Training and Bonding Program Improves Access to Health Care in Malawi

 {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.

The District Health System Strengthening (DHSS) project, funded by the United States Centers for Disease Control and Prevention (CDC) and led by Management Sciences for Health (MSH), is helping fill the workforce gap through its “training and bonding” program.

The program relies on village leaders and health facility advisory committees to identify promising young students in their communities who in the past three years received their Malawi School Certificate of Education Examination with credits in science, English, and mathematics to be trained as nurse midwife technicians or medical assistants. Once identified, DHSS finances their training at the Malawi College of Health Sciences, the Malamulo College of Health Sciences, the Ekwendeni College of Health Sciences, the St. Joseph College of Nursing, or the Mulanje Mission College of Nursing and Midwifery for two years and bonds them to work at rural health facilities near their homes for three years.

The social bond agreement is between the district health officers, on behalf of the Ministry of Health, and the trainees and their parents or guardians. So far, more than 87 trainees have been selected from six districts.

Local leaders have enthusiastically supported the program for its potential to improve staffing at rural health facilities and ensure culturally sensitive service delivery and care.  Nkhata Bay District Commissioner Fred Movete called the training program “a dream come true” for local residents during a signing ceremony for six recently chosen trainees.

The students are eager to serve their communities and gain clinical skills. Trainee Geomack Banda, 21, has been studying at the Malawi College of Health Sciences in Lilongwe for a year.

“I come from a small village, and to be brought to this big city is an achievement,” he said. “It will be a great experience, helping my own people from my community, my friends, and my parents. I’ll be like a role model. It’s something to be proud of.”

To ensure services while the trainees are studying, DHSS offers financial incentives to health workers who volunteer at a remote health facility for a month. The project is currently supporting 21 facilities each month, including 10 in Blantyre, four in Nkhata Bay, four in Chiradzulu, and three in Mwanza.