Chipatala Cha Pa Foni (Health Center by Phone)

Chipatala Cha Pa Foni (Health Center by Phone)

MalawiMalawi
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Growth
Budget: 
$250,000 - $500,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

VillageReach is a non-profit social enterprise with a mission to improve health by increasing access to quality healthcare in remote, underserved communities.

About Project

Problem: What problem is this project trying to address?

Malawi has one of the highest maternal mortality rates in the world and very high rates of mortality for children under five. Despite these risks, there are few resources for medical decision making among pregnant women and new mothers in Balaka, Malawi. This leads a two-fold problem: a) when faced with a potential illness, pregnant women and mothers may go to doctor unnecessarily, wasting time and large portions of their family’s income while further stressing an already over-burdened health system and b) pregnant women and mothers decide to delay seeking care and, if an illness becomes more severe, it may be too late to reach help because of lack of transportation, poor roads and long distances to health centers.

Solution: What is the proposed solution? Please be specific!

Our solution is a maternal and child health hotline known as Chipatala Cha Pa Foni (Health Center by Phone). The hotline allows residents of Balaka district to call toll-free and ask advice on their pregnancy and/or the health of their young children. Hotline workers give advice on common pregnancy and childhood issues and refer those reporting danger signs to the nearest health center. In addition, pregnant women and caretakers of children under five can register for personalized health education messages about maternal or child health. Voice or SMS messages are sent weekly to registrants’ phones or, if a registrant doesn't have a personal phone, messages can be retrieved by using a community phone. Community volunteers conduct outreach to inform the community of the hotline’s existence and purpose as well as explain how to use the toll-free number. The hotline is currently available 12 hours per day, 7 days a week.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

The hotline workers are trained in providing maternal and neonatal health advice as well as integrated community case management for common childhood illnesses. When a community member calls, a hotline worker assesses the reason for their call and any symptoms present requiring care or just health advice. Based on this information, the hotline workers provide the relevant advice according to protocol or refer the caller to an appropriate health facility if needed. Topics of calls range from danger signs needing emergent care to women calling to learn their expected due date. Callers are provided with one-on-one health counseling with a care provider and are empowered to provide home based care and/or seek appropriate care for themselves or their children when appropriate. In addition, callers are registered for the tips and reminders service at the time of their call. The tips and reminders service provides women the opportunity to receive text messages or listen to recorded messages about how to care for themselves and their infants. Messages are targeted to provide relevant and timely health information and reminders based on the stage of pregnancy or age of child such as reminders for ANC visits, birth planning, immunization timing, and the promotion of positive health behaviors such as mosquito net use and exclusive breastfeeding. This program works with referral health facilities and community health workers to improve the health services delivery provided and to better prepare them for referred cases.
Sustainability

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Globally, efforts to improve maternal, neonatal, and child health are widespread. Promotion of positive health behaviors through mobile devices has been employed in countries such as South Africa and Ghana by various organizations that we see as our partners. In Malawi, eHealth is advancing through the work of organizations such as D-tree and Baobob Health Trust, however, we have not met any other organization implementing a project that incorporates a toll-free hotline for health information and advice. Because we share the primary motivation of improving the health of women and children, we have been able to share our experiences, content, and our lessons learned. In Malawi, we work closely with the District Health Office and other organizations to ensure our efforts are complimentary.
Team

Founding Story

In 2009 and 2010, Concern Worldwide Innovations in Maternal, Newborn and Child Health and the Ministry of Health-Malawi launched the Share an Idea, Save a Life campaign. More than 6,000 ideas for improving maternal and child health services were submitted from across the country. One of the winning entries was a 24-hour case management hotline to provide information on maternal and child health issues. VillageReach was chosen as an implementation partner to design, implement, and test this idea and thus Chipatala Cha Pa Foni was born. The success of the first year of CCPF can be seen not only in the large number of users for the hotline and tips services and their positive response, but also in the foundation that was laid for continued success and a transition out of the pilot stage to scale-up. In addition to development of the technological aspects of the project, Year One included several important foundational activities such as MOH relationships and program material development.
About You
Organization:
VillageReach Malawi
About You
First Name

Stacey

Last Name

Cunningham

About Your Organization
Organization Name

VillageReach Malawi

Organization Country

, BLK

Country where this project is creating social impact

, BLK

How long has your organization been operating?

