Examining coverage, content, and impact of maternal nutrition interventions: The case for quality-adjusted coverage measurement
Background Reductions in neonatal mortality remain stagnant, despite gains in health care access and utilization. Nutrition interventions during antenatal care (ANC) and in the immediate postpartum period are associated with improved neonatal outcomes. Adjusting coverage estimates for the quality of care provided yields greater insight into health system performance and potential population health benefits of […]
Gendered norms of responsibility: Reflections on accountability politics in maternal health care in Malawi
Background: This paper aims to provide insights into the role of traditional authorities in two maternal health programmes in Northern Malawi. Among strategies to improve maternal health, these authorities issue by-laws: local rules to increase the uptake of antenatal and delivery care. The study uses a framework of gendered institutions to critically assess the by-law […]
Efficacy of intravenous iron for treating postpartum anemia in low-resource african countries: A pilot study in Malawi
Background: Postpartum hemorrhage may lead to maternal morbidity and mortality, increases risks of transfusion, and incurs costs. We report on the feasibility and efficacy of in-hospital intravenous (IV) iron for treating postoperative anemia at Mtengo wa Nthenga, Malawi. Patients and methods: Twenty-eight consecutive women undergoing surgery for complicated pregnancy or complicated childbirth entered the study. […]
Evaluating the impact of prevention of mother-to-child transmission of HIV in Malawi through immunization clinic-based surveillance
Background: Prevention of mother-to-child transmission of HIV (PMTCT) programs can greatly reduce the vertical transmission rate (VTR) of HIV, and Malawi is expanding PMTCT access by offering HIV-infected pregnant women life-long antiretroviral therapy (Option B+). There is currently no empirical data on the effectiveness of Malawian PMTCT programs. This study describes a surveillance approach to […]
The Integration of vertical and horizontal programmes for health systems strengthening in Malawi: a case study
A challenge for the health system in Malawi is that funding allocation is heavily influenced by donor priorities. As a result, mandated routine elements of service delivery may not be fully offered owing to lack of resources or programmatic priority. Integration of currently active ‘vertical’ programmes (those focused on a specific priority disease entity) into […]
Understanding the mechanisms through which women’s group community participatory intervention improved maternal health outcomes in rural Malawi: Was the use of contraceptives the pathway?
Background: Women’s group intervention is a community based initiative through which rural women form groups, meet regularly to discuss maternal health issues affecting them, and come up with locally available solutions. This intervention has been associated with reduced maternal and neonatal mortality in limited resource settings. Nevertheless, the mechanisms through which women’s groups influence maternal […]
Health surveillance assistants’ practices of postnatal care in Lilongwe District, Malawi
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 […]
Community-linked maternal death review (CLMDR) to measure and prevent maternal mortality: A pilot study in rural Malawi
Background: In Malawi, maternal mortality remains high. Existing maternal death reviews fail to adequately review most deaths, or capture those that occur outside the health system. We assessed the value of community involvement to improve capture and response to community maternal deaths. Methods: We designed and piloted a community-linked maternal death review (CLMDR) process in […]
Impact of postpartum tenofovir-based antiretroviral therapy on bone mineral density in breastfeeding women with HIV enrolled in a randomized clinical trial
Objectives We set out to evaluate the effect of postnatal exposure to tenofovir-containing antiretroviral therapy on bone mineral density among breastfeeding women living with HIV. Design IMPAACT P1084s is a sub-study of the PROMISE randomized trial conducted in four African countries (ClinicalTrials.gov number NCT01066858). Methods IMPAACT P1084s enrolled eligible mother-infant pairs previously randomised in the […]
Prevention of mother-to-child transmission of HIV: A cross-sectional study in malawi
Objective To estimate the use and outcomes of the Malawian programme for the prevention of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). Methods In a cross-sectional analysis of 33 744 mother–infant pairs, we estimated the weighted proportions of mothers who had received antenatal HIV testing and/or maternal antiretroviral therapy and infants who had received […]
