The maternal mortality ratio in Malawi is one of the highest in sub-Saharan Africa, at 439 per 100,000 live births, of which an estimated 25% is due to postpartum hemorrhage (PPH).1,2 Despite an increase in institutional deliveries, up from 51% in 1992 to 91% in 2015,3 many preventable maternal deaths continue to occur at facilities. Additionally, only 42% of women receive a check-up within 48 hours of delivery. Facilities in Malawi face persistent challenges including limited human resources, provider vulnerabilities, weak infrastructure, commodity availability, and lack of functioning referral systems and quality improvement efforts. In light of these challenges, there is a need to develop and implement effective strategies and interventions to advance PPH prevention and treatment in Malawi.
In response to this need, and as part of ongoing efforts to accelerate reductions in maternal deaths, U. S. Agency for International Development (USAID) is supporting a one-time catalytic investment in Malawi and Madagascar collectively referred to as Advancements in Postpartum Hemorrhage Care (APPHC). The APPHC Partnership is led by Breakthrough RESEARCH and the Health Evaluation and Applied Research Development (HEARD) Projects. A description of the APPHC Partnership Approach is also available.
This brief outlines the portfolio of research activities underway in Malawi. A similar brief describes the Madagascar portfolio.