Aim:

To reduce maternal and neonatal mortality (by 30 percent) and morbidity in the three participating districts (Salima, Kasungu, and Lilongwe) in Malawi over three years.

Objectives:

• Implement measurable improvements in the quality of maternity services within health facilities
• Develop local human capacity in quality improvement for a resource-poor setting
• Permanently enhance Ministry of Health capacity at both facility and central level to collect and use information for continuous improvement
• Implement parallel community-level interventions to simultaneously address the practical problems of health care delivery as well as the cultural issues and practices within Malawian communities that directly contribute to maternal and neonatal mortality
• Permanently enhance community-level capacity to manage healthl in particular, empower women to take greater control of their own and their infants’ health

Other partners in THFC include Liverpool Associates in Tropical Health (LATH), the consulting arm of the Liverpool School of Tropical Medicine; Women and Children First (WCF), an NGO based in the UK; and the Institute for Child Health (ICH) at the University of London. The evaluation of the program, which has been built into the design, will be conducted by ICH.

The core tasks that will be used to achieve the THFC program objectives are as follows:

• Improvement in the collection and use of data nationwide through work with the District Health Teams
• Rapid Cycle Process Improvement in two central referral hospitals, as well as in facilities in three selected districts
• Improvement in use of maternal and neonatal death audits to serve as a base for improvement activities
• Development of village-based women’s groups in local communities in the three selected districts with eventual links between village leaders and the staff of facilities working on improvement
• Direct surveillance of maternal mortality and morbidity, which will permit true evaluation of the program’s effects without having to depend on retrospective surveys

The THFC program is unique in that it combines improvements to the quality of care in health facilities with efforts in communities to increase demand for health services through women’s groups interventions. The community model has been shown in several different resource-poor settings to lead to significant improvement in birth outcomes; THFC will be testing the impact of combining facility and community-based interventions to reduce maternal and neonatal mortality.

Learn more about THFC's ongoing work in Malawi.