Earlier this year, the government of Malawi did something extraordinary for the mothers and children in my home country.
They updated a list.
That might not sound like much, but this list could save the lives of millions of pregnant women and their babies.
The situation in Malawi is alarming: 1 woman out of every 18 dies from basic complications during pregnancy or childbirth. Pregnancy is such a dangerous time that expecting Malawian women are often said to have “one foot in the grave.”
The loss of life from these complications is unnecessary. Common causes of maternal and newborn death—such as postpartum bleeding or newborn sepsis—are preventable with simple medicines and technologies.
Since 85 percent of the country’s citizens live in rural areas, clinics are the only access to healthcare for the majority of the population. The medicines these clinics stock truly mean the difference between life and death. The challenge is getting medicines to those who need them most.
A global commitment raises hopes for change
Saving lives begins with the government and a pledge.
In 2012, Malawi’s government signed on to a global initiative called the UN Commission on Life-Saving Commodities for Women and Children, pledging to make a list of 13 “commodities” (or simple medicines and technologies) available to women and children around the country. The commission estimated that widely providing these commodities could save the lives of more than 6 million women and children across the globe.
Despite the government’s pledge in 2012, the Malawi Essential Medicines List (EML) was missing a number of the 13 medicines: newborn resuscitation devices, antenatal corticosteroids, injectable antibiotics for newborn sepsis, and contraceptive implants to prevent unintended pregnancy. For another two years it remained out of date, preventing crucial medicines from reaching the women who needed them.
Keeping the pressure on
As a health advocate for the last 10 years and founder of the Health and Rights Education Programme (HREP), I watched Malawi’s commitment to the UN with excitement. I know how important the government’s role is to improving the lives of its people.
Equally important, I believe, is our role as citizens to hold the government accountable to its promises.
As the incomplete list sat on a shelf, I knew we had to act. Through advocacy training and support from PATH, HREP gathered 15 partner organizations to present a civil society petition to the government.
Over the course of six months, we met with high-level officials in the Ministry of Health to remind them of their commitments and ensure they understood the most recent evidence on the missing commodities.
We also informed media. Our voices were small compared to the government, but we knew that we could “make some noise” by educating journalists and broadcasters. Our efforts were covered by every Malawi daily newspaper and various radio programs. As attention from the public—including health workers—increased, health officials and other government stakeholders began expressing their support for updates to the EML.
A completed list
I’m proud to say that this January, the Ministry of Health updated Malawi’s EML to include every missing commodity. My fellow health advocates and I were thrilled to hear the news, as this is the first critical step to saving the lives of so many Malawian women and children.
Officials like Dr. Dominic Nkhoma, head of policy at the Ministry of Health, praised the advocacy that was key to this success:
“Health policy advocacy is important in Malawi as it affords an opportunity for lower-level health officers to appreciate and understand the new and reviewed health policies—in this case the new EML—which could have taken a long time. Local CSOs like HREP did a fantastic job in this regard.”
More promising, Secretary of Health Chris Kang’ombe declared that health workers around the country would receive education on each of the new inclusions.
I applaud this important step by the government to increase access and save lives. But like many health advocates know, this is only the beginning. Now civil society, the government, and the health community must come together to make sure that that our completed list translates to action to help Malawi’s mothers and their children lead healthy lives.