By Jessica Crawford, Health Systems Group Lead, VillageReach
I am a new mom. I recently returned to the United States after having lived and worked in Malawi for the past three years as VillageReach Country Director. In my role, I was responsible for managing health teams across multiple health interventions, a role my past experience and training adequately prepared me for. In my role as a new parent, however, I confess I had no idea what I was in for. My baby girl is now 10 months old, and thankfully, a healthy and happy baby. Even so, over the past year, I cannot count how many times I’ve used my phone to access information on her health and well-being. From kick counts in pregnancy to introducing new foods at six months or treating a minor fever. As a parent, I search for all kinds of information multiple times a day. I recognize that I am extraordinarily fortunate to have access to this information at my fingertips. In my experience in remote and rural communities in Malawi, I’ve lived and worked alongside women who don’t have this kind of information available to them. Instead of picking up a phone to get answers to the kinds of routine questions that a majority of expecting, new and even experienced mothers have in developed countries– these moms may walk hours to the nearest health center or, more likely, they don’t ask the question at all. The result can be catastrophic. Now, more than ever, I’m motivated to ensure access to quality health information for these women because I personally know how incredibly valuable and empowering that information is.
In Malawi, VillageReach operates Chipatala Cha Pa Foni (CCPF), or “Health Center by Phone,” where individuals, primarily pregnant women and new moms in the community can call free of charge and talk directly with a hotline worker. The hotline worker is trained in protocols to identify danger signs during pregnancy or early childhood and refer those callers to their nearest health center. For most callers, the hotline workers are able to answer simple questions about their pregnancy or their child’s health and give advice on how to treat minor ailments at home. We’ve seen tremendous impact of CCPF at the community level and have the evidence to demonstrate that impact in real terms. Women who use CCPF know more about how to care for themselves and their children and they act on that knowledge. Information matters, and being able to know where and when to go for care is absolutely critical to providing the best care for themselves and their children.
Last month, we announced a new partnership between CCPF and Airtel, Malawi’s leading mobile network operator (MNO), to merge the service with Airtel Malawi’s Dial-A-Doc program. As a result of the partnership, all calls to the hotline are zero-rated, meaning Airtel does not charge the client or us for the airtime, and we will be able to triage complicated case calls to doctors.
Our vision is for CCPF to scale up nationally in Malawi supported by the Ministry of Health (MoH) and their partners and for similar solutions to be introduced in countries with similar health access challenges. CCPF has been operating for four years now, serving more than 300,000 women and children with multiple partners and donors.* Even with strong buy-in from the Malawi MoH and clear evidence of impact, the effort to scale and transition CCPF responsibly requires significant time, effort and resources. As with any intervention, government support is key to sustainability, and yet we must consider what is truly feasible given that we work in countries with scarce resources who have challenges in providing basic health services, let alone running a national health hotline.
Our partnership with Airtel is a significant step forward to ensuring the long term operation and sustainability of CCPF in Malawi. It is a step made possible by strong MoH partnership and demonstrates a successful model for public-private partnership; a potential solution to the sustainability challenges facing mHealth implementers, including us.
While we haven’t yet solved the entire sustainability challenge, we are one major step closer to making sure that new moms like me and all mothers (regardless of where they live) have access to quality information regarding their own health and that of their families.
*CCPF Partners Include: Concern Worldwide, Baobab Health Trust, Airtel Malawi and GIZ and with the support from the UN Foundation, Seattle International Foundation, and Vitol Foundation
Jessica Crawford, Senior Manager & Group Lead, Health Systems, has over a decade of experience in the design, implementation, and evaluation of health system programs in both in the USA and abroad. She has led projects in Malawi, Tanzania, and Mozambique and most recently served as Malawi Country Director overseeing a broad portfolio of work. As Health Systems Group Lead, Jess provides direction and leadership to the health systems team.
Prior to joining VillageReach, Jess worked in Health Services Administration at the University of Washington specializing in quality improvement and previously served as a community health educator in Tanzania with the Peace Corps. Jess holds a MPH in Health Services and a MA in Policy Studies from the University of Washington and as well as a BS in Cell and Molecular Biology and BA in Sociology.
Photo credit: VillageReach