Exploring Midwives’ Experiences Regarding Implementation of Maternal Death Surveillance and Response at Mwanza District Hospital, Malawi
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Date
2025-04-15
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Abstract
Despite the Malawi government's implementation of the Maternal Death Surveillance and
Response initiative in 2002, preventable maternal deaths persist. Data from Mwanza
District Hospital revealed 9 maternal deaths in 2023 alone. This demonstrated that Malawi,
like many other low- and middle-income countries, is still far from attaining the
Sustainable Development Goals (SDGs) for reducing maternal mortality. Midwives play a
pivotal role as members of the MDSR team, and there is potential for midwives to indirectly
experience trauma from such role. However, little is known about their experiences during
implementation of the MDSR. The main objective of the study was to explore the
experiences of midwives regarding the implementation of maternal death surveillance and
response. We employed a qualitative explorative descriptive design. In-depth interviews
with 18 purposively selected individuals were used to collect qualitative data using a semistructured interview guide. Data analysis was carried out in accordance with Braun and
Clarke's six phases of theme analysis, with Nvivo 12 software. The study highlighted three
themes based on midwives' experiences with MDSR: maternal death identification,
notification, and reporting. Experiences with the maternal death review and audit
processes, as well as the implementation and follow-up of action plans. These themes
illustrate the complexities of MDSR, such as emotional impact, protocol obstacles, and
implementation barriers. The possible recommendation that emerged was the need for
more research and development of national policy to identify high quality interventions to
support midwives through the MDSR.