Obstetrics & Gynaecology

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Browsing Obstetrics & Gynaecology by Author "Chakholoma, Beatrice Chimwemwe"

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    Assessing factors that influence service readiness for preterm births in health facilities of Malawi: Evidence from the harmonized health facility assessment survey 2018-2019
    (Kamuzu University of Health Sciences, 2021-12-16) Chakholoma, Beatrice Chimwemwe
    Type of Research This is a Descriptive Cross-sectional study. Problem statement Preterm birth is a significant cause of death and long-term loss of human potential amongst survivors worldwide. Preterm birth complications are the single most significant direct cause of neonatal deaths, responsible for 35% of the world's 3.1 million deaths a year, and the second most common cause of under-5 deaths after pneumonia [1]. In almost all high- and middle-income countries of the world, preterm birth is the leading cause of child death. While this may be true, disparities exist in the distribution and survival of these babies among regions. However, the burden of preterm births is high in low and middle-income countries, especially those in Sub-Saharan Africa and South Asia [2]. Malawi is one of the countries with a higher incidence of preterm births, estimated at 18.1 percent per 1000 live births [3]. Studies have shown that improving maternal and neonatal care quality would help reduce morbidity and mortality for premature babies. A cross-sectional study conducted in Malawi indicated that delivering at a higher-quality facility is associated with a reduction of 23 deaths per 1,000 live births, which were in line with a study by Winter R et al., which found that facilities that could not provide newborn care in the five countries of the study had a high burden of neonatal deaths. [4,5] Study objectives This study aims at assessing factors that influence service readiness for preterm births in health facilities of Malawi. Specifically, the project will determine the proportion of health facilities that had met the criteria of service readiness for preterm births by the time HHFA was being conducted, identify the characteristics of health facilities with service readiness for preterm births and determine the extent of differences of Service Readiness for preterm birth care by geographical location, Rurality, urban and staff satisfaction and level of health care. Methodology. This is a descriptive cross-sectional study using secondary data from the Health Facility Assessment Survey. The sample for health facilities which were assessed during this survey will be used. Using the Service Availability and Readiness Assessment tool. Variables of interest will be extracted from the HHFA data sets. The outcome of interest is preterm birth Service Readiness Quality and the Predictor outcome are the characteristics of health facilities. A quality index for preterm birth service readiness will be generated from these five domains of Service Readiness. Summary scores of the five domains of service readiness will be made for each health facility. Permission will be sought to use the survey data and the proposal will be sent to College of Medicine Research and Ethics Committee for approval. The extracted variable datasets will be analyzed using STATA version 14.1 Expected findings and their dissemination The investigator expects to find high readiness scores in urban than rural hospitals due to challenges of geographical location which might affect distribution of resources. Government facilities are expected have inadequate medicines and equipment due to challenges in funding The investigator also expects to find out why other facilities will have higher scores or low scores of service readiness despite having same facility characteristics. A copy of the final report of the research findings will be submitted to College of Medicine Research and Ethics Committee (COMREC), College of Medicine Library, The Health Sciences Research Committee, The University Research and Publication Committee (URPC) (through the COMREC Secretariat) and to Center for Medical Diagnostics who recommended further analysis of the survey findings. The results will also be presented at conferences.