Save the Children Saving Newborn Lives Program Trip Report SITES:

Mchinji and Lilongwe, Malawi

TRAVELERS:

Joy Lawn, Senior Advisor for Policy and Research Steve Wall, Senior Advisor for Neonatal Health Shyam Thapa, Associate Director for Policy & Research

TRAVEL DATES:

Thapa (February 10-19, 2007) Lawn (February 13-17, 2007) Wall (February 12-17, 2007)

I. Executive Summary Following the SNL Program Managers’ meeting in Jo’burg, Thapa, Lawn and Wall traveled to Malawi. Working closely with the Save the Children/Malawi office staff, the three assisted MoH, UNICEF and other stakeholders in organizing a workshop on identifying and developing a comprehensive strategy and design for a home- and community-based newborn health intervention at scale. In addition, Thapa visited the MaiMwana Project site (Mchinji) and followed up on research management and other related issues. II. Key Persons Contacted See attached (Annex 1)

III. Purpose of the trip 1. To follow up with the MaiMwana Project particularly on operational issues 2. To participate in the preparation and co-facilitation of a workshop and assist the MoH and other stakeholders in designing a community-based newborn health project at scale

1

IV. Activities/Accomplishments

1. MaiMwana Project Thapa, together with Geroge Chiundu, visited the MaiMwana site in Mchinji, about an hour’s drive from Lilongwe, to meet with MaiMwana staff. Several staff there provided briefing on various aspects of the program. Thapa and George also visited a women’s group. Three of the five staff that were the victims of a tragic accident (in June 2006) have recovered fully and two are still recovering. Tambosi Phiri, Sonia Lewycka and Mikey Rosato, currently away in the UK, are expected to return to Mchinji soon. Following the Project site visit, Thapa met with four senior MaiMwana staff -Peter Kazembe, Charles Mwansambo, Ian Khwiya and Central Hospital in Lilongwe.

Sipho Jale -- at Kamuzu

The purpose of this meeting was to discuss key

management and research issues pertaining to the way forward for the MaiWwana Project. One of the issues concerned the plan for interim data analysis and review by the DSMB. The MaiMwana team reported that about 70% of the data has already been entered and the rest is in process. The first DSMB is planned for April or June, depending on the pace of data entry and analysis of data. The other points discussed have been summarized in a separate memo (Annex 1, not included in

this version). 2. The Newborn Health Workshop Prior to the workshop, we also met with the PMNCH mission that was visiting Malawi to asses the strategic role of PMNCH for scale-up efforts in the country. We also visited WHO and UNICEF offices for reviewing the agenda and respective roles in the workshop. Because of competing activities going on with the Ministry of Health, the newborn health project design workshop was limited to two days, February 15-16. The detailed agenda is attached (Annex 2). The three objectives of the workshop were: (i) to scan the existing situation, coverage of care and trends to identify opportunities and gaps for saving 16,000 newborns that die in Malawi each year,

2

linking with the SWAp and existing health system; (ii) to identify key building blocks for the delivery of a package to promote healthy home behaviors, and deliver an effective, sustainable postnatal care package (what, who, how, and supervision); and (iii) to agree on the next steps to detail the package and develop and test it in practice and maximize effective scale-up. The workshop was attended by about 40 individuals, with the representation of a broad range of stakeholders, including the MoH, UNICEF, WHO, UNFPA, the visiting delegates of the PMNCH, Save the Children, and other professional organizations (Annex 3). The workshop was declared open by the Principal Secretary

in

the

Ministry

of

Health,

together

with

the

highest-level

representatives of UNICEF, WHO and Save the Children/Malawi. The UNICEF representative, head of programmes and head of health attended virtually the entire workshop. There was a big turnout of UNICEF health technical staff and Luwei Pearson from UNICEF ESARO. Realtionships with UNICEF were very good with high level of agreement on package content and way forward. Joy provided an overview of the Malawi newborn health situation and Steve presented an overview of the lessons learned from the SNL-supported projects in India, Bangladesh, Pakistan and Nepal. Other presentations on the first day included newborn policy analysis and options in Malawi, the SWAp framework and current status, the Road Map for Malawi, and IMCI and ACSD frameworks. The team that visited Godchuroli also provided an overview of the visit and subsequent developments. The key elements of a draft proposal that had been developed in consultation with Abhay Bang during the India visit were also presented. Following these presentations on the first day, three working groups were formed to review and provide feedback on the possible package design in terms of the following aspects: what, linkages with other programs, who, where, when and how. Despite the limited time there was a good level of consensus on the major issues:

