Process Evaluation of "The Hygienic Family" Intervention: A Community-Based Water, Sanitation, and Hygiene Project in Rural Malawi.

Process evaluations of environmental health interventions are often under-reported and under-utilized in the development of future programs. The "Hygienic Family" intervention targeted improvements in hygiene behaviors of caregivers with under five-year-old children in rural Malawi. Delivered through a combination of open days, cluster meetings, household visits, and prompts, data were collected from two intervention areas for ten months.

Distance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.

Background: Malawi has halved the neonatal mortality rate between 1990-2018, however, is not on track to achieve the Sustainable Development Goal 12 per 1,000 live births. Despite a high facility birth rate (91%), mother-newborn dyads may not remain in facilities long enough to receive recommended care and quality of care improvements are needed to reach global targets. Physical access and distance to health facilities remain barriers to quality postnatal care.

Acceptability of menstrual products interventions for menstrual hygiene management among women and girls in Malawi.

Background: A key challenge for menstruating girls and women in low-resource countries is the inadequate and unreliable supply of menstrual products. Although development partners are implementing menstrual product interventions to address this challenge in Malawi, there is a paucity of information on the distribution of menstrual products and the acceptability of these interventions among users.

Methods: We conducted in-depth interviews with girls (n = 20) and women (n = 26) and 4 focus group discussions (FGDs) with women (n = 35) and 7 FGDs with girls (n = 60) to explore the acceptability of menstrual products interventions in 8 districts.

Exploiting the emergent nature of mixed methods designs: insights from a mixed methods impact evaluation in Malawi.

The application of mixed methods in Health Policy and Systems Research (HPSR) has expanded remarkably. Nevertheless, a recent review has highlighted how many mixed methods studies do not conceptualize the quantitative and the qualitative component as part of a single research effort, failing to make use of integrated approaches to data collection and analysis. More specifically, current mixed methods studies rarely rely on emergent designs as a specific feature of this methodological approach.

Prevalence and determinants of unmet need for family planning among married women in Ghana-a multinomial logistic regression analysis of the GDHS, 2014.

Background: Documentary evidence points to high unmet need for family planning across sub-Saharan Africa. Modern contraceptive use has been staggering over decades with unacceptable marginal increases given that one in three women still report unmet need in Ghana. This study sought to re-examine through a further analysis on the prevalence and determinants of unmet need for family planning in Ghana using married women extracted from the recent 2014 Ghana Demographic and Health Survey.

'The money can be a motivator, to me a little, but mostly PBF just helps me to do better in my job.' An exploration of the motivational mechanisms of performance-based financing for health workers in Malawi.

Performance-based financing (PBF) is assumed to improve health care delivery by motivating health workers to enhance their work performance. However, the exact motivational mechanisms through which PBF is assumed to produce such changes are poorly understood to date. Although PBF is increasingly recognized as a complex health systems intervention, its motivational effect for individual health workers is still often reduced to financial 'carrots and sticks' in the literature and discourse.

Implementation research to improve quality of maternal and newborn health care, Malawi.

Objective: To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi.

Methods: We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities' essential drug stocks, equipment maintenance and clinical obstetric care processes.

Perceptions of quality across the maternal care continuum in the context of a health financing intervention: Evidence from a mixed methods study in rural Malawi.

Background: In 2013, Malawi with its development partners introduced a Results-Based Financing for Maternal and Newborn Health (RBF4MNH) intervention to improve the quality of maternal and newborn health-care services. Financial incentives are awarded to health facilities conditional on their performance and to women for delivering in the health facility. We assessed the effect of the RBF4MNH on quality of care from women's perspectives.

How do Malawian women rate the quality of maternal and newborn care? Experiences and perceptions of women in the central and southern regions.

Background: While perceived quality of care is now widely recognized to influence health service utilization, limited research has been conducted to explore and measure perceived quality of care using quantitative tools. Our objective was to measure women's perceived quality of maternal and newborn care using a composite scale and to identify individual and service delivery factors associated with such perceptions in Malawi.

Methods: We conducted a cross-sectional survey in selected health facilities from March to May 2013.

Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi.

Objective: To identify factors associated with delivery outside a health facility in rural Malawi.

Method: A cross-sectional survey was conducted in Balaka, Dedza, Mchinji and Ntcheu districts in Malawi in 2013 among women who had completed a pregnancy 12 months prior to the day of the survey. Multilevel logistic regression was used to assess factors associated with delivery outside a facility.