To consolidate and refine the Malawi MoH national diabetes/NCD response, with emphasis on capacity building and quality of care.
This second phase national programme support to Malawi from WDF will build on outcomes, structures and procedures successfully established under WDF14-938 (first phase national diabetes/NCD response support) and other preceding WDF-funded projects in Malawi (since 2008) and integrate interventions across all three regions of Malawi.
This second phase programme will encompass;
- District level awareness raising, prevention and community mobilisation
- Screening and outreach clinic services
- Integrated primary level care/onwards referral
- Patient support and monitoring with focus on adherence and retention
- Systematic patient/cohort level monitoring and evaluation, incl. with indicators on service delivery and supply chain
Noting the considerable achievements of preceding WDF funded projects (in particular WDF14-938), this second phase will also seek to consolidate a health system re-orientation and enhance quality of diabetes/NCD care through:
- Ongoing training based on a ‘mentorship model’ approach at clinic level, already applied by MoH and PiH in a pilot district and also based on PiH interventions in similar sub-Saharan Africa settings
- Analysis of supply chain and implementation of activities to address pipeline shortages
- Implementation of a ‘triaging model’ with multiple initial screenings (diabetes, hypertension, HIV, TB, nutrition etc) to be carried out at primary level with onwards appropriate care and referral; and
- Integrated HIMS patient data systems to be strengthened
All previously prepared and endorsed training, education and awareness material produced through WDF grants will be revised and adapted, incl. materials concerning diabetes foot care and eye care.
Notably, this second phase will also include type 1 diabetes based on WDF fundraiser activities and on PiH experience, with focus on the four referral hospitals in Malawi.
- Sensitisation and mobilisation of MoH district level health management team (DHMTs) and of DAM, CADH and DCT local representatives (incl DAM branch strengthening) completed in all districts, with 30 new radio listening clubs established and 25 sustained (55 in total), 2,160 community level awareness events convened and radio programmes aired, reaching out to very large population groups in all three regions of Malawi.
- Close to 500 HCPs and DAM/community leaders provided basic training on diabetes/NCD risk factors and screening, and approx. 480 screening camps held with more than 50,000 at risk people screened for diabetes and hypertension and referred to primary/secondary level.
- More than 600 HCPs trained on diabetes/NCD care, representing 115 diabetes/chronic care clinics at different levels, and with more than 250 of these HCPs enrolled into ‘mentorship model’ (approx. 1,800 sessions).
- Targeted clinics provided necessary equipment and at least 100,000 patients (of these 20,000 diabetes patients) to have received improved care, education and monitoring.