An individual-based modelling study estimating the impact of maternity service delivery on health in Malawi

Collins, Joseph H., Allott, Helen, Ng’ambi, Wingston, Lin, Ines Li, Giordano, Mosè, Graham, Matthew M., Janoušková, Eva, Kachale, Fannie, Kawaza, Kondwani, Mangal, Tara D., Mfutso-Bengo, Joseph, Mnjowe, Emmanuel, Mohan, Sakshi, Molaro, Margherita, Nkhoma, Dominic, Revill, Paul, Rodger, Alison, She, Bingling, Tamuri, Asif U., Tann, Cally J., Twea, Pakwanja D., Cambiano, Valentina, Hallett, Timothy B., Phillips, Andrew N. and Colbourn, Tim (2025) 'An individual-based modelling study estimating the impact of maternity service delivery on health in Malawi'. Nature Communications, Vol 16, Issue 1, p. 3925.

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Abstract

Maternal and perinatal morbidity and mortality remain high in Malawi, partially due to gaps in the coverage and quality of health services. We developed an individual-based model of maternal and perinatal health and healthcare in Malawi, situated in a ‘whole-health system, all-disease’ framework (Thanzi La Onse). We modelled sixteen scenarios estimating the impact of current and improved coverage and quality of antenatal, intrapartum, and postnatal services from 2023 to 2030. Whilst current service delivery is inferred to avert morbidity and mortality, the largest reductions in the stillbirth, maternal and neonatal mortality rates were observed when the use and quality of all services was maximised concurrently (a 10%, 52% and 57% reduction respectively). When services were considered in isolation, generally, increased coverage without quality improvement did not impact mortality or DALYs. In only three scenarios was a sufficient reduction in neonatal mortality observed to achieve target 3.2 of the United Nation’s Sustainable Development Goals (SDG), and in no scenarios was a reduction in maternal mortality sufficient to achieve SDG target 3.1 observed, reaffirming that system wide investments are essential to achieve these goals.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1038/s41467-025-59060-2
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	08 May 2025 11:50
Last Modified:	08 May 2025 11:50
URI:	https://archive.lstmed.ac.uk/id/eprint/26625

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