Who? – through the existing extension worker, the HSA, but this would mean that the new 6000 HSAs to be recruited and trained should include enough females (majority are currently male) to do this work. Supervision should be through health centers and community nurses and management through existing district teams

What and when? – The HSA would undertake home visits ANC and PNC (numbers to be decided after more formative research but provisionally 3 ANC and 4 to 6 PNC

3

plus extra for LBW). At this point in the discussion Dr Namatie and others felt that neonatal resus at home would not be in the first stage, and the focus for the intrapartum period would be on using TBAs to increase skilled attendance (an eg of TBAs being paid for referral to facility in labour was given) and on improving EmOC and resus at facilities. Resus at home without going back to training TBAs seemed to give mixed messages. The HSAs would generally not be at delivery so would not be an option for resus. In terms of increasing access to management of neonatal infections, the HSAs are apparently to be trained in the new IMCI algorithm for young infant care but would refer babies with infections. There may be an option of training the HSAs in the “Where there is no referral module” but this would need piloting and process data and policy change. The second day of the meeting focused on the question: in order to guide and accelerate the scaling up of the package, what do we need to do and what do we need to know? The sub-questions discussed were: what policy and programmatic questions needed to be answered; what level of evidence is warranted; what is the duration of the evidence-generation (pilot) project; in which districts should the project be undertaken; who are the potential partners; and who will do what? The final session focused on identifying the next steps. The main points discussed, and tentatively agreed upon, included: •

Sites: Thyolo, Dowa, and Chitipa districts, representing three regions of the country, should be selected as the evidence-base districts for the newborn health intervention package These three are among the 10 districts where cIMCI program is being accelerated. Thus, the three will be the “study” districts where close monitoring and evaluation activities will be undertaken.

•

Remit: The study should be designed to answer specific operational questions and should represent the whole district, collaborating closely with the DHO in each district. The main policy questions to be addressed should include the use of antibiotics by the community health workers (HSAs and midwives), feasibility, content, netcost and sustainability of resuscitation at the community level, and the frequency and timing of postnatal visits at home.

•

Linkages to health system and scaling up: Given the focus on sustainable impact at scale, it was agreed that the study would need to be implemented within the

4

larger health delivery system with the cadre of providers that have been formally approved. This means that the project should try to mobilize, and test the effectiveness of, HSAs and community nurse-midwives, among others. •

Process: The formation of a Newborn Working Group representing various organizations as partners. The MoH RHU was designated as the coordinator for the Working Group. The first task of this group is to develop the terms-ofreference. It would be best if the protocol could be developed before the midterm review of the SWAp, so that the plan may be presented at the SWAp meeting.

•

Measurement: Specific indicators or design issues were not discussed, but it was felt that the Working Group should:

(a) produce recommendations for

review and vetting by the stakeholders; (b) address the question of duration for the “study” which would largely depend on “what” are being measured (e.g., neonatal

mortality

or

other

proximate

behavior-change

communication

indicators); and (c) identify specific roles and responsibilities for the key partners, with specific timelines of activities. After closure of the workshop, representatives of UNICEF (Dr Eliab Some and Luwei Pearson), MoH (Dr Martias Joshua), and Save the Children (Paul Mecartney, Jeanne Russell, and Shyam Thapa) met to review the outcome of the meeting. The following points were discussed: a) The workshop report with specific recommendations for action would need to be submitted to the Ministry for review and vetting by the senior management team so that the other directors are onboard. This process will begin after SC prepares and submits the report to the Ministry by the end of February. b) SC would need to recruit a full-time research manager for the project in order to move it forward in a coordinated and timely manner. c) SCSNL could simultaneously begin assisting in the development of the project/study proposal. In the meantime, UNICEF could begin preparation at the district level. d) The pace and extent of the filling of the HSA and community nurse-midwife positions in the three evidence-base districts, and the number of female HSAs there. If at least 70% or so of the staff working at the community level are not

