Thoughts from the Last Mile Welcome to the VillageReach Blog

Category Archives: Health Worker Capacity

06.01 2018
Laiford at work in Mbang’ombe 1 Health Center drugstore

Mbang’ombe 1 Health Center is in the back yard of Lilongwe International Airport. In terms of access to quality health services however, the facility might as well be far from Lilongwe. At approximately 50 km from the Lilongwe District Health Office and Central Medical Stores, the facility serves a rural community. It has one clinician, four nurses, 11 Health Surveillance Assistants (HSAs) and several support staff who serve over 5,000 households, a total population of 24,762 people. The facility has never had pharmacy personnel.

Laiford Nandolo is one of the two HSAs that help manage the drugstore in the absence of a trained Pharmacy Assistant. Although Laiford has over 10 years of experience as a health worker, most of his drugstore clerk experience has been on the job without formal training, except a one-day training he received back in 2014.

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04.25 2018

I had the privilege of meeting Ruphin Ndumbala on my recent visit to Equateur province, DRC. Ruphin is one of the many frontline health workers who go above and beyond to ensure vaccines reach every last child. Recently, he made a promise, and I was honored enough to see him deliver.

“I used to spend at least two days’ roundtrip to collect vaccines.” Ruphin spoke outside of his clinic in rural Equateur province. “It was a big concern for my family that I was leaving behind, but also for the patients I was leaving unattended.”

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04.25 2018

Stories coming from Lolanga-Mampoko district in Equateur province often focus on the challenges communities face in accessing health care. I see these challenges every day and work with partners to help communities overcome them. But not all of our stories are about challenges. For this African Vaccination Week, we are celebrating what we have achieved over the past year.

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07.22 2017

I am pleased to announce that the Malawi Ministry of Health has signed a Memorandum of Understanding (MOU) to scale the mobile health hotline Chipatala Cha Pa Foni (CCPF), or “Health Center by Phone,” nationally. When complete, CCPF will be the first, government-run national mobile health hotline in Africa. This MOU solidifies the Ministry’s commitment to fully adopt and integrate CCPF into the established health system. As with any innovation, and particularly within the digital health landscape, getting to this stage of scale is a major achievement.

“When complete, CCPF will be the first, government-run national mobile health hotline in Africa.”

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08.05 2016

Kwitanda HSA Supervision-6_Malawi_2015_CREDIT_Jodi-Ann BureyMalawi has made incredible strides over the past few years to reduce morbidity and mortality, specifically among women and children under 5 years old. Key to this success has been a focus on using community health workers, known in Malawi as Health Surveillance Assistants (HSAs), to push direct healthcare services throughout the most rural, hard-to-reach, quintessential last mile communities. As a result, people who otherwise may not have reached a health facility can now access basic services from their HSA—sometimes even in their own homes. At the same time, however, more HSAs work in isolation or as the only person from their cadre within their area, with little interaction with colleagues, supervisors or other healthcare providers.

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06.23 2016

Untitled designGraduation season is upon us. It’s a time of reflection for those about to embark on a new phase of their lives. For many this means entering the workforce for the first time, a pivotal life moment.  At VillageReach, we recently celebrated the graduation of the second cohort of pharmacy assistants. Once deployed, these 85 graduates will begin careers as employees of the Malawi Ministry of Health and will be placed in rural, public-sector health facilities across Malawi. The 85 graduates will join their previous cohort who are already working in the field and making significant improvements in the quality of medicines management and patient care at the last mile. But this recent event is not the only graduation we’re celebrating.

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12.22 2015

In response to this article by Dr. Mahad Ibrahim on the role of data during the Ebola outbreak, some interesting questions were sparked among our team. The piece evoked a lot of great insights about the opportunities and challenges the piece addresses, as well as how we see those topics evidenced in our VillageReach work. This topic is of particular interest to us, as we and our partners at the University of Washington are actively developing and testing an open-source tool for paper to digital data conversion, ODK Scan.

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08.13 2015
Malawi village clinic
VillageReach HSA, Pemphero Katondo leads Jailosi Village clinic

As a Community Health Facilitator for VillageReach in Malawi, I see the impact of Community Case Management (CMM), a strategy that promotes the early care-seeking behavior, assessment, diagnosis, recognition, and appropriate treatment for childhood illnesses at the community-level.

Over the last few years, CCM has evolved into a more comprehensive strategy that addresses the three main diseases that commonly kill young children under 5

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02.09 2015

VillageReach, in collaboration with D-tree, is proud to announce the implementation of a new mHealth application in Malawi. What an exciting partnership! During the first week of February 2015, 25 health surveillance assistants (HSAs), nurses and other health workers in Balaka District received intensive training on smartphone technology and the capabilities of a new maternal and neonatal health (MNH) assessment application developed by D-tree. Using smartphones to improve the assessment of pregnant women and their children will increase access to health care and improve the quality of care provided in rural villages.

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12.04 2014

The Role of Data Collection and One Community’s Path Toward Change

While working on the Kwitanda Community Health Project (KCHP), based in the Kwitanda catchment area, Balaka District, in southern Malawi, I have seen firsthand how critical the role of data collection is to improving health outcomes. In this rural and remote setting, the news of a maternal death spreads quickly, but quietly, almost like a rumor or story. “Did you hear? Another mother died in childbirth in that village. Another neonatal death occurred last week.” It is difficult to understand the causes of the death, or how often they occur because little information is collected and reported on these events.

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Malawi healthcare worker