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Chitekesa’s long walk to quality health services

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HAPPY—Andisambula

Until 2017, Andisambula Likhomo of Chitekesa Village, Traditional Authority Jenala in Phalombe District, used to send her mother to the hospital to receive treatment on her behalf whenever she was sick.

Then, 42-year-old Andisambula, a visually impaired person, would surrender her health card so that her mother could use it to access medical support for her at the nearby Chitekesa Health Centre.

“I was not interested in going to the hospital for medical assistance because the facility itself was not easily accessible for people with disability and, apart from that, some healthcare workers at the health centre used to ridicule me. That is why I resorted to having my mother go to the hospital for me,” Andisambula says.

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That is not the only challenge Andisambula and other people, especially women and children, used to face whenever they wanted to access medical support in the area.

Chitekesa Health Centre had no ambulance, making it difficult for the facility to transport serious cases to the hospital at the Boma.

The lone ambulance available was also servicing other healthcare service facilities, making it difficult for people at Chitekesa to access the service during emergencies.

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As a result, community members used to dig deeper into their pockets to pay a sum of K10,000 in transport costs whenever they were referred to the district hospital many kilometres away for secondary health care.

“It was almost impossible for many of us to pay that much for transportation alone when we also had many other challenges at home requiring money. So, we would opt to stay home and hope for the best,” Andisambula says.

Another woman, Elina Sonkho, could not easily access the health facility in Chitekesa Village.

Elina, however, faced challenges when time came for her to deliver a child.

“The maternity ward was just a room along the corridor, where everyone could pass by and see what was going on. There were no curtains and no privacy at all,” narrates the 40-year-old woman.

Apart from the lack of privacy, Chitekesa Health Centre had no reliable water source.

This affected operations at the primary healthcare service facility which provides services to over 44, 000 households in the area.

Well, that was years ago, before community members started actively participating in issues that affect them.

Now, the District Health Office (DHO) has provided the facility with an ambulance, which has lessened transport challenges; potable water has been connected and the maternity ward has curtains, which are providing the much needed privacy to women when giving birth.

In addition, pavements have been constructed so that Andisambula and other people with disability can be accessing services at the facility.

“Iam now go to the facility on my own and even the attitudes of the healthcare workers has changed,” Andisambula says.

Had it not been for a radio listening club that community members formed at the height of the challenges they were facing, particularly on access to healthcare services, Andisambula and Elina would still be facing challenges familiar in most rural communities.

The club has been advocating the provision of quality healthcare services in the area by acting like a bridge between authorities and the community.

Apart from conducting sensitisation campaigns in the area, the club uses a recorder to record locals on the challenges they face.

The recordings are then played to authorities in the district for their action.

The club then records responses from the authorities, which are also played back to community members.

“Recordings of the grievances act as evidence of how people on the ground are feeling; as such, the authorities have first-hand information on the situation and, by playing the responses, we ensure that community members hear for themselves what the authorities have in store for them.

“As a result, and over time, service provision, even at the health centre, has improved,” says Joseph Mukhawa, chairperson for the radio listening club.

It is through such acts that the people at Chitekesa can take those in authority to task on issues such as access to quality healthcare services.

“Whenever there are concerns over the performance of healthcare workers, people voice out their concerns,” Mukhawa says.

The sentiments are echoed by Senior Health Surveillance Assistant at Chitekesa, Daker Umali, who says radio listening clubs have helped improve the provision of healthcare and social services in the area.

“Through its work, the radio listening club has assisted in the construction of a mortuary and some toilets around the hospital. In fact, the club has been instrumental in ensuring quality standards during the construction of such facilities,” Umali says.

Charity Oxfam in Malawi, with funding from Oxfam Ireland, has been implementing a programme aimed at promoting good governance in the health sector.

The programme aims at increasing access to essential services in Malawi through holding duty bearers accountable.

In Balaka and Phalombe, Oxfam has partnered Development Communications Trust (DCT) to implement the programme.

Project Coordinator at DCT Thandi Mchiswe says, since the project started in 2017, a lot has changed in as far as universal health coverage is concerned.

“Since we started implementation in 2017, community members, including youths, women and people with disabilities, have been in a position to speak on issues that affect them,” Mchiswe says.

According to Mchiswe, the project has also led to a rise in demand for quality healthcare services by community members, including in rural areas.

Malawi has a proud history of delivering free healthcare services to citizens but bypass fees for hospitals, lack of resources and personnel have in the recent past caused hardship by excluding poor people from accessing services they need.

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