded and used by decision-makers or health policymakers for decision making and policy formulation. In addition to effective resource allocation, decision-makers, especially in low-income settings often confront ethical dilemmas about determining...
Article
Full-text available
Introduction In 2016, the WHO published recommendations increasing the number of recommended antenatal care (ANC) visits per pregnancy from four to eight. Prior to the implementation of this policy, coverage of four ANC visits has been suboptimal in many low-income settings. In this study we explore socio-demographic factors associated with early i...
Article
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Background There have been notable investments in large multi-partner research programmes across the agriculture-nutrition-health (ANH) nexus. These studies often involve human participants and commonly require research ethics review. These ANH studies are complex and can raise ethical issues that need pre-field work, ethical oversight and also nee...
Article
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Background: Selenium deficiency is widespread in the Malawi population. The selenium concentration in maize, the staple food crop of Malawi, can be increased by applying selenium-enriched fertilizers. It is unknown whether this strategy, called agronomic biofortification, is effective at alleviating selenium deficiency. Objectives: The aim of the A...
Article
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Background The participant recruitment process is a key ethical pivot point when conducting robust research. There is a need to continuously review and improve recruitment processes in research trials and to build fair and effective partnerships between researchers and participants as an important core element in ensuring the ethical delivery of hi...
Preprint
Full-text available
Background The objective of this study was to assess the feasibility and acceptability of institutionalizing Health Technology Assessment (HTA) in Malawi focusing on the form, scope, capacity and financing requirements for a limited resource setting such as Malawi.Methods This study employed a desk review and qualitative research methods. An extens...
Preprint
Full-text available
INTRODUCTION In 2016, the WHO published recommendations increasing the number of recommended antenatal care (ANC) visits per pregnancy from four to eight. Prior to the implementation of this policy, coverage of four ANC visits has been suboptimal in many low-income settings. In this study we explore socio-demographic factors associated with early i...
Article
Full-text available
Background Exclusive breastfeeding is widely accepted as a key intervention with proven efficacy for improving newborn survival. Despite international commitments and targets to support and promote breastfeeding, there are still gaps in meeting and maintain coverage in many sub-Saharan African countries. This paper aimed to triangulate the perspect...
Article
Full-text available
Background: COVID-19 mitigation strategies have been challenging to implement in resource-limited settings due to the potential for widespread disruption to social and economic well-being. Here we predict the clinical severity of COVID-19 in Malawi, quantifying the potential impact of intervention strategies and increases in health system capacity...
Article
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Background: This study reports findings from formative research conducted to assess the feasibility and inform the design and implementation of the Addressing Hidden Hunger with Agronomy (AHHA) trial. The AHHA trial was a randomised, controlled trial conducted in rural Malawi, in which participants were given maize flour biofortified with selenium...
Preprint
Full-text available
Background This study reports findings from formative research conducted to assess the feasibility and inform the design and implementation of the Addressing Hidden Hunger with Agronomy (AHHA) trial. The AHHA trial was a randomised, controlled trial conducted in rural Malawi, in which participants were given maize flour biofortified with selenium o...
Article
Full-text available
Introduction Kangaroo mother care (KMC) involves continuous skin-to-skin contact of baby on mother’s chest to provide warmth, frequent breastfeeding, recognizing danger signs of illness, and early discharge. Though KMC is safe, effective and recommended by the World Health Organization, implementation remains limited in practice. The objective of t...
Article
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Background Kangaroo mother care (KMC) is an effective intervention for preterm and low birth weight infants. Effective implementation of KMC relies on a multidisciplinary team centering on the newborn’s caregiver, who delivers care with support from health care workers. This study explored the experiences of caregivers on the implementation of KMC....
Article
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Introduction: Health seeking behaviour (HSB) refers to actions taken by individuals who are ill in order to find appropriate remedy. Most studies on HSB have only examined one symptom or covered only a specific geographical location within a country. In this study, we used a representative sample of adults to explore the factors associated with HS...
Article
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Objective To characterise health seeking behaviour (HSB) and determine its predictors amongst children in Malawi in 2016. Methods We used the 2016 Malawi Integrated Household Survey data set. The outcome of interest was HSB, defined as seeking care at a health facility amongst people who reported one or more of a list of possible symptoms given on...
Preprint
Full-text available
Background COVID-19 mitigation strategies have been challenging to implement in resource-limited settings such as Malawi due to the potential for widespread disruption to social and economic well-being. Here we estimate the clinical severity of COVID-19 in Malawi, quantifying the potential impact of intervention strategies and increases in health s...
Article
Full-text available
Background: There is growing interest in the collection, storage and reuse of biological samples for future research. Storage and future use of biological samples raise ethical concerns and questions about approaches that safeguard the interests of participants. The situation is further complicated in Africa where there is a general lack of govern...
Article
Full-text available
Background Preterm birth complications are the leading cause of neonatal deaths. Malawi has high rates of preterm birth, with 18.1 preterm births per 100 live births. More than 50% of preterm neonates develop respiratory distress which if left untreated, can lead to respiratory failure and death. Term and preterm neonates with respiratory distress...
