At the opening of the new maternity waiting shelter, the Ministry of Health Director for Reproductive Health, Fannie Kachale, praised the Our Lady of Mount Carmel Sisters for building the Kapiri Community Hospital maternity waiting shelter. Kachale said;
“They could have used the money to buy short-term supplies such as drinks for staff meetings, fuel or medical supplies but the Sisters thought of the pregnant women who face problems with the absence of a waiting shelter.”
Matthew Nviiri, Country Director, said Kapiri has been saving its reward money and had invested in a very beautiful, well-constructed maternity waiting shelter while others choose to buy fuel and other supplies.
“Every quarter we give 32 participating hospitals performance-based rewards, 60 percent of which is divided among staff, 40 percent is facility investment which is used to improve maternal health in the respective facilities and the Catholic Sisters chose to construct a shelter,” Nviiri said.
Our Lady of Mount Carmel Community Hospital, Sister-in-Charge, Jovita Protasia, said they built the maternity waiting shelter in phases using the money earned from the programme’s quarterly rewards because they wanted to uphold the dignity of expectant mothers.
The Results-based Financing for Maternal and Newborn Health (RBF4MNH) Initiative, known locally as Uchembere wa Ngwiro, uses performance-based and demand-side financing approaches to improve quality of care at participating basic and comprehensive emergency obstetric care facilities. Financial rewards are used to incentivise health facility and district health teams based on their performance which is measured through improvements in the quantity and quality of care. A portion of the funds is paid directly to staff as a bonus, and an amount is also paid to the facility and district teams to invest in facility improvements. The ability to decide as a team how to spend the funds has introduced a degree of autonomy at the facility level which was new to Malawi and has proved to be highly motivating for staff.
In Malawi, the maternal mortality rate remains unacceptably high (439/100,000 live births). In a country with remote rural areas where women have to walk long distances, sometimes up to 20km, to reach health facilities, as well as poor communication and transport systems, waiting shelters offer a safe alternative. Although the majority of complications occur during labour, delivery, and the immediate postpartum period, the 15-20% of maternal deaths in Malawi are due to patient delays. The RBF4MNH initiative is supporting the construction of waiting shelters which enable women to stay at health facilities before the onset of labour and help to reduce the delays in getting essential care.