Health leaders from across Malawi, as well as non-profit and private sector partners, championed the use of Health Center by Phone as a means of working towards Universal Health Coverage for Malawian citizens and beyond, during a three day South African delegation to Lilongwe.
“It’s a hospital on your phone, it provides services, it’s like a call center whereby if you have any health-related issues, you are free to call,” said Honorable Khumbize Kandodo Chiponda, Malawi Minister of Health, who welcomed the delegation on Tuesday, speaking to the Times 360 Malawi.
“You don’t pay anything, you can call and it’s managed by our health workers. You have nurses, you have clinicians who can attend to different issues which have been raised here by the public. It’s a very important service.”
She also noted how the service has been critical in tackling emergency health issues, including COVID-19, polio and the current cholera outbreak.
The delegation, held February 7-9, was an opportunity for the South African National Department of Health to learn about Health Center by Phone. The visiting group of government leaders, alongside administrative and service providers, toured the service call center and learned of its impact across Malawi’s health system during a visit to Chileka Health Centre.
The visit gave deeper insight into Health Center By Phone’s scale-up and sustainability, as the visiting group looks to expand the South African Contact Centre into primary health services.
Background of Health Center by Phone
Health Center by Phone originated in Malawi as Chipatala cha pa Foni (CCPF), beginning in 2009 when the Malawi Ministry of Health (MoH) called on community innovators for ideas to increase access to maternal, newborn and child health.
In response, VillageReach developed jointly CCPF with the MoH, Airtel and Viamo, as an integrated telehealth solution that provides free health information in multiple languages, 24 hours a day, creating a link between the health center and under reached communities in Malawi.
“It works as a triage mechanism,” said Claudia Shilumani, VillageReach’s Vice President of Partnerships and Impact. “If they don’t need to come to the health facility, they will get assistance over the phone. If they do need to come to the health facility, they are referred to the health facility.”
CCPF has provided more than 7 million health interactions, reaching over 5,000 callers daily, through voice (talk to health worker or automated) or texts through WhatsApp.
It transitioned from VillageReachto the MoH in 2020, becoming one of the first government-run, nation-wide health hotlines in Africa.
Success during COVID-19
During the first day of the visit, the delegation heard that CCPF was embedded in the national health system and became a crucial national resource for COVID-19 information.
“People were really scared to go to hospitals. They thought that if you went, you were going to get COVID. So it was a very stressful period. CCPF really provided comfort to people. You could call them even if you were isolated to talk about any issue,” said Honourable Minister Khubize.
Support for mental health as well as family planning, PPE, noncommunicable diseases and a range of health concerns were provided during this time. VillageReach and the Malawi MoH also utilized a process called social listening to respond to vaccine questions and misinformation in public discourse as a way to boost vaccination rates in Malawi.
Since 2020, calls to CCPF have increased five-fold as the service continues to expand to meet greater demand and further contribute to disease surveillance.
The South African Contact Centre was established in 2021 to offer COVID-19 information. The government is now hoping to replicate the Malawi experience of expanding telehealth to include more health topics and pathways to primary health care.
The successful scale-up and transition of CCPF can serve as a model for telehealth services outside of Malawi, as has been demonstrated by the South African delegation visit.
“It shows that Malawi has done something very wonderful, that deserves other countries with better health systems to come and learn from,” said Claudia Shilumani, speaking of the visit.
Its sustainability and integration into Malawi’s national health systems provides an opportunity for cross-country learning during the delegation visit, as South Africa looks to shift its telehealth services from being COVID-focused to being responsive to the broader health needs of South Africans.
“We now want to extend the hotline into offering primary health care services and be a much broader service to the whole country. We still need to walk that journey of integrating and making it sustainable with the Ministry of Health,” said Candy Day, Project Lead of the National Contact Centre in South Africa, who was part of the delegation.
“We really want to supplement and make the communications between our Ministry of Health and the people of South Africa responsive,” she added.
Dr. Zemeer Brey from the Bill and Melinda Gates Foundation, who was also part of the delegation, had commented on how it was clear that the Malawi MoH really drives CCPF, making it government driven as opposed to partner and donor driven. “Malawi has stood out as a continental example!” he said.
With CCPF’s use of instant patient feedback and social listening to preempt health challenges and strengthen service delivery quality at the point of access, it is clear that national telehealth can extend the reach of quality health care to meet people’s changing needs. Cross-country learning experiences such as this visit help build upon our understanding of responsive health systems as we work collectively to achieve Universal Health Coverage.