BACKGROUND: The shortage of doctors in all specialties in Malawi is particularly severe in rural areas. Contributory factors are the low number of students graduating each year, migration of doctors, and the preference of new graduates for practising in urban areas. Attempts to increase the output from Malawi's only medical school are insufficient to meet the country's healthcare needs. METHODS: We studied the factors influencing career choices of medical undergraduates of the College of Medicine in Blantyre, Malawi, who were surveyed by means of a self-administered questionnaire (N=205) and individual interviews (N=17). RESULTS: Most respondents (89.4%) indicated that they intend to specialise abroad, predominantly to study in 'better institutions' and to get the 'experience' of a different country; 87.0% indicated that they intend to live in Malawi long-term. Although, in general, the rural lifestyle was unattractive to medical students, respondents from rural areas and small towns, and whose parents were 'non-professionals', were more likely to intend working in rural areas and small towns, and to settle in Malawi, than students from urban and professional families. CONCLUSIONS: The College of Medicine should consider increasing its intake of students with lower socio-economic backgrounds and from rural areas/small towns to increase the number of doctors working in rural areas and settling in Malawi. However, the Ministry of Health may need a multipronged approach to reduce the mismatch between doctors' career expectations and the country's healthcare needs.

OBJECTIVE: There is a growing interest in injury as a public health issue across the world. There is paucity of data on the prevalence and social correlates of non-fatal interpersonal violence in low- and middle-income income nations. The objective of this study was to estimate the prevalence of, and associated factors for physical fighting among school-going adolescents in Santiago, Chile. METHOD: We conducted a secondary analysis of the Chilean Global School-Based Health Survey conducted in 2004 in Santiago. We aimed to assess the prevalence and social correlates of having been involved in a physical fight in the prior 12 months. RESULTS: Of the 2111 respondents, 40.7% (54.3% males and 26.6% females) reported having been in a physical fight in the prior 12 months. Males were more likely to have been in a physical fight than females [OR = 3.89, 95% CI (3.11, 4.85)]. Substance use (cigarette smoking, drinking alcohol, and using drugs) and bullying victimization were positively associated with fighting [OR = 3.05, 95% CI (2.40, 3.87) for substance use, and OR = 1.65, 95% CI (1.32, 2.05) for bullying]. Parental supervision was negatively associated with physical fighting [OR = 0.62, 95% CI (0.50, 0.78)]. CONCLUSION: We have estimated the prevalence of having engaged in a physical fight among in-school adolescents in Santiago, Chile. We have found that the prevalence is similar to what has been reported in diverse settings in Africa, Europe and North America.

OBJETIVO: Existe un creciente interés en el daño como un asunto de salud pública a través del mundo. Hay escasez de datos en la prevalencia y correlaciones sociales de violencia interpersonal no fatal, en naciones con bajos y medianos ingresos. El objetivo de este estudio fue estimar la prevalencia y el factor asociado a lucha física entre estudiantes adolescentes en Santiago, Chile. MÉTODO: Hemos conducido un análisis secundario de la Encuesta Global Chilena de Salud Basada en Escuelas, realizada en el 2004 en Santiago. Nuestro objetivo fue determinar la prevalencia y correlaciones sociales de haber estado involucrado en agresión física en los pasados 12 meses. RESULTADOS: De los 2111 respondedores, 40.7% (54.3% masculinos y 26.6% femeninos) reportaron haber estado en una agresión física en los pasados 12 meses. Los varones tuvieron más probabilidad de haber estado en una agresión física que las mujeres [OR = 3.89, 95% CI (3.11, 4.85)]. El uso de substancias (fumar cigarros, beber alcohol y usar drogas) e intimidaciones violentas estuvieron positivamente asociados con agresión [OR = 3.05, 95% CI (2.40, 3.87)] La supervisión parental estuvo asociada negativamente con agresión física [OR = 0.62, 95% CI (0.50, 0.78)]. CONCLUSIÓN: Hemos estimado la prevalencia de haber estado involucrado en una agresión física entre adolescentes escolares en Santiago, Chile. Encontramos que la prevalencia es similar a la que ha sido reportada en diversos lugares en Africa, Europa y Norteamérica.