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Maternal Healthcare Services in Rural Malawi: Insights and Recommendations

This study examines pregnant women's access to healthcare in Chilaweni, Malawi, highlighting challenges and solutions. Key findings include unplanned pregnancies, contraception usage, and educational impact. Findings support the need for improved maternal health services in the region.

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Maternal Healthcare Services in Rural Malawi: Insights and Recommendations

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  1. Healthcare Services for Pregnant Women in Chilaweni, Rural Malawi Results from A Cross Sectional Questionnaire Survey Presenting authors : Freya Yoward, Miranda Geddes-Barton Additional authors: Katy Kuhrt, Katia Florman, Danielle Alexander, George Ryan, Gavin Stead

  2. Objectives • Background • Healthcare structure in Malawi and AMECA • Methods • Results • Key Findings • Strengths and Limitations • Discussion

  3. Healthcare Statistics Malawi Population: 17,000,000 200 Physicians 15 Surgeons UK Population: 65,000,000 240,000 Physicians 20,000 Surgeons 3,000 x Health Workload • Maternal Death Rate 634/100,000 (2015) • Stillbirth Rate • Neonatal Death Rate 21/1000 (2015) • Illegal to give birth in villages without presence of a trained health professional • Contraception free if covered by local service level agreement

  4. Healthcare Structure

  5. AMECA Healthcare Clinic AMECA Charity : Alex’s Medical & Educational Clinic in Africa • 11 remote villages – 16,200 people • Sustainable; memorandum of understanding taken with the Malawi Ministry of Health

  6. Methods • Meeting with District Health Officer in Blantyre and visited existing Health Clinic • Designed a questionnaire to collect qualitative and quantitative data • Employed field officers for translation • Met with the Chiefs • 2 weeks collecting data

  7. Data collection

  8. Results (n=60 pregnant women) 60 pregnant women; age range 14-45, average age 24, response rate 100% (60/60) • 25% of women hadn’t seen a healthcare worker in this pregnancy • The remainder had seen a healthcare worker at the local healthcare clinic 6-10km away

  9. Results (n=60 pregnant women) • Most (87%) women planned to give birth in a healthcare center and the remaining 13% in hospital • 45 women had given birth previously • 16% of these women had been unable to reach a healthcare centre and said that they had delivered en route • A fifth (22%) of these 45 women had previously experienced the death of a child • All women reported that their existing children had been vaccinated

  10. Results (n=60 pregnant women) 92% of women had left school before completing secondary education • 37% due to pregnancy • 53% for financial reasons • 2% ‘other’ • On average women interviewed had 6 siblings • On average women ideally wanted 4 children (48/60) • 12 women hadn’t decided ideal number of children • 66% reported their current pregnancy was unplanned • 62% reported using DepoProvera contraception

  11. Key Findings • Nearest healthcare center 6-10km away • All women planned to give birth in healthcare centre or hospital • A fifth reported previously giving birth en route to health center • 66% unplanned pregnancies • 62% using DepoProveracontraception • 92% of women had left school before completing secondary education - 37% due to pregnancy • The majority of women wanted less children than the number of siblings they had • Ease of completing the project due to immense help given from the chiefs/villagers/DHO office

  12. Strengths and Limitations Strengths • 100% response rate • Hard to reach population • Crucial data for planning of service provision Limitations • ? % of pregnant women reached • Inaccuracies due to self reporting of data legal issues (illegal to give birth outside of hospital/healthcare center) • Inaccuracies due to use of translators

  13. Discussion Birthing facilities • Maternal death rate 5.1/1000 births • A fifth reported giving birth en route to clinic (6-10km walk) • No women reported planning to give birth at home with traditional birth attendant • Contraception • 66% unplanned pregnancies but 62% reported using DepoProveracontraception • ?difficulty attending health clinic • ?Unaware contraception only lasted 3 months • ?Lack of resources at the clinic • Education • Improved family planning • ?Further educational level for women • Provision of general medical services

  14. Conclusion • Data along with the passion and enthusiasm felt amongst village chiefs and villagers strongly supports the need for maternal health service provision at the AMECA clinic • £150,000 thought to be needed to build sustainable maternity unit. Fundraising in progress! • http://ameca.org.uk/

  15. References • 1. Kumbani LC. Maternal and newborn health in Malawi. Malawi Med J. 2007;19(1):32-33. http://www.ncbi.nlm.nih.gov/pubmed/23878631. Accessed March 2, 2017. • 2. Malawi African Region Maternal and Perinatal Health Profile Department of Maternal, Newborn, Child and Adolescent Health (MCA/WHO) Demographics and Information System Health status indicators -Maternal and Perinatal mortality

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