Citizen Voice and Action (CVA) leads to Improved Maternal Health in Malawi's Phalombe District

In Dindi Area Program, in Phalombe district, Malawi, a grassroots advocacy initiative known as the Citizen Voice and Action (CVA) is tirelessly working to improve local healthcare services for expectant mothers and the whole community.

According to Chairperson for Chiwalo CVA, Gracious Kulanga, this community-driven approach empowers citizens to advocate for better public services, such as healthcare and education.

Explains Kulanga: “Recently, Chiwalo CVA successfully advocated for posting of 10 additional Health Surveillance Assistants (HSAs) from the government, and the construction of a new placenta pit to replace the old, overflowing one that posed health risks to patients and nearby residents. 

The placenta pit initiative supported by the Inter-Aide organization addressed the immediate health hazard but also aligned with cultural norms that discourage improper disposal of the placenta in open spaces.”

Although a placenta pit may appear like just a mare facility for disposing of medical wastes, an interaction with expectant women at Nambazo Health Centre reveals that due to cultural beliefs, the unavailability of secure placenta pits may discourage other pregnant women from rural areas to give birth at a health facility. 

Charity Luciano concurs with Kulanga and recalls the stench she and her guardian endured in the past when she came to Nambazo Health Centre to deliver. 

"Before the intervention, the stench from the old pit was unbearable, so it was a relief to see the community take action to safeguard our health and dignity,” she says.

Chikondi Chinthenga, a Health Surveillance Assistant (HSA) in the area, emphasizes the critical impact of the new pit. 

"The old pit attracted flies and posed a risk of cholera and other diseases, the new pit has significantly improved hygiene standards, ensuring a safer environment for all, we are grateful to the efforts made by the CVA which brought us the development through Inter-Aid,” says Chinthenga. 

However, CVA Chairperson, Kulanga, refuses to take all the credit alone. 

“The success of Chiwalo CVA is due to the support we receive from World Vision Malawi, which provides essential resources such as advocacy training, bicycles for outreach, and tools like scorecards,” he says. 

He adds: "World Vision's support has been instrumental, it has enabled us to amplify our voices and hold authorities accountable for delivering on their commitments to the community.

Through collaborative dialogue and non-confrontational advocacy, we will continue our efforts to enhance the accessibility and quality of healthcare but also encourage other community members to take collective responsibility for their well-being.”

Chiwalo CVA was formed in 2019 and it has four committees responsible for child protection and education issues, environmental issues, health issues and agriculture and food security issues.