Making Quality Health Care a Reality in Malawi

Nisa PatelArticle, News

Village Health Worker Eneles Manyamba holds Violet Paolo's daughter, Vanessa, after their six-week postnatal checkup at Chifunga Health Center in Neno, Malawi. Photo by Jeanel Drake / Partners In Health

Village Health Worker Eneles Manyamba holds Violet Paolo’s daughter, Vanessa, after their six-week postnatal checkup at Chifunga Health Center in Neno, Malawi. Photo by Jeanel Drake / Partners In Health


Violet Paulo, a 40-year-old woman living in Neno, Malawi, was pregnant with her fifth child last November when she learned she might have preeclampsia—or high blood pressure—that could harm her and her baby if not treated. Eneles Manyamba, a Partners In Health village health worker, noticed her swollen ankles and urged her to visit Chifunga Health Center for tests and monitoring. Paulo was able to stay in a maternity waiting home for the last week of her pregnancy, and on December 26, a midwife helped Paulo give birth to a healthy girl, Vanessa.

Paulo’s experience was unusual. Millions of Malawi’s poor don’t have access to health care. Normally, public clinics in rural areas like Paulo’s fall into disrepair or charge fees people can’t afford. Women cope with pregnancy without medical care and most often deliver their babies at home. As a result, thousands of women in the country die every year from complications during pregnancy.

People with other health issues face the same challenge. Anyone suffering HIV, tuberculosis, malnutrition, and chronic diseases such as diabetes and cancer can do little about their illnesses without health care. The road to recovery is steep, diseases spread, and people are constantly fighting ill health. As such, the life expectancy of the average Malawian is only 54 years old.

PIH, known in Malawi as Abwenzi Pa Za Umoyo, has been working to change this since 2007. Starting with individuals like Manyamba, PIH has brought care to people’s homes by training village health workers to check on people living in their communities. Manyamba makes sure malnourished children get treatment, pregnant women receive prenatal care, and sick individuals have the medicine they need. She does this by connecting people with one of the 12 rural clinics and two hospitals PIH has renovated and built in Neno district, where most of PIH’s efforts are focused. She organizes their checkups and goes with them to their appointments.

Chifunga Health Center is one of the clinics where Manyamba will travel with patients, and where clinicians who are trained by PIH provide quality comprehensive care. Patients are often very sick with multiple diseases and receive treatment free of charge. Women go for prenatal and postnatal checkups at the clinic, and to deliver their babies. Anyone in need of evaluations for more complex illnesses such as cervical cancer or conditions requiring surgery are referred to one of the hospitals PIH supports. After patients’ appointments, Manyamba and other village health workers will help them follow their treatment regimens and keep track of their progress.

In the last decade, PIH has treated tens of thousands of people and the demand for health care remains high. Every morning, village health workers have long lists of patients to see and clinic waiting rooms are overflowing. But PIH collaborates closely with Malawi’s Ministry of Health to ensure the work contributes to strengthening the country’s national health system. The aim is not just to improve health care in Neno, but across the country by using Neno as model for public health authorities to emulate in other districts. PIH’s long-term goal is to ensure every Malawian has access to quality health care.

Paulo’s story is a testament to what hardworking village health workers, a functioning clinic, and a strong public health system can do. It shows how quality health care can reach people who have so long struggled without it. And it’s an example of what PIH aims to achieve across Neno—and the country.

During one of Manyamba’s visits to Paulo’s home, the two women chatted easily. Manyamba has now helped Paulo through three of her pregnancies over the seven years they have known each other. “She’s a constant support,” said Paulo.

See Paulo’s story in pictures.

Partners In Health is a non-governmental organization that provides quality health care to people living in poverty around the world. The organization works closely with national governments to strengthen public health systems and ensure improved and far-reaching health care lasts for the long-term. GBCHealth supports PIH through the Health Credit Exchange, a new and innovative platform to connect companies, donors and philanthropists to vetted health programs that receive funding entirely based on performance.

Nisa PatelMaking Quality Health Care a Reality in Malawi