This study was conducted to assess quality of postnatal care that midwives provide to women seeking postnatal services in health facilities in Dedza district, the central region of Malawi. The study design was descriptive cross sectional and utilized quantitative data collection and analysis method to determine structural, process and outcome components of postnatal care in two facilities that offer emergency ob- stetric and neonatal care and five that offer basic emergency obstetric and neonatal care. All 60 mid- wives who were providing postnatal care during the time of study in the district were interviewed using a structured questionnaire. In addition, the midwives actual practice was observed and compared to a standard checklist on postnatal care practice which was developed by the Malawi Ministry of Health. Data were analyzed using SPSS version 16.0. Results show that structure for providing postnatal counseling services was inappropriate and inadequate. Furthermore, the contents of postnatal services were be- low reproductive health standards because the clients were neither monitored nor examined physically on discharge. On average, all the seven facilities scored 48% on postnatal services rendered which is far below the recommended 80% according to the Reproductive Health Standards. There is a need to provide basic infrastructure in all the basic emergency obstet- ric and neonatal care facilities. In addition, refresher training courses for midwives in maternal and neo- natal health with emphasis on postnatal care are re- commended. There is also a need to restructure the maternal and neonatal health departments in the fa-cilities so that the postnatal care units become stand- alone priority sites to improve the quality of the post- natal care services rendered.
Keywords: Quality Postnatal Care; Reproductive Health Standards; Postnatal Care Structure, Process and Outcome; Maternal and Neonatal Health; Postnatal Care Standards