Improving care for mothers and babies in Malawi

No one is more vulnerable than a newborn baby.

Newborns are totally dependent on their mothers. And their mothers, in turn, rely on skilled doctors and nurses, with access to working equipment, medicines, infrastructure, and information systems. When mothers give birth at home, without access to a skilled birth attendant, the chance that they or their newborn baby will die is many times higher.

Making sure mothers and babies can access health services is key to keeping them alive and healthy.

This fact has not been lost on governments and development partners. Indeed, in recent years, governments and donors have doubled down on efforts to improve access to health services, and coverage has increased.

But progress has been uneven: while there have been important increases in coverage of maternal, newborn and child health services, these have not always led to corresponding improvements in newborn and child survival. In fact, in 2015, 2.7 million babies died during their first 28 days of life – the majority of them from totally preventable causes.

“We want to see is happy mothers, happy families and happy babies - that is what we want,” said Beatrice Chigamba, Head Nurse at the Ngabu Clinic, Malawi.
UNICUNI173468/Schermbrucker“We want to see is happy mothers, happy families and happy babies – that is what we want,” said Beatrice Chigamba, Head Nurse at the Ngabu Clinic, Malawi.

In many cases, the problem is quality: If staff are not trained, supplies are lacking and infrastructure is substandard, the risks remain high, even for mothers giving birth in a health facility. When quality is poor, there is often low demand for health services, with mothers preferring to deliver at home, or with an untrained birth attendant.

Malawi is a case in point. The country has made huge progress on child mortality, and 89 percent of women deliver in a health facility. But because quality remains low, maternal and newborn mortality rates are still too high –for every 1000 live births, 22 newborns die. In some facilities, health workers are not adequately trained and lack confidence in caring for newborn babies, especially if there are birth complications. In other cases, the challenge is a lack of basic medical supplies, which results in the needless death of countless mothers and babies.

Improving health systems’ ability to deliver high-quality care is critical. And this is why last month, Malawi together with eight other countries, launched a new network to promote quality of care for newborns. In launching the network, Malawi, Bangladesh, Côte d’Ivoire, Ethiopia, Ghana, India, Nigeria, Tanzania and Uganda committed to investing in staff training, strengthening infrastructure, improving supply chains and working to improve the equitable distribution of resources, so that every mother and every child will have access to high-quality health care.

The network will give these countries an opportunity to accelerate improvements in quality care and promote investments that serve to strengthen and improve health systems and quality. It will also provide a platform for learning, knowledge sharing, and evidence gathering on quality care by the nine countries.

By focusing on building strong health systems that deliver quality services, we can put an end to the global injustice of preventable maternal and child mortality. And because we can, we must – for every mother and every child.

Johannes Wedenig, UNICEF Malawi Representative, and Dr. Stefan Peterson, UNICEF Chief of Health


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