5

deployed, then the study might not be able to determine whether it was the ineffectiveness of the package or inadequacy of providers providing the interventions that affected the overall outcomes. The Ministry might be able to assign higher priority to filling the positions in the study districts; this would need to be followed up. e) Newborn health program is under the RHU at the Ministry while HSAs are under a different department. This means a higher level coordination at MoH is warranted in order for all the Ministerial-level coordination activities relating to newborn to be managed effectively. f) The Working Group on the study protocol would perhaps need to specify the minimum criteria requirements for the study.

Whether the Primary Health

Center should be the sampling unit for the study needs to be determined. g) Finally, a quick costing exercise would need to be carried out so that the potential donor agencies -- UNICEF and SCSNL among others -- could assess what is feasible and doable financially. Next Steps for SCSNL The following steps are necessary for SCSNL to move the initiative forward: 1. Recruitment of a qualified person to serve as manager/liaison particularly for the study; 2. Defining the operatrions research questinos and development of a study protocol, which should also include assessment of the sample size and the sampling unit; 3. Development of the minimum staffing and roles and other criteria that are required for the study; 4. Assist the MoH in developing the terms-of-reference for the Newborn Health Working Group; and 5. Work with UNICEF in conducting a costing exercise for work in the three districts, then identify the components that can be supported by SCSNL. Overall, despite the competing activities especially with the MoH, the workshop was

6

able to have the participation of all the key stakeholders was very well attended and made concrete progress. The Principal Secretary and other senior-level staff in the MoH were committed to giving newborn health the priority it needs, within the frameworks of the Road Map, IMCI/ACSD, and the SWAp. Another 1-2 additional days would have helped the workshop especially in sorting out some of the details. However, the key areas were discussed in a wide group and the formation of a Newborn Health Working Group provides the framework within which further more detailed progress can be made. The workshop has provided momentum to all for moving forward. In this context, Save the Children has much to accomplish and contribute. The Country Office needs technical support in a timely and rapid manner. The development of the draft study protocol needs to begin soon. This and other needs need to be followed with the Country Office. Jeanne Russel, Evelyn and Thapa met and discussed the following points: •

Timeline: It might be too ambitious to aim at having the protocol ready for the SWAp meeting,, as UNICEF had suggested during the workshop.

•

Geog remit: The inclusion of Chipita as a study district could turn out to be expensive especially in light of travel cost involved. We wondered whether there might not be a way to propose to the MoH and others in the Working Group as well as the stakeholders a phased-in approach in which the proposed project in Chipita would be deferred until the next phase and the initial focus be on Thyolo maybe simultaneously with Dowa.

•

Cost: It is important that SCSNL has good a estimate of the cost of the study for each of the districts. Depending on the cost estimate, SCSNL/Malwai would have, for instance, the option of either selecting certain components for all the study districts or focusing on just one district. We discussed the possibility of initiating preliminary costing exercise in the nearby Dowa district, possibly with assistance from UNICEF.

•

Design and sample size: It is important to initiate the background work for the study protocol. SCSNL HQ will find out from Simon Cousens if he could be available to review and assist in the task of sampling under different scenarios. Meanwhile, SNL/Malawai is initiating the advertisement for a research manager for the study.

7

•

MaiMwana presents a great learning opportunity for the SC/Malawi staff. In Thapa’s opinion, particularly the SCSNL/MaiMwana staff need to learn from what is being learnt already. To this end, it might be worthwhile to send the SNL-specific staff to MaiMwana for at least two weeks to learn the “nuts and bolts” of program development at the grass-root level. Each staff should generally learn about all aspects of the study, but at the same time each member should be given one aspect to pay special attention to, such as community mobilization, home visit, data collection and management, monitoring, feedback to the villages. Afterwards, Thapa spoke to Charles about this and he was agreeable to the proposition. This may be a great mechanism for the SC/Malawi staff to learn, and sharpen their knowledge and skills, about newborn health interventions.

