Emergency obstetric care: How do we stand in Malawi?

Leigh, Bailah; Mwale, Theresa Gloria; Lazaro, Dorothy; Lunguzi, Juliana

doi:10.1016/j.ijgo.2008.01.012

Cited by 32 publications

(24 citation statements)

References 7 publications

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“…The designation of EmONC and BEmONC facilities in the country was to ensure quality maternal and neonatal care, however, the situation is that the quality of care is substandard in these designated facilities. These results agree with those reported by Leight et al [31] that almost twice the minimum number of recommended EmONC facilities existed in Malawi but only 2% of the facilities met the basic requirements for the provision of quality maternal and neonatal care.…”

Section: Outcomes Quality Assessmentsupporting

confidence: 92%

Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi

Chimtembo¹,

Maluwa²,

Chimwaza³

et al. 2013

OJN

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This study was conducted to assess quality of postnatal care that midwives provide to women seeking postnatal services in health facilities in Dedza district, the central region of Malawi. The study design was descriptive cross sectional and utilized quantitative data collection and analysis method to determine structural, process and outcome components of postnatal care in two facilities that offer emergency obstetric and neonatal care and five that offer basic emergency obstetric and neonatal care. All 60 midwives who were providing postnatal care during the time of study in the district were interviewed using a structured questionnaire. In addition, the midwives actual practice was observed and compared to a standard checklist on postnatal care practice which was developed by the Malawi Ministry of Health. Data were analyzed using SPSS version 16.0. Results show that structure for providing postnatal counseling services was inappropriate and inadequate. Furthermore, the contents of postnatal services were below reproductive health standards because the clients were neither monitored nor examined physically on discharge. On average, all the seven facilities scored 48% on postnatal services rendered which is far below the recommended 80% according to the Reproductive Health Standards. There is a need to provide basic infrastructure in all the basic emergency obstetric and neonatal care facilities. In addition, refresher training courses for midwives in maternal and neonatal health with emphasis on postnatal care are recommended. There is also a need to restructure the maternal and neonatal health departments in the facilities so that the postnatal care units become standalone priority sites to improve the quality of the postnatal care services rendered.

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Section: Outcomes Quality Assessmentsupporting

confidence: 92%

Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi

Chimtembo¹,

Maluwa²,

Chimwaza³

et al. 2013

OJN

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“…This approach may assist in educating women important on topics associated with improved maternal health outcome. The topics include pregnancy induced conditions such as diabetes, high blood pressure, anaemia, urinary tract infections, sexual transmitted diseases, et cetera, as well as other important general topics such as birth preparedness, nutrition and family planning 4 . A study conducted in Nigeria concluded that quality of maternal health care was the major predictor associated with under utilization and delay in use of ANC services in public based health care facility 20 .…”

Section: Discussionmentioning

confidence: 99%

“…In sub-Saharan Africa, Malawi reported the highest maternal mortality rated at 510 deaths per 100,000 live births which implied that 1 in every 34 women died during child birth, in the same year 2,1 . Previous scholars asserted this public health challenge to preventable direct causes upon women's timely seeking of maternal health care services during and after gestation period [3][4][5] . Among the direct causes include hypertensive disorder, abortion, obstructed labour, haemorrhage, sepsis among others and indirect causes such as malaria and anaemia which are often times aggravated due to women's pregnancy condition 5 .…”

Section: Introductionmentioning

confidence: 99%

Factors influencing women’s utilization of public health care services during childbirth in Malawi Public health facility utilization

Machira¹,

Palamuleni²

2017

Afr H. Sci.

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Background: Maternal mortality remains a public health challenge claiming many lives at the time of giving birth lives. However, there have been scanty studies investigating factors influencing women's use of public health facilities during childbirth. Objective: The aim of the study was to explore the factors associated with women choice of public health facility during childbirth. Methods: The study used 2010 Malawi Demographic Health Survey dataset and a binary logistics regression analysis to estimate the determinants influencing women's use of public health facilities at the time they give birth. Results: Of 23020 women respondents, 8454(36.7%) chose to give birth in public health facilities. Multivariate analysis reported that frequency of antenatal care (ANC), birth order, women's education, wealth status and quality of care were the major predictors increasing women's choice to use public health facilities at childbirth. Conclusion:There is need to use multimedia approach to engage women on significance of utilizing public health facilities during childbirth and promote quality of care in facilities if their health outcome is to improve in Malawi.

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“…The midwives stated they had a somewhat limited skills and knowledge base. Some midwives reported not feeling competent in dealing with complications like manual removal of placenta, management of obstructed labour, management of eclampsia, and postpartum hemorrhage 20,21 . This lack of proficiency critically affects the quality of care that is rendered to the women and may result in loss of life.…”

Section: Inadequate Supervision/continuing Educationmentioning

confidence: 99%

Service providers’ perception of the quality of emergency obsteric care provided and factors indentified which affect the provision of quality care

Chodzaza¹,

Bultemeier²

2011

Mal. Med. J

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AimThe aim of the study was to investigate health workers' perception of the quality of, and factors which impact provision of quality emergency obstetric care. MethodsThis exploratory, descriptive qualitative study was conducted at Mwanza district hospital in Malawi. Qualitative data was obtained through 14 individual in-depth interviews with the health workers involved in the management of women who experienced major obstetric complications. ResultsThe health workers' overall perception of the quality of emergency obstetric care provided was poor. The poor quality of care was identified as related to client related factors and facility/staff factors. Client factors which emerged as contributing to poor quality care were; the client delay in seeking care: reliance on TBAs, reliance on traditional medications, and lack of awareness regarding signs of an obstetric emergency. Facility/ staff themes which emerged as contributing to the poor care were; inadequate resources, inadequate staffing, poor teamwork, and inadequate knowledge/supervision. ConclusionThe findings of this study reveal that health care workers rate the quality of emergency obstetric care they provide as poor. They were able to identify structure and process factors which contribute to this overall poor quality emergency obstetric care provided. These were attributed to health care system problems and client problems. Only through addressing the contributing factors will true improvement of management of obstetric emergencies occur.

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Emergency obstetric care: How do we stand in Malawi?

Cited by 32 publications

References 7 publications

Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi

Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi

Factors influencing women’s utilization of public health care services during childbirth in Malawi Public health facility utilization

Service providers’ perception of the quality of emergency obsteric care provided and factors indentified which affect the provision of quality care

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