Community Score Cards responding to SDG III in Mzimba North

For residents of Traditional Authority Mthwalo in Mzimba district access to health care has been a search for a needle in haystack. 

As 66 year old granny of 15 at Davite Thupa village in the area accounts, the residents have had to travel to Mzuzu just to have a Tuberculosis (TB) test. This has been the case because the nearest facility, Kaweche Health Centre has not had any TB testing equipment for a while.

“Kaweche Health Centre has not had TB testing equipment, as such we had to use private transport, spending over Mk10,000 to Mzuzu just to get tested,” says Mary Musi.

But access to health and well-being as embedded in the Sustainable Development Goal 3(SDG3) continues to be a global challenge.

For example The United Nations report of 2024 shows sub-Saharan Africa and Southern Asia accounted for around 87% (249,000) of the estimated global maternal deaths by 2020. 

In a bid to reduce health iniquities, Global Fund has been channeling support in Malawi through World Vision Malawi to create a just and accessible health system.

Through cycle number six of the Global Fund support, World Vision partnered with Malawi Network of Aids Services Organization (MANASO) for the Resilient and Sustainable Systems for Health (RSSH) module to champion community-led HIV and TB service as well as Community Score Card (CSC) activities in eight districts in the country.

Today, through the Community Score Card (CSC) which is a two-way, ongoing participatory tool for the assessment, planning, monitoring and evaluation of services, communities can now wear smiling faces as most of the health challenges are being ironed out.

The CSC model brings together the demand side (service users) and the supply side (service providers), ultimately advocating for improved service delivery at facilities by engaging duty bearers at district and national levels.

Today, people of Traditional Authority Mthwalo in Mzimba North like Musi now can access TB services right at Kaweche Health center courtesy of the CSC in the community.

“Because of the efforts by our Community Score Card, we now have the TB testing equipment. Apart from that, the health center had struggled with transport facility, but today, expectant mothers who need special maternal care are easily transported to Mzuzu Central hospital as we now have an ambulance,” says Musi.

Kaweche CSC chairperson, Rodwin Mhango says his team got the training on CSC tools from MANASO. Since then, they have been working tirelessly to bail out Kaweche Heath Center out of its health challenges.

His team in conjunction with Health Advisory Committee (HAC) at the facility conducted the scoring of the challenges at the facility before calling the duty bearers for an interface to discuss solutions. Following their action plan, Kacheche Health Center now has an ambulance, a fully functional mortuary, a 30 horse power generator for power back up, two additional nurses as well as eleven Health Surveillance Assistants (HSAs).

“Our lobbying have been successful as we had support from duty bearers both from government as well as private sector. We are glad that the District Health Office provided us with an ambulance, sent additional staff. We are also grateful to Tropha Estate who bought us a generator for power back-up, but we are ultimately grateful to the Global Fund through MANASO and World Vision for giving us the capacity,” he says.

Masho Mwenefumbo, clinician in-charge at Kaweche Health Center says the staff boost has enhanced service delivery, also reducing workload on their side.

“Before the CSC, we had a lean staff, and this meant much work for the fewer of us. But with the CSC advocacy model, authorities are drawn to responding to our concerns in time, as we now have two more nurses and eleven Health Surveillance Assistants(HSAs),” says Mwenefumbo.