•

We also discussed, albeit briefly, a new project funded by the UK Health Foundation in three districts – Kasungu, Lilongwe, and Salima – with the aim of improving the quality of maternal and neonatal health services. The project has three key partners including the Institute of Child Health (responsible for evaluation), Institute of Health Care Improvement (responsible for quality of care at the hospitals and, eventually, the Primary Health Centers), and Women and Children First (responsible for community mobilization). This is a three-year project with the possibility of a two-year extension at the end. Because it does not specifically aim at postnatal home visits and related access to newborn care within the first few days of life, this project that aims to cover 2.5 million population could be a great complement for SCSNL/Malawi. SCSNL/Malawi could dovetail with the project by providing the postnatal home-visit component. The Malawi-based staff (Roger LeCompte and Bejoy Nambiar) of this Health Foundation Project have expressed willingness to consider partnering with SC/Malawi. Of course, this would have to be discussed with Anthony Costello as well. As agreed, Thapa will follow up with Anthony Costello and, in the meantime, the Malawi-based Health Foundation Project staff are expected to provide a detailed briefing to SCSNL/Malawi. If this partnership works out, it could indeed be yet another great stride for SCSNL/Malawi toward impact at scale -- without having to go through the lengthy process of project development, approval and setup. ♦

8

9

Annex 2 – Agenda of the Newborn Health Workshop

Improving Newborn Survival in Malawi  15th – 16th February 2007 Objectives of the meeting 1. To scan the existing situation, coverage of care and trends to identify opportunities and gaps for saving the 16,000 newborns who die in Malawi each year, linking to the SWAp and existing health system 2. To identify key building blocks for delivery of a package to promote healthy home behaviours and to deliver an effective, sustainable postnatal care package (what, who, how, supervision 3. To agree on the next steps to detail the package, develop and test it in practice and maximise effective scale up Venue - The Capital Hotel, Lilongwe DAY 1 - Thursday, 15 February 2007 08h00

Coffee and tea

08h30

Welcome

Chair Dr. D. Namate (Director of Health and

(Official opening postponed until 2pm )

Technical Services – MOH) ƒ Fannie Kachale (Acting Deputy Director, Clinical Services – RHU MOH) ƒ Evelyn Zimba (Programme manager for Newborn health, Save the Children) ƒ Dr. Fannie Kachale

08h45

Group introductions and announcements

09h00

Goals and objectives of Design Workshop

09h10

Objective 1: Scanning the situation for Malawi’s Chair Dr. D. Namate newborns, current coverage, trends and gaps An overview of newborn health in Malawi

ƒ

Q&A ƒ Presentation on Neonatal Mortality in Malawi and Policy Options (10 min)

10

Dr. Joy Lawn, (Senior Research and Policy Advisor, Newborn health, Save the Children) Girmay Haile (Head of Section Social Policy, Advocacy & Communication)

Q&A 10h00

TEA BREAK

10h15

Objective 1: Scanning Malawi’s policy and Co-chair Dr. D. Namate and Dr Juan Ortiz program environment for opportunities to scale (Deputy Country Representative, UNICEF) (after each talk pause for clarifications but

up newborn care linked to the SWAp

hold major discussion for end of this

11h00

ƒ

The SWAp – opportunities for newborn care scale up (10 min)

session) ƒ Dr. Ann Phoya, Director SWAp

ƒ

The Road Map (10 min)

ƒ

Fannie Kachale

ƒ

IMCI and ACSD/c-IMCI (10 min)

ƒ

Kelvin Nindi, IMCI Secretariat, MOH

ƒ

Volunteer Counselor/home visitor Model-Mai Mwana (10 min)

ƒ

Sipho Jale / Dr. Charles Mwansambo

Plenary discussion of key opportunities and

Facilitated by Fannie Kachale and Jeanne

remaining gaps

Russell (Deputy Country Director, Save the Children)

11:30

Learning

and

adaptation

from

newborn

care Chair: Dr. Some, UNICEF

packages ƒ MOH reports of visits to SEARCH ƒ Policymakers visit to India & Pakistan (10 mins) ƒ ƒ Possible package design based on SEARCH visit proposal (20 mins)

Dr Namate, / Dr. M. Joshua Zonal Health Officer Central East Dr. Noor Alide – District Health Officer, Thyolo

