In July 2015 the Malawian Ministry of Health (MOH) and partners celebrated the country’s achievement of Millennium Development Goal 4—Reduce Child Mortality. Despite this remarkable success, neonatal mortality remains high and Malawi is listed as having the highest PTB rate in the world (18.1/1,000 live births). LBW occurs in an additional 14% of births in the country (Situational Analysis of Newborn Health in Malawi, 2013). To catalyze action for improved newborn health the MOH launched Malawi’s Every Newborn Action Plan (ENAP) in July 2015. Major challenges in newborn care identified by the MOH include inadequate staffing and insufficient essential supplies, gaps in the quality of care at the time of birth and in newborn/KMC units, weak referral and follow-up systems after discharge to the community, and inadequate support to families during home-based care.
In Malawi, Every Preemie is strengthening the community and practice pathways for improved preterm/LBW newborn care in Balaka district. Every Preemie’s work in Malawi includes two components – targeted technical assistance and implementation research.
Targeted Technical Assistance: In collaboration with the Balaka District Health Office, Every Preemie developed the Family-Led Care model as a new and innovative approach to providing care for the preterm/LBW newborn in Balaka district. The model is designed to improve facility- and home-based care of preterm/LBW newborns, including enhancements to the existing referral system. Family-Led Care is currently being rolled out in Balaka district – more information can be found here.
Every Preemie also works closely with PCI’s USAID-funded food security project, Njira, to enhance the preterm/LBW content of its maternal, child health and nutrition activities implemented via community networks, such as Care Groups.
Implementation Research: Every Preemie is conducting implementation research (IR) in Malawi in collaboration with local research partners. The IR in Malawi ties directly to the project’s implementation of the Family-Led Care model in Balaka district and is designed to assess the effectiveness of the model. The model is designed to improve inpatient care of early/small newborns and to empower families to engage in that care at the facility level and to manage the care of their newborns once home. The IR will explore post-discharge follow up care and the role of Health Surveillance Assistants (HSAs) in that care, including home visits and the identification of danger signs and referral to facility-based care.
In order to assess whether the Family-Led Care model has achieved its expected outcomes, Every Preemie will use the following three approaches:
- Measure parent/family caregiver knowledge, attitudes and care practices for early/small newborns as related to the Family-Led Care model (via Maikhanda) through a Parent/Family Caregiver Study
- Measure health care providers’ (including HSAs) abilities, competencies, attitudes, perceptions and practices as related to their experience implementing the Family-Led Care model (via the University of Malawi, College of Medicine) through a Health Care Provider Study; and
- Gather data available through MOH clinical records to measure key indicators over time.