Child Health

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Browsing Child Health by Author "Gresh, Ashley"

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    Adapting and implementing group-based postpartum/well-child care at clinics in Blantyre District, Malawi
    (Kamuzu University of Health Sciences, 2021-07-29) Gresh, Ashley
    Type of Research Study: A mixed methods study. The Problem: Postpartum care, defined in this study from the time of birth through the first year, sets the stage for long-term health and well-being for both the mother and her child; further it is a critical time to reduce maternal and infant morbidity and mortality. The World Health Organization (WHO) recommends that every mother and baby should have at least four postpartum visits within the first six weeks of giving birth. The first year after childbirth is a period of not only physical recovery but is an important time to identify and manage health and social challenges including psychosocial adaptations and transitions to a parental role, that make women and children vulnerable for poor health outcomes. Globally there is no standardized package of care for the first year postpartum. Further, there are low rates of postpartum care attendance, revealing women’s unmet needs during this critical period in their life course. Sub-Saharan Africa, including Malawi, has some of the highest rates of maternal and infant mortality (MMR 439 maternal deaths per 100,000 live births and 42 infant deaths per 1,000 live births) globally. High rates of maternal and infant morbidity and mortality and preventable illness and disease necessitate transformation in the delivery of postpartum and wellchild care in this critical time in the maternal/infant life course. There is a need to develop through innovative strategies a postpartum/well-child care model that is sensitive to maternal-infant dyads in low resource contexts where rates of maternal and infant morbidity and mortality are high. Objectives: Main objective: The purpose of this study is to adapt, implement, and evaluate the feasibility and acceptability of an integrated postpartum and well-child care group-based healthcare model, called CenteringParenting, in Blantyre District, Malawi. Specific Objective 1: Explore Malawian women’s expectations for culturally appropriate postpartum and well-child clinic care. Specific Objective 2: Co-design with Malawian women, midwives and community volunteers an adapted prototype of group postpartum/well-child care. Specific Objective 3: Examine the acceptability of group postpartum/well-child care with Malawian women, midwives, and community volunteers at clinics in Blantyre District, Malawi. Specific Objective 4: Examine the feasibility of group postpartum/well-child care with Malawian women, midwives, and community volunteers at clinics in Blantyre District, Malawi.Methodology: The proposed mixed methods study will use the five-steps of design thinking approach to adapt CenteringParenting: 1) empathize (interviews); 2) define (data analysis); 3) ideate (incubator sessions); 4) prototype (data analysis); and 5) test. This will be done through a rapid ethnographic assessment through interviews and incubator sessions with women, health surveillance workers, community volunteers and providers to create the group postpartum/well-child care prototype. The prototype will then be tested to determine feasibility and acceptability in the Malawian context through interviews, focus groups and surveys. Expected findings: We expect to co-create a prototype for group-based health care for the first year of postpartum and well-child care that will be acceptable and feasible. The findings will inform the next step in future research to determine the effectiveness of the CenteringParenting program model in Malawi. Dissemination of results: Results will be disseminated to the global research community through international journal publications and presentations at international and national research conferences. We also plan to present results at the COMREC conference, an excellent venue that is attended by policy-makers and researchers in Malawi.