ƒ

Dr Steve Wall (Senior Newborn Health Research Advisor, Save the Children)

ƒ

Facilitated by Dr Some and Mr Nindi

Evidence and experiences from India, Bangladesh, Pakistan and Nepal (30 mins)

Plenary discussion regarding adaptation to the Malawian context 13h00

LUNCH

14h00

Official Opening

Facilitated by Dr. D. Namate ƒ Aida Girma, UNICEF Country Representative ƒ Dr Matshidiso Moeti, WHO Country Representative ƒ Paul Mecartney, Save the Children

11

ƒ 14h30

Country Office Director Mr. Kang’ombe – Principal Secretary for Health

Objective 2: Defining the building blocks of the Facilitated by Dr Lawn and Dr Phoya package: Group work to review and provide feedback on the possible package design in terms Group 1- Dr Namate and Dr Susan Kambale

of: ƒ ƒ

What (package content) Linkages with other programmes, e.g., maternal health programs, ACSD/c-IMCI, PMTCT and paediatric HIV/AIDS (how to operationalise a continuum of care with linkages between key packages and between home and facility) Who (delivery of the package) Where? When? How (Training, supervision, logistics management, etc.)

ƒ ƒ ƒ ƒ

Group 2 – Dr Noor Alide and Dr. Juan Ortiz

Group 3 - Fannie Kachale and Evelyn Zimba

(see group work sheet for details) 1600

Break

1615

Group work continues

17h00

End of day DAY 2 – Friday, February 16

08h00

Tea and coffee

08h30

Group feedback

ƒ

Facilitated by Dr Some and Jeanne Russell

10h00

BREAK

10h15

Objective 3: Maximizing effective scale up: To ƒ

Facilitated by Dr Some and Jeanne Russell

10 mins per group 10 mins discussion after each group Plenary discussion 30 mins

be able to scale up this package what do we need to do and what do we need to know to guide and accelerate effective scale up? ƒ

ƒ

Joy Lawn

Context and some examples from other African countries testing similar packages. Group 1 - Dr. Noor Alide and Dr Susan

Small group work

12

ƒ ƒ ƒ ƒ ƒ

Questions to be answered by testing in the pilot Kambale area (eg package design, process, effects on behaviours and careseeking, impact, cost?) Level of evidence required and possible evaluation designs Group 2 – Dr Joshua and Dr Juan Ortiz When? (When does the pilot begin and end?) Where? Who are the partners? Who will do what? Group 3 - Fannie Kachale and Evelyn Zimba

13h00

LUNCH

14h00

Feedback from small groups

ƒ

Group feedback

Facilitated by Dr Some and Shyam Thapa

10 mins per group 10 mins discussion after each group Plenary discussion 30 mins 15h30

BREAK

15h30

What are the next steps?

ƒ

Facilitated by Fannie Kachale

16h00

Closing remarks

ƒ

Dr M. Joshua/Fannie Kachale MOH

ƒ

UNICEF - TBD

ƒ

Paul Mecartney

16h15

End of workshop

13

Annex 3: List of Participants of Improving Newborn Survival in Malawi Workshop DATE: 15th & 16th February 2007; VENUE: Capital Hotel NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL

1.

Kistone Mhango

Ekwendeni Mission Hospital

Cell: 08 333499

PHC Director

P.O.Box 19

Tel: 01 339235/246

Ekwendeni

Fax: 01333 059 [email protected]

2.

Dr. Dorothy Namate

Ministry of Health

Cell:

Director of Clinical services

Box 30377

Tel: 01 789 400

Lilongwe

Fax: 01 789 365 E-Mail: [email protected]

3.

Dr. Somanje

Cell:

Ministry of Health

Tel: 01 789 400

Director of Preventative Health Box 30377 Services

Fax: 01 789 365

Lilongwe

E-Mail: 4.

Mr. Kelvin Nindi

Ministry of Health

Cell:

National Program Officer - IMCI

Box 30377

Tel: 01 789 400

Lilongwe

Fax: 01 789 365 E-Mail:

5.

