Background
Adolescent pregnancy is a public health concern in Malawi as it is associated with high risks of adverse pregnancy outcomes. Almost 29% of adolescent women aged 15–19 years are already mothers and adolescent fertility rate is also high estimated at 136 per 1000 women. Therefore, the aim of the study was to explore knowledge of pregnant adolescents on importance of antenatal care and health promotion during pregnancy.
Methods
A qualitative descriptive design was used to solicit information on significance of antenatal care and how adolescents promote their health during pregnancy. Data was collected from 77 pregnant adolescents, purposively sampled from Namitambo and Namadzi Heath Centres in Chiladzulu District, Malawi. A semi-structured interview guide was used for data collection. Data were analysed manually following principles of qualitative content analysis.
Results
Themes that emerged from the qualitative data included: knowledge deficit on the purpose and benefits of antenatal care; knowledge deficit on services offered at antenatal care clinic; knowledge deficit on danger signs during antenatal period and antenatal emergency care; knowledge deficit on effects of alcohol and smoking; knowledge deficit on nutrition during pregnancy; and knowledge deficit on importance of rest during pregnancy.
Conclusion
This study has shown knowledge deficit among adolescent mothers that may contribute to poor pregnancy outcomes. Several factors could be attributed to such knowledge deficit. Therefore, healthcare systems and healthcare professionals have a responsibility to enhance health literacy of pregnant adolescents with an ultimate goal of improving maternal and neonatal health outcomes.
Background/aims The partograph is a tool used to monitor events during labour and was recently modified by the World Health Organization to improve intrapartum care. However, it is unknown how obstetric care providers in Malawi perceive this modified partograph. This study aimed to evaluate the perceived strengths and challenges regarding the World Health Organization's modified partograph design among obstetric care providers in Malawi. Methods For this qualitative study, data were collected from a sample of 34 obstetric care providers from two purposively-selected urban health facilities through in-depth interviews and focus group discussions. The data were subjected to thematic analysis, with the strengths and challenges of using the modified partograph designated as the two major themes. Results The participants reported that there were more challenges than strengths with utilisation of the modified partograph. Two subthemes emerged among the strengths: the partograph is comprehensive and the partograph is clear. Three subthemes emerged from the challenges: 1) unrealistic fetal monitoring intervals, 2) confusing partograph design regarding documentation of caput and moulding and 3) small font. These challenges made partograph use impractical to complete, particularly in the context of chronic understaffing of the labour ward. Conclusions Until staffing levels are improved in Malawi and other resource-limited settings, it is unlikely that the modified partograph design will significantly improve maternal or neonatal outcomes. However, some improvements can be made to the design to help facilitate its use, and more training on its use is needed to prevent confusion.
In many countries, women fall pregnant much sooner than desired and have more pregnancies and bear more children than they want. Pregnancies are usually associated with an array of negative health, economic, social and psychological outcomes for women and children. Preventing unintended pregnancies through family planning is an integral component in limiting associated consequences and population growth. However, despite widely available contraceptives, the demand for family planning among married women is still high. A quantitative study was conducted to explore the prevalence and determinants of unintended pregnancy among married women seeking antenatal care at Bwaila District Hospital in Lilongwe, Malawi. Permission was granted by the relevant authorities to conduct the study. Between July and August 2019, 413 married pregnant women were interviewed. The women gave written consent before joining the study and all the completed questionnaires were personally collected daily. Descriptive statistics were used to analyse the data while nonparametric tests were used to explore associations amongst the variables. The mean age of the participants was 23 years and 43.1% of the participants reported that their most recent pregnancy was unintended. Multivariate analysis revealed that young age (18–25 years), low education level and preference for the sex of the child were significant determinants of unintended pregnancy. Inconsistent use of family planning methods increased the risk of unintended pregnancy. Unintended pregnancy among married women indicates the need for improving education among women to delay marriage to the universal minimum of 18 years, and increasing access to long-term family planning methods to avoid failure and discontinuation of contraceptives.
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