Health System Strengthening
Since 2016, we have been working in Mangochi - Malawi - to deliver free, quality healthcare as a part of its commitment to Health System Strengthening in one of the poorest regions in the country. In 2020, we also began working with local partners to rehabilitate 21 healthcare facilities in Makanjira, Blantyre and Salima, as well as providing both clinical and non-clinical healthcare training sessions such as Obstetric emergencies, paediatric resuscitation, data management, infection control, governance and strategies.
Continued work has taken place to improve the physical space of the clinics, the equipment available as well as all the quality improvement work around improved clinical care. Innovative projects such as the Ambubike, a type of bicycle ambulance able to be used in rural areas to help patient access care 24hrs a day.
Zainabu’s Story
Zainabu, a 23 year old mother, had to walk and wait 18 hours for a total of 6 minutes of clinical consultation with a medical officer. She has had aches and pains in her body for days and her baby has had open sores on her thigh for two months. This is her third visit to the health facility. Zainabu received painkillers but the ointment prescribed for her baby was out of stock. She doesn’t have the money to buy it anyway – it costs £1.50 and she doesn’t even have the 40p it costs to take a minibus to the clinic. Even then, Zainabu doesn’t complain. She is happy there is a free clinic service and that she managed to see a clinical officer and get some advice. For many others like her, this is not an uncommon situation. Your support can create a new reality for Zainabu, and allow others like her to receive better quality consultations, medical care support and transport.
Help mothers in difficult circumstances access healthcare without barriers >Why is the HSS Project Needed?
Malawi is a small landlocked country in southern Africa with over 75% of its 17 million population living on less £1 a day. In 2021, the World Bank ranked Malawi as one of the poorest countries in the world. Malawi's health system struggles due to the high burden of diseases, low level of health workers and overall lack of funding to provide health services to the population. The top causes of death are HIV/AIDS, respiratory infections and diarrhoeal diseases, malaria, complications at birth and malnutrition. One of the biggest healthcare challenges in Malawi is therefore the lack of access to high quality healthcare services.
Most people in Malawi will never see a doctor in their lives and will only be treated by a Clinical Officer or Medical Assistant. Approximately 1.7 million Malawians live more than 8km away from a healthcare facility. Meanwhile, patients in Mangochi often walk 2-3+ hours to the clinic and wait a further 3-4 hours to be seen by a Clinical Officer. Women often have to travel for hours in labour to access maternity facilities with 56% stating that the distance to healthcare facilities is the main barrier to accessing services (Ministry of Health).
“Support from DWW has eased the burden... and enabled us to concentrate on improving our service delivery.”
“We are striving to reach the needy in the most rural parts of Malawi where the locals have little or no access to basic healthcare facilities. Our aim is to give every Malawian his/her basic right to access healthcare services and we pride ourselves on the provision of quality healthcare services with minimal or in other cases no charge at all.”
The HSS Project in Action
With your support, Doctors Worldwide is rehabilitating 20 healthcare clinics, training healthcare workers and providing extra clinical officers and medical assistants in the facilities we support. In addition, we are developing a pilot project of ambu-bikes services stationed at two health care facilities in Malawi dedicated to local community, in order to increase access to non emergency patients, patients with mobility issues, maternal healthcare services and ANC services to prevent birthing complications that can often lead to illness and even death.
- Rehabilitating healthcare services at 21+ healthcare clinics
- Training healthcare workers to ensure a high standard of patient consultations, including early detection of hypertension, greater HIV/AIDS service coverage, identification and treatment of malnutrition and patient follow ups
- 4 high-level Administration officers and 1 Clinical Officer to implement sustainable financial, governance and HR systems for all 21+ healthcare clinics.
- Extra clinical officers and medical assistants in 4 of the clinics including 1 nurse at a maternity clinic. This doubles the amount of clinical staff to allow for better quality consults and shorter waiting time.
- Additional needs that arise such as PPE, infection prevention material etc
As a result of this collaborative work, we have already seen a significant rise in the detection and treatment of hypertension, as well as much greater access to HIV Testing and Counselling which will reduce further HIV infection risks and increase the life expectancy of those affected. Furthermore, DWW has identified major bottlenecks and barriers to the delivery of good quality healthcare and we are working with our local partners to develop training and technical support to enable local staff to provide better care to more patients.
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