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ENHANCE Study Begins Baseline Phase

Lilongwe, Malawi — The ENHANCE study has officially begun its baseline phase in Malawi, marking a significant step toward improving maternal and newborn health outcomes in the region. The phase commenced on Monday, 9 February 2026, as researchers and health authorities advance efforts to strengthen antenatal care services.

The study, formally titled “The Enhanced Antenatal Care Bundle to improve Maternal and Newborn Outcomes in Malawi and Zambia: a multi-country, parallel cluster-randomised trial”. It seeks to determine whether an enhanced package of pregnancy care can reduce maternal and newborn deaths compared to standard services offered in primary health centres across Malawi and Zambia.

Under the study, standard antenatal care will be compared with an enhanced antenatal care bundle of evidence-based practices that includes strengthened patient education,  leadership training, mentorship, task shifting, and the provision of additional essential supplies. The research is led by Associate Professor Linda Nyondo Mipando, whose team aims to address persistent challenges in resource-limited settings by reducing complications and mortality among mothers and newborns.

The launch follows a two-week training programme held from 2 to 13 February, during which 32 primary health centres from Mangochi and Lilongwe districts were enrolled and 186 healthcare workers trained in baseline procedures. The final training session took place in Lilongwe. Each participating facility established teams of between three and eight staff members, including midwives and a data clerk, to implement the study protocol and manage electronic data collection using REDCap.

District Health Management Teams and Safe Motherhood Coordinators were actively involved throughout the training across all participating districts, providing oversight and support. Speaking during the programme, District Health Office representative Dr Atupele Mwale welcomed the initiative and encouraged healthcare workers to take ownership of the study.

“We are very happy and welcome this platform to work hand in hand with our partners like MLW, to improve antenatal care services and outcomes in our facilities,” said Dr Mwale. “I want to appeal to all ANC providers here today to take ownership of this initiative. The results of this study should be something we take pride in and be able to say that we did this study and these are the good outcomes we have achieved for our ANC mothers, and this is how service delivery will be improved moving forward.”

Safe Motherhood Programme Manager Dr Mtisunge Gondwe described the completion of training and the launch of the baseline phase as a major milestone, expressing confidence that the study will generate critical evidence to guide improvements in antenatal care in Malawi, Zambia, and similar settings.

The ENHANCE study is funded by the National Institute for Health and Care Research (NIHR) through the NIHR Safe Motherhood Programme (NIHR 134781: Improving the quality of maternal healthcare in Africa). The views expressed are those of the authors and not necessarily those of the NIHR or the UK Department of Health and Social Care.

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