Impact Stories

Malawi, Lilongwe District (2013-2016):
Enhancing Team Cohesiveness for Better Health Outcomes


Lack of Team Cohesiveness and Commitment

Lilongwe District faced issues with low attendance at monthly meetings to discuss Prevention of Mother-To-Child Transmission (PMTCT) issues, indicating a lack of commitment to a team-based approach. The District Health Officer (DHO) was not providing leadership, and team members were disengaged and overworked, compromising the quality of service delivery. 


Deliberate Actions to Improve Team Cohesiveness

The transformation began after a poor performance at a review meeting prompted embarrassment and a realization of the importance of teamwork. The DHO initiated regular team meetings to discuss challenges, improved communication through a WhatsApp group, and encouraged sharing of workplans and updates. This increased resource utilization efficiency, particularly for facility visits. The DHO also promoted open dialogue and peer support, encouraging team members to offer constructive criticism without fear. A champion was appointed to lead mentorship sessions, reducing dependency on the DHO and fostering innovation.


Enhanced Teamwork and Improved Health Metrics

The focus on teamwork and communication led to:

  • Increased use of data, with updated monthly data readily available.

  • Improved understanding of contributing factors to challenges.

  • Better utilization of district partners for improved outcomes. 
    These changes resulted in increased HIV ascertainment in ANC from 91% to 98% and early infant diagnosis from 13% to 39% over 18 months. The team demonstrated a strong sense of oneness and shared purpose, significantly enhancing service delivery and health outcomes. 

Lessons Learned

Eastern Cape Province, South Africa