Maternal, Neonatal and Child Health Training & Systems Strengthening Project
Development PartnerDuration2013 - 2016
Focus Areas
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Location
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Project Overview
The "CHAM Maternal, Neonatal, and Child Health Training and Systems Strengthening Project" (MNCH Project) is a collaboration between Norwegian Church Aid (NCA) and CHAM. The project started in October 2013. Some portions of the project ended in 2015, but other portions have extended into 2016. The project aim is to reduce maternal, neonatal, and child mortality in Malawi.
The MNCH project was initiated in 12 member units under NCA coordination, and it was phased up in 13 other facilities under CHAM Secretariat coordination. The project involved three key result areas (listed above at right), and under these results areas numerous activities have been undertaken, including:
The MNCH project was initiated in 12 member units under NCA coordination, and it was phased up in 13 other facilities under CHAM Secretariat coordination. The project involved three key result areas (listed above at right), and under these results areas numerous activities have been undertaken, including:
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Project Outcomes
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1. Improved maternal, child and neonatal health service delivery in CHAM units
Prior to the project, 1st trimester ANC visits made up 4.3% of total ANC visits. Attendance more than doubled to 9.7% of total visits. Male attendance at ANC visits almost tripled, from 13.9% of total visits to 40.4% (see photo at right). Neonatal death rates in the units decreased from 6.9 to 5.5 per 1000 live births, and births occurring before arrival to health facilities decreased from 7.2% to 4.5%. Outcomes were inconsistent across and within facilities, with many facilities succeeding in some result areas while struggling in others. Generally, facilities with greater 1st trimester ANC attendance saw greater improvement across indicators. 2. Improved quality of nursing and midwifery training in CHAM training colleges Training colleges were mentored and monitored to increase procurement capacity, reduce fraud and improve training. 19 computers, 48 books and 2 printers were procured for 10 training colleges. NCA also worked with CHAM to help colleges improve management and expand research capacity. With the help of NCA, numerous CHAM training colleges were able to establish research protocols and conduct research projects. 3. Improved capacity of CHAM Secretariat to lead and coordinate CHAM units IT equipment and services were installed at the CHAM Secretariat. This strengthened internet connectivity (reducing downtime from 8 hours/week to less than 1 hour/week) and allowed for the creation of institutional emails for facilities. This increased email connectivity at the facility level from 45% to 100%. 70% of facilities now access their email (up from 40%), improving CHAM's ability to manage and monitor its facilities. CHAM also upgraded its payroll and finance systems, reducing monthly payroll errors reported by the health facilities and the Ministry of Health. This has enabled CHAM to minimize fund loss from payroll errors and gain credibility and trust among stakeholders. Challenges Despite improvements in capacity at the Secretariat, capacity challenges remain at the facility level, especially regarding IT, financing and communications. Staff turnover at implementing facilities also affected project continuity, and potentially decreased efficacy. Despite successes, maternal mortality has not significantly changed in target facilities. Deaths resulted from hemorrhage and delayed referral from communities/primary care. Future intervention should target maternal mortality specifically. |
Men escort their partners to ante-natal care visits at Mwanga Health Center
A community outreach clinic at a health post run by Mvera Health Center
The old incinerator at Makapwa Health Center (left), and the new incinerator that is under construction
MNCH Village Savings & Loan Committee Training at Thomas Health Center
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