Dr. Chisale Mhango

MOH – RHU

Cell:

Director

Lilongwe

Tel: 01 751 552 Fax: 01 751 539

14

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL E-Mail:

6.

Dr. Ann Phoya

Ministry of Health

Cell:

Director – SWAp

Box 30377

Tel: 01 789 400

Lilongwe

Fax: 01 789 365 E-Mail:

7.

Dr. Charles Mwansambo

Kamuzu Central Hospital

Cell: 08 826946

Pediatrician

P.O.Box 149

Tel: 01 762025 - Home

Lilongwe

Fax: 01 756380 [email protected]

8.

Ms. Aida Girma

UNICEF

Cell:

Country Representative

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162 E-Mail: [email protected]

9.

Dr. Juan Ortiz

UNICEF

Cell:

Deputy Country Representative

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162 [email protected]

10.

Dr. Eliab Some

Cell:

UNICEF

Tel: 01 770 788

Head of Health & Nutrition Section Box 30375

Fax: 01 773 162

Lilongwe

E-Mail: [email protected] 11.

Lucy Kachapila

UNICEF

Cell:

15

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL

Project Officer

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162 E-Mail: [email protected]

12.

Joyce Mphaya

UNICEF

Cell: 08 891 561

Project Officer

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162 E-Mail: [email protected]

13.

Francesca Munthali

UNICEF

Cell: 08 306 165

Assistant Project Officer

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162 E-Mail: [email protected]

14.

Stanley Chitekwe

UNICEF

Cell: 09 964 548

Project Officer

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162 E-Mail: [email protected]

15.

Girmay Haile

UNICEF

Cell:

Head of SPAC

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162 E-Mail: [email protected]

16.

Dr. Miriam Chipimo

UNICEF

Cell:

RH/ HIV Unit Head

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162

16

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL

SIGNATURE

E-Mail: [email protected] 17.

Maternal

&

Cell:

UNICEF

Luwei Pearson Newborn

Tel: 01 770 788

Health Box 30375

Program Coordinator for Regional

Fax: 01 773 162

Lilongwe

E-Mail: [email protected]

Office of East & Southern Africa 18.

Katema Aschenaki Buzuneh

UNICEF

Cell:

Head of Health Unit

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162

Apologies

E-Mail: [email protected] 19.

Fannie Kachale

MOH- RHU

Cell: 08 586 485

Acting Deputy Director

Lilongwe

Tel: 01 751 552 Fax: 01 751 539 E-Mail: [email protected]

20.

MOH-RHU

Diana Khonje Principal

Reproductive

Cell: 09 411 400

Health Lilongwe

Tel: 01 751 552 Fax: 01 751 539

Officer

E-Mail: [email protected] 21.

Lilly Banda Maliro

USAID

Cell:

Reproductive Health Specialist

Box 30455

Tel: 01 772 455

Lilongwe 3

Fax:

Apologies

E-Mail 22.

Aly Cameron

USAID

Cell:

17

Apologies

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL

HPN Team Leader

Box 30455

Tel: 01 772 455

Lilongwe 3

Fax: 01 773 181

SIGNATURE

E-Mail 23.

Catherine Chiphazi

USAID

Cell: 09 960 017

Child Health Advisor

Box 30455

Tel: 01 772 455

Lilongwe 3

Fax: 01 773 181 E-Mail: [email protected]

24.

Esperanza Fundira

UNFPA

Cell:

Country Representative

Box 30135

Tel: 01 771 444

Lilongwe

Fax: 01 771 402

Apologies

E-Mail 25.

Dorothy Lazaro

UNFPA

Cell:

Program Officer

Box 30135

Tel: 01 771 444

Lilongwe

Fax: 01 771 402

Apologies

E-Mail 26.

Annie Chinombo

UNFPA

Cell:

Program Officer

Box 30135

Tel: 01 771 444

Lilongwe

Fax: 01 771 402 E-Mail

27.

Dr. Matshidiso Moetie

W.H.O.

Cell:

Country Representative

Box 30390

Tel: 01 772 215 /755

Lilongwe 3

Fax: 01 772 350

18

Apologies

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL E-Mal: [email protected]

28.

Teleza Mwale

W.H.O.

