Abstract

Purpose

In Malawi as demand for maternity services continues to surpass supply and overstretch frontline healthcare providers, it is important to improve the quality of maternity care to address the burden of maternal mortality and morbidity. Appreciative Inquiry (AI) is a method through which healthcare providers can make organisational change to improve clinical care and their working lives. It harnesses the energy and ideas of staff through a four-stage cycle: Discover (how it is now), Dream (of what it could be), Design (concrete plans) and Destiny (implement plans).

The purpose of the study was to assess the feasibility of implementing Appreciative Inquiry in three district level facilities in Malawi using participatory aproach.

Methods

Between April 2015 and January, 2016 we adapted and implemented AI through participatory action cycle sessions.

Findings:

We have successfully implemented AI with contributions from the entire ward team (patient attendants, nurses, clinical officers and clerks). Each team chose a different focus for their activities including ‘team spirit’ and ‘infection prevention ’. In two hospitals there have been some steps towards change, driven largely by key midwives team leaders. In one hospital the team have lobbied the management to have security guards to support their ‘traffic control’ policies in addition to successfully implementing the removal of shoes before entering the nursery and kangaroo wards. Another team has reduced the number of incidences of overfull sharps bins and waste in the incorrect bins on the ward. The main challenges faced were from constantly changing teams and the lack of time and resources to dedicate to the change process.

Conclusion

It is feasible to implement AI in maternity settings in Malawi when the care providers stay positive. However, the presence of committed champions seems important and health system challenges necessitate realistic goal setting; further study is needed to understand the effectiveness of the intervention

Author Details

Zione Dembo, MSc, BSc, RNM; Abi Merriel

Sigma Membership

Chi at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Appreciative Inquiry, Malawi, Maternity Services

Conference Name

28th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Dublin, Ireland

Conference Year

2017

Rights Holder

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All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Acquisition

Proxy-submission

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Feasibility of Using Appreciative Inquiry to Improve Maternity Services in District Hospitals of Malawi

Dublin, Ireland

Purpose

In Malawi as demand for maternity services continues to surpass supply and overstretch frontline healthcare providers, it is important to improve the quality of maternity care to address the burden of maternal mortality and morbidity. Appreciative Inquiry (AI) is a method through which healthcare providers can make organisational change to improve clinical care and their working lives. It harnesses the energy and ideas of staff through a four-stage cycle: Discover (how it is now), Dream (of what it could be), Design (concrete plans) and Destiny (implement plans).

The purpose of the study was to assess the feasibility of implementing Appreciative Inquiry in three district level facilities in Malawi using participatory aproach.

Methods

Between April 2015 and January, 2016 we adapted and implemented AI through participatory action cycle sessions.

Findings:

We have successfully implemented AI with contributions from the entire ward team (patient attendants, nurses, clinical officers and clerks). Each team chose a different focus for their activities including ‘team spirit’ and ‘infection prevention ’. In two hospitals there have been some steps towards change, driven largely by key midwives team leaders. In one hospital the team have lobbied the management to have security guards to support their ‘traffic control’ policies in addition to successfully implementing the removal of shoes before entering the nursery and kangaroo wards. Another team has reduced the number of incidences of overfull sharps bins and waste in the incorrect bins on the ward. The main challenges faced were from constantly changing teams and the lack of time and resources to dedicate to the change process.

Conclusion

It is feasible to implement AI in maternity settings in Malawi when the care providers stay positive. However, the presence of committed champions seems important and health system challenges necessitate realistic goal setting; further study is needed to understand the effectiveness of the intervention