Behavioral design for antenatal and postnatal care in Malawi
Loading...
Date
2020-09-16
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Type of study: Behavioral formative research
ii. Problem:
According to USAID’s 2019 statistics, Malawi has one of the highest maternal mortality rates in
Africa and globally, with 439 maternal deaths per 100,000 live births. Recently, the government
adopted the new WHO guidelines that recommend 8 antenatal contacts during pregnancy. The 2015-
2016 Demographic and Health Survey (DHS) found that 95% of women accessed ANC. Yet, only
51% of women completed (the previously recommended) 4 visits. Only 24% of women seek ANC
during the first trimester. At a global level, UNICEF’s 2019 data reports that at least 85% of women
access antenatal care with up to 65% receiving 4 antenatal visits. In comparison, only 46% of
Malawian mothers meet the previously recommended 4 ANC sessions. In Malawi, women often
attend ANC late.
JHPIEGO will conduct implementation research (IR) for antenatal and postnatal service delivery
models and tools in Malawi (and Ethiopia and Mali). This IR will generate evidence on how best to
strengthen antenatal and postnatal platforms—not only to deliver equitable, high quality services,
but also robust and resilient enough to test interventions and transition to scale. JHPIEGO’s study
design will employ human-centered design to explicitly reflect actual conditions and incorporate
considerations necessary to understand and inform scale up and sustainability.
The project will use human-centered and behavioral design (HCD) to develop context-specific
program implementation strategies, approaches, and models of antenatal and postnatal care for
pregnant and postpartum women in Malawi. In the first phase (empathy) of the HCD approach that
will be used end users are engaged to better understand the barriers and drivers to antenatal and
postnatal care, and to solicit their suggestions for interventions that better meet the needs of the
population. For this activity, interviews and group discussions will be conducted with women, aged
18-49 who live in Blantyre (Malawi) to understand their realities and how they facilitate or hinder
access to and use of antenatal and postnatal care services. In addition, interviews will be conducted
with related individuals and community groups identified by the women, to understand their
perspectives and the way in which they influence women’s decisions. All of these participants shall
advise and subsequently validate ideas generated through the inquiry period. The ideas generated
through this workshop will then be narrowed down and prioritized for further testing after approval
from local authorities.
The intent of this study is to work with women, related individuals, and community groups using the
HCD methodology to gather information in order to design, develop and implement an intervention.
The results are not designed to be generalizable. They would be applicable to women in Malawi
only. Ideas will be generated during the design workshop but after prioritization and selection of the
ideas, separate studies that will be designed from these activities will examine the feasibility and
acceptability for the intervention(s) designed as a result of HCD. These protocols will be developed
and submitted in the future since they will be human subjects research.
Description
Keywords
Research Subject Categories::MEDICINE