ArticleBMC health services research2026
Co-development of a contextually relevant maternity service user feedback tool in Malawi using participatory consensus methods.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
backgroundImproving the quality of maternity care requires systematic incorporation of women's experiences into quality improvement processes. Although several instruments exist to measure maternity care experiences, few have been developed for routine feedback within low-resource health systems, and existing tools used in Malawi are generic and do not adequately capture maternity-specific experiences. This study aimed to co-develop and establish stakeholder-informed content validity for a context-specific maternity service user feedback tool for routine quality improvement in Malawi.
methodsWe conducted a qualitative participatory consensus study involving two multi-stakeholder workshops held in Malawi between July 2024 and February 2025. Stakeholders included maternity service users, healthcare providers, policymakers, programme implementers, researchers, and community representatives. The tool was developed through a structured pathway comprising preparatory stakeholder engagement, co-design, prototype development, iterative refinement, and validation. World Café discussions, group discussions, gallery walks, structured voting, and thematic analysis were used to identify, prioritise, and refine feedback domains, indicators, and delivery modalities.
resultsA total of 48 stakeholders participated in the co-design workshop and 39 participated in the validation workshop. Through iterative stakeholder consensus, approximately 300 recommendations were synthesised into 35 descriptive categories and subsequently refined into seven priority domains: respectful and dignified care; communication and health education; emotional support; timely and equitable access; continuity and coordination of care; quality of services received; and overall satisfaction. These domains informed the development of a maternity service user feedback tool comprising 27 antenatal care, 28 labour and delivery, and 32 postnatal care indicators organised into three modular questionnaires. Stakeholders recommended piloting both paper-based and electronic versions to support feasible implementation within routine maternity quality improvement systems.
conclusionThis study developed a stakeholder-informed maternity service user feedback tool tailored to the Malawian health system. The findings establish the tool's contextual relevance and stakeholder-informed content validity while providing a foundation for future evaluation of feasibility, reliability, construct validity, and implementation within routine maternity quality improvement programmes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.