MRF’s healthcare and awareness initiative in

Malawi

MRF Meningitis Symposium

Bristol

3 October 2012

Barriers to Treatment

MRF funded research into barriers of recognition and action in treating ABM in Malawi

Recognition barriers: • Misdiagnosis of malaria or other illness• Low recognition of severity of illness and

need for social validation in community

Barriers to Treatment

Action barriers: • Priority focus on maternal health• Negative perceptions of health services

(wait time, attention by health workers)• Financial constraints in community• Gender and age-based decision making

in community

Situation Analysis• Patients queue and wait for hours at

primary clinics- first come, first served• Limited number of health workers,

equipment and supplies• Patients have to wait hours/days for

ambulance transport• Some die while waiting for assistance or

transport

Action Meningitis• Targeting health workers to break down

barriers to treatment, improve treatment rates and healthcare delivery in Malawi and improve outcomes in children

• Public awareness messages of meningitis signs & symptoms to raise awareness amongst public and prevent misdiagnosis

Primary Health Clinics• Priority: Improve identification of severe illness in

children for treatment & referral to hospital using WHO triage system

• Urban and peri-urban clinics with varying catchment populations

Primary Health Clinics• Training frontline health workers• Evaluating effectiveness and feasibility of triage

system

mHealth & ETATUsing mobile technology to improve health (mHealth)

to establish WHO Emergency Triage Assessment and Treatment (ETAT) system in clinics

Emergency

Priority

Queue

mHealth & ETAT

• Developing phone application of ETAT for health workers to screen children upon arrival/ in queue

• Using phone data to track ETAT classification and hospital referrals

Community Awareness

• Health Talk weekly radio programme on MBC- national radio

• Health research news to Radio Listening Clubs and public

• 8 episodes focusing on meningitis to improve recognition in communities

Community Awareness• Ambi-bikes at villages/ clinics for

medical transport

Partners• Partnering with Malawi-Liverpool-

Wellcome Trust, Malawi Ministry of Health, hospital and primary clinics in Blantyre

• Working with D-tree International for mHealth component

• Assessing feasibility and expansion across Malawi

Project Outcomes• Prioritise ill children and reduce wait

times at clinics• Track referrals to hospital for severe

illness in children• Increase knowledge and awareness of

meningitis amongst public • Provide ambi-bikes for medical

emergency transport