Malawi

    1. Improving high quality, equitable maternal health services in Malawi
    This project is implemented by the University of Malawi in collaboration with the University of British Columbia in Canada and the Ministry of Health in Malawi.

    Malawi has the highest preterm delivery rate in the world. This, paired with inadequate newborn care at health facilities, results in high rates of infant mortality. Managing the healthcare needs of preterm infants remains a challenge. They face complications during and after birth, and they have an increased risk of death, chronic medical problems, and malnutrition later in life.

    This project aligns with efforts in many other resource-constrained contexts to reduce neonatal mortality, through the implementation of innovative low cost and locally appropriate interventions in health facilities. These interventions include a package of care comprised of bubble continuous positive airway pressure for breathing support (bCPAP), low-cost phototherapy lights for treatment of jaundice, “hot cots” which are locally assembled for providing warmth to newborns, Kangaroo Mother Care for using a mother’s body heat for warmth, and optimal infant feeding through breastfeeding counselling. While a number of these interventions have been introduced into Malawi’s secondary and tertiary level health facilities, this project aims to identify barriers and facilitators to implementing innovative technologies for neonatal care in district hospital setting. Further, evaluating the costs of implementing these interventions will contribute to planning for scale up of these services to other parts of the country.

    2. Improving high quality, equitable maternal health services in Malawi (IMCHA)

    This project is implemented by the University of Malawi in collaboration with the University of Alberta, in Canada, the African Medical and Research Foundation (AMREF) and the Ministry of Health in Malawi.

    While Malawi has made progress toward better access to skilled delivery with approximately three out of every four women giving birth at a health facility, this has not translated into expected reduction in maternal deaths. Common causes of maternal deaths in Malawi include haemorrhage (bleeding), sepsis (infection) and hypertensive disorders (high blood pressure being one of the signs of this) - all requiring high-quality emergency obstetric care. Through a review of maternal deaths, it was identified that the majority of these deaths take place in health facilities, raising concerns about the poor quality of care. While poor quality of care can directly lead to maternal death, it can also deter women and their families from seeking timely care, with delay in access to care being a major determinant of poor health outcomes.

    This project explores how interventions that have been proven to enhance quality of care, specifically the Standards Based Management-Recognition for Reproductive Health initiative, are being operationalized in Malawi. This includes an assessment of the quality of maternal healthcare in facilities, identification of factors that support or undermine effectiveness of the initiative and development of strategies that further enhance its operation.

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