Blair AH, Openshaw M, Mphande I, Jana O, Malirakwenda R, Muller A, Rankin S, Baltzell K. Assessing Combined Longitudinal Mentorship and Skills Training on Select Maternal and Neonatal Outcomes in Rural and Urban Health Facilities in Malawi.
J Transcult Nurs 2022;
33:704-714. [PMID:
36062416 PMCID:
PMC9561805 DOI:
10.1177/10436596221118113]
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Abstract
Introduction:
Despite successful efforts to improve clinical access and skilled birth
attendance in Malawi, it still faces high rates of maternal and neonatal
mortality. In 2017, the UCSF-GAIN partnership began a nurse-midwifery
clinical education and longitudinal mentorship program. While it has
received positive reviews, it is unclear whether routinely collected
indicators can assess such a program’s impact.
Method:
A longitudinal review of the Malawian DHIS2 database explored variables
associated with maternal and newborn care and outcomes before and after the
intervention. Data were analyzed using generalized estimating equations
(GEE) to account for facility-level correlations over time.
Results:
Quality issues with DHIS2 data were identified. Significant changes
potentially associated with the GAIN intervention were noted.
Discussion:
The GAIN approach appears to be associated with positive trends in maternal
and neonatal care. National summary databases are problematic, however, for
evaluating targeted interventions and the provision of care to specific
outcomes.
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