Poor infrastructure impedes access to health


ACCESS to quality maternal and neonatal healthcare remains a major challenge in Malawi’s rural areas with a majority of women and children still failing to access quality care and services.

The Sunday Times has observed that with a health system characterised by drug and staff shortages, lack of proper infrastructure is perpetuating the challenges.

For instance, at Linyangwa in Kasungu, women are delivering babies in the open because the clinic previously used for deliveries was destroyed in a heavy storm and it is yet to be rehabilitated. The only alternative women have is to travel a distance of about 50km to Kasungu District Hospital.


According to Gasten Muotcha, a medical assistant at the hospital, the development has been further compounded by financial challenges and a poor road network. Muotcha says this has led to an increase in cases of maternal complications and, in some cases, neonatal deaths which could be prevented.

“At least three women give birth at home or on the way to the hospital every day, which increases the risk for infections to the new-born and the mother,” said Muotcha.

In a quest to gauge the extent of the challenges being faced in Kasungu, this reporter embarked on a journey to assess the historical situation in the district. On February 20 2017, 30-year-old Chrissy Phiri delivered her sixth born daughter in a bush at midnight on her way to the district hospital.


She defied the odds to take herself through the baby delivery process in the middle of nowhere, while a hired young kabaza boy (bicycle peddler) waited for her at a distance. She wonders why the government, through Kasungu Municipality and the district health office, is not paying attention to the health challenges in the area.

“Nurses advise us to go and wait at the district hospital during the last trimester, but it’s impossible for most of us working on estates. Our bosses don’t allow that. The only solution is to have a maternity facility nearby,” Phiri lamented.

Esther Banda, who delivered her fourth born child at home in January, observed that in the wake of such inadequacies, campaigns on safe motherhood and neonatal health are futile.

“Health rights for women, children and the general population are being infringed upon, contrary to what nongovernmental organisations teach us about rights,” Banda said. Meanwhile, Linyangwa Clinic has been moved into the chiefs’ court two kilometres away from the old structure.

Community midwife Charity Kamphinda at Linyangwa says work at the new site is affected by water challenges. In a telephone interview, member of Parliament for the area, Alex Meja (Kasungu West-MCP), said plans are in the pipeline to construct an out-patient department (OPD) at Lunyangwa in 2018.

“Authorities are aware of the situation and we have drawn up a K40 million budget for an OPD. [Construction of the building] would commence next year if the budget is approved,” said Major. Commenting on the situation, National Initiative for Civic Education Regional Civic Education Officer for the North Vincent Kalawa said through their ‘Deliver Life Project’, they endeavour to help underprivileged women reclaim their maternal health rights.

The situation is no different in Karonga, where at Thawiro an old structure belonging to Wovwe Area Development Program has been turned into an antenatal clinic, while children under the age of five access services under a tree.

“We lack proper beds and storage facilities for various medical supplies; need I say that even issues of privacy and confidentiality are compromised for our pregnant women and those who come for family planning methods?” said Ruth Ngwalo, a community nurse and midwife technician.

When quizzed on why government continues to neglect the rural population in terms of health service delivery, Ministry of Health spokesperson Adrian Chikumbe said Capital Hill waits for the people at the grassroots to make demand.

“We can’t manage to have facilities at every 10km as stipulated by the World Health Organisation.

After all, we encourage people to stay healthy. Having clinics everywhere is tantamount to having a sick nation,” Chikumbe explained.

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