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.

Author Details

Isaac Mphande Partners in Health, Neno District, Malawi and Dr. Mercy Pindani, Principal for Kamuzu College of Nursing, Lilongwe, 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

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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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.

Review Type

Faculty/Mentor Approved: Sigma Academy Participant Poster

Acquisition

Proxy-submission

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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.