Preventing Maternal Sepsis in Low resource settings

Parent and Child Health Initiative (PACHI) together with University of Birmingham has been implementing the ‘Evaluation of maternal sepsis FAST-M feasibility study’ in 15 health facilities of Malawi belonging to Lilongwe and Dowa Districts. The study aims to improve maternal care through use of tailored tools to help in early recognition of maternal infections and sepsis, diagnose maternal infections and sepsis, and manage maternal sepsis. This will result into reduced maternal deaths as a result of maternal sepsis in low-income settings and globally which is the 3rd common cause of maternal deaths.

With the tools proving improved results in managing maternal infection and sepsis in Dowa and Lilongwe, a recommendation from health care providers was made to add the component of infection prevention to study. ‘I feel if we could start from Infection Prevention (IP) in the maternity wings. We have to try as much as possible to prevent cross transfer of infections in the maternity departments. Most of our wards lack enough IP materials and are highly congested therefore increasing the risk of patients acquiring infections within the hospital setting,’ said the hospital matron Mrs. P. Makhaki of Mitundu Community Hospital in one of the meetings.


Matron P. Makhaki of Mitundu Hospital

The main components being addressed in the FAST-M study component of infection prevention are ward hygiene infrastructure and hand washing practices; infection prevention practices in pregnancy and childbirth; and appropriate use of antibiotics to treat simple infections.

The study is focusing to deliver the WHO multimodal hand hygiene strategy within the Malawian Healthcare system and evaluate its suitability for use in maternity settings. The study will also focus on optimizing the delivery of the WHO 20 recommendations for prevention and treatment of peripartum infections and the Malawian Standard treatment guidelines for the infections in pregnancy, for use in the Malawian healthcare system. The staff members from Dowa District Hospital, Kabudula Community Hospital and Mitundu Community Hospital have been trained on the infection prevention components and trainings will continue as required.


One of the staff training sessions on Infection Prevention in Dowa District

‘PACHI and University of Birmingham has helped the hospital to develop more knowledge on infection prevention, early recognition and management of maternal infection and sepsis. The tools have benefited the facilities greatly. The wheel chart, credit cards, handwashing infrastructure on infection prevention and management is an added advantage for the hospital and will be used effectively to manage mothers in the maternity department,’ said Dr. P. Makoza, District Health Officer of Dowa District Hospital.



Picture of the antibiotic/gestation wheel tool and the credit card tool provided to each and every health worker of the maternity department at Dowa District Hospital, Kabudula Community Hospital and Mitundu Community Hospital


Nurse Midwife Austin Bandawe of Dowa District Hospital assists the team assembling the Hand washing stations to be placed in each ward or the maternity department.

The study is currently under the intervention phase where assessment of the components of the training, tools and implementation delivery promote and hinder sustainable change in behavior in health care practice.


One of the Health Care Providers presents scenario findings on FAST-M to fellow Health Care Workers in one of the training sessions.


Health Care workers stand along complete hand washing stations and wave their certificates of training attendance