Papers by Esther Saka
ABSTRACT Background: Malawi's maternal mortality rate is among the highest in the world. ... more ABSTRACT Background: Malawi's maternal mortality rate is among the highest in the world. Improving childbirth safety in resource-limited countries requires innovative structural interventions. Methods: Within a 5-year, mixed-methods, quasi-experimental study in rural central Malawi, we investigated how Village Savings and Loan Associations (VSLA) affected birth practices. We purposively sampled VSLA members (60 women / 30 men) for 90 in-depth interviews and 9 focus groups analyzed thematically. Results: Participation in VSLA mobilized individuals to improve childbirth safety in tangible ways. Loans obtained early purchased transport to antenatal visits and supplies for hospital births. Ahead of labor, women and accompanying female family members traveled to faraway health care facilities and camped there for days or weeks until delivery. VSLA cash secured care for children left at home, and covered costs of residing at hospital. Many women still delivered at home, however, when they could not be spared from household responsibilities for such lengthy periods, or because influential men objected to births outside the village. Families' cultural ties to traditional home births and trepidation about western medicine also kept women from professional obstetric services. If childbirth complications arose, the critical issue became transport to hospital. Emergency VSLA loans paid for precious conveyance via bicycle, ox cart, or ambulance. Conclusions: Localized microfinance affords responsive, time-sensitive decisions by trusted neighbors who understand financial pressures associated with maternal health in rural environments. By building capacity for saving at the village level, VSLA provide an economic safety net to respond to routine as well as emergent obstetric needs.
Background: Malawi's maternal mortality rate is among the highest in the world. Improving chi... more Background: Malawi's maternal mortality rate is among the highest in the world. Improving childbirth safety in resource-limited countries requires innovative structural interventions. Methods: Within a 5-year, mixed-methods, quasi-experimental study in rural central Malawi, we investigated how Village Savings and Loan Associations (VSLA) affected birth practices. We purposively sampled VSLA members (60 women / 30 men) for 90 in-depth interviews and 9 focus groups analyzed thematically. Results: Participation in VSLA mobilized individuals to improve childbirth safety in tangible ways. Loans obtained early purchased transport to antenatal visits and supplies for hospital births. Ahead of labor, women and accompanying female family members traveled to faraway health care facilities and camped there for days or weeks until delivery. VSLA cash secured care for children left at home, and covered costs of residing at hospital. Many women still delivered at home, however, when they coul...
Background: Malawi has struggled with widespread food insecurity and associated health problems f... more Background: Malawi has struggled with widespread food insecurity and associated health problems for years due to drought, depleted soil, decreased food diversity, and poverty. Sustainable agriculture may offer a solution by diversifying the range of foods grown and rehabilitating soils, resulting in more stable food supplies and better nutrition. Methods: As part of a larger study, we conducted a random household survey (N=1001) in the Kasungu district of central Malawi, and assessed food security and use of a variety of sustainable agriculture techniques. Results: 762 households (76%) experienced at least one month of food insecurity in the past year (Median = 3 months); 239 households (24%) reported being food secure. Food secure households were more likely to use vetiver grass (for erosion management) (23% vs 13%, p Conclusions: Use of sustainable agriculture methods was associated with food security among smallholder agriculturalists in Malawi. Interventions to increase the use ...
Conference Presentations by Esther Saka
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Papers by Esther Saka
Conference Presentations by Esther Saka