Background Postnatal care (PNC) service is a neglected yet an essential service that can reduce maternal, neonatal and infant morbidity and mortality rates in low and middle-income countries. In Malawi, maternal and infant mortality rates remain high despite numerous efforts by the government and its partners to improve maternal health service coverage across the country. This study examined the determinants of PNC utilization among mothers in Mangochi District, Malawi. Methods A community based cross-sectional study was conducted among 600 mothers who gave birth in the past 2 years preceding January 1–31; 2016. A multistage sampling technique was employed to select respondents from nine randomly selected villages in Mangochi district. A transcribed semi-structured questionnaire was pre-tested, modified and used to collect data on socio-demographic characteristics and maternal related factors. Data was coded in EpiData version 3.1 and analysed in Stata version 12. A multivariable logistic regression adjusted for confounding factors was used to identify predictors of PNC utilization using odds ratio with 95% confidence interval and p-value of 0.05. Results The study revealed that the prevalence of PNC service utilization was 84.8%. Mother’s and partner’s secondary education level and above (AOR = 2.42, CI: 1.97–6.04; AOR = 1.45, CI: 1.25–2.49), partner’s occupation in civil service and business (AOR = 3.17, CI: 1.25, 8.01; AOR =3.39, CI:1.40–8.18), household income of at least MK50, 000 (AOR = 14.41, CI: 5.90–35.16), joint decision making (AOR = 2.27, CI: 1.13, 4.57), knowledge of the available PNC services (AOR = 4.06, CI: 2.22–7.41), knowledge of at least one postpartum danger sign (AOR = 4.00, CI: 2.09, 7.50), health facility delivery of last pregnancy (AOR = 6.88, CI: 3.35, 14.14) positively associated with PNC service utilization. Conclusion The rate of PNC service utilization among mothers was 85%. The uptake of PNC services among mothers was mainly influenced by mother and partner education level, occupation status of the partner, household income, decision making power, knowledge of available PNC services, knowledge of at least one postpartum danger signs, and place of delivery. Therefore, PNC awareness campaigns, training and economic empowerment programs targeting mothers who delivered at home with primary education background and low economic status are needed.
Background: Mental health research is essential in the implementation of evidence-based interventions. This can be impeded by unavailability or limited access to local evidence in low- and middle-income countries (LMICs) such as Malawi.Aim: The aim of this systematic mapping was to describe the availability, extent and distribution of mental health research conducted in Malawi.Setting: The study was conducted at Kamuzu University of Health Sciences in Malawi.Methods: A systematic search of four electronic databases from inception to September 2021 was carried out. All published and unpublished mental health studies in all languages were eligible for inclusion. Studies were screened against inclusion and exclusion criteria, and data were extracted, analysed and presented in tables and as a narrative synthesis.Results: Cross-sectional studies (33.6%, n = 76) were found to be the most common study design for mental health research in Malawi. More studies were conducted on women (21.2%, n = 48) compared to men (1.3%, n = 3). Mental health research was concentrated in the southern region of the country (44.8%, n = 120) and in the three cities of Lilongwe (17.9%, n = 48), Blantyre (16.4%, n = 44) and Zomba (9.0%, n = 24).Conclusion: This systematic mapping suggests that there are few studies on mental health in Malawi which are not equally distributed across the country. There is a pressing need to conduct more mental health research using robust designs across disciplines.Contribution: Research on mental health is urgently needed to produce culturally acceptable data in Malawi.
BackgroundPostnatal care (PNC) services such as antenatal care, labour and delivery care services are paramount in maternal, neonatal morbidity and mortality rates reduction in low and middle income countries. Several factors impede the effective utilization of these services by mothers which makes them access few services than recommended by world health organization. This study examined the determinants of PNC utilization among mothers in Mangochi District, Malawi.MethodsA community based cross-sectional study involving a multistage sampling of 600 mothers from nine randomly selected villages in Mangochi district, Malawi was conducted in the month of January, 2016. A transcribed semi-structured questionnaire was pre-tested, modified and used to collect data on socio demographic, socio-economic and socio-cultural characteristics. A Pearson Chi square (𝜒2) test was used to determine the association between the socio-demographic, socio-cultural, and socio-economic factors and PNC utilization. A multivariable logistic regression with 95% confidence interval was performed to determine the predictors of PNC service utilization.Results84.8% of the mothers utilized PNC services at least once within the postnatal period. Among the PNC users, 74.5% attended once, 20% attended two to three times and 5.5% attended more than three times. The predictors of PNC service utilization were education level of the mother (AOR= 2.42, CI: 1.97-6.04) education level of the partner (AOR=1.5, CI: 1.25-2.49) , occupation status of the partner (AOR= 3.2, CI: 1.25-8.01), household level of income (AOR=14.4, CI: 5.90-35.16), decision making (AOR=2.27, CI: 1.13-4.57), knowledge of available PNC services (AOR=4.2, CI: 2.22-7.41), knowledge of at least one postpartum danger signs (AOR=4.0, CI:2.07-7.50), and place of delivery (AOR=6.9, CI: 3.35-14.14).ConclusionThe rate of PNC service utilization among mothers was 85%. The uptake of PNC services among mothers was mainly influenced by education level of the mother and partner, occupation status of the partner, household level of income, decision making power, knowledge of available PNC services, knowledge of at least one postpartum danger signs, and place of delivery. Therefore, reinforcement of the existing policies and strategies to increase awareness about PNC services among mothers through awareness campaigns, training and empowerment programs is needed.
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