Access to public services is a critical issue for planners and policy makers to take into consideration when making evidence-based plans, budgets and policies. In an exercise conducted through Score Cards and Feedback Desk Operators (FDO) on Water, Sanitation and Hygiene amongst selected Health Centres in Lilongwe District, the results were far from satisfactory.

One of the clinics that stood out in the FDOs was Mngoni Health Centre, which is situated in Lilongwe City North East Constituency in Traditional Authority Mtema. The Health Centre has a population of over 40,000 in its catchment area and it accommodates an average of over 200 Out Patient Department per day with one Medical Assistant attending to these patients.

Among other issues there is lack of an ambulance at the clinic, shortage of drugs, forcing patients pay for medical services yet the services are meant to be accessed freely, turning back patients when they go to the hospital at night, lack of proper beds plus beddings in the maternity wing, shortage of staff, patients not being respected by Health Officers and unnecessary closure of the clinic when Health Officers are attending to other demands.

During one of the visits, CONGOMA officials interacted with one of the service users, a twenty-five-year-old lady, Gladys Binisoni, coming from Mtema area, Traditional Authority Mtema. This mother of four children said that she started giving birth in 2007 and she has been receiving medical attention from Mngoni hospital all these years.

She highlighted that the Medical Assistant at the Health Centre does not give them enough medical attention when they seek medical services. She said there were many occasions where expectant women reached an extent of giving birth on their own due to the unavailability of the Medical Assistant at the hospital.

“This Doctor does not give us enough attention. He usually tells us to wait for long hours before receiving treatment and that has contributed too many of us giving birth on our own like the way I delivered my baby on my own in 2007 where the doctor was at his home. The time the doctor was coming I had already delivered and I had severe wounds, as a result I was forced to visit the Traditional Healer for extra treatment to heal the wounds”, lamented Binisoni.

She further said that the Health Centre lacks proper beddings, beds, and mattresses in the labour ward, a situation which make patients bring their own beddings when going to the hospital.

“Things have not been improving at this Health Centre. Patients and guardians are prone to contracting diseases as there are only two toilets and water is a problem since the nearby borehole is not reliable. Sometimes the borehole runs out of water forcing guardians walk long distances to fetch water for their patients”, further complained Binisoni.

In her concluding remarks, Binisoni appealed for urgent support from well-wishers to make the hospital favourable to those who are less privileged. This was supported when she mentioned that patients pay MK200 to the Medical Assistant for them to access Panado and MK500 to be given an injection whenever there is congestion and those who do not have money are the ones who suffer more.

Separately, Medical Assistant at Mngoni, Doska Gondwe, highlighted that the Health Centre lacked enough beds as well as mattresses in the Maternity ward and some patients sleep on the floor. He explained further that even the bed used for deliveries was not fit for the purpose, implying women were still having problems during delivery.

He also complained that the working environment was still getting tougher for him as continuously attending to patients without having enough rest. He attributed this problem to inadequate members of staff and that the nurse who was assigned to work along with him had not yet reported for duties.

Based on this evidence from the ground, it is vivid enough that urgent attention is needed at Mngoni Health Centre so that members of the community access reliable services all the time. The Citizen Report Card that was conducted through the Feedback Desks Operators provided an eye opener on actual issues which members of the community are facing on the ground and the kind of help they actually need from duty bearers. CONGOMA therefore picked up the raised issues to a National Interface where various officials from the District Health Office, District Commissioner, Members of Parliament, Service Users, Anti- Corruption Bureau, and all relevant Stakeholders were present to map way forward.

Top official from District Health Office (DHO), Ethel Rambiki, admitted that Health Centres from rural areas were indeed facing challenges and she promised that the office of the DHO would intervene with urgency to address some of the challenges being faced at Mngoni Health Centre. She also clarified that each Health Centre in line with Malawi standards needed to have a minimum of two Medical Assistants, two Nurses and one Assistant Environmental Health Officer. She however said the situation was not like that on the ground because Government does not have enough money to pay for wages of these Health workers.

Responding to the findings, Member of Parliament for Lilongwe City North East, Chrissy Tembo, where Mngoni Health Centre is found said she was aware of some challenges faced at the Heath Centre. She confirmed some extreme scenarios which needed to be addressed urgently. She was grateful to have been presented with the findings and she promised to take up the concerns and follow up the issues with relevant authorities to end the problems which members of her constituency were facing.

As a way forward CONGOMA is therefore expected to produce Policy Papers from the findings, follow up the issues with relevant stakeholders and engage duty bearers on necessary steps to take to help in alleviating such problems.

CONGOMA in partnership with Centre for Youth and Children Affairs (CEYCA) and Centre for Youth Development and Social Empowerment (CYDSE) with financial support from IM Swedish Development Partner has been implementing Social Accountability Programmes since January 2018. This ongoing project for the past months has been focusing on areas such as Health, Education as well as Water, Sanitation and Hygiene (WASH). The exercise in Health was conducted in Chiwe, Lemwe, Kasiya, Kabudula, Kawale, Mitundu, Area 18, Mtenthera, Chiwamba, Mngoni, Ukwe and Chikowa.