Abstract
Background - A maternity waiting home is a building located near a health facility where high or low risk pregnant women who reside very far are accommodated to await labor and delivery. Maternity waiting homes have been in existence in Malawi for more than a decade, however the maternal mortality rate remains unacceptably high.
Purpose - The study analysed quality of maternal care at maternity waiting homes in Chitipa District based on the Donabedian's Structure Process and Outcome model.
Methods - A descriptive mixed methods study design was followed. Two semi-structured questionnaires were used to collect quantitative data from 82 nurses/clinicians with more than 4 years' work experience, and 48 pregnant mothers (aged between 18 and 38, given birth more than once and attained primary education). Individual in-depth interviews were done with 15 guardians (aged between 36 to 40 years) of pregnant waiting mothers in maternal waiting homes. An observation checklist was used to collect data on the availability of resources for maternal waiting homes. Quantitative data were analysed with the aid of SPSS 20.0 while qualitative data were analysed manually through thematic analysis.
Results - The idea of maternal waiting homes was welcomed by the majority of nurses/clinicians, pregnant waiting mothers and their guardians. However, 92.7% (n=76) of nurses/clinicians lacked knowledge on maternal waiting homes implementation. Consequently, they provided sub-optimal maternal care. Users of maternal waiting homes faced many challenges which included poor condition of the shelter, lack of basic resources such as food and soap to support hospital stay, scarcity of resources such as medications and a high workload to nurses and clinicians.
Conclusion - Quality of maternal care provided at maternal waiting homes was poor in the Chitipa District with shortfalls in all the elements of quality, namely structure, process and outcome according to Donabedian's model. Essentially, the findings indicate potential that maternal care provided at maternal waiting homes might improve if highlighted areas in the study findings are addressed.
Implications - The findings inform policy and practice by unearthing the need for clear guidelines on maternal care to be provided in maternal waiting homes. On the other hand, the positive attitudes held by the users of these facilities provide potential for improvement of maternal health in Malawi.
Sigma Membership
Non-member
Lead Author Affiliation
Partners in Health, Neno District, Malawi
Type
Poster
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Mixed/Multi Method Research
Keywords:
Maternal-Child Health, Maternity Waiting Homes, Maternal Care
Recommended Citation
Mphande, Isaac and Pindani, Mercy, "Quality of maternal care at maternity waiting homes in Chitipa District in Northern Malawi" (2019). Maternal-Child Health Nurse Leadership - Africa. 11.
https://www.sigmarepository.org/mchnla/2019/posters/11
Conference Name
Inter-professional Education and Collaborative Practice for Africa Conference
Conference Host
Tau Lambda at-Large Chapter of Sigma Theta Tau International||Amref International University||WHO-FIC Collaborating Centre for the African region||Africa Interprofessional Education Network (AfrIPEN)||WHO Regional Office for Africa
Conference Location
Nairobi, Kenya
Conference Year
2019
Rights Holder
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Review Type
Faculty/Mentor Approved: Sigma Academy Participant Poster
Acquisition
Proxy-submission
Quality of maternal care at maternity waiting homes in Chitipa District in Northern Malawi
Nairobi, Kenya
Background - A maternity waiting home is a building located near a health facility where high or low risk pregnant women who reside very far are accommodated to await labor and delivery. Maternity waiting homes have been in existence in Malawi for more than a decade, however the maternal mortality rate remains unacceptably high.
Purpose - The study analysed quality of maternal care at maternity waiting homes in Chitipa District based on the Donabedian's Structure Process and Outcome model.
Methods - A descriptive mixed methods study design was followed. Two semi-structured questionnaires were used to collect quantitative data from 82 nurses/clinicians with more than 4 years' work experience, and 48 pregnant mothers (aged between 18 and 38, given birth more than once and attained primary education). Individual in-depth interviews were done with 15 guardians (aged between 36 to 40 years) of pregnant waiting mothers in maternal waiting homes. An observation checklist was used to collect data on the availability of resources for maternal waiting homes. Quantitative data were analysed with the aid of SPSS 20.0 while qualitative data were analysed manually through thematic analysis.
Results - The idea of maternal waiting homes was welcomed by the majority of nurses/clinicians, pregnant waiting mothers and their guardians. However, 92.7% (n=76) of nurses/clinicians lacked knowledge on maternal waiting homes implementation. Consequently, they provided sub-optimal maternal care. Users of maternal waiting homes faced many challenges which included poor condition of the shelter, lack of basic resources such as food and soap to support hospital stay, scarcity of resources such as medications and a high workload to nurses and clinicians.
Conclusion - Quality of maternal care provided at maternal waiting homes was poor in the Chitipa District with shortfalls in all the elements of quality, namely structure, process and outcome according to Donabedian's model. Essentially, the findings indicate potential that maternal care provided at maternal waiting homes might improve if highlighted areas in the study findings are addressed.
Implications - The findings inform policy and practice by unearthing the need for clear guidelines on maternal care to be provided in maternal waiting homes. On the other hand, the positive attitudes held by the users of these facilities provide potential for improvement of maternal health in Malawi.