By Chikondi Manjawira
Malawi can achieve Universal Healthcare Coverage through the implementation of the National Community Health Strategy (NCHS) which was launched in July 2017, the Ministry of Health has said.
In an interview with Maravi Post, Doreen Ali — Deputy Director for Preventive Health Services responsible for Community Health — said the ministry plans to recruit 7,000 health surveillance assistants (HSAs) and construct 900 health posts in hard-to-reach areas countrywide by 2022.
“This five-year plan is not a standalone strategy. It will work together with the Health Sector Strategic Plan 2. At the community health level, we need adequate human resource to deliver the National Community Health Strategy, meaning we have to close the existing gap of 7,000 HSAs. These are the core community health workers on the ground.
“One HSA will be responsible for 1,000 people, which will make HSAs available to the community for 24 hours a day, as opposed to the current ratio of one HSA to 2,500, which makes it difficult for community members to access basic health services,” Ali said.
On the funding to the NCHS, Ali said the department has set aside some money for infrastructure and human resources as it continues to mobilise and lobby for more resources from partners such as non-governmental organisations.
Kondwani Mamba, President for Malawi Environmental Health Association, described the NCHS as an important tool which has come at the right time.
Mamba said Malawi is coming from a background where the community health system was not well coordinated due to lack of guidelines and policies.
He added that the strategy would harmonise community health services to make sure that the management of community health system is well managed and organised to have improved community health indications at that level.
“In health, we also talk about cost effectiveness of interventions. There is evidence that community health provides the prevention part of the health system. Hence, recruiting more community health workers is likely to increase workforce at that level and, therefore, increase access to available effective interventions at community level which in the long run will reduce mobility and mortality,“ Mamba said.
Amref Health Africa in Malawi is one of the partners promoting and monitoring the implementation of the NCHS to produce the desired outcomes such as Universal Healthcare Coverage.
Amref Health Systems Advocacy Manager Benedict Chinsakaso said community health workers are the first point of contact on health at community level before a health facility.
He further said that when one talks about universal health coverage, the main emphasis is that nobody should be left behind.
“If someone needs health services they should access them without problems, without facing financial difficulties. So, the presence of community health worker at community level does increase access to health services by the community. In a way, it means we are moving towards achieving universal healthcare coverage because community health workers definitely improve access to community health services by members of the community,” Chinsakanso said.
The National Community Health Strategy highlights six core objectives: health service delivery, human resources, information, communication and technology, supply chain and infrastructure, community engagement and leadership and coordination.
About US$421 million is needed for a successful implementation of the strategy which will run until 2022.