Malawi: Our Impact

 {Photo Credit: Rhiana Smith}Aziz Abdallah, DHSS Project Director, MSH, greets guests at end-of-project eventPhoto Credit: Rhiana Smith

The District Health System Strengthening and Quality Improvement for Service Delivery (DHSS) Project shared its achievements on Wednesday, March 7, after five years of work to reduce the burden of HIV/AIDS in Malawi. Guests gathered at the Bingu International Conference Center in Malawi’s capital, Lilongwe, for an end-of-project event that featured speakers from DHSS, the Ministry of Health, United States Centers for Disease Control and Prevention (CDC), and Management Sciences for Health (MSH), which led the DHSS Project,  

{Photo Credit: Chisomo Mdalla}Inspecting the water system at Mitundu Rural Hospital.Photo Credit: Chisomo Mdalla

When a blackout occurred after Pilirani Kabango ended her shift one September evening in 2017, she did not anticipate any unusual consequences. Power outages during this time of year are not uncommon in Malawi, and despite high temperatures and the fact that the rivers supporting electricity generation were drying up, demand for power continues. The three water tanks at Lilongwe’s Mitundu Rural Hospital, where Pilirani works as a nursing supervisor—among the biggest rural public hospitals in Malawi—had a combined capacity of 30,000 liters.

{Photo Credit: Henry Nyaka}Grace Mathunda.Photo Credit: Henry Nyaka

At the time that Grace Mathunda started to fall ill, she also grew increasingly concerned over the poor health of her second child. Eventually he became so weak that he stopped going to school. When Mathunda, 32, became pregnant again, she went to Makhetha Health Center in Blantyre, Malawi, where she was tested for HIV. As with over 30 percent of people living with HIV in the country, Mathunda was unaware of her status.[1] She tested positive.

{Photo credit: Henry Nyaka}Malawian Minister of Health and Population Atupele Muluzi and US Ambassador Virginia Palmer cut the ribbon to officially open the Umodzi Family Center, an HIV and tuberculosis clinic at Queen Elizabeth Central Hospital in Blantyre, Malawi, on World AIDS Day.Photo credit: Henry Nyaka

The Umodzi Family Center, an HIV and tuberculosis clinic at Queen Elizabeth Central Hospital in Blantyre, Malawi, officially opened on World AIDS Day with the support of Management Sciences for Health (MSH). Speaking at the opening ceremony, Minister of Health and Population Atupele Muluzi said the time had come for the southern region to have a referral HIV center. “I have to thank all stakeholders and development partners, more especially the United States, for the collaboration in making this project a success,” said Muluzi.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

On this World AIDS Day, Management Sciences for Health (MSH) honors those who have been affected by HIV and AIDS and recommits to working with governments, the private sector, and communities to prevent new infections and reach all people living with HIV with high-quality, patient-centered care. As we reflect on our global successes in scaling up HIV prevention and treatment efforts and averting new infections, we stand in solidarity with the many people around the world who are still being denied their right to health.

Erik Schouten

In 2011, Malawi implemented an ambitious and pioneering “test-and-treat” HIV strategy for pregnant and breastfeeding women, known as Option B+. Erik Schouten, MSH's Country Lead and Project Director of  the District Health System Strengthening and Quality Improvement for Service Delivery Project in Malawi, supported the roll-out of the program.

Maria Galasiano and baby Miliasi

Maria Galasiano had been in labor for 16 hours. Finally, the medical assistant on duty called Balaka District Hospital 66 km away to send an ambulance to pick up the young mother. The lives of her and her baby were at risk. The ambulance arrived at Phimbi Health Center after midnight and also had to take an IV-bound man on a stretcher, plus caretakers for both patients, and a nurse. They all packed into the ambulance.

 {Photo credit: MSH staff}South SudanPhoto credit: MSH staff

UNICEF has comissioned MSH to develop a cost modeling tool and methodology that will help countries structure, plan, and finance integrated community health services. UNICEF, the United Nations Children's Fund, is a worldwide leader in promoting and supporting community health services as a key strategy to improve coverage of high-impact maternal, newborn, and child health interventions and reduce health inequities from pregnancy to adolescence and beyond.

 {Photo credit: Colin Gilmartin/MSH}A community health volunteer in Madagascar demonstrates how to provide Depo-Provera.Photo credit: Colin Gilmartin/MSH

Throughout sub-Saharan Africa, community health workers represent the foundation of the health system, addressing priority health areas ranging from maternal and newborn health to family planning and Ebola prevention. Not only do community health workers extend access to health services for the underserved and those living in hard-to-reach areas, they help countries accelerate certain health outcomes, and achieve the Sustainable Development Goals and related targets for universal health coverage.

MSH supported the roll-out in 2011 of an ambitious and pioneering public health program in Malawi known as Option B+, a test-and-treat strategy for pregnant and breastfeeding women. Under Option B+, all HIV-infected pregnant and breastfeeding women are provided with lifelong antiretroviral therapy (ART) regardless of their CD4 count or World Health Organization clinical stage.

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