A critical appraisal on the implementation of facility-based maternal death audits: The case of Ntcheu District, Malawi
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Date
2022-03-16
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Kamuzu University of Health Sciences
Abstract
1 EXECUTIVE SUMMARY
Nearly 349 women per 100000 live birth die with pregnancy-related complications in
Malawi. This high maternal deaths prompted the Ministry of Health to adopt maternal death
audit, a strategy to reduce these deaths in all district and central hospitals. Maternal death
audit reveal causes of deaths. This induces solutions to deaths that are preventable. A facilitybased maternal death audit is one of the approaches mostly practiced by hospitals in Malawi.
The implementation of this strategy faces barriers with few facilitators in Ntcheu district.
This study will assess the implementation of facility-based maternal death audit to improve
the quality of care and to prevent future deaths in Ntcheu district.
Broad objective
To assess the implementation of the facility-based maternal death audit to improve the quality
of maternal care and to prevent future maternal deaths in Ntcheu district, Malawi.
Specific objectives
1. To establish the proportion of completed maternal death reviews in Ntcheu district in
the 2020/2021 fiscal year.
2. To describe the barriers and facilitators of maternal death audit implementation in
Ntcheu district
Methodology
Qualitative approaches will be used to gather data through key informant interviews, focus
group discussions and maternal death reviews. Key informant will include hospital managers
directly involved in the implementation of maternal death audit. Three focus group
discussions will be conducted with health care team of labour and delivery, postnatal and
female wards. The study will also review maternal deaths documents and reports for the
2020/2021 fiscal year.
The research runs from May 2021 to 0ctober 2022. The study will recruit participants through
convenience sampling. Data will be collected by the principal investigator. All interviews and
group discussions will be conducted in English, recorded and transcribed verbatim. The data
will be stored in the personal computer and protected by passwords. The data will be
analysed using the CFIR framework.
Expected findings and their dissemination.
The study expect to find a strong level of MDA practice in the district. It is expected that a
facility-based maternal death audit is being practices. The assessment expect to find
guidelines for conducting MDAs in place and abided to. There should be a formal system of
reporting maternal death. The assessment will reveal facilities’ analysis of data and
presentation of trends as stipulated in national maternal death audit guidelines. There should
be evidence of implementation of recommendations from audit meetings. The research
further expect to find linking MDR to other quality improvement activities at the facility.
The dissertation will be submitted to the course coordinator and supervisor for partial
fulfillment of a Master’s degree in Global Health Implementation. The final report will also
be forwarded to COMREC, the Kamuzu University of Health Sciences library, and the
Ntcheu district health office. The results will be further disseminated at the College of
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Medicine research dissemination symposium. Presentation of the findings at the Ntcheu
district health office will be presented to the DHMT at an arranged meeting and all members
of staff during the morning report.