This document discusses a health partnership project between Scotland and Malawi. It contains the following key points: 1) The project aimed to reduce maternal and neonatal mortality rates in Ntcheu district, Malawi by training midwives and promoting community health through motherhood taskforces. 2) Successes included improvements in antenatal care, facility deliveries, and maternal health knowledge that aligned with government priorities. 3) Challenges included staff turnover disrupting planning and a lack of understanding between partners about roles. 4) An evaluation found increased clinic attendance and skilled birth attendance, and decreased infant and neonatal mortality rates, showing the project was effective.

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2. Partnership
Principles
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3. Partnership
Principles
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4. Partnership
Principles
Planning and implementing together
Appropriateness
Respect, trust and mutual understanding
Transparency and Accountability
No one left behind
Effectiveness
Reciprocity
Sustainability
Do no Harm
Interconnectivity
Parity (equality)
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5. Partnership
Principles
• Which partnership principle/s do you
feel confident about in your link?
• Which partnership principle/s do you
feel you’d like to work on in your link?
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6. VSO health
partnerships
in Malawi
Presentation to SMP Health
Forum
28 October 2014

7. VSO: bringing people together to fight
poverty through the lasting power of
volunteering
• World-leading independent development organisation
working for change through volunteers
• Programmes in 35 countries in Africa and Asia, supporting
over 660 partners working in health, HIV and Aids,
education, participation and governance, and secure
livelihoods
• Range of volunteering approaches - international, national,
community volunteers and youth volunteers, placed with
partners including national and local government, NGOs and
local partners

8. Ntcheu Integrated Maternal Health (NIMH)
Project – Scottish Government funded 2012-2015
Goal
To contribute to the
reduction of maternal
and neonatal mortality
and morbidity rates in
Ntcheu district by 2015.
Objectives:
•To improve the skills of clinical staff
– specifically midwives – to promote
maternal services
•To improve knowledge and health
seeking behaviour of communities
in Ntcheu (Ganya and Njolomole
Traditional Authorities)

9. Continuous Professional Development
(CPD) for nurse/midwives
•Mentorship program
providing on job training to
nurse-midwives in 10 rural
health facilities, linked to
introduction of national CPD
programme
•Partner - CPD team of Ntcheu
District Hospital

10. Community health promotion
Establishment of 80 Safe
Motherhood taskforces
Partners – Parent and Child
Health Initiative (PACHI and
Perinatal Care Project (PCP)
Monthly SMT meetings to –
•Identify, prioritise MNH
problems
•Design, Implement and
evaluate strategies

11. Successes
Appropriateness
Good fit with local and
governmental priorities
•Ministry of Health initiated
CPD programme regulated by
Nurses Midwives Council of
Malawi
•Safe Motherhood Taskforce –
President Banda initiative
Effectiveness:
Embedded monitoring and
evaluation – enabled us to be
responsive to community needs
to learn, to develop the project
and the partnership .
For example, mobilisation of
cadre of health promoter
volunteers to support local
volunteers to provide 1:1 support
especially to young mothers who
tend not to go to SMTs

12. Challenges
Planning and implementing
together
New partners – PCP and PACHI
Staff turnover – lack of
continuity from planning to
implementation – leading to
confused expectations of roles
Unreliable MoH Maternal
mortality stats used in
baseline
-Respect, trust and mutual
understanding
-Disagreements between
partners about roles and
responsibilities
-Time taken to re-negotiate
project implementation plan
-Creation of additional VSO
project management role to
provide closer supervision

13. Findings and recommendations from
mid term evaluation
• Significant increases in antenatal/postnatal care facility
delivery
• Improvement in MNH knowledge
• Organise forums where community members and service
providers come together to discuss ways of improving
delivery of MNH services
• Build stronger links between Village Health committees and
Safe Motherhood groups to implement and sustain local
strategies for MNH

14. Recommendations from mid term
evaluation, continued
No one left behind
SMT members need more
information about maternal &
neonatal complications so they
can carry out awareness
campaigns
Young women receive
information from health
volunteers, rather than
participation in SMTs

15. Results – mid term evaluation
Antenatal clinic attendance in first trimester increased from
16.3% to 28.7%
Increase in % women attending 4 ANC visits from 44.8% to
49.8%.
Increase in % of recently delivered women receiving post natal
care within 24 hours after delivery from 80% to 92%.
Facility delivery births increased from 92.9% to 96.3%
Percentage of births attended by a skilled birth attendant
increased from 80.6% to 93.5%.
Neonatal mortality fallen from 14 per1000 births to 9 per1000
live births

16. Zikomo

17. Partnership
Principles
• Which partnership principle do you feel
confident about?
• Which partnership principle do you feel
you’d like to work on?
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18. NHS Scotland
Health Links
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19. Health Updates
From Malawi
• MDGS II Health Priority areas and Health
SWAP
• Govt of Malawi/SG priority areas 2015-2018
• Health Strand Meetings in Malawi
• National Cancer Centre approved
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20. Health Updates
From Malawi
• Malawi and the MDGs –
• Infant mortality (per 1000 live births): Reduction from 86
(00-04), 60 (05-09) to 53 (10-14) = 38% decrease
• Under 5 mortality (per 1000 live births): Reduction from
146 (00-04), 100 (05-09) to 85 (10-14) = 42% decrease
• BBC article “ Infant mortality: surviving
childhood in Malawi!”
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21. Funding
• Scottish Government Small Grants Round –
deadline 26th November 2014
• UK Aid Direct – deadline for concept notes
21st November
• DFID Funding Finder
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22. Practical Support
and Resources
• THET: “A toolkit for medical equipment donations to
low resource settings”:
• SMP “Practical Advice and Support on per diems”:
• SMP Updated “Practical Guide for Visiting Malawi”
• SMP “Common Challenges, Shared Learning”
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23. Practical Support
and Resources
• Support for Visa Applications- contact SMP office for
advice and support
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24. Upcoming
Events
• SMP Film screening: “B’ella” 4th November 2014, Glasgow
• CPG on Malawi, 19th November, 1.30-3pm, Scottish
Parliament
• THET event: “Health Workers Together” 9th December 2014,
Edinburgh
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25. Evaluation
Forms
We’re keen the forums are as useful for you
and your links as possible- please fill in the
evaluation to help us improve!
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