District Health System Strengthening and Quality Improvement for Service Delivery in Malawi: Our Impact

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.

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.

 {Photo credit: Cindy Shiner/MSH}Geomack Banda, 21, has been studying at the Malawi College of Health Sciences in Lilongwe for a year as part of the training and bonding program.Photo credit: Cindy Shiner/MSH

Whether ill, pregnant, or simply needing to refill medication, many Malawians living in remote areas need to walk for several hours to reach a health facility. When they arrive, they might find it poorly stocked, inadequately staffed, or even closed. Hard-to-reach facilities are often difficult to staff because young people have limited opportunities for training as health workers, poor access to markets and other resources, and little chance to participate in meetings and other activities.

 {Photo credit: MSH}Staff at the new HTC site in Bvumbwe Prison test an inmate for HIV.Photo credit: MSH

In 2012, the US Centers for Disease Control and Prevention (CDC) initiated a program designed to improve the quality, access, and coverage of health services related to HIV in seven districts of Malawi. The Service Delivery Quality Improvement and Health Systems Strengthening project, led by Management Sciences for Health (MSH), works with local stakeholders to this end, including improving HIV prevention and care at prisons in these seven districts.

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