Eighty-four percent of Malawi’s population–about 15.4 million people–live in remote areas with limited healthcare access. But community-based organizations are working tirelessly to improve the lives of new mothers and their newborns.
Wandikweza, a healthcare nonprofit and partner of the Mortenson Family Foundation, stands among these organizations. A recipient of the 2023 Presidential Zikomo Award, Wandikweza is one of 13 entities recognized for positively impacting citizens and contributing to socio-economic development in Malawi.
A remarkable initiative by Wandikweza is the Nurses on Bikes program, which offers free pediatric nurse services to new mothers during crucial developmental stages in their infants’ health. Let’s delve into this initiative and its profound impact on countless Malawian families.
Rooted in Community
Meandering dirt roads in remote areas of Malawi make transportation by car time-intensive and expensive. Moreover, constrained infrastructure and resources contribute to a dearth of medical professionals, healthcare facilities, medical supplies, and health education programs. Paired with the country’s restricted healthcare budget and systemic disparities, this amalgamation has led to high rates of maternal and infant mortality.
Mercy Kafotokoza, a midwife and nurse with a master’s degree in public health, realized that most of these deaths would be preventable with access to high-quality, timely health care. After gaining deep experience in the hospital and in communities as a country director and health coordinator, she started Wandikweza in 2016 to deliver basic health services to women and young children.
The organization relies on community health workers, who play a pivotal role in improving health outcomes, and its efforts have led to a steady decline in national maternal and infant mortality rates. Ninety-five percent of the women Wandikweza serves receive postnatal care within 24 hours of delivery, 60 percent of pregnancies are registered for antenatal care during the first trimester, and 80 percent of children with concerning symptoms are assessed within 24 hours. Moreover, Wandikweza ensures 80 percent of infant deliveries happen at a health facility.
“[Community health workers] have an immediate impact in their communities and can deliver health services at a low cost per person without access to expensive high technology,” says Mercy. “Not only do they provide basic health care, but their ongoing presence in the community changes attitudes towards health.”
Wandikweza has several impactful programs, including mobile clinics, a dedicated health center, and horticultural therapy. In particular, its Nurses on Bikes program provides swift, comprehensive care when new mothers need it most.
Riding Ahead: The Nurses on Bikes Program
The Nurses on Bikes (NoB) program facilitates healthy newborn development through regular check-ups during critical growth stages. It offers maternal and child health services, in-home assessments, and emergency medical response.
The initiative’s main goal is to prevent deaths in children under the age of five. The program collaborates with government health centers to reach pregnant women in remote areas of Malawi’s Dowa District, where the Wandikweza Health Centre is located. Nurses conduct home visits from pregnancy to age five, targeting developmental milestones and providing parent education. They also address nutrition, sexual health, family planning, and more.
Equipped with efficient motorbikes that can navigate challenging terrain, Wandikweza’s nurses respond to even the furthest communities within 30 minutes. Some ride up to 74 kilometers (about 46 miles) roundtrip to serve communities that cannot be reached by motor vehicles.
The regular check-ups enable Wandikweza to identify and address health issues early, significantly reducing infant mortality rates. The program promotes emotional well-being among new mothers and fosters a supportive partnership with nurses.
The Nurses on Bikes program has touched many lives, reassuring mothers and providing critical care. It has also helped Wandikweza demonstrate to village chiefs that changes in local attitudes around issues important to women, like family planning and domestic violence, can be beneficial for the whole community.
“I lost my firstborn child due to malaria on my way to the hospital three years ago. So when Solomon started convulsing, I was really afraid,” says one mother, who received early management of her child’s convulsions at home before a referral. “[I] thank [Wandikweza] so much for saving the life of my baby.”
The program has also transformed the lives of nurses, instilling a sense of purpose in their work.
“It is our job to make sure that under-five children receive exceptional care at home,” says Precious Dzowa, a nurse. “No one wants to be in hospital if they can help it, and we do everything we can to prevent admission.”
Fuel scarcity, low stock of essential medicines, and ensuring the security of the nurses and motorbikes are some challenges this program faces. The nurses work from 8 am to 4:30 pm, and they don’t respond to emergencies during the night. Despite these hurdles, Wandikweza currently has six nurses on bikes who care for 24,500 clients. The organization plans to expand the program to include 20 nurses.
On the Horizon
Wandikweza envisions affordable, high-quality healthcare for all and aspires to scale the Nurses on Bikes program through government systems and the public health sector more broadly. The organization plans to upgrade its Health Centre to a hospital and expand services to five more districts by 2030. By collaborating with local organizations and community leaders, it creates a sustainable impact and in lives across Malawi.
“I want other nurses to see what wonderful professional opportunities the community offers,” Precious says. “That way, we carry on developing and improving the Nurses on Bikes model and continue to meet more patients’ needs at home.”