#HealthForAll #HealthForAll ichc2017.org ichc2017.org History and - - PowerPoint PPT Presentation

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History and Future

• f Community

Health Workers in Malawi

Ministry of Health March 27, 2017

Malawi Ministry of Health

2

Malawi Context

3

Sources: CIA Factbook 2016; Bowie & Mwase Malawi Burden of Disease data sets, 2011, Malawi Demographic Health Survey 2015-16

84%

Rural

24%

Not within 8km of health facility

4%

Rural access to power

61yrs

Life expectancy

53%

Of deaths caused by top 4 illnesses (HIV/AIDS, LRI, Diarrhoeal, Malaria)1

Malawi’s population is 17 million

Community Health in Malawi

Malawi Ministry of Health 4

Before the nineties Malawi’s community health was delivered by: Volunteers Health Inspectors Primary Health Nurses

Malawi Ministry of Health 5

Since then until Since then until Since then until Since then until today community today community today community today community health has primarily health has primarily health has primarily health has primarily been delivered by been delivered by been delivered by been delivered by Health Surveillance Health Surveillance Health Surveillance Health Surveillance Assistants (HSAs) Assistants (HSAs) Assistants (HSAs) Assistants (HSAs)

HSAs are full-time CHWs employed by MOH

Malawi Ministry of Health 6

HSA’s & Senior HSA’s are over half of MoH’s clinical staff

Medical / Clinical Officer; 1,4 Nursing Officer; 1,1 Nurse Midwife Technician; 3,5 Medical Assistan t; 1,2 Pharmacy and Lab Technician; 0,6

Senior HSA; 1,2

HSA; 8,0

MoH Clinical Staff (thousands)

HSAs are meant to reside in their catchment area The recommended HSA to population ratio is 1 to 1,000 people

HSAs have a wide range of responsibilities and must work alongside key partners

Malawi Ministry of Health 7

Health promotion Prevention Disease surveillance Basic curative services

HSAs

Community Health Volunteers Village Health Committee Community Health Nurses

• Env. Health

Officers

HSA Responsibilities HSA Key Partners

Community health activities have contributed to significantly improved health outcomes for Malawi

Malawi Ministry of Health 8

135 76 42 234 133 64 1992 2004 2016 Deaths per 1,000 Year

Infant Mortality Rate & Under 5 Mortality Rate

Infant Mortality Under 5 Mortality

46% 24%

2011 2014

Malaria Case Fatality Rate

14% 6%

2008 2016

Proportion of Households with no toilet facility

Sources: HSSP II Situation Analysis October 2016

However, Malawi continues to face sub-optimal health coverage and outcomes

Malawi Ministry of Health 9

81% 71%

2010 2016

Children aged 12-23 months fully immunized

55% 45%

2010 2016

% of Children Under 5 years sleeping under ITN

574 155

2015 2016 Target

Maternal Mortality Rate per 100,000 live births

Sources: HSSP Situation Assessment 2016, MDG End Survey 2014

Significant resource constraints and inconsistencies of community Significant resource constraints and inconsistencies of community Significant resource constraints and inconsistencies of community Significant resource constraints and inconsistencies of community health services contribute to these sub health services contribute to these sub health services contribute to these sub health services contribute to these sub-

• optimal outcomes
• ptimal outcomes
• ptimal outcomes
• ptimal outcomes

Malawi Ministry of Health 10

51% 51% 51% 51%

• f HSAs not staying in

their Catchment Area

+7,000 +7,000 +7,000 +7,000

New HSA’s needed to reach policy level Senior HSAs trained in supervision

NO NO NO NO

National Community Health Strategy or Policy

Malawi Ministry of Health 11

The MOH is acting quickly to address this The MOH is acting quickly to address this The MOH is acting quickly to address this The MOH is acting quickly to address this

The Community Health Services (CHS) The Community Health Services (CHS) The Community Health Services (CHS) The Community Health Services (CHS) section has been strengthened to section has been strengthened to section has been strengthened to section has been strengthened to address these challenges as the overall address these challenges as the overall address these challenges as the overall address these challenges as the overall community health coordinator for Malawi community health coordinator for Malawi community health coordinator for Malawi community health coordinator for Malawi

Malawi Ministry of Health 12

Our Vision: To improve the livelihoods of all people

all people all people all people in

Malawi.

Our Mission

Malawi Ministry of Health 13

To ensure quality, integrated community health services are affordable, culturally acceptable, scientifically appropriate, and accessible to every

every every every household household household household through community

participation to reduce deaths and the socio-economic burden of illness in Malawi.

In 2017 the CHS section has made significant progress through teamwork, partnership, and participation

Malawi Ministry of Health 14

Situation Assessment Developed Partnerships and Mobilized Resources Consultative Workshops

Malawi’s first ever National Community Health Strategy

But we are just getting started…

Malawi Ministry of Health 15

Phase 1 Strengthen the System Phase 2 Implement of the System Assessing the System

Clarify roles and teams for CHWs Develop Integrated Training Curriculums Establish standard CHW supply list Establish CHW HR and Residency Policy Integrated community health indicators Hire more CHWs Train CHWs on integrated service Provide all CHWs with critical supplies CHW housing and service structures mHealth and digital data collection

Malawi Ministry of Health 16

This is more than just a strategy.

With a stronger community health system we can all contribute to improved livelihoods for all people in Malawi

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