Integrating Midwife-Led Basic Obstetric Ultrasound Scanning into Antenatal Services at Ndirande Health Centre in Blantyre, Malawi

Abstract

Background: Access to basic obstetric ultrasound scanning is essential for improving maternal and neonatal out comes; however, it remains limited in low-resource settings. Integrating mid wife-led ultrasound scanning into ante natal care (ANC) services enhance the early detection of complications and improve maternal health outcomes.

Aim: This study investigated the feasibility, acceptability, and impact of integrating midwife-led basic obstetric ultrasound scanning into routine ante natal care at the Ndirande Health Centre in Blantyre, Malawi.

Methods: This quality improvement project employed a phased approach to integrate basic obstetric ultrasound into antenatal care via sequential steps of training, piloting, mentorship, and full integration. A total of 7 Midwives underwent training in basic obstetric ultrasound techniques at Kamuzu University of Health Sciences (KUHES), selected based on their role as key providers at antenatal care. Routine scans were incorporated into antenatal visits over a six-month pilot period.

Results: Integration of midwife-led ultrasound scanning resulted in a 30% increase in ANC attendance. Pregnant women reported enhanced trust in antenatal services and greater confidence in pregnancy management. Mid wives demonstrated a 95% accuracy rate in identifying fetal viability and position compared with obstetrician confirmed results. However, challenges included technical difficulties with the equipment and initial resistance due to unfamiliarity with the intervention.

Conclusion: Midwife-led basic obstetric ultrasound scanning is a feasible and acceptable intervention that improves ANC utilisation and maternal satisfaction in low-resource settings. Addressing technical and training challenges will be critical for broader implementation and sustainability.