Cell:

Maternal & Child Health Officer

Box 30390

Tel: 01 772 215 /755

Lilongwe 3

Fax: 01 772 350 E-Mal: [email protected]

29.

Dr. Susan Kambale

W.H.O.

Cell:

Project Officer

Box 30390

Tel: 01 772 215 /755

Lilongwe 3

Fax: 01 772 350 E-Mal: [email protected]

30.

Desiree Mhango

CHAM

Cell:

Director of Health Programs

Box 30378

Tel: 01 775 404

Lilongwe

Fax: 01 775 406 E-Mail

31.

The Acting Registrar

Nurses & Midwives Council

Cell:

Box 30361

Tel: 01 772 044

Lilongwe

Fax: 01 773 932 / 01931 E-Mail

32.

Mrs. Jacintha Mtengezo

Nurses & Midwives Council

Cell:08 863 080

Box 30361

Tel: 01 772 044

Lilongwe

Fax: 01 773 932 / 01931 E-Mail: [email protected]

19

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

33.

Mrs. Asernia J. S Banda

Women

34.

35.

&

Children

First

CELL, TEL FAX, E-MAIL ( Cell: 09 292 504

Perinatal Care)

Tel:

C/O Ntcheu DHO

Fax: 01 235 459

Ntcheu

E-Mail

The Health Foundation

Cell: 08 206 892

Manobec Complex

Tel:

P/Bag 418

Fax: 01 754 103

Lilongwe 3

E-Mail:

George Chiundu

Save the Children

Cell: 09 234662

NBH M & E Officer

P.O.Box 30374

Tel: 01 753888

Lilongwe

Fax: 01 756257

Stewart Mwalabu

[email protected] 36.

Dr. Martius Joshua

Dowa District Hospital

Cell: 09 912 683

Zonal Officer

Dowa

Tel: 01 282 222 Fax: 01 282 200 E-Mail

37.

Dr. Noor Alide

Thyolo Hospital

Cell: 08 366 786

DHO Thyolo

Box 21

Tel: 01 473 411

Thyolo

Fax: E-Mail

20

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL

38.

Dr. Alexandra Piprek

P/Bag 1

Cell: 08 554 208 – Dr. Gonani

Zonal T/A

Mzuzu

Cell: Dr. Alexander Piprek : 09 158 676

SIGNATURE

Tel: Fax: 01 331 883 E-Mail: [email protected] E-Mail: [email protected] 39.

Leonard Banda

Cell: 08 339 050 / 09 683 693

Acting Zonal Officer

Tel: 01 872 130

South West

Fax: 01 872 551

Blantyre

E-Mail: [email protected] 40.

Mr. Jere

Mzimba District Hospital

Cell: 01 342 165

DHO Mzimba

Box 131

Tel:

Mzimba

Fax: E-Mail

41.

Dr. Ellen Mbweza

Kamuzu College of Nursing

Cell: 08 940 513

Box 415

Tel:

Blantyre

Fax: 01 756 424 E-Mail: [email protected]

42.

Dr. Pat Walker

College of Medicine

Cell: 09 796 772

Blantyre

Tel: Fax:

21

Apologies

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL E-Mail: [email protected]

43.

44.

Mrs. Madalo Malemba

Malawi

College

of

Health Cell: 09 945 244

Sciences

Tel: 01 756 777

Box 30368

Fax:

Lilongwe 3

E-Mail: [email protected]

Loveness Kaunda

Save the Children

Cell: 09 957 054

NBH Project Assistant

Box 30374

Tel: 01 753 888

Lilongwe

Fax: 01 756 257 E-Mail: [email protected]

45.

Steve Wall

Save the Children

Cell:

Snr Newborn Health Advisor

Box 30374

Tel:

Lilongwe

Fax: E-Mail: [email protected]

46.

Shyam Thapa

Cell:

Save the Children

Tel:

Associate Director of Policy & Box 30374 Program Research

Fax:

Lilongwe

E-Mail: [email protected] 47.

Joy Lawn

Save the Children

Cell:

Snr research & Policy Advisor

Box 30374

Tel:

Lilongwe

Fax:

22

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL E-Mail: [email protected]

48.

