Assessing factors that influence service readiness for preterm births in health facilities of Malawi: Evidence from the harmonized health facility assessment survey 2018-2019
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Date
2021-12-16
Authors
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Publisher
Kamuzu University of Health Sciences
Abstract
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.
Description
Keywords
Service readiness for preterm births in Health facilities in Malawi