Contributor: Felix Chisoni
In Malawi, the national health system is riddled by many challenges. For instance, it has been a challenge to collect timely, reliable and accurate data. Most of the rural areas of Malawi are off the national power grid. As a result, alternative energy sources are necessary for implementation of electronic systems.Solar energy has proven to be a viable alternative source of energy in poorly resourced settings.
In village Chief Chalasa, TA Mtema, solar panels convert sunlight into electrical energy, which is channeled to and stored in batteries. The batteries power up touchscreen based computers for data entry. The coming of this system brings many benefits, beyond the data entry, which if implemented across the country will fetch far more benefits and therefore adding value to the targeted communities.
The Community vitals (births, deaths, and marriages)system, funded by the The Union Against Tuberculosis and Lung Disease (Union), Electronic Medical Records Grant program, are managed through Baobab Health Trust based in Capital Lilongwe. The system called Community Vitals Registration helps the National Registration Bureau strengthen vitals registration both at community and Health facility level.
The need for technological services across the country keeps advancing and yet many facilities are off the main electricity power grid. BHT’s director of Operations, Alex Gondwe notes that “The need to collect data in all health facilities including those in rural areas is inevitable. We therefore must put up systems that will work both in urban and rural areas. In order to make this happen in rural settings, we intend to set up power systems that are reliable, affordable, appropriate and scalable. It requires relevant technologies that should keep systems running all times, but also technologies that add value to the users and the local community”
In this regard, Gondwe notes that it is Baobab’s vision is to ensure that it deploys systems that have impact beyond the targeted solution. It is noted that while it is necessary to provide systems for vitals registration and recording of patient data for reporting and managing patient outcomes, the same power should be used to light labour wards or entire facility, for example, thus contributing to maternal health among other key issues. From an economical point of view, rural people must be able to charge their phones, power up radios use light for reading among others.
“Light prolongs productivity hours in cases where people have an opportunity to read long hours at night, thus promoting education, reduce dependency on dry cells, and times listening to radios hence have access to information for development. In some cases, through readily charged phones, they may have access to the Internet where they can again get vital survival information”, notes Gondwe.
In settings where development lags behind, it is recommended that development initiatives should help change the perception of the targeted communities and the surrounding area. For instance, the proposed use of solar powered bulbs may appear to have high initial implementation costs but this, overtime will transpire to be the most cost effective and with far wide ranging benefits. This may later persuade the community who may for so long been believing that large solar panels are the only solution for rural areas which are off main electricity power grid.
Baobab Health Trust and The Union have collaborated for years in the development of electronic medical records systems (EMRs) The Union has so far supported the development of systems for managing Anteretroviral Therapy (ART) and Out Patient Diagnosis (OPD) patients at Ntcheu District Hospital in the Central Malawi.
The vitals registration project intends to work within the framework of the National Registration Bureau and Ministry of health in strengthening vitals registration. The Community Vitals Registration module intends to record demographic details of babies and their parents, death demographics, birth and death reports and consolidate village registers.
Section 3 of the National Registration Act of 2009 calls for the Government of Malawi establish a National Registration System that records births, deaths, and marriages at the village, traditional authority, district, and national levels. The registration system must also include a registry of everyone in Malawi who is 16 years or older and is a Malawian citizen or has a permanent residence permit, a temporary employment permit, or a business residence permit.
It is for this reason that Baobab Health Trust with support from the Union intends to complement government’s efforts through this pilot program implemented at TA Mtema’s area 30km North West of Lilongwe City.
According to the Ministry of Energy and Mining, rural households are not connected to the main power grid. With a population of about 15, million, it is estimated that only about 8.1 percent of Malawians have access to electricity. From this, 92 percent are from urban areas.
Recently, the government launched the Rural Electrification Program. It also increased electricity megawatts from 250 to 350 megawatts in-order to meet the current energy demand. But rural areas still remain unconnected, as such, deployment of Electronic Medical Record systems will remain a challenge in rural and peri urban areas and yet, information must be captured for planning and other issues.
Given success recorded at TA Mtema’s area, the use of solar power if well executed can be a viable source of energy at least for the foreseeable future. This may also be used in Health facilities for lighting and other operations. So far over 1300 citizens have been registered in two villages at Village Chief Chalasa and Mtema giving hope on the viability of solar powered systems in health care.
The NRB continues to heavily rely on paper based records in manging vitals. Only one facility currently produces birth reports and TA Mtema only records vitals.