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Increasing Access to High-Quality Services in Malawian Facilities and Communities

Among the world's most densely populated and least developed countries, Malawi faces a number of health challenges. With one of the highest maternal mortality ratios in the world and an ongoing HIV/AIDS crisis, this agricultural country is struggling despite recent gains in economic growth.
 
To address these issues, MCHIP works with its partners to support the Ministry of Health (MoH) at the community level, with facilities in all 28 districts, and on a national scale to improve the quality of reproductive health (RH) services. These include infection prevention (IP) and control practices, Basic Emergency Obstetric and Neonatal Care (BEmONC), Prevention of Mother-to-Child Transmission of HIV (PMTCT), and Postpartum Family Planning (PPFP). MCHIP also promotes the correct and consistent use of Long-lasting Insecticide Treated Nets (LLIN) among pregnant women and children under 5 years and behavior change communication on prevention and treatment of malaria.
 
Specifically, key Program interventions include:
  • Improving performance of facility-based providers through introduction of PQI approach in IP and RH and skills strengthening of supervisors
  • Equipping Health Surveillance Assistants (HSAs) with knowledge and skills to identify pregnant and postnatal mothers, providing counseling on maternal and newborn care, recognizing danger signs, providing family planning counseling, and referring to appropriate facilities
  • Strengthening HSA skills and capacity to manage maternal and newborn health (MNH) activities in the community and supporting community engagement as a means to achieve improved MNH outcomes in communities
  • Strengthening the quality of pre-service nurse-midwifery education by training tutors and preceptors in BEmONC and PPFP and conducting supervisory visits to nursing/midwifery schools
  • Ensuring access to and correct use of LLINs for pregnant women and children under 5
  • Providing comprehensive IEC messaging on using LLINs and Lumefantrine Artemether for treatment of malaria for children under 5
  • Strengthening PMTCT continuum of care as part of integrated package of MNH services
  • Introducing and scaling up ambulatory and community KMC for management of low birth weight newborns
  • Procuring and promoting the use of ORS Thanzi to treat diarrhea in children under 5
  • Expanding social marketing of SafePlan oral and injectable Contraceptives in the private sector
Due to Program efforts, Mzuzu Central Hospital was already recognized as a Center of Excellence for achieving RH standards in February 2010. In less than one year, the hospital was able to make substantial quality improvements in all areas of RH, ensuring consistent, high-quality delivery of MNH services.
 
And in the coming year year, MCHIP/Malawi will continue to aim high: assisting three district and/or central hospitals to achieve RH and IP standards; increasing the number of Malawi’s midwifery tutors updated in BEmONC and KMC skills to 69%; and distributing more than 1.5 million LLINs nationally.
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