The BMJ published a case study led by VillageReach for a special series on ‘Making Multisectoral Collaboration Work’. It is based on the seven-year journey of Chipatala cha pa Foni (CCPF), a health hotline that started in one small district in 2011 and is now available to Malawians from every district, nationwide.
Easily accessible by mobile, CCPF provides information on nutrition, health promotion, preventive behaviours and sensitive issues such as sexual and reproductive health through a convenient and cost-free program.
CCPF is well down the path to complete transfer of ownership to the government of Malawi by 2019. It will essentially provide an extra health center in every district, community, and home, strengthening the health system by extending its reach.
In scaling up CCPF in Malawi, we share five lessons from our journey. They include:
- Plan from the start for government ownership. All partners were aligned to pass on stewardship to the Ministry of Health and prioritized working closely with government to ensure smooth integration and long-term sustainability. Finding the right champions within multiple government departments can provide both the will and technical assistance.
- Address community needs. An innovation must address challenges that are important to the community and be inclusive for users and beneficiaries. Understanding the barriers to health services, prioritising the end user, and engaging them in the development of the service – such as adding reproductive health services – have been key to CCPF’s success and uptake.
- Use Monitoring and Evaluation (M&E) and quality assurance (QA) to identify strengths and weaknesses. An evaluation of the CCPF pilot produced evidence of impact, demonstrating that CCPF could deliver successfully on a small scope and scale before expanding to additional services and districts. Ongoing QA and M&E help the team continuously improve the service.
- Identify allies across sectors and a neutral party to broker discussions. Working with the private sector was critical – Airtel made all incoming calls to the hotline free. However, it was important for VillageReach to act as a broker to overcome the potential uncertainty of stakeholders who are not used to collaborating. Without the Airtel partnership, the costs of nationalization might have prevented the government from taking full ownership.
- Prepare for the valley of death. Brace for the difficult times required to progress an idea to scale. VillageReach took a risk to sustain CCPF, both self-funding and implementing alone while sourcing new partnerships and funders.
A recent World Health Organization report (PDF) for the World Health Assembly recognized the significant role of digital technologies in health system strengthening. The report said there was a need to address (1) a lack of multi-sectoral approach between government ministries and departments, as well as among donor agencies, and; (2), pilot projects that lack a process for bringing to scale.
CCPF partners have tackled both of these challenges and demonstrated how increasing equitable access to health information requires many hands – and a mobile phone – to empower people who face geographic or social barriers to health care. And with the government leading and expanding CCPF for all Malawians, Chipatala cha pa Foni will contribute to the ability for Malawi to deliver Primary Health Care for all.
Carla Blauvelt is the Malawi Country Director at VillageReach, and will be speaking at the Partnership for Maternal, Newborn & Child Health (PMNCH) Partners’ Forum in Delhi on a panel about making multisectoral action work to improve sexual and reproductive health.