Insights on skilled attendance at birth in Malawi - the findings of a structured document and literature review

Increasing the number of women who access skilled attendance at birth is the goal of many developing countries including Malawi. The Skilled Attendance for Everyone (SAFE) international research programme coordinated by the Dugald Baird Centre for research on Women\'s Health at the University of Aberdeen, developed a Strategy Development Tool (SDT). The tool comprised five modules: Problem identification, Situation analysis (Document and Literature review and Interpretive guidelines), Needs assessment, Monitoring system and Synthesis. The Document and Literature review component of the tool was piloted in Malawi in collaboration with the Ministry of Health & Population. The findings revealed that Malawi has a critical shortage of Skilled Attendance which encompasses both the Skilled Attendant and an enabling environment. While health sector educational programmes appear to be strong, the country has lost significant numbers of health personnel, especially Midwives through resignation death and retirement. Only 55% of women access health facilities and of these, 56% are assisted by Skilled Attendants at birth. Cultural factors, staff negative attitudes and long distances among other factors, hinder access and utilization of the available Skilled Attendance at birth. Malawi Medical Journal Vol.16(2) 2005: 40-4