Maternal mortality and morbidity in Malawi and the Gambia

This project is an expansion and continuation of an already ongoing program in maternal health research in Africa. One focus is the Gambia, a poor, muslim West African country with high maternal mortality, but relatively low HIV prevalence, and Malawi, a similarly poor country in Southern/Central Africa, with high Maternal Mortality Rate and HIV. The various subcomponents are as follows: 1. An assessment of causes and contributing factors to maternal mortality in the Gambia. Data collection finished, t wo articles published. 2. An assesment of why women prefer to deliver at home instead of in institutions in the Gambia (data collection to start fall 2006) 3. An assessment of why women prefer to deliver at home in Malawi. Data collected 2005, one draft article submitted 4. A facility based and community perspective study on maternal morbidity caseload and causes in the Gambia. Data collection ongoing 5. A study of factors that contribute to stigma, non compliance and non adherence with treatment guidel ines for prevention of mother to child transmission (PMTCT) of HIV among pregnant women in Malawi. Data collected 2005-6, articles are being written 6. A study of causes and contributing factors to maternal deaths in Malawi, including how HIV/AIDS impacts on mortality and service delivery (partial funding for fild work already available), data collection to start as soon as a PhD grant can be released. 7. A PhD study on PMTCT introduction to maternal care services in the Gambia (under planning). It also seeks to bridge the various sub-studies in order to create some basic understandings of how health care for expecting mothers can be modelled to encompass quality of care aspects that enable and attract women to come to the health systems, the role of an tenatal care especially models of integrating HIV/AIDS prevention and aspects of prevention of emergency obstetric problems into the services (health systems integration).