In the sun-baked villages of Nkula, under Traditional Authority Kunthembwe in Blantyre, a quiet revolution is taking shape.
It does not involve loudspeakers or grand rallies— but a group of resilient women walking from door-to-door with burning commitment to protect lives of babies.
They are members of Tikondane Mother Care Group (MCG), and their mission is simple but powerful: ensure that every child in their villages receives life-saving vaccines.
With determination, they traverse the dusty paths of villages like Mtenthe, Malekano, Chikaonda and Siyilesi— knocking on doors, checking vaccination records, and urging mothers not to miss immunisation appointments.
“When we started around the year 2000, vaccine coverage here was about 40 percent.
“Today, we are above 90 percent. But we will not stop until we reach 100 percent. Forward ever, backward never,” says Tikondane MCG chairperson Harriet Divason.
These women are the grassroots champions of a much bigger health initiative— the Gavi Health Systems and Immunisation Strengthening (HSIS) Project.
This five-year project is a collaboration between the Government of Malawi and Gavi, the Vaccine Alliance, with implementation support from the Malawi Health Equity Network (Mhen) through the Ministry of Health.
The goal of the project is to strengthen Malawi’s health systems in line with the Sustainable Development Goals (SDGs)—particularly SDG 3, which aims to end preventable deaths of new-borns and children under five by 2030.
“MCGs are helping us close gaps in vaccine access. They support service delivery, raise awareness and act as a bridge between the health system and communities—especially in hard-to-reach areas,” explains Mhen executive director George Jobe.
Mhen is implementing the project in Blantyre, Lilongwe, Mchinji, Dowa, Ntchisi, Kasungu, Mzimba South, Mzimba North and Chitipa where the organisation has established and trained 196 MCGs.
The groups operate in hard-to-reach rural areas and urban slums, where access to health services is obstructed by poor roads, scattered villages, economic pressures or cultural and religious barriers.
Each MCG comprises 30 women and a group village head, acting as volunteers who trace defaulters, raise awareness and mobilise community support for immunisation and other essential health services.
At the heart of their strategy is a simple, but effective tool: the defaulter tracing box.
Each baby’s immunisation card is placed into a box divided by month.
When a child receives a vaccine in January, the card is moved to February. If it stays in January, it means the child missed the next dose and this triggers a home follow-up.
“It’s a practical way to track defaulters. We don’t need fancy gadgets—just community knowledge and determination,” says Alinafe Bonongwe, another member of Tikondane MCG.
And the approach is working.
Chipambano, Namende, Mdeka, Chiswe and Nangafuwe MCGs are also using the same system to trace defaulters.
In Nangafuwe, chairperson Bethia Musano and secretary Ellen Mkwate report a steady rise in vaccine uptake.
“Since we introduced the defaulter tracing box, we have seen real change,” says Musano. “We know every baby by name, and no child is left behind.”
The local mobilisation campaign is changing the district’s immunisation profile.
“Blantyre is now a shining example of community-driven health progress,” says Gladys Chithyoka, Blantyre EPI deputy coordinator. “We have exceeded 80 percent vaccine coverage due, in large part, to the MCGs.”
The district has also been recognised at national level for its immunisation success.
Dr. Gift Kawalazira, Director of Health and Social Services in Blantyre, credits the MCGs for pushing vaccine access to the last mile.
“We have expanded immunisation centres and improved storage using solar fridges, but the MCGs are the heartbeat of our efforts.
“They reach places we cannot, and speak to people in a language they understand,” he explains.
Beyond vaccines, the MCGs contribute to broader health outcomes by advocating for antenatal care, nutrition and sanitation.
They also mobilise local leaders to support immunisation efforts—building a network of trust that counters misinformation and cultural resistance.
In line with the Malawi Growth and Development Strategy (MGDS), particularly key priority Area 5 on health and population, HSIS project strengthens participatory health governance. It reduces barriers to equitable access, focusing on communities systematically left behind due to geography, poverty or cultural beliefs.
As the sun sets on another long day, the women of Tikondane gather under a tree, recounting stories from the day’s visits. They laugh, update their defaulter boxes, and plan for the next week.
They may not wear white coats or draw salaries, but these women are changing lives—one visit, one card, one vaccine at a time.
“We’re just mothers helping other mothers,” says Harriet. “Because when one child is protected, the whole community is safer.”
