Surrounded by numerous hills, valleys, networks of streams, rivers, and potato and plantain fields, it is difficult for villagers whose children are experiencing the symptoms of illnesses like malaria to seek treatment on time at a nearby health facility.

There is no shorter way to reach Ntchisi District Hospital, for example, which is 15 kilometres away from T/A’s Kalumo.

The closest clinic, Khuwe Health Centre, is about 10 kilometres away in Dowa. You cross a rickety and dangerous bridge to get there. Avoiding it means taking a longer route through the bushes which is very scary.

As a result, most of the community’s young children die of preventable deaths as they fail to access healthcare facilities. Those that manage to reach clinics often arrive in serious condition.

This narrative is substantiated by Group Village Head Semu.

He says his subjects are obstructed from access to healthcare services especially for children by longer distances they have to travel.

“The nearest hospital is in Dowa, many kilometres from where we are. Alternatively, my subjects have to cough about K4000 or more to travel to Ntchisi District Hospital to receive medication, “he says.

Licksina Hardwick is mother of two. She has fresh memories of the distance that she had to journey to get to a makeshift under-five clinic. The services were offered at a church structure.

She had to go there every month for closer monitoring of her pregnancy when she was expecting her first born son.

She says it was a serious problem when her son fell sick in the middle of the night.

“Life was so hard to access medical services. We had to travel to Ntchisi District Hospital for medical attention. Life was not easy considering that we rely on farming to make ends meet here.”

For people of Kachilandozi, the story is almost the same. This village is separated by 3 to 4 kilometers from Ng’anga.

During the rainy season, one cannot cross to go to Ntchisi District when a nearby river bursts its banks. Neither can one cross to get to Ng’anga.

People here feel isolated in such circumstances.

Alice Kawayula, a mother of three, says access to basic health services has always been a challenge in the area.

She also says access to family planning services were an uphill task for people around Kachilandozi.

She recounts how a few could travel to Ntchisi District Hospital for family planning services.

“Child spacing in families here was an issue because, in the first place, despite people knowing the importance of family planning, access to such services was a tall order. You can check for yourself statistics around here. People could not access such a service,” says Kawayula.

Change

For the past two years or so the story has changed.

People around Ng’anga area have under-five and basic medical services closer to them - thanks to World Vision Malawi.

With assistance from World Vision South Korea, the organisation constructed village clinics in the area of Traditional Authority Kalumo.

The intention was to ease mobility challenges that people, especially women, faced to access medical assistance.

With the passage of time, the facilities have also turned out to be a must-go-to place for the youth in the areas. They are able to access reproductive health services of quality.

Kawayula, whom we bumped into at the facility, was here for her monthly contraceptive injection.

She says the facility at Ng’anga has eased her access to family planning methods.

“My second born child is three years old now. This could have not been the case if it were not for family planning services that I access at this facility. The youth also have access to such services,” adds Kawayula.

Douglas Kasoka Mpasa, a health surveillance assistant at Ng’anga Health Post says since the clinic was opened, in the area there has been no notable death of a child from a preventable disease.

He says even at the height of the infamous cholera outbreak that claimed hundreds of lives between 2022 and 2023, Ng’anga area did not record even a single case.

Mpasa attributes this to the closeness that he has with the people which he says helps him give them the much-needed health services.

“The time the health post was opened, we recorded close to twenty cases of malnutrition. Deaths and illnesses from malaria were at an all time high and that is evidenced by the number of children that required medical attention from this area.

“That has, however, changed. We have had about two cases of malnutrition here but no death from malaria. You can clearly see that the situation has improved,” says Mpasa.

Ng’anga Health Post serves about 1700 people in a month. Of this number, close to 800 are children; 600 are women and the rest are youth.

The sister post, Kachilandozi, also serves around 1000 people with similar services.

Are the rural hospitals really a necessity in Ntchisi?

Getrude Chiwotha is the Intergrated Community Clinics Officer for Ntchisi District.

She says the district has 181 hard-to-reach areas that need village clinics.

Chiwotha says in this number, 111 have the clinics while people from the other 70 have to travel longer distances to access under-five clinics and other health services.

“The need is so huge in this district. Most places have Community Based Organisation structures being used as makeshift health structures for under-five clinics. The disadvantages come in because these are just once-off structures. They offer services once in a month and that restricts people from getting essential services” she observes.

She is however grateful that World Vision has come in to help address the challenge.

“You see, people from Kachilandozi and Ng’anga had to travel to Dowa for medical attention, otherwise, it was not ideal,” she says.

The situation that was in Ntchisi, is a true reflection of the reality in many other districts of Malawi.

This trend brings into question Malawi’s quest to attain universal health coverage - including access to general healthcare, medicines and vaccines – a crucial pillar of the 17 UN Sustainable Development Goals adopted by world nations in 2015 and intended to be met by 2030.

To get there, more has to be done, and surely, the government needs bailouts given the complicated priorities on its table.