Local health workers' perceptions of substandard care in the management of obstetric hemorrhage in rural Malawi
Beltman, J.Jan.; van den Akker, T.; Bwirire, Dé.; Korevaar, A.; Chidakwani, R.; van Lonkhuijzen, L.; van Roosmalen, J.
Bmc Pregnancy and Childbirth 13: 39
2013
ISSN/ISBN: 1471-2393 PMID: 23414077 DOI: 10.1186/1471-2393-13-39Document Number: 642120
To identify factors contributing to the high incidence of facility-based obstetric hemorrhage in Thyolo District, Malawi, according to local health workers. Three focus group discussions among 29 health workers, including nurse-midwives and non-physician clinicians ('medical assistants' and 'clinical officers'). Factors contributing to facility-based obstetric hemorrhage mentioned by participants were categorized into four major areas: (1) limited availability of basic supplies, lack of human resources, inadequate clinical skills of available health workers and substandard referrals by traditional birth attendants and lack of timely self-referrals of patients.Health workers in this district mentioned important community, system and provider related factors that need to be addressed in order to reduce the impact of obstetric hemorrhage.