Health System Strengthening
Since 2016, we have been working to deliver free, quality healthcare, in Mangochi, one of the poorest regions in Malawi, and to support high risk patients in the city of Blantyre, benefiting 10,000 patients a month. In 2020, we also began working with local partners to rehabilitate 18 healthcare facilities, build clinics, improve transport access to clinics via ambu-bikes, develop palliative care provisions, and provide both healthcare and health management training where access to quality training is unavailable.
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 2018, the International Monetary Fund (IMF) ranked it as the 3rd poorest country 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
This is due to minimal government investment with only 11% of the GDP being spent on the healthcare sector (WHO) . This has resulted in a limited senior staffing resource and a lack of staff training opportunities. Most people in Malawi will never see a doctor in their lives and will only be treated by a Clinical Officer or Medical Assistant. There are also an insufficient number of healthcare facilities resulting in an inadequate population health coverage with approximately 1.7 million Malawians living more than 8km away from a healthcare facility. 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 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).
The HSS Project in Action
With your support, Doctors Worldwide is rehabilitating 18 healthcare clinics, building a new maternity unit, training healthcare workers and providing extra clinical officers and medical assistants in the clinics we support. In addition, we are developing a network of ambu-bikes, run by volunteers in the local community, in order to increase access to maternal healthcare services and prevent birthing complications that can often lead to illness and even death. An integrated palliative care pathway is being built between healthcare clinics and the local community, whilst we also cover any additional needs that arise such as PPE.
- 2 new Healthcare clinics including maternity units and services to be built in vital locations
- Rehabilitating healthcare services at 18+ 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 18+ Healthcare clinics.
- Extra clinical officers and medical assistants in 3 of the clinics including 4 nurses at a maternity clinic. This doubles the amount of clinical staff to allow for better quality consults and shorter waiting time.
- Ambubikes to increase access to maternal healthcare services by transporting pregnant women and women in labour. This will help to prevent birthing complications that lead to illness and even death
- An integrated palliative care pathway between healthcare clinics and the local community tying in the work of community volunteers, primary carers, healthcare workers and spiritual leaders. This will increase the provision of palliative care services by over 100%
- 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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