Malawi

Background

Over 98% of all maternal deaths occur in developing countries, and half of these are in sub-Saharan Africa.

In 2008, Malawi had one of the worst maternal mortality rates in the world, with 1,100 maternal deaths per 100,000 live births. The newborn mortality rate was also tragically high: 29 out of every 1,000 babies died in the first 28 days of life, compared with only three in every 1,000 in the UK. This means that, each year, nearly 21,000 mothers lose their babies when they have barely begun to live.

Malawi is one of the first African countries to have developed a Road Map for maternal and neonatal health, and has mobilised more than 50% of the funds required to implement it. The appointment of Joyce Banda as President of Malawi in April 2012 augurs well, as she has promised to promote maternal and newborn health in her country and has expressed a particular interest in the work of Women and Children First. Nevertheless, pregnancy is still such dangerous time in a woman’s life that it is considered unlucky to tell people about it.

Working in partnership

Women and Children First supports the objectives of both the Road Map and of the Millennium Development Goals (MDGs) 4 and 5 by strengthening the capacity of communities and individuals to address issues that affect maternal and neonatal health. In Malawi we work with of two community based programmes covering four districts.

MaiKhanda

MaiKhanda (which means MotherBaby) is a maternal and newborn health programme funded by The Health Foundation and implemented in partnership with the Institute for Healthcare Improvement .

MaiKhanda supports both the community and the health system so that together they can play an active part in achieving better health and saving lives. The programme works in three districts: Lilongwe, Salima and Kasungu.

Women and Children First supported the project team in establishing participatory women’s groups in 805 villages – the largest intervention of its kind in Africa. The groups identified the maternal and newborn healthcare problems they face in their communities and have worked to overcome these problems through low-cost solutions, which they themselves have devised and put into action.

The strategies of the women’s groups include:

• Growing iron-rich vegetable
• Purchasing bicycle ambulances
• Obtaining bed-nets to prevent malaria.

The groups were given help to evaluate their strategies and to decide what to do next. Most of them decided to continue meeting, and to train one member to facilitate meetings so that the original facilitators would be free to establish new groups.

Maternal and child health in Ntcheu

Women and Children First has worked in partnership with the Malawi Ministry of Health in the district of Ntcheu since 2005. In early 2010 we successfully concluded a programme with 86 women’s groups, which laid the groundwork for a new three-year programme, funded by Comic Relief.

This project, which started in 2010, continues the collaboration with the Ministry of Health with the aim of setting up 144 women’s groups in Ntcheu District, covering a population of 72,000.

Building on the foundations laid by the earlier work, the project continues to:

• Improve maternal and child health practices in the community, and
• Raise the quality of health services for pregnant women and their children.

We are also:

• Implementing a low cost data collection system to support health service planning, and
• Establishing an informal referral service to ensure the provision of skilled care.