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MRF’s healthcare and
awareness initiative in
      Malawi
    MRF Meningitis Symposium
            Bristol
        3 October 2012
Barriers to Treatment
MRF funded research into barriers of
  recognition and action in treating ABM in
  Malawi
Recognition barriers:
• Misdiagnosis of malaria or other illness
• Low recognition of severity of illness and
  need for social validation in community
Barriers to Treatment
Action barriers:
• Priority focus on maternal health
• Negative perceptions of health services
  (wait time, attention by health workers)
• Financial constraints in community
• Gender and age-based decision making
  in community
Situation Analysis
• Patients queue and wait for hours at
  primary clinics- first come, first served
• Limited number of health
  workers, equipment and supplies
• Patients have to wait hours/days for
  ambulance transport
• Some die while waiting for assistance or
  transport
Action Meningitis
• Targeting health workers to break down
  barriers to treatment, improve treatment
  rates and healthcare delivery in Malawi
  and improve outcomes in children
• Public awareness messages of
  meningitis signs & symptoms to raise
  awareness amongst public and prevent
  misdiagnosis
Primary Health Clinics
• Priority: Improve identification of severe illness in
  children for treatment & referral to hospital using
  WHO triage system
• Urban and peri-urban clinics with varying
  catchment populations
Primary Health Clinics
• Training frontline health workers
• Evaluating effectiveness and feasibility of triage
  system
mHealth & ETAT
Using mobile
technology to
improve health      Emergency
(mHealth)
to establish WHO     Priority
Emergency Triage
Assessment and        Queue
Treatment (ETAT)
system in clinics
mHealth & ETAT
        • Developing phone
          application of ETAT for
          health workers to screen
          children upon arrival/ in
          queue
        • Using phone data to
          track ETAT classification
          and hospital referrals
Community Awareness
• Health Talk weekly radio programme on
  MBC- national radio
• Health research news to Radio
  Listening Clubs and public
• 8 episodes focusing on meningitis to
  improve recognition in communities
Community Awareness
• Ambi-bikes at villages/ clinics for
  medical transport
Partners
• Partnering with Malawi-Liverpool-
  Wellcome Trust, Malawi Ministry of
  Health, hospital and primary clinics in
  Blantyre
• Working with D-tree International for
  mHealth component
• Assessing feasibility and expansion
  across Malawi
Project Outcomes
• Prioritise ill children and reduce wait
  times at clinics
• Track referrals to hospital for severe
  illness in children
• Increase knowledge and awareness of
  meningitis amongst public
• Provide ambi-bikes for medical
  emergency transport

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Action meningitis: Meningitis Research Foundation healthcare and awareness initiative in Malawi

  • 1. MRF’s healthcare and awareness initiative in Malawi MRF Meningitis Symposium Bristol 3 October 2012
  • 2. Barriers to Treatment MRF funded research into barriers of recognition and action in treating ABM in Malawi Recognition barriers: • Misdiagnosis of malaria or other illness • Low recognition of severity of illness and need for social validation in community
  • 3. Barriers to Treatment Action barriers: • Priority focus on maternal health • Negative perceptions of health services (wait time, attention by health workers) • Financial constraints in community • Gender and age-based decision making in community
  • 4. Situation Analysis • Patients queue and wait for hours at primary clinics- first come, first served • Limited number of health workers, equipment and supplies • Patients have to wait hours/days for ambulance transport • Some die while waiting for assistance or transport
  • 5. Action Meningitis • Targeting health workers to break down barriers to treatment, improve treatment rates and healthcare delivery in Malawi and improve outcomes in children • Public awareness messages of meningitis signs & symptoms to raise awareness amongst public and prevent misdiagnosis
  • 6. Primary Health Clinics • Priority: Improve identification of severe illness in children for treatment & referral to hospital using WHO triage system • Urban and peri-urban clinics with varying catchment populations
  • 7. Primary Health Clinics • Training frontline health workers • Evaluating effectiveness and feasibility of triage system
  • 8. mHealth & ETAT Using mobile technology to improve health Emergency (mHealth) to establish WHO Priority Emergency Triage Assessment and Queue Treatment (ETAT) system in clinics
  • 9. mHealth & ETAT • Developing phone application of ETAT for health workers to screen children upon arrival/ in queue • Using phone data to track ETAT classification and hospital referrals
  • 10. Community Awareness • Health Talk weekly radio programme on MBC- national radio • Health research news to Radio Listening Clubs and public • 8 episodes focusing on meningitis to improve recognition in communities
  • 11. Community Awareness • Ambi-bikes at villages/ clinics for medical transport
  • 12. Partners • Partnering with Malawi-Liverpool- Wellcome Trust, Malawi Ministry of Health, hospital and primary clinics in Blantyre • Working with D-tree International for mHealth component • Assessing feasibility and expansion across Malawi
  • 13. Project Outcomes • Prioritise ill children and reduce wait times at clinics • Track referrals to hospital for severe illness in children • Increase knowledge and awareness of meningitis amongst public • Provide ambi-bikes for medical emergency transport