Assessment of the implementation of 2016 World Health Organization antenatal care model in Malawi: a case study of Neno District, version 1.0
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Date
2022-05-09
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Kamuzu University of Health Sciences
Abstract
Type of the study: This is a descriptive cross sectional mixed methods study.
Background of the problem: Malawi is one of the countries with high maternal, neonatal
mortality. Maternal mortality ratio is 439/100,000, Neonatal Mortality Rate is at 27/1000.
Antenatal Care (ANC) is one of the essential elements in helping to reduce the maternal and child
mortality. It provides a foundation of a good pregnancy outcomes through screening for health
problems and treating them and preparing for birth according to the needs of the pregnant woman.
The World Health Organization introduced new ANC schedule in 2016 for a positive pregnancy
experience and encouraged nations to move from the previous focused antenatal care to the new
schedule to promote quality ANC and prevent pregnancy complications and maternal deaths. This
study will assess the implementation of the 2016 World Health Organization (WHO) antenatal
care model in Neno, Malawi.
Objectives of the study: The main objective of the study is to assess implementation of 2016
World Health Organization Antenatal care model by health care workers in Neno district, Malawi.
Specific objectives of the study are to determine the proportion of women who had 8 contacts by
the end of their term pregnancy; assess the availability of required equipment, medication and
supplies for the implementation of the 2016 WHO ANC model; review the assessments and tests
that pregnant women have during their antenatal care contact with the health care workers; explore
factors influencing implementation of WHO 2016 ANC model and explore key informant’s
perspectives on implementation of WHO 2016 ANC model in Malawi. Methodology: The study will employ a mixed methods research design utilizing both quantitative
and qualitative methods. The participants will be health care workers who provide ANC services,
pregnant women through their facility records and key stakeholders of the ANC model
implementation. In-depth interviews will be conducted with 10 midwives who provide antenatal
care in the selected health facilities: Neno district hospital, Zalewa health center and Matope health
center and will be conducted by the researcher. Checklists will be used to check if all the required
equipment, drugs and supplies for the implementation of the new model are available at a health
facility. Antenatal care register reviews will also be done to determine the number of pregnant
women who completed 8 contacts at term of their pregnancy. The care provided and documented
in the ANC register will also be reviewed. Key informant interviews will also be done to get the
perspectives of the key stakeholders in the implementation of 2016 WHO ANC model and these
will include ministry of health officials. Ethical approval will be sought from College of Medicine
Research and Ethics Committee (COMREC) and permission from the Director of Health and
Social Services (DHSS) for Neno district council.Expected findings and dissemination: The findings of this study will establish how the 2016
WHO ANC model is being implemented by the health care workers. It will also find out the
enablers and barriers to implementation. These will be useful to inform policy makers and
implementers on how best they can improve the implementation strategies so that they are in line
with the model and that its implementation ultimately yields the intended outcomes. The results
will be shared through a report to COMREC, College of Medicine library and Neno District Health
Office. A report will also be shared by means of presentations at conferences organized locally
and internationally.
Description
Type of the study: This is a descriptive cross sectional mixed methods study.