Izizi ndi Zathu Zomwe. This is ours. That’s the name my team of adolescent researchers has given a groundbreaking public health initiative—a close study of their peers’ needs, behaviors, and preferences related to contraceptives. That name signals the importance of the qualitative, context-specific information required to succeed in such an initiative—proximity is necessary to develop the new approaches that will improve healthcare access for all. The data from this study will assist product manufacturers and policy stakeholders to address the unique and specific contraceptive needs of young people.
Vaccines are extremely sensitive to temperature. They must remain between 2 and 8 degrees Celsius in order to remain viable. Outside of this temperature range, vaccines become less effective at preventing diseases. Because of this, the storage and handling of vaccines need careful attention. The equipment and devices used to ensure vaccines stay in the right temperature range are known as the “cold chain.” When vaccines are transported, stored in a refrigerator, or used in an immunization session, the cold chain keeps the temperature right. Significant investments have been made in updating cold chain equipment in many countries, but overall performance remains a significant concern.
With our new partner Bull City Learning, VillageReach is strengthening the vaccine cold chain in Malawi. Using human-centered design principles, we are creating an easy-to-use, interactive, digital manual on refrigerator maintenance and repair. By providing this tool for cold chain technicians, we hope to improve routine maintenance of essential equipment used to keep vaccines at the right temperatures.
This week, Chipatala cha pa Foni (CCPF) or “Health Center by Phone” moved its operations from Balaka, a rural community in southern Malawi, to its new facility in the capital city of Lilongwe. As we packed up the phones, headsets, and files, I was struck by how symbolic the moment was. This move is more than a change of location. It represents the progress of CCPF many years in the making: from a maternal and child health service in one district to a comprehensive health hotline accessible to more than 5 million people across the country. From this new facility, CCPF will have the proper infrastructure and operational capacity to become Malawi’s first government-run national health hotline, a goal we are on track to reach by December of this year. At that stage, the service will be accessible to over 17 million Malawians. Having supervised this program for one and a half years, I feel privileged to have had the opportunity to work with the Government of Malawi Ministry of Health, our dedicated CCPF teams, and all of the donors and partners who have made this day possible.
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.”
I recently returned from a trip to Malawi where I had the opportunity to visit several families who have benefited from Chipatala Cha Pa Foni, or Health Center by Phone, a toll-free health hotline in Malawi that connects individuals directly with trained health workers who provide information, advice and referrals over the phone. One of those visits was with the Richards family who live in Kazondo Village in Balaka, a district in southern Malawi.
Having just returned from a visit to Malawi and Mozambique, I had the opportunity to meet with many health workers who contribute to and shape VillageReach’s work at the last mile. Most of them work in incredibly rural and remote locations, challenged by many of the barriers we talk about most frequently at the last mile – lack of infrastructure, human resources, information, and access to medicines. One of the health workers that made an indelible impression on me was Mackson Khalawako. Mackson joined VillageReach in September 2008 as a Health Surveillance Assistant (HSA). In this role, he serves a population of around 1,000 from two villages: Bakili and Makande. In addition to the health surveillance assistant’s duties facilitating community clinics for vaccinations, growth monitoring and health education, Mackson also helped to implement and continues to run a village clinic for children under 5.
VillageReach supports HSAs as part of the Kwitanda Community Health Project which aims to address healthcare through a community-led and managed approach, supporting health interventions that address the most critical needs of the community. I caught up with Mackson at the Bisani clinic for children under five, held in a small, two-room structure that was built brick-by-brick by the community members last year. Previously, the clinic had been conducted outside under a tree, not uncommon for village clinics in rural communities like Kwitanda. His performance has won the hearts of many people in his catchment area, and it’s easy to see why.
Last week, the Reproductive Health Supplies Coalition (RHSC) brought together hundreds of the top minds in global reproductive health issues at the Coalition’s 17th Annual Meeting. This meeting provided a forum for discussing the many triumphs and continuing challenges of reaching 120 million additional women with reproductive health services by the year 2020. Access to reproductive health commodities allows women to decide if and when to have children. This ability is not only a human right, it can be a life or death situation for many women and young girls. Increasing access to reproductive health is also one of the most effective and cost-efficient ways to reduce infant and maternal deaths. As an active member of the RHSC’s System Strengthening Working Group, VillageReach eagerly engaged in this week of conversation and idea exchange. Many of the central themes reflect the work of VillageReach, allowing us to bring our experience and expertise to the conversation while learning and growing from the experiences of our partners.
One hundred and thirty minutes. That’s just over two hours. It’s a long time to wait to see a doctor no matter where you are in the world. Then after waiting for two hours, patients talk to a healthcare provider for less than 2 minutes – 140 seconds – before they are back out the door. These are the average times spent waiting for and with healthcare providers in a rural health center in Malawi, where a recent study examined the flow of patients to help uncover opportunities for improvement.
Malawi 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.
Graduation 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.