The situation in Malawi
In the year 2006, there was only one hospital in Neno. That was the Neno Rural Hospital. Its facilities were limited and inadequate. Electricity and water supplies were poor and inconsistent. Shortage of staff members was also acute. There were only two nurses, one medical assistant, one clinical officer and seven support staff working at the hospital. The hospital was approximately 50 kilometers from the nearest tarmac road within the government and commerce center of Neno district. Nurses walked to the surrounding villages to deliver services and worked 15 hours a day. In that same year threw were eight other government health facilities in Neno. Access to HIV treatment, Testing, canceling and TB treatment services were limited (Watcher, Rosenberg & Weintraub, 2013). The district health officer led the district health management team.
Objective of PIH/APZU
Partners in Health (PIH), is an international NGO with its headquarters in Boston, Massachusetts. It had been working to provide high-quality community-based health care. In 2006 when PIH arrived in Neno, the first task by its members was to seek vulnerable people within the community and get them on treatment. Later in that year, PIH began to register Abwenzi Pa Za Umoyo (APZU) as an independent NGO. This NGO’s objective was to work on a community-based HIV prevention and treatment program. The program was integrated with public-sector primary care, as well as programs for TB, Malaria, STIs and women’s health.
Actions of PIH/APZU
APZU hired more than 20 HIV testing counselors from Neno and trained and deployed them throughout the district. Together with the ministry of health, they established an electronic HIV registry. They also renovated the local hospital. Later on, APZU was able to procure chemotherapy medicine regularly through a reliable, cost-effective supply chain from India.
Impact on the community
Both the PIH and the APZU lobbied under joint efforts paid the roads authority to bring engineers to Neno. This led to the construction of a road that soon became known as the “Keith’s Highway.” This road would eventually lead to better patient care and transportation of complicated maternity cases. The result of this was that people were able to receive better medical care; employees had better-working conditions and received better payment through efficient means. At the end of 2007, there were 406 HIV patients on therapy in Neno, and PIH was testing 1,400 patients per month, up from 400 per month at the beginning of 2007.
Roles of the CHDI
The Clinton Hunter development Initiative (CHDI), Promised $100 million over ten years for agribusiness and safe water projects in Rwanda and Malawi. The CHDI staff members worked with farmers to increase wheat production and establish export agreements with wheat purchasers. Other additional roles delegated to CHDI were to carry out prevention of mother-to-child transmission of HIV and infant and child nutrition programs. They also formulated plans together with the public works ministry to build three homes and 20 duplex units close to the hospital to house all project staff.
Role of the ministry and the council
The ministry of health assisted in the hiring of staff. They were also an intermediary between the government and NGOs. One of the major roles was the central approval and finalization of the government’s budget. It coordinates the public healthcare system which includes community, primary, secondary and tertiary care.
Why PIH/APZU was a success
Indeed, the efforts of the PIH & APZU were a success in terms of capacity development. Facilities were expanded and improved, more staff was employed, and most importantly, more people obtained easy and cheaper treatment.
References
Watcher, K., Rosenberg, T., Weintraub, R. 2013. Partners in Health in Neno District, Malawi. Global Health Delivery.
