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Healthcare Services for Pregnant Women in Chilaweni , Rural Malawi

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. Objectives.

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Healthcare Services for Pregnant Women in Chilaweni , Rural Malawi

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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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