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The relevant qualitative studies, though useful with discussions on the contribution of livelihood factors, could not contribute information on the estimate of the association between the livelihood measures of interest and adherence, and, as a result, were excluded.
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In addition to descriptive material, we abstracted data on prevalence e.g. of other livelihood factors associated with adherence, and the types and magnitudes of associations e.g. of education with adherence, reported in each study.
It can seriously impact on the livelihood factors of human such as lifestyle, productivity, societal activity, and health of an individual.
Some of these are consistent with the findings of our 2011 systematic review exploring livelihood factors and ART adherence [ 25] although we were limited by the available literature and could not identify new factors that may be relevant or specific to Malawi.
Importantly, the included studies reflect a range of experiences in the association between various livelihood factors and adherence to ARVs.
While few studies consistently measured the same independent (i.e. livelihood) factors and dependent variable (i.e. adherence) we chose to run three separate meta-regressions for each type of livelihood measure (financial, human, social) as a predictor to determine if there were individual effects on adherence levels.
The prevalence of various livelihood measures were determined and the proportion of participants reporting each livelihood factor was also captured from individual studies.
Education level was the most commonly measured livelihood factor.
For factors reflecting the harm of livelihood due to EWCE consequences, most interviewees reported that their families have been harmed by salinization and river erosion (Table 2).
There appears to be an increased awareness of mines/UXO risk, however, the fundamental factor still remains one of livelihood.
Other preventive factors included providing alternative and respected sources of livelihood, access to supportive social networks and alternative avenues for non-violent activism.
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