Maternal and Neonatal Health
Access to quality maternal and newborn care is the cornerstone of many community health programs. For many women living in last mile communities, pregnancy can be a vulnerable time. There is a need for community health programs to support early pregnancy registration, consistent antenatal care (ANC) visits, and in-facility deliveries. In addition, the short time window following delivery for postnatal care (PNC) is a critical time for catching life-threatening danger signs for the new mother and baby.
The maternal and newborn health workflow ensures that women receive the care that they need during their pregnancy with the support of CHWs. Early pregnancy registration, timely antenatal care visits, and improved care coordination between CHWs and clinics increase the likelihood that women will deliver in a facility with the support of skilled birth attendants. This ultimately will help save the lives of mothers and babies, as well as strengthen the maternal and newborn health services of the health system. The CHT Application is used by health workers and clinical staff to:
- Register pregnancies
- Provide a schedule for on-time ANC visits
- Offer education for the mother at each stage of pregnancy
- Screen for and report danger signs in the pregnant woman and newborn
- Refer and encourage pregnant women to deliver at a facility
- Ensure on-time PNC visits for mother and newborn
- Guided monthly screening to ensure adherence to MoH Malawi ANC protocols
- Referral follow up tasks for referred patients
- Monthly follow up tasks for registered pregnancies
- Dashboards to monitor ANC related activities and outcomes
- Supportive supervision ratings to identify gaps and mentorship opportunities
- Register all women
- Regularly screen eligible women for pregnancy
- Accompany any suspected pregnancy case to the facility for confirmation
- Follow up on referred cases for facility attendance
- Register any new pregnancies
- Follow up all pregnant women for danger signs screening and appointment reminders.
- Refer any pregnant woman due for delivery to the waiting home for skilled delivery.
- All pregnancies that are due are followed up for delivery confirmation.
- All new deliveries are registered by the CHWs within 48 hours
- All women in PNC period and newborns are followed up by CHWs on the 3rd and 5th day for danger sign screening and facility PNC clinic reminder
- All PNC women attend PNC clinic visits at week 1 and 6
Assumptions
- CHWs aware of the PNC protocol
- Facilities are sufficiently stocked
- CHWs are equipped with functional phones
- CHWs have community trust and good relationship with community
- Site supervisors (SS) will report deliveries immediately
- SS has full access to facility delivery records
- Good internet connectivity at health facilities
Improve maternal and newborn health outcomes through addressing complications during the crucial post-delivery window resulting from timely and continuous postnatal care visits and increased coordination between CHWs and facility.
Once a hierarchy of people and places is established, forms are added at different levels. This diagram indicates the forms that can be filled about a person in the app (in this case, family members at the household level), as well as the person/user who will access these forms and make the reports (CHWs at the CHW Area level). Some forms are accessible as actions from the family member’s profile as actions, others from the CHW’s task list as tasks, and some as either.
Both maternal and newborn care workflows are defined to connect form actions and data with people. Detailed documentation for these forms and task schedules are linked from the workflow diagrams below. Accompanying this documentation are tips and insights into the design decisions made along the way, and suggestions for how and where to customize the forms.
