Effect of a novel vital sign device on maternal mortality and morbidity in low-resource settings: a pragmatic, stepped-wedge, cluster-randomised controlled trial
Background: In 2015, an estimated 303 000 women died in pregnancy and childbirth. Obstetric haemorrhage, sepsis, and hypertensive disorders of pregnancy account for more than 50% of maternal deaths worldwide. There are effective treatments for these pregnancy complications, but they require early detection by measurement of vital signs and timely administration to save lives. The […]
The cost-effectiveness of using results-based financing to reduce maternal and perinatal mortality in Malawi
Introduction Results-based financing (RBF) is being promoted to increase coverage and quality of maternal and perinatal healthcare in sub-Saharan Africa (SSA) countries. Evidence on the cost-effectiveness of RBF is limited. We assessed the cost-effectiveness within the context of an RBF intervention, including performance-based financing and conditional cash transfers, in rural Malawi. Methods We used a […]
Screening for infectious maternal morbidity – knowledge, attitudes and perceptions among healthcare providers and managers in Malawi: a qualitative study
Background: Maternal morbidity and mortality related to infection is an international public health concern, but detection and assessment is often difficult as part of routine maternity care in many low- and middle-income countries due to lack of easily accessible diagnostics. Front-line healthcare providers are key for the early identification and management of the unwell woman […]
Impact of a maternal and newborn health results-based financing intervention (RBF4MNH) on stillbirth: a cross-sectional comparison in four districts in Malawi
Background: Malawi implemented a Results Based Financing (RBF) model for Maternal and Newborn Health, “RBF4MNH” at public hospitals in four Districts, with the aim of improving health outcomes. We used this context to seek evidence for the impact of this intervention on rates of antepartum and intrapartum stillbirth, taking women’s risk factors into account. Methods: […]
Association between mass media use and maternal healthcare service utilisation in malawi
Introduction: Using data from Malawi Demographic and Health Survey (2015–16), in the present study, we aimed to assess the role of exposure to family planning information through various mass media on the utilization of maternal healthcare services. Methods: The sample population included 13,217 women aged 15–49 years with a history of at least one childbirth. […]
Quality care during labour and birth: A multi-country analysis of health system bottlenecks and potential solutions
Background: Good outcomes during pregnancy and childbirth are related to availability, utilisation and effective implementation of essential interventions for labour and childbirth. The majority of the estimated 289,000 maternal deaths, 2.8 million neonatal deaths and 2.6 million stillbirths every year could be prevented by improving access to and scaling up quality care during labour and […]
Promoting universal financial protection: Contracting faith-based health facilities to expand access – lessons learned from Malawi
Background: Public-private collaborations are increasingly being utilized to universalize health care. In Malawi, the Ministry of Health contracts selected health facilities owned by the main faith-based provider, the Christian Health Association of Malawi (CHAM), to deliver care at no fee to the most vulnerable and underserved populations in the country through Service Level Agreements (SLAs). […]
A qualitative study assessing the acceptability and adoption of implementing a results based financing intervention to improve maternal and neonatal health in Malawi
Background: Results Based Financing (RBF) interventions have recently gained significant momentum, especially in sub-Saharan Africa. However, most of the research has focused on the evaluation of the impacts of this approach, providing little insight into how the contextual circumstances surrounding the implementation have contributed to its success or failure. This study aims to fill a […]
Effect of the CRADLE vital signs alert device intervention on referrals for obstetric haemorrhage in low-middle income countries: a secondary analysis of a stepped- wedge cluster-randomised control trial
Background: Obstetric haemorrhage is the leading cause of maternal death worldwide, 99% of which occur in low and middle income countries. The majority of deaths and adverse events are associated with delays in identifying compromise and escalating care. Management of severely compromised pregnant women may require transfer to tertiary centres for specialised treatment, therefore early […]
Stool frequency recording in severe acute malnutrition (‘StoolSAM’); An agreement study comparing maternal recall versus direct observation using diapers
Background: Approximately 50% of the deaths of children under the age of 5 can be attributed to undernutrition, which also encompasses severe acute malnutrition (SAM). Diarrhoea is strongly associated with these deaths and is commonly diagnosed solely based on stool frequency and consistency obtained through maternal recall. This trial aims to determine whether this approach […]
