Over the past decade, leaders in Malawi have significantly reduced deaths among women and children. Still, the country struggles with the highest premature birth rate in the world, high rates of maternal mortality, and a lack of access to safe, effective family planning methods.
Too often, women and babies die from causes that are preventable and treatable. Many of these deaths could be averted if Malawi’s health workers, especially those in the rural areas where 85 percent of the country’s people live, had access to lifesaving medicines and technologies.
Getting the right tools in the right hands could save millions of lives. But first, someone had to put the issue in the public spotlight. PATH helped local advocates succeed.
In 2012, recognizing the need to improve access to key health supplies, Malawi’s government signed on to a global initiative called the United Nations Commission on Life-Saving Commodities (UNCoLSC) for Women, Children, and Newborns. The initiative provides a blueprint for increasing access to and use of critical health supplies. In particular, it recommends the adoption and distribution of 13 key health commodities.
Two years later, however, many of these commodities still remained unavailable to Malawi’s women and children.
How advocacy unlocked innovation
To tackle this delay, PATH supported a civil society organization in Malawi called the Health and Rights Education Program (HREP) to coordinate a group of local advocacy partners.
Beginning in 2014, the group developed a strategy to persuade the Ministry of Health to make key revisions to the country’s Essential Medicines List (EML). The EML guides national drug policy, details safe and cost-effective medicines that should be widely available, and helps the government identify funding and support for those commodities.
The advocates noted that the EML was missing 4 of the 13 UNCoLSC-recommended commodities:
- Newborn resuscitation devices, which deliver oxygen when a baby’s first breath fails.
- Antenatal corticosteroids, which are crucial for premature babies whose lungs need more time to develop.
- Injectable antibiotics to treat deadly newborn sepsis infections.
- Contraceptive implants to help women choose when and whether to become pregnant.
Without these products, too many babies and women faced unnecessary risks.
To get the commodities on the list, HREP gathered 15 partner organizations to present a civil-society petition to the government. They also caught the public’s attention by educating journalists and broadcasters about their goals—sparking newspaper and radio coverage that increased momentum and brought more attention to the issue. In addition, they met with government decision-makers to remind them of their commitments and ensure they understood recent evidence on the value of the missing commodities.
As a result of HREP’s efforts, the Ministry of Health included the four missing commodities in the EML update in January 2015. Even more, the Secretary of Health committed to training health workers to put the tools to work.
Although there is still much to be done, the changes are a crucial first step to empowering health workers and ensuring that they have the tools they need to protect women and babies.
Now, the Ministry of Health is working with partners to establish the funding, training guidelines, and other resources and policies necessary to put the changes into practice. As they do so, HREP and its partners will continue their efforts and ensure that government leaders remain accountable for their commitment to Malawi’s women and newborns.
Project partners: The Malawi Ministry of Health, United Nations Population Fund, the Health and Rights Education Program, and the United Nations Commission on Life-Saving Commodities