Scaling up a health and nutrition hotline in Malawi: the benefits of multisectoral collaboration

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Abstract

Carla Blauvelt and colleagues describe a multisectoral collaboration that enabled the scale up of a health advice telephone service and its transition to government in Malawi

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Women’s perspectives on quality of maternal health care services in Malawi

Kennedy Machira, Martin Enoch Palamuleni (2018)

Despite promotion by many stakeholders to improve maternal health outcome in many developing countries including Malawi, many analysts agree that the utmost success in maternal health will arise if maternal health care services are an unparallel led source for women’s health care solutions for any problem related to childbirth. Health advocates worldwide claim that even though maternal services are provided, women’s utilization of such services has not been ascertained. The objective of this study was to explore women’s perspectives on the quality of health care service delivery in Malawi. This article therefore investigates women’s perspectives on the quality of maternal health care services in Malawi. We used six focus group discussions in six health facilities that were selected across Malawi. We found that erratic availability of medical resources and unethical practices among health workers adversely affected quality of maternal health care service delivery. We concluded that the expensive routine operational audits of medical resources and service delivery across health facilities are imperative if women’s health outcomes are to be enhanced in Malawi.

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Examination of patient flow in a rural health center in Malawi

M A Jafry, A. Jenny, S J Lubinga … (2016)

Background Malawi, like many low-income countries, is facing a severe health worker shortage. A potential stop-gap solution to this crisis is improving the efficiency of health center operations. Given the lack of research on center efficiency in rural health centers in Malawi, we conducted a study to identify deficiencies in center organization and barriers to patient flow. Methods We performed a time-motion survey at a rural health center in Ntaja, Malawi over a period of 1 week. We used a standardized questionnaire to collect information on the amount of time a patient spent with each health worker, the number of center staff that attended to each patient, and the total time spent at the center. Additionally, at the end of the visit, we conducted an exit survey to collect demographic information and data on perception of quality of care with the center visit for all patients. Results A total of 1018 patients were seen over the five-day study. The average total time spent at the center by the patients was 123 min (2–366 min). Adults had an average total time spent at the center of 111 min (2–366 min) and children 134 min (7–365 min). Patient waiting time (PWT) was higher in the early morning hours ranging from 157 min (between 06:00 and 08:00) to 53 min (between 14:00 and 16:00). Health worker contact time (HCT) was higher for adults (2.3 min) than children (1.7 min). Shorter wait times were associated with higher perceptions of quality of service. Conclusion Despite shortages in health workers and funds, opportunities are available to increase efficiency in rural health centers. By removing bottlenecks to increase the productivity of health workers, centers in low-income countries can treat more patients and improve service quality. Electronic supplementary material The online version of this article (doi:10.1186/s13104-016-2144-x) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Carla Blauvelt: Role: country director

Melissa West: Role: director and group lead advocacy and communications

Luciana Maxim: Role: senior monitoring and evaluation adviser

Alinafe Kasiya: Role: deputy country director

Isaac Dambula: Role: director of the central monitoring and evaluation division

Upile Kachila: Role: CCPF technical adviser

Hope Ngwira: Role: senior advocacy and communications adviser

Corinne E Armstrong: Role: independent consultant

Journal

Journal ID (nlm-ta): BMJ

Journal ID (iso-abbrev): BMJ

Journal ID (publisher-id): BMJ-UK

Journal ID (hwp): bmj

Title: The BMJ

Publisher: BMJ Publishing Group Ltd.

ISSN (Print): 0959-8138

ISSN (Electronic): 1756-1833

Publication date Collection: 2018

Publication date (Electronic): 07 December 2018

Volume: 363

Electronic Location Identifier: k4590

Affiliations

[1 ]VillageReach, Lilongwe, Malawi

[2 ]VillageReach, Seattle, USA

[3 ]Government of Malawi Ministry of Health, Lilongwe, Malawi

[4 ]London, UK

Author notes

Correspondence to: Carla Blauvelt, carla.blauvelt@ 123456villagereach.org

Article

Publisher ID: blac047385

DOI: 10.1136/bmj.k4590

PMC ID: 6282726

PubMed ID: 30530659

SO-VID: ae04af10-b17d-4cff-ab89-935fea5cb61f

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This is an Open Access article distributed under the terms of the Creative Commons Attribution IGO License ( https://creativecommons.org/licenses/by-nc/3.0/igo/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited.

Scaling up a health and nutrition hotline in Malawi: the benefits of multisectoral collaboration

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Women’s perspectives on quality of maternal health care services in Malawi

Examination of patient flow in a rural health center in Malawi

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