Adapting and implementing group-based postpartum/well-child care at clinics in Blantyre District, Malawi
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Date
2021-07-29
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Kamuzu University of Health Sciences
Abstract
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.