Umoyo Wa Ana Athu – Our Children’s Health

The Malawi - Else Kröner child health programme: levering synergies for prevention and care

Malawi has a predominantly young population, with approximately 52% aged less than 18 years. Population projections indicate that this figure is expected to double by 2050. While the threat of infectious diseases has diminished, NCDs now constitute a significant portion of the disease burden in Malawi (figures 1a and 1b). In 1990, NCDs and injuries combined accounted for 33% of the total disability-adjusted life years (DALYs) among 5 to 19-year-olds in Malawi. By 2019, this rate had risen to 46%. 

Despite the pressing need to respond to this epidemiological shift, healthcare workers are ill-prepared to address the changing health needs. Inadequate and outdated training opportunities and resources for preventing, diagnosing, and treating child NCDs contribute to a lack of skills among healthcare workers to effectively identify, manage, or refer children with chronic conditions. Another challenge is that existing guidelines for NCD management primarily target adults leaving out NCDs among children and adolescents. This poses a particular challenge for those working in the field of child healthcare.

What is done?

This project aims to achieve the following goals: 
  • Develop national NCD child health services guideline package: guidelines, training materials and communication tools, including an app
  • Roll out the NCD package´s elements nationally, prioritizing geographical areas most in need
  • Monitor and evaluate the NCD package´s impact on existing child health services

How is it done?

                    1. Child Health NCD Guidelines

The guideline development first started with reviewing existing national and international paediatric NCD guidelines (desk review). During the phase, we considered the varying levels of healthcare facilities and available resources, considering the perspectives and experiences of over 30 senior paediatricians who author the guidelines and work in district and central hospitals across Malawi. In order to make the guideline comprehensive, each chapter encompasses not only clinical components but also integrates public health aspects, covering health promotion and prevention. The final product undergoes internal and external reviews conducted by the project´s core members who are paediatricians, as well as external reviewers and relevant stakeholders such as the MoH, Directorate of Quality Management etc.

                       2. App

A user-friendly app (name to be provided) is to be created to serve as a practical tool for delivering guideline content and facilitating interactive training and collaboration among healthcare workers. The app is designed to be used offline and includes knowledge-check questions in each chapter. We will keep records of the number of downloads and uninstalls to track the app´s utilization. Additionally, feedback will be collected from healthcare workers to evaluate the overall acceptance and usability of the app.

                       3. Guideline implementation – Trainings of Trainers

Under the guidance of PACHA, the guidelines will be implemented initially through group training sessions utilizing the paper-based guidelines and the newly developed app.

                       4. Information, Education, and Communication (IEC) materials

IEC materials will be developed and deployed to inform patients, including children and their caregivers, about the importance of prevention, early screening and detection of NCDs, and the associated risks, as well as preventive measures. These materials aim to raise awareness and prevent negative consequences stemming from chronic conditions. 

                         5. Monitoring and Evaluation (M&E)

The M&E process aims to track the progress of the entire project and assess its success using the method of an interrupted time series analysis. Data collection and evaluation will take place in all four central hospitals (Blantyre, Lilongwe, Zomba, Mzuzu) as well as the following district hospitals: Phalombe, Mwanza, Mchinji, Nsanje, Nkhatabay and Dowa, along with six designated health centers namely: Mpamba Health Center, Mponera Rural Hospital, Kapiri Health Center, Migowi Health center, Tulonkhondo Health Center and Mbenje Health Center. 

The primary data sources include the Health Management Information System, patient´s mastercards on paediatric NCDs, exit interviews with caretakers, and surveys of healthcare workers.

Scroll to Top