Abstract
M.Tech. (Radiography)
Antenatal care aims to ensure that every pregnancy culminates in the birth of a healthy baby without
any compromising maternal health. As part of antenatal care, routine antenatal ultrasound facilitates
optimal pregnancy management by enabling the assessment of gestation age, early detection of
multiple gestations, clinically unsuspected fetal malformations and life threatening maternal risk
factors.
The purpose of this cross-sectional descriptive correlational study was to assess, explore and describe
the knowledge and practice of health workers regarding routine antenatal ultrasound in Malawi, in
order to arrive at a better understanding of the limited use of ultrasound as part of routine antenatal
care.
A self-administered questionnaire was distributed at 5 hospitals in Malawi in June 2016. One hundred
and twenty five questionnaires were distributed with final statistical analysis being performed on 93
complete data sets. Knowledge, policy and practice scores were used to summarise questionnaire data.
Inferential statistics were computed using Kruskal Wallis and Mann-Whitney values, interpreted by
p<0.05 equaling statistical significance. The Spearman’s test was used to determine the strength of
correlations between variables while multiple regression analysis was further used to explore the
relationship between knowledge, policy, professional category, hospital level and practice.
A statistically significant difference in ultrasound knowledge, policy and practice was noted between
professional categories (p=0.000) and hospital levels (p=0.000). The best scores for antenatal
ultrasound knowledge and practice levels were recorded for obstetricians and for tertiary hospitals.
Regression analysis model 1, showed a statistical significant positive correlation between antenatal
ultrasound knowledge and policy as predictors of good practice while, model 2 showed a statistical
significant positive correlation between tertiary hospital, obstetrician and policy scores as predictors
of good ultrasound clinical practice.
Based on the results, recommendations for training of health workers in obstetric ultrasound,
availability of obstetric ultrasound clinical guidelines and inclusion of ultrasound in antenatal policy
in Malawi are suggested to facilitate optimal pregnancy management and better pregnancy outcomes.