Health Systems Strengthening at Area 25
Improving the Lives of Mothers and their Babies
Women and children are disproportionately affected by lack of access to health care services, particularly in resource limited settings. Malawian women have some of the worst odds with 675 deaths per 100,000 live births—among the highest maternal mortality ratios in the world. By contrast, the ratio for U.S. women is 14 deaths per 100,000 live births.
To improve these odds, Texas Children’s Hospital and Baylor College of Medicine launched a Global Women’s Health program in 2012 in partnership with the Ministry of Health of Malawi. This public-private partnership leads the way in the development of transformative programs that benefit thousands of women and babies as well as scores of learners in low resource settings.
A close collaboration with Baylor International Pediatric Aids Initiative (BIPAI) and Baylor College of Medicine Children’s Foundation-Malawi (Baylor-Malawi) has enabled sustained growth of the program in Malawi. With continued collaborative efforts, the impact of our programs will grow and become internationally recognized models.
Continued pursuit of diversified funding for these efforts will ensure long-term sustainability of programs and continued operations even during times of financial stress.
Healthcare in Malawi
In Malawi, the government healthcare system is comprised of referral hospitals, district hospitals, and community health centres, each of which provides free healthcare to Malawians. Area 25 Health Centre serves Lilongwe’s most populated catchment area with around 250,000 inhabitants. The hospital currently delivers on average 25 babies per day.
Texas Children’s Hospital and Baylor College of Medicine launched a Global Women’s Health program in 2012 and partnered with the Ministry of Health to improve the healthcare provided to mothers and babies. At Area 25, we have constructed a 4-room operating theatre to perform surgeries for complicated deliveries such as cesarean sections.
Upcoming construction projects include a postpartum unit and neonatal unit including a care unit for premature babies, a laboratory, and a blood bank. With these new additions to the Area 25 Health Centre, we hope to alleviate congestion at the referral and district hospitals in Lilongwe. Consequently, the health centre will begin to transform into a referral centre of its own.
Area 25 Health Centre Transformation
Under a unique public-private-partnership with the Malawi Ministry of Health and Baylor-Malawi, Texas Children’s is constructing a maternal and neonatal care facility at the Area 25 Health Centre in Lilongwe to deliver an unparalleled quality of care for mothers and newborns in this low resource setting.
Texas Children’s extensive experience in maternal and neonatal care in both the U.S. and sub-Saharan Africa will be critical in making this program a success. Faculty from Baylor College of Medicine have been involved in the expansion of services at Area 25 Health Centre over the last few years with the development of a maternity waiting home through a Bill & Melinda Gates Foundation grant and a new maternity unit through private philanthropic funds.
Currently, Area 25 Health Centre performs only normal deliveries with projections of over 3,500 deliveries in 2017. Unfortunately, many women require referral to the referral hospital for cesarean delivery and babies require referral for even minor neonatal issues. The referral hospital is overburdened and transport is always risky.
Texas Children’s has begun building a four-room operating theatre with an anticipated completion date of February 2018. This will rapidly be followed by the construction of a new post-partum and neonatal unit which will also include a care unit for premature babies, laboratory and blood bank.
The addition of these new buildings and services at Area 25 Health Centre will significantly alleviate the burden of increasing demand for maternal and neonatal services at Kamuzu Central Hospital (the referral hospital) and Bwaila Maternity Hospital, the largest maternity unit in the region with 17,500 deliveries per year. Since the addition of the maternity waiting home and the maternity unit, deliveries at Area 25 have increased significantly over the last 2 years and we anticipate further increases with the introduction of the operating theaters and the post-partum/neonatal unit.
There is a vibrant permaculture garden surrounding the maternity waiting home at Area 25. Permaculture is a system of sustainable agriculture that relies on patterns of natural ecosystems. In a country where the majority of people are small scale farmers with a limited range of healthy crops, the garden provides a unique opportunity to teach healthy crop cultivation for the patients to take home.
Electricity at the Area 25 facility will be renewable with an initial focus on solar power. Solar power will be backed up by generators and the local power grid, but we anticipate meeting most of the electricity needs for the facility by renewable energy.