Collins, Joseph H;
Allott, Helen;
Ng'ambi, Wingston;
Lin, Ines Li;
Giordano, Mosè;
Graham, Matthew M;
Janoušková, Eva;
... Colbourn, Tim; + view all
(2025)
An individual-based modelling study estimating the impact of maternity service delivery on health in Malawi.
Nature Communications
, 16
, Article 3925. 10.1038/s41467-025-59060-2.
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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.
| Type: | Article |
|---|---|
| Title: | An individual-based modelling study estimating the impact of maternity service delivery on health in Malawi |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1038/s41467-025-59060-2 |
| Publisher version: | https://doi.org/10.1038/s41467-025-59060-2 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Malawi, Humans, Female, Pregnancy, Maternal Health Services, Infant, Newborn, Maternal Mortality, Infant Mortality, Delivery of Health Care, Infant, Adult |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10207884 |
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