Jeanne Russell

Save the Children

Cell: 08 206 848

Deputy Director - Programs

Box 30374

Tel: 01 753 888

Lilongwe

Fax: 01 756 257 E-Mail: [email protected]

49.

Paul Mecartney

Save the Children

Cell: 08 206 828

Country Director

Box 30374

Tel: 01 753 888

Lilongwe

Fax: 01 756 257 E-Mail: [email protected]

50.

Rueben Ligowe

Save the Children

Cell: 08 508 538

NBH Program Officer

Box 30374

Tel: 01 753 888

Lilongwe

Fax: 01 756 257 E-Mail: [email protected]

51.

Evelyn Zimba

Save the Children

Cell: 08 277 091

NBH Program Manager

Box 30374

Tel: 01 753 888

Lilongwe

Fax: 01 756 257 E-Mail: [email protected]

52.

Maggie Kambalame

Save the Children

Cell: 08 308 064

NBH Project Officer

Box 30374

Tel: 01 753 888

Lilongwe

Fax: 01 756 257 E-Mail:

23

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL [email protected]

53

Kumbukani Kuntiya

Save the Children

Cell: 08 866 033

WRA

Box 30374

Tel: 01 753 888

Lilongwe

Fax: 01 756 257 E-Mail

54

55

Ellious Chasukwa

Christian Health Association of Cell: 09 948 583

HAC

Malawi

Tel: 01 775 180

Box 30378

Fax:01 775 406

Lilongwe 3

E-Mail: [email protected]

Hilda Chapota

Maimwana Project

Cell: 08 393 486

HSSO

Box 2

Tel: 01 242 476

Mchinji

Fax: E-Mail:[email protected]

56

Martha Mondiwa

Nurses & Midwives Council

Cell: 09 407 207

Acting Registrar

Box 30361

Tel: 01 772 044

Lilongwe

Fax: 01 773 932 E-Mail: [email protected]

57

Sipho Jale

Maimwana Project

Cell: 08 879 285 / 09 705 995

Acting Project Manager

Box 2

Tel: 01 242 476

Mchinji

Fax: E-Mail: [email protected]

58

Michele Usuelli

Cestas Cestas

Cell: 08 591 895

24

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL

Cesta Med. Coordinator

Box 20479

Tel: [email protected]

Lilongwe 2

Fax: E-Mail

59

60

Feliatas Siyameda

Kamuzu central Hospital

Cell:

Enrolled Nurse Midwife

Box 149

Tel: 01 791 094

Old Wing

Fax:

Lilongwe

E-Mail

Dr. Sinyiza

Mzimba district Hospital

Cell:

DHO

Mzimba

Tel: Fax: E-Mail

61

Mr. Enock Bonongwe

Ministry of Women

Cell:

Lilongwe

Tel: Fax: E-Mail

62

Dr. Bejoy Nambiar

THFC, Area 4

Cell: 08 748 486

Manobec Complex

Tel:

Lilongwe

Fax: E-Mail: [email protected]

63

Elsie Chitedze

UNICEF

Cell: 08 868 905

Project Assistant

Box 30375

Tel: 01 770 788

Lilongwe

Fax: 01 773 162

25

SIGNATURE

NO

NAME &TITLE

ORGANIZATION& ADDRESS

CELL, TEL FAX, E-MAIL

SIGNATURE

E-Mail: [email protected]

Bernadette M.E.G Dalemans, Medical Director, Dept of Child and Adolescent Health and Development, WHO/Geneva; [email protected] Rober B. LeCompte, Quality Improvement; [email protected] Vincent Fauveasu, MD, Senior Advisor, Maternal Health, UNFPA Geneva Office; [email protected] Peter N. Kasembe, MBChB, Executive Director, Kumuzu Central Hospital/Baylor college of Medicine; [email protected] Issac Chipofya, Deputy Country Director, Finance and Administration, Save the Children, Malawi; [email protected] Sarah Macfarlance; [email protected] Mamadou Hady Diallo, Senior Advisor, Country Support, PMNH, WHO/Geneva; [email protected] Bejoy Nambiar, Resident Advisor, ICH/Health Foundation Project, Malawi; [email protected]

26

27