In rural Malawi, there's no tradition of antenatal check-ups or hospital delivery. From early pregnancy to caring for a newborn child, many women here face health risks without expert help.
It’s customary for women to give birth in their village, not at a clinic. But birth attendants don’t have formal training, and the warning signs of complications aren’t well understood. There are financial pressures too: low incomes make it difficult for couples to save for childcare essentials.
Flora Mkolongo lives in the village of Mwankenja with her husband Atusaye. His bicycle taxi provides an income, but when she became pregnant, Flora realised it wasn’t enough.
She spoke to Esnart, from her Village Savings and Loans Association. She helped Flora to borrow MK15,000 (about £15) to buy clothes, a basin and wraps for her twins. As well as providing access to lower-interest loans, the VSLA advises women’s groups about saving for their children’s future needs.
Esnart is known and trusted locally, and she has been trained to provide antenatal and maternal health advice, as Flora explains:
We were given information about the benefits of delivering at the hospital, instead of using traditional birth attendants, as well as the importance of attending antenatal clinic visits and nutrition.
The scheme is changing cultural attitudes among local leaders, to the extent that some communities now have byelaws that encourage women to visit the centres. Attendance is improving - in fact, Flora worries that the nurses need more support to cope with demand.
More and improved services are required, but the results have been positive. “I think the programme has really helped us a lot,” says one midwife. “Maternal deaths, which were high in this area, are now on the decline… mainly because communities have introduced byelaws.”
What does the supporting data tell us?
Below you can explore how the results changed from the Start to the End of the project, based upon the survey questions. Filter by community using highlighted areas of the map to view impact at a local level and by gender to see how answers from men differed from those of women.
If using a mobile, click on the full-screen option.
Read more about our maternal and neonatal health programme in Malawi.