AimQuality of service delivery for maternal and newborn health in Malawi isinfluenced by human resource shortages and knowledge and care practicesof the existing service providers. We assessed Malawian healthcareproviders’ knowledge of management of routine labour, emergencyobstetric care and emergency newborn care; correlated knowledgewith reported confidence and previous study or training; and measuredperception of the care they provided.MethodsThis study formed part of a large-scale quality of care assessment inthree districts (Kasungu, Lilongwe and Salima) of Malawi. Subjects wereselected purposively by their role as providers of obstetric and newborncare during routine visits to health facilities by a research assistant. Researchassistants introduced and supervised the self-completed questionnaire bythe service providers. Respondents included 42 nurse midwives, 1 clinicalofficer, 4 medical assistants and 5 other staff. Of these, 37 were staffworking in facilities providing Basic Emergency Obstetric Care (BEMoC)and 15 were from staff working in facilities providing ComprehensiveEmergency Obstetric Care (CEMoC).ResultsKnowledge regarding management of routine labour was good (80%correct responses), but knowledge of correct monitoring during routinelabour (35% correct) was not in keeping with internationally recognizedgood practice. Questions regarding emergency obstetric care were answered correctly by 70% of respondents with significant variation depending on clinicians’ place of work. Knowledge of emergency newborn care was poor across all groups surveyed with 58% correct responses and high rates of potentially life-threatening responses from BEmOC facilities. Reported confidence and training had little impact on levels of knowledge. Staff in general reported perception of poor quality of care.ConclusionSerious deficiencies in providers’ knowledge regarding monitoring duringroutine labour and management of emergency newborn care weredocumented. These may contribute to maternal and neonatal deaths inMalawi. The knowledge gap cannot be overcome by simply providingmore training
