Improving Healthcare Quality in Malawi (MaiKhanda)

In brief

Our work in Malawi – the MaiKhanda programme – ran from 2006 to 2013. It aimed to reduce by 30% the number of maternal and neonatal deaths in the Lilongwe, Kasungu and Salima districts of Malawi, working within the strategy already established by the Malawi Ministry of Health’s roadmap for maternal health.

MaiKhanda – which means ‘mother and baby’ in Chichewa – was led on the ground by the Institute for Healthcare Improvement, working in partnership with Women and Children First, and also working with the Institute of Child Health at University College London who we commissioned to undertake an independent evaluation of the programme.

MaiKhanda worked with 11 hospitals and 32 health centres to improve obstetric services. At the same time, it used a community mobilisation approach to educate and empower women through 729 women’s groups.

We believe that this dual approach – first, to ensure that clinical facilities are of a higher quality and second, to ensure that the people who live in these districts have the knowledge and confidence to use those facilities most effectively – was critical.  

The work of the programme was underpinned by the well-established ‘Three delays’ model (delays in the decision to seek care, delay in getting to the place of care, and delay in delivering care).

We hope to secure a legacy of durable improvements in maternal and neonatal healthcare, working with district health systems to sustain improvements in clinical care, data monitoring and community mobilisation.