Building the capacity of Health Centre Management Committees to deliver immunization and emergency transport services
This project is focused on revitalizing Health Centre Management Committees (HCMCs) in the districts of Lilongwe and Dowa in Malawi, with a specific focus on increasing immunization coverage and establishing emergency transportation systems in the target districts.
Why this project is important
The percentage of health facilities with the capacity to deliver Malawi’s essential health package fell from 74% in 2011 to 52% in 2015, meaning that fewer people are accessing crucial health services in many parts of the country. District and community health systems face significant resource constraints and inconsistencies related to the quality and availability of supplies and services, including a shortage of midwives and doctors who can provide obstetric and neonatal services.
This project is using the Community Health Strategy to mobilize communities and help them strengthen local health systems, improve the quality of health services, and increase access to and demand for priority health services in the target districts.
Project Strategies and Objectives
Revitalize HCMCs in targeted health facilities and oversee and report on the functionality of the committees.
HCMCs play a pivotal role in determining health facility projects and activities. They also reinforce human rights, accountability and the moral integrity of the community health system. However, some health facilities in the target districts do not have HCMCs, and those that do often lack the capacity to perform their duties.
To address these issues, CPAR project staff are:
- Conducting extensive consultation and collaboration with local community leaders and groups to obtain their input and build ownership and sustainability for the project
- Mapping all health facilities in the target districts to assess and report on the level of functionality of the HCMCs, the needs of the HCMCs and how CPAR can support them
A robust monitoring and reporting system is being put in place to ensure HCMCs are following guidelines and to monitor activities. This includes providing mentorship and conducting random inspections to verify that meetings occur, records are kept up to date, and regular reports to appropriate oversight bodies are made.
Increase immunization coverage in the target districts
Immunization is a proven and cost-effective public health intervention that saves millions of lives from preventable diseases every year. Malawi’s Demographic and Health Survey Report (2015-2016) shows that only 71.5% of children in Malawi are fully immunized; universal coverage is considered to be reached when 80% of the population is fully immunized. In addition, the Routine Immunization Performance Feedback report (2019) shows that the Lilongwe and Dowa districts have consistently high numbers of unimmunized children.
This project supports the United Nations’ Extended Program on Immunization (EPI) through the development and implementation of EPI micro plans to:
- Improve immunization access for all children in the target districts,
- Support the improvement of micro-planning at the health facility levels,
- Increase immunization coverage for all antigens,
- Ensure proper documentation of EPI data in the registers.
CPAR is using the Reaching Every Child approach to help ensure that every infant in the target districts is fully immunized with the required vaccines in the national immunization schedule. Community involvement is vital to accessing hard to reach areas; to that end, outreach work plans are being developed that include focus groups, home visits, drama presentations, and community gatherings to share information on immunization.
Strategies to increase immunization coverage include Reaching Every Child micro-planning, EPI data documentation, defaulter tracing, health worker mentorship, and community mobilization.
Facilitate the identification and establishment of emergency transport systems in the target districts.
Most communities and health facilities in the target districts face issues related to:
- Inadequate, limited, and expensive transportation for emergency referrals,
- A lack of timely access to emergency services,
- Long distances to the nearest health facility.
Through the mapping exercise, CPAR is developing a register of community health structures in the health facilities in the target districts. CPAR, the HCMCs, and the identified community health structures are working collaboratively to establish innovative emergency transportation systems for communities in Dowa and Lilongwe that are five kilometres or more from a health facility.
Part of this process includes holding open days to raise awareness of the concept of emergency transportation systems and also of the various systems that may be available, which could include stretchers, bicycles, wheelbarrows, carts, motorcycles, or other locally driven systems.
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