Anglican Council in Malawi Integrated Health Program
In the past seven years, remarkable efforts on malaria control have led to the reduction of malaria cases in the operation areas of Anglican Council in Malawi. The Anglican Council played a significant role by mobilizing communities to become the frontline in the fight against malaria through traditional dances, drama, school club competitions and malaria open days and building capacity for project coordinators, health workers, and volunteers which created behavioral change interventions that encouraged sleeping under treated bed nets and early treatment seeking for malaria; and distribution of LLITNs to households, Engagement of stakeholders and community influential leaders facilitated community ownership. The initiative has promoted a community response to tackle malaria in the four dioceses of Anglican Council in Malawi through partnership with communities, National Malaria Control Program (NMCP), health workers, peer educators, other stakeholders and the main donor, Episcopal Relief & Development. Beside remarkable contribution made by Anglican Council malaria project in Malawi in reducing mortality and morbidity caused by malaria in the operation areas, malaria and other childhood illnesses namely pneumonia and diarrhea still remain the major causes of deaths of children under five in Malawi, accounting for 18%, 23% and 14% respectively (MDHS, 2010). Most of these deaths can be prevented if parents know the risk and ways to prevent and treat these diseases. Children need access to quality health care such as growth monitoring, immunizations, prevention, treatment and control of these major childhood illnesses. Malawi however faces many challenges, including widespread poverty, weak institutional and human capacity, limited resources because of competing needs, deep-rooted harmful traditional practices coupled with lack of adequate health knowledge and challenges in transportation to access early treatment for complicated illnesses. The Anglican Council in Malawi seeks to address Maternal, Neonatal and Child Health (MNCH) issues through an integrated service delivery. This will encompass health promotion & prevention (primary focused on interruption of the disease at the household level with strong emphasis on SBCC), and facilitation for curative interventions with multiple diseases particularly malaria, diarrhea and pneumonia in communities who otherwise lack easy access to case management in health facilities. As there is significant overlap of symptoms and high co-infection rates of the three major diseases affecting children under five years, the project intends to promote community health service delivery for these diseases through the Integrated Community Case Management (iCCM) strategy, which is endorsed by the Malawi Ministry of Health (MoH) and the National Malaria Control Program (NMCP). In 2016, ACM plans to implement an integrated community-based health program with a strong emphasis on Social Behavior Change Communication to help contribute to the improvement of maternal and child health. Key constituents of the program include LLIN distribution (universal coverage), distribution of Vitamin A supplements and deworming tablets to children under five and diagnosis and treatment for malaria, diarrhea and pneumonia for children under five. The mass nets distribution will cover the entire program areas; however, the iCCM piece and the distribution of vitamin supplements and deworming tablets will be implemented in four of the project sites. ACM hopes to scale up after about 3 years to include the other project sites based on the impact in the four pilot sites.
Facilitators conduct community mobilization and program promotion, Form Savings with Education groups, Training of trainers for staff on Savings with Education methodology, Train volunteers on Climate Change Preparedness and New methods of Agriculture, Supervise trained volunteers, Conduct a baseline survey, Conduct planning and review meeting with volunteers, CHAM, health workers to review project progress, Conduct biannual planning and review meetings with Diocesan project staff to review project activities and finances, Conduct quarterly supervisory visit to Dioceses for technical support and motivation, Conduct quarterly project visit to health workers, HSAs, volunteers and school patrons for technical support and motivation, Conduct follow up visits for 600 volunteers, Train 20 project staff and Environmental health officers on integrated community case management (iCCM) and Social Behavior Change Communication, Negotiate agreements in country with the health services and relevant stakeholders for commodities' supply to HSAs, Regular coordination meetings with Ministry of Health and other health stakeholders, Procure iCCM drugs for the program, Improve referral system for HSAs to connect families to health facilities, Facilitate integration of HSAs data into Health Management Information Systems (HMIS),Community planning and action to solve transportation issues to health facilities, Conduct capacity building for 54 Health Surveillance Assistants (HSAs),Train 600 community volunteers on Integrated Community Case Management (iCCM),Diocesan Coordinators, Health Surveillance Assistants (HSAs) and volunteers reinforce key practices, adherence and referrals during home visits, focusing on mothers/primary caregivers, Distribute Vitamin A and Albendazole to children under five years, Conduct door to door follow up on nets usage to encourage consistent and correct usage of LLINs by beneficiaries, Conduct drama shows in communities on malaria, pneumonia and diarrhea, Commemorate World Malaria Day and other Special Health Events, Source and distribute 100,000 IEC materials on diarrhea, pneumonia and malaria, Sensitize community members on malaria, diarrhea and pneumonia, Distribute 1.2 million Long-lasting insecticidal nets to registered beneficiaries, Promote nutrition, WASH, disease prevention (diarrhea, malaria, pneumonia), signs/symptoms, appropriate home care, available treatments and when to seek those services
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