Assessing the quality of postnatal care offered to mothers and babies by midwives in Lilongwe District

Abstract

Background: The quality of care received by mothers and newborns in low-resource settings is often poor. This may partly explain the high rates of  maternal deaths (60%) that occur during the postpartum period in Malawi. However, the quality of care provided to mothers and newborns in the  country has not been adequately assessed. Therefore, this study aimed at assessing the quality of postnatal care services offered to mothers and  babies by midwives in Lilongwe District.

Methods: This was a quantitative study that used a sample of 58 midwives to assess the quality of postnatal care at three selected health facilities. A  structured questionnaire, an observation tool and a facility checklist were used to collect data. Descriptive statistics were used to analyse the  data. The study received ethics approval from the relevant authority.

Results: The study found that the percentages reported by midwives regarding client monitoring varied and were below the 80% threshold.  Midwives did not always follow the reproductive health standards on client examination so that less than 75% of midwives inspected perineal  wounds (52.2%), checked vital signs of neonate (66.7%) and mother (62.2%), and inspected lochia drainage (30.4%). Most midwives (91.3%) never  assessed the emotional state of the mother. Midwives covered a range of topics during health education and counselling. However, some topics,  including immunisations (31.1%), were never taught.

Conclusion: The study has suggested that the postnatal care offered by midwives at three health facilities was generally substandard and midwives  do not always monitor, assess and counsel postnatal clients.