Promoting Community Participation in Improving Maternal and Neonatal Health in Ntcheu District, Malawi: Suggestions for the First National Community Health Strategy
Keywords:community participation, challenges, maternal and neonatal health, community health strategy, Malawi
Malawi, a developing country in southern Africa, adopted its first National Community Health Strategy 2017-2022 to strengthen community health through a harmonized and integrated community approach. The challenges faced with community participation in maternal and neonatal health (MNH) contribute to the country’s health system failures threatening chances of achieving the sustainable development goals targets in the area. A qualitative case study utilizing a phenomenological approach was used to suit the exploration of challenges in promoting community participation to improve MNH. The study was conducted in Ntcheu district, the central region of Malawi. Thirty-five respondents were purposively sampled from functioning teams and committees at various levels within the district health system. The challenges were explored by using key informant interviews of health managers in Ntcheu district, Malawi. Data was manually analyzed using thematic analysis technique and processed and cleaned using Microsoft excel and word processing programs. The study found the issues presenting as challenges as socio-cultural differences detrimental to MNH, problems with community health volunteering, and inadequate health care workers and facilities to respond to community needs. The study recommended integrated health promotion with well-composed MNH messages that capture all sections of society to deal with the socio-cultural issues. The study reinforced the need for good coordination and adequate support for community health volunteer activities. Resource mobilization and building more capacity of the health workforce and facilities to improve service provision are needed to adequately respond to the community needs.
Angwenyi, V., Aantjes, C., Kondowe, K., Mutchiyeni, J. Z., Kajumi, M., Criel, B., . . . Bunders-Aelen, J. (2018). Moving to a strong (er) community health system: analysing the role of community health volunteers in the new national community health strategy in Malawi. BMJ global health, 3, e000996.
Bath, J., & Wakerman, J. (2015). Impact of community participation in primary health care: what is the evidence? Australian journal of primary health, 21, 2-8.
Cherrington, A., Ayala, G. X., Elder, J. P., Arredondo, E. M., Fouad, M., & Scarinci, I. (2010). Recognizing the diverse roles of community health workers in the elimination of health disparities: from paid staff to volunteers. Ethnicity & disease, 20, 189.
Davis, J., Luchters, S., & Holmes, W. (2012). Men and maternal and newborn health: benefits, harms, challenges and potential strategies for engaging men. Melbourne, Australia: Compass: Women’s and Children’s Health Knowledge Hub.
Fullman, N., Barber, R. M., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., . . . Abera, S. F. (2017). Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. The Lancet, 390, 1423-1459.
Gilmore, B., & McAuliffe, E. (2013). Effectiveness of community health workers delivering preventive interventions for maternal and child health in low-and middle-income countries: a systematic review. BMC public health, 13, 847.
Government of Malawi. (2017a). Health sector strategic plan II 2017-2022. Capitol Hill Lilongwe, Malawi: Ministry of Health
Government of Malawi. (2017b). National community health strategy 2017-2022. Capitol Hill Lilongwe, Malawi: Ministry of Health
Kululanga, L. I., Sundby, J., & Chirwa, E. (2012). Male involvement in maternity health care in Malawi. African journal of reproductive health, 16, 145-157.
Malawi National Statistical Office (NSO), & ICF. (2017). Malawi demographic and health survey 2015-16. Retrieved from Zomba, Malawi, and Rockville, Maryland, USA:
Marks, C., Dietsch, E., & Sidebotham, M. (2016). Maternal and neonatal health in Malawi: an integrative literature review. African Journal of Midwifery and Women's Health, 10, 42-47.
Mgawadere, F., Unkels, R., Kazembe, A., & van den Broek, N. (2017). Factors associated with maternal mortality in Malawi: application of the three delays model. BMC pregnancy and childbirth, 17, 219.
Mkandawire, E., & Hendriks, S. L. (2018). A qualitative analysis of men’s involvement in maternal and child health as a policy intervention in rural central Malawi. BMC pregnancy and childbirth, 18, 37.
Nations, U. (2015). Transforming our world: the 2030 agenda for sustainable development. Resolution adopted by the General Assembly.
Nutbeam, D. (2008). The evolving concept of health literacy. Social science & medicine, 67, 2072-2078.
Preston, R., Waugh, H., Larkins, S., & Taylor, J. (2010). Community participation in rural primary health care: intervention or approach? Australian journal of primary health, 16, 4-16.
Rifkin S. B. (2014). Examining the links between community participation and health outcomes: a review of the literature. Health Policy Plan, 29 Suppl 2, ii98-106. doi:10.1093/heapol/czu076
Rosato, M., Laverack, G., Grabman, L. H., Tripathy, P., Nair, N., Mwansambo, C., . . . Costello, A. (2008). Community participation: lessons for maternal, newborn, and child health. The Lancet, 372, 962-971. doi:10.1016/S0140-6736(08)61406-3
World Health Organization. (2008). Ouagadougou declaration on primary health care and health systems in Africa: achieving better health for Africa in the new millennium. Brazzaville: WHO Regional Office for Africa.
How to Cite
Copyright (c) 2022 Journal of Nursing and Health Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.