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other·obstetrics and gynecology, pediatrics, public health, family medicine, clinical trial·PMC10576327

Adapting group care to the postpartum period using a human-centered design approach in Malawi

BMC Health Services Research · 10 authors, 5 centres

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TL;DR

This qualitative study used interviews and collaborative workshops with Malawian mothers and healthcare workers to co-design a prototype for group postpartum and well-child care.

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Researchers employed a human-centered design framework to adapt group care for the postpartum period in Malawi. The recommended structure includes 6 group sessions over 12 months, corresponding with the child vaccination schedule. The study demonstrates the feasibility and acceptability of this co-design process.

STUDY TYPE

other

SPECIALTY

obstetrics and gynecology

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100% · A

ORIGINAL PAPER

PMC10576327

Adapting group care to the postpartum period using a human-centered design approach in Malawi

BMC Health Services Research

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ABSTRACT

Background Responsive and resilient strategies to reduce high rates of maternal and infant mortality and clinician shortages are needed in low- and middle-income countries (LMICs). Malawi has some of the highest maternal and infant mortality rates globally. Group healthcare is a service delivery model that integrates these strategies. Although primarily implemented during the prenatal period, its potential for improving both maternal and infant health outcomes during the postpartum period has not been realized. The purpose of this study was to adapt and co-design the prototype for an evidence-based group care model for the postpartum period using a human-centered design approach with key stakeholders in Malawi. Methods We completed steps of a framework guiding the use of human-centered design: 1) define the problem and assemble a team; 2) gather information through evidence and inspiration; 3) synthesize; and 4) intervention design: guiding principles and ideation. Qualitative methods were used to complete steps 2–4. In-depth interviews ( n = 24), and incubator sessions ( n = 6) that employed free listing, pile sorting and ranking were completed with key stakeholders. Data analysis consisted of content analysis of interviews and framework analysis for incubator sessions to produce the integrated group postpartum and well-child care model prototype. The fifth step is detailed in a separate paper. Results All stakeholders reported a desire to participate in and offer group care in the postpartum period. Stakeholders worked collaboratively to co-create the prototype that included a curriculum of health promotion topics and interactive activities and the service delivery structure. Health promotion topic priorities were hygiene, breastfeeding, family planning, nutrition, and mental health. The recommended schedule included 6 sessions corresponding with the child vaccination schedule over the 12-month postpartum period. Conclusions Using a human-centered design approach to adapt an evidence-based group care model in an LMIC, specifically Malawi, is feasible and acceptable to key stakeholders and resulted in a prototype curriculum and practical strategies for clinic implementation.

CITATION EXPORT

Ashley Gresh, Anne Batchelder, Nancy Glass et al.. Adapting group care to the postpartum period using a human-centered design approach in Malawi. BMC Health Services Research. (2023). https://doi.org/10.1186/s12913-023-10036-2

AUTHORS

10 · 5 CENTRES

Ashley Gresh, Anne Batchelder, Nancy Glass, Janet Mambulasa, Esnath Kapito, Amy MacDonald, Nellie Ngutwa, Cori Plesko, Ellen Chirwa, Crystal L. Patil

1https://ror.org/00za53h95grid.21107.350000 0001 2171 9311Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD 21231 USA
2grid.517969.5Kamuzu University of Health Sciences, Private Bag 360 Chichiri, Blantyre 3 Malawi
3Pomelo Care, Hillsborough, North Carolina USA
4Group Care Global, Philadelphia, PA USA
5https://ror.org/00jmfr291grid.214458.e0000 0004 1936 7347School of Nursing, University of Michigan, 400 N. Ingalls, Suite 3320, Ann Arbor, MI 48109 USA