Maternal Death Malawi
Key Findings
Key findings from Malawi's Maternal Death Report
Leading Causes Of Maternal Death In Malawi
24.8%
Maternal Infection
20.4%
Postpartum Haemorrhage
13.3%
Eclampsia
The Typical Demographic Profile Of A Woman Dying In The Peripartum Period
Married Women
In Her Late 20's
Low Levels Of Education
Not Living With HIV
2 Previous Births
Summary Of Key Findings
01
Early Pregnancy
​
There was evidence of unsafe induced abortion in 27% of abortion-related deaths. However, it is possible that induced abortions are underrepresented in our data set due to cultural, religious and legal barriers to seeking care following induced abortion or disclosing when an abortion has been induced. Of women who died in early pregnancy, 35.1% died of infection (septic miscarriage).
02
Antenatal Care
​
Most women who died had accessed antenatal care during their pregnancy, with an average of 3 visits per woman who died. Danger signs were detected during antenatal care for 21.6% of women who died. However, 23.7% of these had no action taken on danger signs detected.
03
Timing Of Death
​
Most deaths occurred at term (37 weeks gestation). Maternal deaths were highest in the postnatal period (64.9%), particularly within 24 hours after birth (36%). Late postnatal deaths were more common in central hospitals, possibly indicating complex cases referred for specialist care. Infections caused most deaths in the late postnatal period (53%), while postpartum hemorrhage deaths were more frequent in the early postnatal period (80%). Eclampsia deaths were distributed across the antenatal (29.6%), early postnatal (31.5%), and late postnatal (28.7%) periods.
04
Where Women Came From And Condition On Arrival
​
Around 60% of women were referred from another facility to the facility where they died. This was the case for all three leading causes of death. Most women arrived at the facility where they died in a critically ill condition (54.5%), and this was the case across all zones. However, a large number arrived in stable condition (37.6%). Women dying of infection and eclampsia were more likely to arrive in critically ill condition (73.1% and 64.8%). Women dying of PPH were likely to be stable on arrival (60.0%).
05
Giving Birth
​
Over 50% of deaths occurred after Caesarean section (CS), but CS may not be the cause. Further investigation is needed. Among CS deaths, 24% were due to postpartum hemorrhage (PPH), 15% to eclampsia, and 14% to pregnancy-related infections. Vacuum births were more common in PPH deaths, indicating a need for better training and supervision. Around 30% of PPH deaths involved retained placenta, suggesting a need for improved management of third-stage labor complications.
06
Avoidable Factors
​
"Healthcare worker" factors were the leading avoidable causes of maternal deaths in Malawi, accounting for 85% of all deaths. These factors included inadequate monitoring, prolonged abnormal observations without action, and a lack of obstetric emergency skills. More than half of the deaths involved "administrative factors," such as resource shortages, transportation issues, and communication problems, which could have been prevented. "Patient/family factors" also contributed to over half of the deaths, with delays in reporting to a healthcare facility being the most common factor. This delay was particularly notable in deaths caused by maternal infection Avoidable Factors but was prevalent across all causes of death.