Investigating Preterm Care at the Facility Level: Stakeholder Qualitative Study in Central and Southern Malawi
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Investigating Preterm Care at the Facility Level: Stakeholder Qualitative Study in Central and Southern Malawi Austrida Gondwe1,2 • Alister Munthali3 • Per Ashorn4 • Ulla Ashorn4
Springer Science+Business Media New York 2016
Abstract Objectives Malawi is estimated to have one of the highest preterm birth rates in the world. However, care of preterm infants at facility level in Malawi has not been explored. We aimed to explore the views of health stakeholders about the care of preterm infants in health facilities and the existence of any policy protocol documents guiding the delivery of care to these infants. Methods We conducted 16 in-depth interviews with health stakeholders (11 service providers and 5 policy makers) using an interview guide and asked for any existing policy protocol documents guiding care for preterm infants in the health facilities in Malawi. The collected documents were reviewed and all the interviews were digitally recorded, transcribed and translated. All data were analysed using content analysis approach. Results We identified four policy protocol documents and out of these, one had detailed information explaining the care of preterm infants. Policy makers reported that policy protocol documents to guide care for preterm infants were available in the health facilities but majority (63.6 %) of the service providers lacked knowledge about the existence of these documents. Health
stakeholders reported several challenges in caring for preterm infants including lack of trained staff in preterm infant care, antibiotics, space, supervision and poor referral system. Conclusions Our study highlights that improving health care service provider knowledge of preterm infant care is an integral part in preterm child birth. Our findings suggests that policy makers and health decision makers should retain those trained in preterm new born care in the health facility’s preterm unit. Keywords Policy and guidelines Preterm care Health facilities Malawi
Significance These findings are important to the field of public health because they highlight the current situation about the care of preterm infants in some of the health facilities in Central and Southern Malawi. The findings can be used by public health researchers and policy makers to improve maternal and child health outcomes, especially in preterm infant care.
& Austrida Gondwe [email protected] 1
iLiNS Project, College of Medicine-Mangochi, University of Malawi, Zomba, Malawi
2
Department of International Health, University of Tampere, Tampere, Finland
3
Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi
4
Department for International Health, University of Tampere and Department of Paediatrics, Tampere University Hospital, University of Tampere School of Medicine, Tampere, Finland
Introduction Globally, South Asia and sub-Saharan Africa account for approximately two-thirds of the 15 million preterm newborns that are born annually and over three-quarters of the world’s newborn deaths is due to preter
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