Malaria

Monitoring and Support Visit by Malaria Team to Malawi

Monitoring and Support Visit by Malaria Team to Malawi

LUCSA conducted a monitoring and support visit in Malawi from 01 October 2014 – 05 October 2014

The focus was to monitor and support activities in all the three original project districts Nkhotakota, Salima  and  Mangochi.

The aim was to engage with communities (who included community and church leadership, feeding centres, VSLAs, SHGs members and CBEs) and visiting some of the reported projects sites.

The objective of the visit was:

  1. Monitoring the impact made by the church through malaria prevention and control activities to the congregation and surrounding communities.
  2. To assess the relationship the church has with state and other stack holders towards working together on the fight against Malaria.
  3. To identify areas requiring further strengthening and support in the face of the phasing out of the programme.
  4. To monitor livelihoods activities and their benefits to the communities and linkages with malaria, while assessing exit readiness post donor funding.
  5. To monitor utilisation of funds against budget items and advise appropriately

Findings:

At Kapiri and Katema:

  • There was a cordial working relationship between the church and the clinic/government.
  • The church focusing on health education and Behaviour Change Communication (BCC) while the clinic focused on treatment. The church staff is involved sensitising the communities so that they assist the spray operator during Indoor Residual Spraying (IRS).
  • The health facilities were also sources of secondary data collected and used by the church.
  • Community Based Educators (trained church staff) worked well with the government cadre.
  • Health Surveillance Assistants (HSAs) who were the primary health care givers at grassroots level (Village Health clinics) where they do the diagnosis and treatment of malaria.
  • Contribution by the church in purchasing and supplying gloves, Rapid Diagnostic Tests (RDTs), Fansidar for pregnant mothers and other anti-malarial drugs was indeed appreciated by the Ministry of Health. The clinics had adequate supplies of drugs including RDTs contributed by the church.
  • The church was also involved in purchasing and distribution of LLINs targeted to the pregnant mothers, under 5s and the other vulnerable members of the communities.
  • While some of these nets for under-fives were distributed at the clinic during ANC generally, most were distributed through ELCM feeding centres
  • To alleviate challenges of transporting patients to the health facility, the church has donated bicycle ambulances to the communities which have proved quite pivotal in the health care delivery especially from the remote communities.

Sustainable Livelihoods:

Village Savings Loans Associations and Lending Groups

  • Savings and lending groups were formed by the poor in target communities to provide sustainable and profitable microfinance services (micro savings, microcredit, and micro-insurance), especially in remote places with no access to formal financial services.
  • These groups are self-managed and do not receive any external capital and provide members with a safe place to save their money, acquire small loans, and obtain emergency insurance.
  • They focus on building savings and assets, and provide credit proportionate to the needs and repayment capacities of the borrowers.

Findings:

  • The groups were found to be running well with group members accessing to small loans plus share outs (savings and interest), each member receives at the end of each saving circle.
  • Most members are able to increase their engagement in productive enterprises such as petty trading, fish mongering, livestock rearing and other income generating activities.

SHG members making their weekly contribution in NKotakota
Through this group, members can get access to health care services- members of the group are able to cope with unforeseen shocks such as sicknesses due to malaria as they are able to pay to transport the patient to the health facility.

  • They use this facility to Improve housing- type of housing reflects the household’s economic status and to  buy household assets(furniture and livestock) and instill a spirit of competition within households and thus increase their predisposition to access health care and other health related services including a clean environment.
  • All group members contribute towards the social fund according is used as financial mechanism that support members in times of emergencies like sicknesses or shortage of school fees.
  • Saving groups used as forums for social discussions on issues such as malaria, HIV and AIDS, rights to health and other issues involving families. These savings groups empower women.


Challenges

  • Problems of administration of ACT which is given without RDTS being done in the communities may result in wide spread resistance. Government should enforce proper RDT test before ACT is given out.
  • Distance to health facilities and lack of transport compounded by lack of accessible roads/routes.

Recommendations to the Malawi project staff and the church
The church is challenged to consider issues of advocacy in the following areas noted as requiring attention on the part of Government:

  • That there be more HSAs employed, trained on RDTs testing and deployed to cover effectively all the village clinics. This should help improve malaria management and treatment in the communities.
  • Government challenged to ensure that adequate stocks of anti-malaria drugs are supplied to the clinic so that positive cases can be dealt with as soon as they are identified.
  • The church is challenged to engage government and CHAM to reach a common understanding on issues of charges by the clinic for service delivery including malaria treatment, as this can act as a deterrent in an effort to combat malaria.
  • Lobby for more ambulances to the clinics to facilitate transportation of complicated cases to bigger health facilities. This cannot be left to the owners of the patient alone as private transport is very expensive.
  • The church working with Government should intensify public awareness on the dangers of hoarding and taking ACT without due care as it exposes communities to resistance and deprive others who desperately need the drug.
Posted by trisha in Malaria