District Health System Strengthening and Quality Improvement for Service Delivery in 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: 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.

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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