Abstract
Background: In Malawi, there is limited understanding of the personal experiences of women who have survived severe maternal infections that lead to sepsis and of their perspectives on the care they receive. It is essential to consider women's experiences to improve the quality of care for severe maternal outcomes and provide responsive, person-centered care. This study aimed to explore the experiences of maternal sepsis survivors in Malawi to improve sepsis care and management.
Methods: A qualitative study was conducted from April to May 2023 in Blantyre, Malawi. Pregnant, postpartum, and postabortion women older than 16 yearswho had sepsis were included in the study via purposive sampling. Face-to-face interviews were conducted at the women's homes or at convenient locations. We conducted a thematic analysis using the Three-Delays and Respectful Maternity Care frameworks to analyze the interview data.
Results: Women with sepsis face multiple barriers to accessing care, mainly delays in receiving adequate and appropriate care at health facilities. The keybarriers mentioned by participants included inadequate monitoring, inadequate clinical management of infections, delays in diagnosis and treatment, and delays in providing lifesaving obstetric skills. Some women also experienced mistreatment by healthcare providers, such as verbal abuse, neglect, abandonment, lack of dignity, disrespect, denial of care, and inequitable treatment. Additionally, some women continue to experience long-term physical and psychological complications from maternal sepsis.
Conclusion: Exploring women’s experiences reveals key barriers women face throughout their sepsis journey. Patient narratives of near-miss experiences can inform policy and practice to improve maternal healthcare. System-wide interventions need to be implemented to improve the management of maternal infections and sepsis so that Malawi can reduce preventable maternal morbidity and mortality, achieving its global maternal health targets.