Inter Aide is partnering with Lilongwe District Health Office (DHO), Mitundu Health Area and each Health Centre to make improvements to health services. See the Program Document for further details on specific activities.
Staffing and scheduling
Staffing shortages are a significant problem in each Health Centre. Inter Aide works with the Lilongwe DHO to ensure all necessary personnel are present at all time. The program can therefore pay a staff salary until Lilongwe DHO can take over.
Inter Aide is also working with the Health Centre management team to review the staff schedule and identify areas where efficiency improvements could be made. This is particularly focussed on schedules for the Health Surveillance Assistants (HSAs) to ensure they spend the majority of their time in the community. More recently, this support extended to all services of the health centres (out-patient department and maternity for instance) through monthly planning meeting and quarterly evaluation.
The Health Surveillance Assistant for Khuzi station marks which community activities were completed according to the schedule, Katchale Health Centre, 30th June 2014
Supplies and equipment
Stock control to prevent theft and misuse are addressed by revitalising the Health Centre Management Committee who is supposed to oversee control mechanisms. As part of their training the Health Centre Management Committee are taught about the stock control processes at the Health Centre. Following the training they conduct regular audits and checks.
Inter Aide sometimes purchase essential items needed for the maternity ward. This includes beds, mattresses, solar lighting, bed sheets, blankets, and newborn weighing scales. Liliongwe DHO will send technicians to conduct essential maintenance on the solar lighting, roofing and water supply.
Mattresses, sheets, blankets and bed nets being delivered to Katchale Health Centre, 16th July 2014
Transport support
Lack of transport makes it difficult for government supervisors to perform their duties. It also causes delays in the delivery of drugs and supplies.
Inter Aide will loan a motorbike to Katchale Health Centre to be used for supervision and collection of drugs and supplies. Fuel for the motorbike will be provided by Lilongwe DHO. Inter Aide has also purchased a new set of bicycles for the HSAs to allow them to conduct activities in their villages. Katchale Health Centre has taken responsibility for maintenance of the bicycles.
The Inter Aide vehicle will also available throughout the program to help move large equipment and supplies from Lilongwe DHO to Katchale Health Centre.
Village Clinics
Village Clinics provide treatment to children under 5 years in the most remote areas of the catchment. They are run by HSAs who can treat malaria, diarrhea and pneumonia. However, the baseline survey showed that most Village Clinics are underused. The HSAs live a long distance from the Village Clinic location so the clinics are rarely open.
The most immediate need for the Village Clinics is to have the HSAs living in the catchment area so that the Village Clinics are open every day. As a short-term emergency solution Inter Aide will rent a house in each of the three Village Clinic catchment areas. If the set-up is successful then the community will build a house for the HSA with assistance from Inter Aide.
Village clinic committee members, Inter Aide staff and the builder mark out the foundation of an HSA house, Khuzi station, 14th July 2014
Lilongwe DHO has committed to train the senior HSA so that they are able to conduct supervision of Village Clinics. They have also committed to help the HSAs running Village Clinics to use the mobile phone system cStock for reporting their drug consumption and ordering supplies. This should reduce the number of drug shortages.
Supervision and feedback
Lilongwe DHO, Mitundu Health Area and Katchale Health Centre will develop a supervision schedule for activities. Inter Aide will assist by providing transport for supervision and working closely with the Health Centre supervisors.
Patient satisfaction surveys will be conducted every six months at Katchale Health Centre and Village Clinics. Feedback meetings will be held with the Health Centre staff and Health Centre Management Committee to review the results and identify areas for improvement.
