K4Health Malawi Pilot Project
The one-year Knowledge for Health (K4Health) Malawi Pilot Project aims to improve the exchange and use of family planning/reproductive health (FP/RH) and HIV/AIDS knowledge among program managers and service providers at the national, district, and community levels to improve FP/RH and HIV/AIDS services. Funded by the U.S. Agency for International Development, the project is implemented by Management Sciences for Health (MSH) and is part of the global K4Health Project, led by the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs in partnership with MSH and FHI.
The large majority of Malawi’s population (83%) lives in rural areas. Health services are largely delivered in community health centers and district hospitals that can be miles from local villages. Malawi’s Ministry of Health (MOH) has been working with MSH and other partners to revitalize a cadre of volunteer community health workers (CHWs) to bring contraceptives and FP/RH and HIV/AIDS education directly to the rural population. Management teams at district hospitals train and supervise the CHWs.
However, a large information gap among program managers and service providers is challenging the MOH’s outreach effort, as well as other FP/RH and HIV/AIDS service delivery efforts. Health care professionals in Malawi responding to a K4Health health information needs assessment reported that they lack up-to-date and relevant FP/RH and HIV/AIDS information necessary to do their work. Even when information exists, it is scattered and difficult to find. In addition, CHWs rarely receive updates after their initial training, including on new national or district guidelines or protocols.
In order to strengthen FP/RH and HIV/AIDS services, the K4Health Malawi Pilot Project works to improve access to and promote the use of essential health information among program managers and service providers, including CHWs, at the national, district, and community levels. The project focuses on three key intervention areas:
- At the national level, the project established the Knowledge Management Taskforce to manage and disseminate technical information, including centralized “toolkits,” or electronic libraries of essential resources. Four Malawi Toolkits on FP/RH and HIV/AIDS topics include information to support the implementation of national policies and standards, communication materials in the local language, Chichewa, and other locally relevant materials.
- At the district level, two District Learning Centers (DLCs) at hospitals in Nkhotakota and Salima provide a range of resources, including print materials and opportunities for face-to-face training and networking. The DLCs also house computers with free access to online and CD-ROM-based learning, including the Malawi Toolkits.
- At the community level, the project worked in collaboration with Frontline SMS and the Ministry of Health to create an SMS-based mobile phone network between district health centers and CHWs. District health centers use the mobile phone network to alert CHWs about new resources, training opportunities, and changes in protocols through SMS messages. In addition, CHWs send SMS messages to the district management team to report important events such as stock-outs and request specific technical information, for example, about contraceptive side effects.
Since the launch of the project in May 2010, the K4Health Malawi Pilot Project:
- Distributed 663 mobile phones and solar chargers to CHWs in Salima and Nkhotakota districts, serving a catchment area of 652,326 Malawians. CHWs have sent over 1,000 SMS FP/RH and HIV messages to the district hub and the district management team has sent twice as many messages to the CHWs. The mobile phone network has provided prompt responses to emergencies, for example, high-risk pregnancies, and outbreaks such as measles, subsequently saving lives. It also has reduced stock-outs among CHWs.
- Published four Malawi Toolkits, on Family Planning, Young People and Reproductive Health, Maternal and Neonatal Health, and HIV/AIDS.
- Establish two DLCs with 11 computers, staffed by K4Health and the MOH. Over 3,000 people have visited the DLCs to receive basic computer training, search for medical information, use the K4Health Malawi Toolkits, and access print health information resources.