Not long ago, health surveillance assistants (HSAs) in Mdeka, Traditional Authority Chigaru in Blantyre, faced a daunting challenge of delivering life-saving vaccines to under-five children under trees or in makeshift shelters.
Rain, wind and blistering heat were constant disruptions.
At times, immunisation sessions would be cancelled due to bad weather or lack of proper space.
But at Mpanda and Masinde villages that reality has changed, courtesy of members of Mdeka Mother Care Group (MCG).
“We were tired of watching babies get vaccinated under trees. So, we agreed to build proper shelters. We did not wait for the government—we used what we had,” says Mdeka MCG chairperson Chrissy Issa.
Community-led solutions
Established in 2019 by the Malawi Health Equity Network (Mhen) with support from the Ministry of Health and Gavi, the Vaccine Alliance, Mdeka’s is one of the care groups formed under the Health Systems and Immunisation Strengthening (HSIS) Project.
Mhen is implementing the project in Blantyre, Lilongwe, Mchinji, Dowa, Ntchisi, Kasungu, Chitipa, Mzimba North and Mzimba South.
The project seeks to improve access and uptake of immunisation services, especially in hard-to-reach areas and urban slums, as part of Malawi’s push toward achieving Sustainable Development Goal 3 on ending preventable deaths of new-borns and children under five by 2030.
The group comprising 30 women and a group village head (GVH) supports health service delivery, advocate for increased vaccine access and mobilise local resources to improve maternal and child health services.
For the care group, the journey began by identifying a problem: mothers walking long distances and accessing vaccines in open areas.
During meetings, communities and their local leaders agreed to come up with vaccine outreach points and build iron-roofed shelters.
“We set up outreach clinics closer to our communities. But we had no buildings, so children were receiving vaccines in tree shades,” says Issa.
The lack of proper shelters continued to compromise service delivery, especially during the rainy season when sessions had to be postponed or cancelled.
“We approached our traditional leaders and shared the idea of building shelters. They supported us fully. And some well-wishers gave us land while traditional leaders mobilised their people to mould bricks, collect quarry stones, river sand and water,” recalls Elube Bisayi, Mdeka care group secretary.
Support also came from Save the Children and Zaco Company.
At Mpanda, Save the Children funded construction in 2020, covering costs for cement, roofing sheets and builders’ wages. And, a local company Zaco did the same at Masinde Village.
“So far, we have completed two permanent shelters and have already moulded bricks for more at Mtambalika and Grant villages.
“We have also partnered with a Muslim organisation to drill boreholes at Masinde, Libuda and Namikango vaccination sites to ensure we have clean water,” says Bisayi.
Beyond Mdeka
Mdeka is not the only group building community-owned vaccine shelters.
Tikondane and Namende MCGs also mobilised local resources and built modern shelters for offering under-five clinic services.
This approach, according to Mhen executive director George Jobe, is proving that community ownership can help transform health services.
“The shelters offer dignity and safety to mothers and children, and the work these women are doing deserves national recognition,” he adds.
Jobe notes that mothers’ care groups have also helped build houses for HSAs in some areas, ensuring that front-line workers are better supported.
Praise for local efforts
Blantyre district director of health and social services Dr Gift Kawalazira, applauds the role of MCGs in helping the district achieve significant gains in immunisation.
“Currently, Blantyre’s vaccine uptake stands at 80 percent largely due to the passion and commitment of these women.
“Their advocacy, outreach and infrastructure development efforts are an excellent example of how communities can complement health systems,” he explains.
Extended Programme on Immunisation deputy coordinator Gladys Chithyoka says the women volunteers do not only trace children who have missed vaccines, but also ensure that outreach sites are functional, safe and accessible.
“This is the kind of community-driven model that can be scaled across the country,” she says.
Stronger health systems
The project seeks to address systemic barriers to immunisation by building capacity in local health systems and involving civil society in meaningful ways.
“In some villages, cultural or religious beliefs were keeping families from accessing vaccines. In others, it was just the distance or lack of clean facilities. MCGs are bridging those gaps,” explains Jobe.
As Malawi continues its journey toward universal health coverage, the work of grassroots women like those in Mdeka serves as a blueprint for success.
“We did not have money,” says Issa. “But we had unity. And because of that, our children now receive vaccines in safe, dignified places.”
