Background:The quality of care received by mothers and newborns in low-resource settings is often poor. This may partly explain the high rates of maternal deaths (60%) that occur during the postpartum period in Malawi. However, the quality of care provided to mothers and newborns in the country has not been adequately assessed. Therefore, this study aimed at assessing the quality of postnatal care services offered to mothers and babies by midwives in Lilongwe District. Methods:This was a quantitative study that used a sample of 58 midwives to assess the quality of postnatal care at three selected health facilities. A structured questionnaire, an observation tool and a facility checklist were used to collect data. Descriptive statistics were used to analyse the data. The study received ethics approval from the relevant authority. Results:The study found that the percentages reported by midwives regarding client monitoring varied and were below the 80% threshold. Midwives did not always follow the reproductive health standards on client examination so that less than 75% of midwives inspected perineal wounds (52.2%), checked vital signs of neonate (66.7%) and mother (62.2%), and inspected lochia drainage (30.4%). Most midwives (91.3%) never assessed the emotional state of the mother. Midwives covered a range of topics during health education and counselling. However, some topics, including immunisations (31.1%), were never taught. Conclusion:The study has suggested that the postnatal care offered by midwives at three health facilities was generally substandard and midwives do not always monitor, assess and counsel postnatal clients.

Background Information, education, and communication is a strategy to spread awareness through communication channels to a target audience to achieve a desired positive result. Women are supposed to receive information, education, and communication at each contact with the health worker during antenatal care. In Malawi, information, education, and communication for antenatal care is inadequate despite high antenatal care coverage. Most women do not receive it as stipulated. This could be one of the reasons that maternal and neonatal mortality is high. The provision of information, education, and communication is supposed to help in reducing maternal mortality because it is intended to develop positive attitudes towards health behaviours to support pregnant women accessing health services when required. This study, therefore, assessed the status of information, education, and communication as perceived by clients receiving antenatal care at Chiradzulu District Hospital in Malawi. Methods A descriptive study design with a sample of 384 pregnant women attending antenatal care was used. The sample size for the study was calculated using Lemeshow, Hosmer, Klar and Rwanga's formula. Systematic random sampling method was used to select the study participants. Data were analysed using a statistical package for social sciences software version 20.0. Results Findings revealed that information, education, and communication provided during antenatal care were inadequate. Most information was offered. However, no topic was rated adequate by 80% of the respondents according to the Likert Scale that was used. The majority of the respondents (71.4%, n = 274) (95% CI 66.5. 75.8) preferred to receive information, education, and communication from midwives who are in the category of skilled attendants. Results further showed that more than half of the respondents participated passively and spent little time receiving information, education, and communication. Conclusion The findings signify that information, education, and communication provided to women receiving antenatal care at Chiradzulu District Hospital had some gaps. It was inadequate and some topics were not taught. The target audience participated passively. It is recommended that midwives should provide the information, education, and communication and must have adequate contact time with the women. This is so because they are believed to be trusted sources of information.

Many stakeholders have attributed the decisions of education graduates who decline to enter the teaching profession after graduation, to the University of Malawi selection policy, and have called for the abolition of redirecting students to courses other than their choices. The purpose of this study was to measure the relationship between the University of Malawi selection 're-direction policy' and 'entrance of education graduates into the teaching profession'. Cross-section data were collected from the total population of education graduates from the University of Malawi, Chancellor College from 2005 to 2009 (n=760), through document analysis and structured interviews. Using the χ2 test, the calculated χ2 (1df) was 3.265, p = 0.071 denoting that the university selection policy and entrance of education graduates into the teaching profession were independent. The study concluded that education graduates entering or declining to enter the teaching profession after graduation did not depend on whether they chose or were redirected to education during their university selection.

Health surveillance assistants (HSAs) participate in the provision of postnatal care in Malawi, although their knowledge and skills in maternal and reproductive health are limited. This article presents the findings of a mixed-methods study that was conducted in three selected health centres to document the practices of HSAs in the provision of postnatal care to mothers and babies in Lilongwe district in Malawi. A random sample of 97 HSAs participated in the quantitative part of this study and 30 of these participated in the qualitative aspect of the study. Quantitative data were analysed using descriptive statistics while qualitative data were analysed using thematic analysis. This study found that many respondents (>60%) had limited capacity to provide adequate postnatal care and 85.3% of them never checked the vital signs of mothers and babies. They also lacked knowledge and skills in some aspects of postnatal care including danger signs. Almost all the respondents (96.8%) had never received any training in Basic Emergency Obstetric and Neonatal Care (BEmONC), or Emergency Obstetric and Neonatal Care (EmONC). Considering that HSAs have limited capacity to provide postnatal care to mothers and their babies, shifting tasks of nurses or midwives to HSAs should not be considered as an “outright solution” for increasing access to postnatal care in low-resource settings because it may compromise the quality of care.