Maternal mortality and neonatal mortality in Malawi are still among the highest in Africa and in the world. Obstetric complications are particularly high and indirect causes of mortality include delays in seeking care, poor referral systems, and lack of appropriate drugs, equipment and staff capacity.
Conditions can be improved in Malawi by providing better antenatal, perinatal and postnatal care, and additional support for pregnant women at risk. Particular emphasis needs to be placed on attendance of skilled health care providers at deliveries.
Risk factors for obstetric complications are the young age of mothers and lack of education. Nearly 50% of children under 18 – and 11 % of children under 15 – are married. This puts young girls at particular risk: 34% of girls under 18 are already mothers, and most do not have comprehensive knowledge about HIV. More than half of estimated 1.3 million orphans in Malawi have lost one or both parents to AIDS.
The aim of the Kudimba Foundation is to guide young people and support them with education and advice on sexual health and general health, on family planning and life skills. By providing counselling the rate of unwanted pregnancies and sexually transmitted infections can be decreased, and complications reduced.
Premature birth in Malawi
The 2013 State of the World’s Mothers report indicates Malawi has the highest rate of premature births in the world.
In Malawi in 2012, prematurity was the largest cause of death in under fives. Malawi has reduced neonatal mortality by half, whereas globally this reduction was 30%. Decreasing the risk of preterm-birth and effective management of preterm infants in Malawi, could further significantly reduce the under-five mortality rate.
Common disadvantages for surviving premature babies in Malawi include educational and social problems, with an increased chance of long-term neurological problems. The challenges that surviving preterm newborns often encounter include a lifetime of disability, which is a major obstacle in a developing country such as Malawi. Disabilities include learning, visual and hearing problems, with premature children at greater risk of developing mental-health problems in later life.
Prevention, detection and treatment of maternal infection are enormous challenges but have a great impact on the rate of preterm birth in Malawi, as would increasing the number of well-trained healthcare providers.
Kudimba’s goal is to provide tailored maternity support for pregnant women who are at risk, for example due to their young age or disability. This will further assist to reduce the maternal and infant morbidity and mortality rate.