Newsroom & Blog

May 23, 2024   |   Blog Post

Bridging the Gap: Health Care Delivery in Southern Malawi

Boat trip to deliver emergency supplies and health workers to communities in Msinje, Gome, and Illembe areas. Photo credit: Charles Matemba

By VillageReach and Malawi MoH

By Charles Matemba (Senior Manager, VillageReach), Tafwirapo Chihana (M&E Manager, VillageReach), Dr Mike Chisema (EPI Manager, Ministry of Health) and Ken Msiska (Lulanga Environmental Health Officer, Mangochi District Council)

Traveling to the Maganga health facility, in Mambo, Malawi, presents a formidable test of patience and perseverance. The challenging four-and-a-half-hour drive from Mangochi District headquarters, covering 120 kilometers, requires crossing four rivers without bridges. These bridges are casualties of recent cyclones and overburdened trucks.

Photo credit: Charles Matemba

Negotiating these rivers is perilous, as they are often dry but dangerously unpredictable during rains, which characterizes the daily struggle for over 150,000 residents in this region covering Traditional Authorities Namabvi, Makanjira, Lulanga and Mambo.

Patients, urgent medical supplies and everything else transiting these areas face a slow, expensive, risky, unpredictable and on a rainy-day impassable journey. Unfortunately, these hurdles do not stop here but exist in the furthest points north of the district. In Mambo, for example, northern communities (including Gome and Ilembe) take another four hours by boat.

Community health workers do not cover these communities through monthly clinics due to lack of a road network, causing delayed immunizations, which leave children vulnerable to preventable diseases. Outbreaks like cholera can spread quickly due to limited access to clean water and sanitation facilities.

When we made the trip in March 2024, we noted that the children’s health passports’ last entry was 22 November 2023, at least four months behind the immunization schedule.

Working Together: Building Solutions Step-by-Step
Despite the challenges, there’s a spirit of collaboration. Local leaders are strong advocates for health promotion. Here are some initiatives we’ve undertaken alongside the community:

  1. Re-activating Outreach Sites
    We facilitated health workers and volunteers to provide health products and update records and key health services: immunization catch-ups, COVID-19 vaccinations, malaria testing and treatment for children, family planning services and chlorine distribution.
  2. Community Engagement
    We worked directly with community leaders and members to identify their needs and co-create long-term solutions. These efforts are a stepping stone towards achieving universal health care (UHC).

Photo credit: Charles Matemba

The Road Ahead: Innovation for Long-Term Impact
Long-term, sustainable solutions are needed to address such communities’ outstanding challenges. Collaboration among stakeholders, innovation and technology are key to effect a quick change of the status quo.

Key areas for exploration include the following:
• Telehealth: Utilizing technology for remote consultations with health care providers.
• Medical Delivery Drones: Exploring the possibility of drone-based delivery of medical supplies.
• Improved Water Transport: Investing in reliable and efficient boat transportation for health care workers and supplies.
• Innovative Sanitation Solutions: Developing toilets and water points suitable for the area’s sandy soil conditions.
These solutions require collaboration and community input to ensure they fit the context and have a lasting impact.

Delivering health care in remote areas requires a multifaceted approach. We invite everyone to join us in brainstorming and implementing innovative solutions to bridge the gap and ensure health care for all.

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