Estimating the impact of maternity service delivery on health in Malawi: An individual-based modelling study
Abstract Despite improvements in maternal and perinatal health in Malawi, morbidity and mortality remain high, partially due to gaps in the coverage and quality of health services. We developed an individual-based simulation model of maternal and perinatal health and healthcare in Malawi, situated in a ‘whole-health system, all-disease’ framework. We considered scenarios to estimate the impact of current coverage, improved coverage and improved coverage and quality of antenatal, intrapartum, and postnatal services from 2023 to 2030. Whilst current service delivery is inferred to avert morbidity and mortality, there is scope to substantially improve population health through higher coverage of services meeting or exceeding minimum quality of care standards. Generally, increased coverage without quality improvement did not impact mortality or DALYs, with maternal deaths being most reduced through high coverage and quality postnatal service delivery (40% reduction) and stillbirths and neonatal deaths being most reduced through improved intrapartum services (10% and 29% reductions, respectively). Importantly, whilst maximum availability of intrapartum care may reduce neonatal deaths sufficiently to achieve Sustainable Development Goal (SDG) target 3.2 by 2030, no single scenario led to reductions in maternal mortality sufficient to achieve SDG target 3.1, suggesting system wide investments are essential if such targets are to be met..
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Preprint| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
ResearchSquare.com - (2024) vom: 26. März Zur Gesamtaufnahme - year:2024 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Collins, Joseph [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.21203/rs.3.rs-3937439/v1 |
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| 520 | |a Abstract Despite improvements in maternal and perinatal health in Malawi, morbidity and mortality remain high, partially due to gaps in the coverage and quality of health services. We developed an individual-based simulation model of maternal and perinatal health and healthcare in Malawi, situated in a ‘whole-health system, all-disease’ framework. We considered scenarios to estimate the impact of current coverage, improved coverage and improved coverage and quality of antenatal, intrapartum, and postnatal services from 2023 to 2030. Whilst current service delivery is inferred to avert morbidity and mortality, there is scope to substantially improve population health through higher coverage of services meeting or exceeding minimum quality of care standards. Generally, increased coverage without quality improvement did not impact mortality or DALYs, with maternal deaths being most reduced through high coverage and quality postnatal service delivery (40% reduction) and stillbirths and neonatal deaths being most reduced through improved intrapartum services (10% and 29% reductions, respectively). Importantly, whilst maximum availability of intrapartum care may reduce neonatal deaths sufficiently to achieve Sustainable Development Goal (SDG) target 3.2 by 2030, no single scenario led to reductions in maternal mortality sufficient to achieve SDG target 3.1, suggesting system wide investments are essential if such targets are to be met. | ||
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