Background Postnatal care (PNC) ensures early assessments for danger signs during the postpartum period and is to be provided within 24 h of birth, 48–72 h, 7–14 days, and six weeks after birth. This study assessed the uptake of and the barriers and facilitators to receiving PNC care among mothers and babies. Methods A concurrent mixed-method study employing a retrospective register review and a qualitative descriptive study was conducted in Thyolo from July to December 2020. Postnatal registers of 2019 were reviewed to estimate the proportion of mothers and newborns that received PNC respectively. Focus Group Discussions (FGDs) among postnatal mothers, men, health care workers, and elderly women and in-depth interviews with midwives, and key health care workers were conducted to explore the barriers and enablers to PNC. Observations of the services that mothers and babies received within 24 h of birth, at 48–72 h, 7–14 days, and six weeks after birth were conducted. Descriptive statistics were tabulated for the quantitative data using Stata while the qualitative data were managed using NVivo and analysed following a thematic approach. Results The uptake of PNC services was at 90.5%, 30.2%, and 6.1% among women and 96.5%, 78.8%, and 13.7% among babies within 48 h of birth, 3 to 7 and 8 to 42 days respectively. The barriers to PNC services included the absence of a baby or mother, limited understanding of PNC services, lack of male involvement, and economic challenges. Cultural and religious beliefs, advice from community members, community activities, distance, lack of resources, and poor attitude of health care workers also impeded the utilisation of PNC services. The enablers included the mother’s level of education, awareness of the services, economic resources, community-based health support, adequacy and attitude of health workers, seeking treatment for other conditions, and other clinic activities. Conclusion Optimisation of uptake and utilization of PNC services for mothers and neonates will require the involvement of all stakeholders. The success of PNC services lies in the communities, health services, and mothers understanding the relevance, time points, and services that need to be delivered to create demand for the services. There is a need to assess the contextual factors for a better response in improving the uptake of PNC services and in turn inform the development of strategies for optimizing the uptake of PNC services.

ObjectivesA cross-sectional and a policy document review study was performed to investigate perceived acceptability and feasibility to implementing different integration measures for tuberculosis (TB) and diabetes mellitus (DM) healthcare among healthcare workers (HCWs) and health managers, and to describe policy influence through a policy documents review in Malawi.SettingThe survey was performed at eight hospitals, ministry of health offices and 10 non-governmental organisations. We collected data in March and April 2021.ParticipantsOf 95 HCWs and health managers invited; 92 participated. 21/92 (23%) were female, and 17/92 (18%) participants were from clinics that piloted the integrated care for TB and DM.Outcome measuresWe described awareness levels on TB/DM comorbidity, perceptions and experiences in TB/DM care. Furthermore, development processes and contents of included documents were analysed.Results16/17 (94%) of HCWs from clinics piloting integrated care and 65/75 (86%) HCWs from hospitals that do not use integrated care for TB and DM responded that integrated care was acceptable and feasible. In qualitative data, shortage of resources, inadequate information sharing were common themes. We included seven relevant documents for the analysis. On development process and content, six of seven documents were scored ≥70%. In these documents, DM is a recognised risk factor for TB, and integration of healthcare services for infectious diseases and non-communicable diseases is recommended, however, these documents lacked information specifically on integrated care for TB and DM.ConclusionIn this study, we identified inadequate information sharing, and lack of resources as major factors impeding implementation of integration of services, however, awareness on TB/DM comorbidity was high.

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Background Corona Virus disease 2019 (COVID-19) pandemic continues to have serious health and socio-economic consequences. World Health Organisation (WHO) recommends several measures to combat the COVID-19 pandemic. In Malawi, COVID-19 cases are managed at home with hospital admission reserved for severe cases. This study described the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi. Methods This descriptive qualitative study was conducted from January to June 2021 in Blantyre Malawi, among caregivers of confirmed SARS-COV-2 cases enrolled in the SARS-CoV-2 study aimed to explore infections, transmission dynamics, and household impact. We conducted 37 in-depth interviews with caregivers of SARS-COV-2 cases. We captured data using telephonic interviews, digitally recorded, transcribed verbatim, managed using NVivo, and analysed thematically. Results The economic status of a family largely influenced the caregiving roles and abilities because it determined the resources that a household could access or not. Caregivers were committed to their role despite being ill-prepared to manage a COVID-19 patient at home in addition to fears about the contagious nature of COVID-19. They prioritised their patients’ health by ensuring that they were present to offer nutritional and medical treatment. The implementation of preventive measures was however challenging because of financial limitations and cultural factors. The increase in death rates and the lack of proper information challenged their expectation of having their patients healed. Caregivers managed their role by sharing responsibilities, getting better at their role with time, and also getting support from religious institutions and social networks. Conclusion The economic status of a household determined the experiences of caregivers as they managed their COVID-19 patients at home. Caring for confirmed cases of COVID-19 demanded commitment from the caregivers while ensuring that the transmission of the virus is minimised. There is a need to support households while in isolation with the right information on how to manage their patients and streamline social support for the ultra-poor.