Report on the Confidential Enquiry into Maternal Deaths in Malawi: August 2020- December 2022

FINDINGS A total of 1135 maternal deaths were reported in the period of this report; 809 were reviewed locally and therefore included in our analysis. In keeping with global causes of maternal death, and previous analyses of maternal deaths in Malawi, the leading causes of maternal death described in this report are maternal infection, postpartum haemorrhage, and eclampsia. Facility-based birth rates have increased dramatically in recent years, with over 90% of women now delivering their babies in health facilities. However, our analysis determines that “healthcare worker” factors are associated with over 80% of maternal deaths. The reasons for this are likely to be complicated and multifaceted but demand our efforts in understanding them if maternal mortality in Malawi is to be reduced further. Simply getting to the facility is not enough; quality of care must be improved by providing healthcare workers with the resources, skills, and motivation to provide high quality obstetric care. A summary of key findings is found in the following pages. CONCLUSION & RECOMMENDATIONS Recommendations based on the findings of this report were formulated by stakeholders from all levels of the health system and partner organisations. They are intended to be used by policy makers, implementors and funding organisations to effectively reduce maternal mortality in Malawi. They address the need to improve the referral and admissions process, reduce deaths following Caesarean section, tackle the leading causes of maternal death, address healthcare worker factors associated with maternal deaths and improve health-seeking behaviour at the community level. A summary of key recommendations is found in the following pages.