Article
Full-text available
Background: Micronutrient deficiencies including selenium (Se) are widespread in Malawi and potentially underlie a substantial disease burden, particularly among poorer and marginalised populations. Concentrations of Se in staple cereal crops can be increased through application of Se fertilisers - a process known as agronomic biofortification (ag...
Preprint
Full-text available
Background Micronutrient deficiencies including selenium (Se) are widespread in Malawi and potentially underlie a substantial disease burden, particularly among poorer and marginalised populations. Concentrations of Se in staple cereal crops can be increased through application of Se fertilisers – a process known as agronomic (agro-) biofortificati...
Preprint
Full-text available
Background Micronutrient deficiencies including selenium (Se) are widespread in Malawi and potentially underlie a substantial disease burden, particularly among poorer and marginalised populations. Concentrations of Se in staple cereal crops can be increased through application of Se fertilisers – a process known as agronomic (agro-) biofortificati...
Article
Full-text available
Although community engagement is increasingly promoted in global health research to improve ethical research practice, there is sometimes a disconnect between the broader moral ambitions for community engagement in the literature and guidelines on the one hand and its rather narrower practical application in health research on the other. In practic...
Article
Full-text available
Most children die in low and middle-income countries as a result of structural injustice, and while it may not be possible to prove causality between economic policies and breaches of rights, it is possible to audit policy and practices through the lens of human rights. Child health advocates need to highlight the fact that technical interventions,...
Article
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Background Ensuring that countries have adequate research capacities is essential for an effective and efficient response to infectious disease outbreaks. The need for ethical principles and values embodied in international research ethics guidelines to be upheld during public health emergencies is widely recognized. Public health officials, resear...
Chapter
This chapter contextualises health rights and ethics to health programmes and interventions which have been of crucial importance in Africa. It clarifies how ethics principles are applied in ethics. it also shows how human rights and principles of bioethics are interrelated.
Chapter
What makes a good person good? Can a wrong action be a good action and consequently a right action be a bad action? These are questions which have plagued the philosophers and wise persons of antiquity and is still relevant all over the world, including Africa. The aim of this chapter is to position African ethics within the framework of Global Bio...
Article
Full-text available
Although community engagement is increasingly promoted in global health research to improve ethical research practice, there is sometimes a disconnect between the broader moral ambitions for community engagement in the literature and guidelines on the one hand and its rather narrower practical application in health research on the other. In practic...
Article
Full-text available
Controlled human infection (CHI) models are gaining recognition as an approach to accelerating vaccine development, for use in both non-endemic and endemic populations: they can facilitate identification of the most promising candidate vaccines for further trials and advance understanding of protective immunity. Helminths present a continuing healt...
Article
Full-text available
Controlled human infection (CHI) models are gaining recognition as an approach to accelerating vaccine development, for use in both non-endemic and endemic populations: they can facilitate identification of the most promising candidate vaccines for further trials and advance understanding of protective immunity. Helminths present a continuing healt...
Article
Full-text available
The aim of this paper is to present a new framework to design and run a responsive and resilient health system. It can be used by both private and public, profit and non-profit organizations in order to translate strategic goals of an organization into desirable and intended best practice, and results. This includes the health sector. The framework...
Presentation
A 107 presenter Jospeh Mfutso-Bengo Introduction: CHIM studies are currently and mainly being conducted in higher income countries. Very few CHIM studies are taking place in less developed parts of the world and the justification for this difference is not clear. FDA, EMEA and Singaporean Drug Agency have approved CHIM studies. The new most advance...
Book
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Bioethics is moral capital. Many countries have been investing their resources in knowledge and skills development (human capital) only, while ignoring right attitude (value-based learning and character formation).This book gives practical guidance on the use of bioethics in evidence and value based decision-making process and mind-building. From A...
Chapter
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Autonomy is a central principle in bioethics and research ethics. In this essay, a historical account of the moral and philosophical foundations for the principle of autonomy and its conceptualization in bioethical discourse is presented. An explanation on the application of autonomy in clinical practice and biomedical research by contextualizing i...
Article
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Background: This paper discusses the contentious issue of reuse of stored biological samples and data obtained from research participants in past clinical research to answer future ethical and scientifically valid research questions. Many countries have regulations and guidelines that guide the use and exportation of stored biological samples and...
Research
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A field report on ethical and cultural consideration of acceptability of the use of community based therapeutic feeding in Malawi
Chapter
Full-text available
Autonomy is a central principle in bioethics and research ethics. In this essay, a historical account of the moral and philosophical foundations for the principle of autonomy and its conceptualization in bioethical discourse is presented. An explanation on the application of autonomy in clinical practice and biomedical research by contextualizing i...
Article
Full-text available
Obtaining effective informed consent from research participants is a prerequisite to the conduct of an ethically sound research. Yet it is believed that obtaining quality informed consent is generally difficult in settings with low socioeconomic status. This is so because of the alleged undue inducements and therapeutic misconception among particip...