Counting the cost of failing health system

One year-old Griffin (not his real name) is a cheerful little boy who enjoys being with his mother always perhaps, to enjoy the motherly love.

But all is not well with Griffin as he is now living with HIV at a young age which was transmitted to him from his mother during delivery.

Griffin is in this situation because his mother who we shall call Grace from Chigwere village Traditional Authority (T/A) Nyaluwanga in Nkhata Bay district, gave birth at home after failing to access delivery care at a health facility due to lack of a health center in the area.

Grace, a mother of three, claims that in the absence of a health center, she had no money to use for transportation to go and receive free delivery care at the nearest St John’s Mission Hospital in Mzuzu, a distance of about 25 kilometers.

“The main challenge here is that hospitals are far away. I did not want to deliver at home but I had no money. From here to go to St John’s Mission Hospital we pay K1, 000,” Grace says.

She also claims that apart from lacking transportation, she needed extra money to get an authorization letter from Group Village Headman Chigwere to deliver free of charge at St John’s Mission Hospital which she did not have.

In his reaction, Senior Group Village Headman Chigwere claims money which he collects is just a reward for his effort to provide the authorization letters.

“I am always at the farm and I normally leave my work in order to write authorization letters. We as chiefs we don’t receive salaries. Sometimes we receive honoraria maybe after three to four months so I think it’s not fair to me to stop my work and attend to somebody freely,” Senior GVH Chigwere says.

According to the chief, it is the responsibility of every woman to prepare well for her pregnancy by among other things, making sure that they have K1, 000 for the authorization letter.

“It does not make sense for a pregnant woman to claim that there is no money to pay for the authorization letter. I don’t think someone can fail to raise K1, 000 in nine months,” the chief says defiantly.

Senior GVH Chigwere said expectant women who cannot afford to pay for the authorization letter are advised to get treatment at a nearest health center instead of going to St John’s Mission Hospital where they can be charged more money in the absence of the authorization letter.

Public Relations Officer for Nkhata Bay District Hospital, Christopher Singini describes the child’s situation as sad.

Singini, while acknowledging the problem of lack of a nearest health center in the area, says pregnant women from the area can always access services at Chikwina Health Centre for maternal services.

However, Singini highlights that issues of long distances between health facilities in the district are a big challenge due to the district’s hilly terrain.

Ministry of Health and Population spokesperson, Joshua Malango says efforts to improve maternal and child health needs support from all critical players including traditional leaders.

Executive Director for Malawi Health Equity Network (MEHN), George Jobe, says traditional leaders should always strive to promote and improve maternal and child health in their areas.

Jobe asked government to make sure that pregnant women are not travelling long distances to access maternal health services to ensure access to Prevention of Mother to Child Transmission (PMTCT) services.

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