1‐5 years

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Innovation
How long have you been in operation?

Operating for less than a year

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Access, Quality.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

Our goals are to increase the coverage of high-impact MNCH services and practices; and to improve the quality of MNCH client/case management by;
• Providing timely and quality advice in response to common illnesses and danger signs related to maternal and child health issues,
• Providing direct access to the health system for community members that are often unreached and underserved, and
• Increasing the uptake of maternal and child health interventions, use of the health system, and improved community perceptions of quality of care.
VillageReach intends to expand our impact by rolling out the intervention to new Districts and by creating a model that can be used throughout Malawi and other countries where distances to health centers make accessing healthcare a challenge.

What has been the impact of your solution to date?

In the first six months of implementation the hotline has received over 3,000 calls. In addition, over 2,000 women have registered for the hotline’s tips and reminders service. As intended, the hotline is saving women time and money and helping them decide when to go to the health center. A user of the hotline noted, “I am now able to get help even before reaching the hospital.” In addition, women note that they appreciate being able to talk with a health provider freely as opposed to being rushed through a health center visit. Similarly, employees at the health centers are noticing a difference. One health care worker said that the hotline is “helping to reduce the flow [at the health center] because women [used to come] for reasons that were not treatable, now they are caring for themselves at home. Now they are coming with genuine problems.” Users of the hotline have also noted that it is helped them know what to expect during their pregnancy and be more prepared for delivery.

What is your projected impact over the next five years?

Our vision is that uptake and coverage of high-impact MNCH services such as timely ante-natal care, facility based delivery, and preventive and curative health services for children under-five will be increased dramatically across Malawi. In addition, the actual and perceived quality of the high-impact MNCH services will be improved to ensure the highest benefit to the women and children who receive them. We envision that this intervention will be adopted by the Ministry of Health-Malawi and/or other partners to be used on a national level. We have designed the intervention and the staffing to be easily adopted by ministries of health or other partners and we have used open source software in the project in order to allow for sharing of code and easy transfer to other partners.

What barriers might hinder the success of your project? How do you plan to overcome them?

Barriers to the success of our project are largely financial resources for ongoing support and scale-up. We are working closely with Balaka District as they undergo their District Implementation Plan to ensure that CCPF is incorporated into the district plan. Telecommunications costs account for the largest financial need. We are working with telecommunication providers to provide reduced cost packages for governments and partners in the scale-up efforts. Finally, we are working to promote the achievements of CCPF so that other organizations can assist in the expansion of the service nationally and in new countries.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

Position CCPF for national uptake

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Quantify cost-effectiveness of the program as evidence for uptake

Task 2

Create "turn-key" tool kit for new implementers

Task 3

Negotiate with telecommunication service providers and tiered rate system.

Now think bigger! Identify your 12-month impact milestone

Launch CCPF in at least one additional district using tools from above.

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Identify target district

Task 2

Identify implementing partner

Task 3

Support implementation

Sustainability
Tell us about your partnerships

We have three major partners on this project. Baobab Health has designed and deployed health technology solutions that are user-focused, appropriate for the environment, and integrated into the health system. PATH has provided generation and behaviour change expertise, with a specific focus on helping to develop messaging for tips and reminders service. Invest Knowledge Initiative (IKI) has provided expertise in evaluating the impact of the project on the Balaka community. Finally, throughout implementation of the project we have received strong support and buy-in from the Ministry of Health.

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

We currently target women of child bearing age, caregivers of and children under five years old in Balaka District. Balaka District was chosen due to its majority rural population and the pervasive maternal and child mortality issues in the district. Our messaging service is currently targeting caregivers of children through their first year of life and we are looking to expand that to messages up through the first five year.

What type of operating environment and internal organizational factors make your innovation successful?

VillageReach as an organization is focused on improving access to quality healthcare in remote, underserved communities. Thus, the tools, perspective and experience VillageReach as an organization brings to addressing specific barriers to quality healthcare has been instrumental in the success of CCPF.
Our strong relationships with local partners and government as well as our strong ties to the community have also been critical to the implementation of CCPF. Finally, the VillageReach staff and volunteer network were essential in ensuring the quality and reach of the services provided by CCPF.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
randomness