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Working Together to Save Lives: Delivering quality maternal healthcare in Malawi

7 March 2022


Every woman deserves access to quality healthcare. In this interview, we hear from Pilirani Makungwa on how COVID-19 has impacted maternal health outcomes and quality of care, and how working in partnership has offered effective solutions.



Pilirani Makungwa is a Nursing Officer at Queen Elizabeth Central Hospital where she has worked since 2019. Prilirani is currently based in the Obstetrics and Gynaecology Department where she deputy in-charge.

Through THET’s COVID Response Fund, the Department of Obstetrics and Gynaecology at Queen Elizabeth has been working with Ammalife and Birmingham Women’s Hospital to reduce the direct and indirect effects of COVID-19 on maternal health.

Pilirani Makungwa prepares to assist a pregnant woman in labour. Image Credit: THET/Thoko Chikondi.

Why did you decide to work in healthcare and specialise in nursing?

When I was younger, I was very interested in new-born babies and that is when my passion for nursing started. I worked hard in secondary school, then I went to Kamuzu College of Nursing, where I did my Bachelor of Science in Nursing and Midwifery. After graduating, I went to Nkhoma Mission Hospital and I loved the Obstetrics and Gynaecology Department, so I worked for some time there. I then started working at Kamuzu Central Hospital for some months, before moving to Queen Elizabeth Central Hospital, where I asked to be relocated to the Labour Ward because I really want to save new-borns’ lives, together with their mums.

Being a midwife is something I’ll never regret because whatever you do, the fruits are seen right away. If you properly take care of a woman who is in labour or has issues, you feel satisfaction. Or maybe you save the mum’s life. Maybe the mum was bleeding profusely post-delivery, if you stop it right away, she will still be breathing, she’ll be stable and can start breastfeeding the baby. If you have enough resources and the proper management, everything goes well.

Can you tell us about your team and the patients you deliver care to?

The team here is very big. It involves the midwives, doctors, interns and lab personnel, anaesthetists for Caesarean sections, the theatre team, the matrons, our colleagues from other wards in the department such as the antenatal ward and postnatal ward. We work together in providing care to the patients.

Being a tertiary level hospital, we receive much of the referred cases from the surrounding health centres within the Blantyre catchment area, and sometimes from the district hospitals like Thyolo or Nsanje, depending on the conditions of the patients.

Has COVID impacted the maternal health outcomes and quality of care?

Because of the rumours that were speculating, a lot of patients were not reporting to the hospital. People were saying that if they came to the hospital, we would try to kill them. So, a lot of the mums were going to traditional birth attendants to be assisted with their delivery. This led to rising complications that would later be referred to us. However, they would be referred late and some of the women would die.

What impact has COVID-19 had on your wellbeing and the wellbeing of your team?

COVID affected everyone – including healthcare workers. If members of the team felt unwell or tested positive, they had to stay at home until the results came back negative or their symptoms were gone. It meant few health workers on the ground doing the job. We already had a crisis; the number of healthcare workers was already inadequate. The COVID pandemic has meant that, out of the already few health workers that were doing their jobs in the ward, some were sick with COVID. Due to this shortage, we have been working really hard. We are working to the extreme, we are very tired because of the workload. It has had impact on our mental state because we haven’t had time to rest.

What has the COVID-19 response been like within Queen Elizabeth Central Hospital?

During emergencies, the small number of health workers who were available on the ground usually worked hand-in-hand. There was always good teamwork, it wasn’t a one-person thing. Everyone was taking part in helping to save the patients’ lives. So, everyone was trying, to be honest. Despite the numbers.

What impact has the partnership had on the hospital?

Through virtual maternal health meetings, we were learning new ideas on a weekly basis on how we can provide care to pregnant women or to postnatal mums who had COVID. We were hearing experiences from different hospitals and sharing our knowledge on how we can help the patients. During education sessions, we have been helping one another and learning from different angles. We have really learnt a lot about infection prevention measures: how we can handle our soiled linen, how we can handle our waste, how we can now keep our COVID ward free from infection. It has really helped.

Has this improved the quality of patient care?

Patient care also improved because during the first wave of COVID, a lot of healthcare workers were afraid to provide care to COVID patients. But with the Zoom meetings and the local education sessions, when we were approaching the second wave, people had knowledge on how best to take care of a patient with COVID.

What are your hopes for the future of the partnership?

We’re hoping that they will continue to be our partners, that they will still be with us.


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