Aim:The study aimed to explore factors related to the initiation and utilization of focused antenatal care (FANC)in the Southern District of Mzimba,Malawi.Methods:This study used an exploratory qualitative design.Total of 22 in-depth interviews with pregnant women and community midwife assistants were conducted from December 2015 to January 2016 in Mzimba.Thematic analysis approach was adopted to identify the facilitator and barriers of the FANC initiation and utilization.Results:Facilitator of FANC initiation and utilization included seeking pregnancy confirmation,medical treatment for an existing health problem and the support by community health extension workers.Barriers included the additional cost to free FANC service,lack of essential equipment,unfriendly adolescent reproductive health service,and HIV stigma.Conclusion:Early initiation of FANC relies on both woman's awareness and community support.Promoting the use of FANC should focus on creating an enabling environment,e.g.,increasing investment of essential med-ical equipment,reducing additional costs of FANG services,eliminating the discrimination against adolescent pregnancy and people living with HIV,and strengthening health personnel's training.

This study aimed to investigate the perceptions of nursing students trained in a new model teaching ward in Malawi. A total of 90students from five nursing colleges were randomly assigned to one model ward and two ordinary wards in a single teaching hospital. The students were administered a revised version of the Student Evaluation of Clinical Education Environment questionnaire. Significant differences among the three wards were found in all items in the communication/feedback subscale, with the exception of the item "nursing staff provided constructive feedback" (P=0.162). Within the learning opportunities subscale all items showed significant differences among the three wards, whereas 50% of the items in the learning support/assistance subscale had significantly different responses among the three wards. Within the department atmosphere subscale, no significant differences were found in the items assessing whether an adequate number and variety of patients were present in the ward (P=0.978). The strategies that are being implemented to improve the educational environment showed positive results. Students scored the model teaching ward highly. Students who underwent precepting in the model teaching wards reported having more learning opportunities and a positive learning environment.
Atmosphere ; Education ; Education, Nursing ; Hospitals, Teaching ; Humans ; Learning ; Malawi* ; Nursing* ; Students, Nursing*