Impact of a maternal and newborn health results-based financing intervention (RBF4MNH) on stillbirth: a cross-sectional comparison in four districts in Malawi

Abstract Background Malawi implemented a Results Based Financing (RBF) model for Maternal and Newborn Health, “RBF4MNH” at public hospitals in four Districts, with the aim of improving health outcomes. We used this context to seek evidence impact intervention on rates antepartum intrapartum stillbirth, taking women’s risk factors into account. Methods maternity unit delivery registers districts obtain information about stillbirths. purposively selected two hosting RBF4MNH non-intervention comparison. Data were extracted from develop logistic regression models variables associated fresh macerated stillbirth. identified 67 stillbirths among 2772 deliveries representing 24.1 per 1000 live births which 52% ( n = 35) (intrapartum) 48% 32) (antepartum) losses. Adjusted odds ratios (aOR) stillbirth RBF versus non-RBF sites 2.67 (95%CI 1.24 5.57, P 0.01) 7.27 2.74 19.25 < 0.001) respectively. Among examined, gestational age was significantly increased Conclusion The study did not identify positive or Within scientific limitations non-randomised using routinely collected service data, findings point need rigorously designed tested interventions strengthen focus elements needed ensure quality care, order reduce burden