Can new models of care work in the real health system?
National implementation research on pre-eclampsia and maternal anaemia.
A research journey — from question to scale-up decision.
Founder experience · Principal Investigator · Jhpiego / Unitaid · 2026
The research journey — from question to a national scale-up decision.
The problem
Pre-eclampsia and maternal anaemia remain leading causes of maternal death. The clinical answers largely exist; what is unknown is which delivery models actually prevent, detect and manage them inside Malawi's routine primary and secondary care — and whether those models can scale.
Why it was hard
This is an implementation question, not an efficacy one. It spans facility, district and national levels, demands mixed methods, implementation-fidelity and costing evidence, cross-country harmonisation, and layered ethics across WHO, Johns Hopkins and national committees.
The approach
- 1
Designed and led a national mixed-methods implementation-research programme of roughly USD 600,000 as Principal Investigator.
- 2
Co-designed the Malawi Learning Agenda, research protocol and data-collection tools with the Ministry of Health, Jhpiego, Amref and Community Advisory Boards.
- 3
Tested antenatal-care delivery models — Group ANC, midwifery-led care and networks of care — for feasibility, acceptability, scalability, fidelity and cost.
- 4
Harmonised methodology with Principal Investigators in Tanzania, Kenya, Ghana and Senegal to generate comparable, region-relevant evidence.
What was created
Malawi Learning Agenda
Implementation-research protocol and data tools
A validated climate and health-equity scorecard for maternal and child health
Implementation-costing model
Policy briefs and national validation workshops
What changed
Designed to generate the feasibility, scalability and cost evidence Malawi needs to decide on national scale-up. The programme is current — evidence in progress, not a closed result.
Frameworks & methods
What this demonstrates