Zomba Central Hospital
In 2011, Malawi became the first country to adopt Option B+ which provides universal life-long ART for all HIV infected pregnant and breastfeeding women regardless of clinical or immunological stage. We were positioned to assist in the effective implementation of Option B+ in all nine districts in the Central region. We also worked very closely with the Department of HIV and AIDS (DHA) and the Central West and Central East zonal health management teams. Egpaf and mothers2mothers were integrated into the district teams, with Egpaf also providing co-funding for review meetings. It was in Malawi Central that the coaching and thought partnership phase was increased from one to two years as we realised after one year, teams were not fully prepared to sustainably continue with the new way of thinking with no support.
We worked closely with DHA to improve data quality within the pMTCT program. We facilitated the standardisation of indicators across all nine districts as well as the amendment of data collection tools that would give districts access to current data and thus allowing them to make program decisions with agility, driven by data.
The use of WhatsApp as a platform for continuous inter-district brainstorming and problem solving in between review meetings was piloted successfully, leading to its adoption even at district team level to enhance communication amongst the district management team.
Programmatic improvements were also realised across all tracer indicators. Of note was the significant improvement of the proportion of Infants born to HIV positive women receiving DNA PCR test within 2 months. This was attributed to the collection of context specific solutions developed by districts.
At the end of the two year implementation period, the ministry champions within DHA successfully identified existing platforms they could leverage for continuity of the review meetings, effectively demonstrating asset based thinking.