Mulanje Mission Hospital in 2015

1. Mulanje Mission Hospitalin 2015

4. Governance • Member of Christian Health Association of Malawi (CHAM) • Overseen by CCAP Blantyre Synod Health Board, reports to Deputy General Secretary • Work in partnership with Government - since 2006 Service Level Agreement with Mulanje District Health Office, providing free services for • Maternal health for catchment population • Inpatient services for children under 5 Mulanje Mission Hospital

5. MMH Mission Statement ‘Mulanje Mission Hospital is a health facility under CCAP Blantyre Synod committed to provide quality preventive, curative, rehabilitative and palliative health care to the community in the catchment area and all others who seek our services, irrespective of gender, age, religion or social status, in an environment where Christian values are upheld’ Mulanje Mission Hospital

6. Mulanje Mission Hospital

7. Services provided at MMH (205 beds) OUTPATIENT SERVICES • Reproductive health • Under 5s clinic • Dental clinic • Outpatient clinics • HIV care and ART clinic INPATIENT SERVICES • Maternity wing • Female ward • Children’s ward • Male ward • Isolation ward PRIMARY HEALTH CARE • Environmental health • Orphan Care Centre • Nutrition rehabilitation unit • 12 outreach clinics • Palliative care SUPPORT SERVICES • Pharmacy • Laboratory • Radiology • Laundry • Mortuary • Maintenance Dept • Guardian shelter Mulanje Mission Hospital

8. Mother and Child Health clinic Mulanje Mission Hospital

9. Main diagnoses in 2013/14 • HIV testing and counsellling (10,714) • Patients on ART for AIDS (7,300) • Malaria (5,524) • Sexually Transmitted Infections (2,703) • Maternity care (2,600 women) • Acute Respiratory Infections (1,517) • New HIV infections (1,456) • Opportunistic infections (962) • TB (185 new cases) Mulanje Mission Hospital

10. Mulanje Mission Hospital

11. In 2013/14 MMH provided: • 74,136 ART clinic attendances • 32,064 general outpatients • 32,284 under 5 outpatients • 13,828 Family Planning attendances • 8,299 admissions • 7,547 antenatal visits • 2,323 deliveries • 451 caesarian sections Mulanje Mission Hospital

12. Staffing in 2014/15 • 6 Senior management team • 2 volunteer doctors • 11 clinicians + 2 interns • 9 technicians • 58 nurses • 167 support staff Mulanje Mission Hospital

13. Primary Health Care • Catchment area: • 111 villages ( grouped as 72 villages by Govt) • 84,000 people • 12 outreach clinics • Four focus areas: • Environmental Health • Maternal and Child Health • Nutrition • HIV / AIDS and palliative care Mulanje Mission Hospital

14. Community outreach – there are often 450 mums and babies waiting when we visit this clinic Mulanje Mission Hospital

15. New village pump Mulanje Mission Hospital

16. Recent Developments • Renovation and extension of operating theatres Mulanje Mission Hospital

17. Recent Developments 3 new community health posts constructed Mulanje Mission Hospital

18. Recent Developments • Installation of solar power to key areas of hospital Mulanje Mission Hospital

19. Developments in 2014/15 Scaling up of ART service – towards 8000 patients Primary care – wider implementation of malaria control strategy Strengthening district wide palliative care programme Participation in College of Medicine teaching of 4th year medical students on Family Medicine programme Continuing emphasis on Infection Prevention and control Mulanje Mission Hospital

20. Capital Programme for 2014/15 • Insulation of nursery ceilings • Improvements to hospital water supply - completed • Improvements to drainage and sewer system • Renovation of male ward private rooms - completed • Extension of solar PV to male and female ward • Accommodation for palliative care students • One new health post • Renovation of antenatal ward Mulanje Mission Hospital

21. Future plans • Expansion of palliative care clinic • Expansion of chronic disease management (diabetes and HT) • New site for dental clinic • Development of High Dependency Unit • Move Isolation ward to more appropriate site • Staff capacity building for the above Mulanje Mission Hospital

22. Future plans (2) All these developments require staff- one of the major constraints on recruitment of staff is accommodation We currently urgently need 9 houses; • Two for senior clinicians returning from degree programmes in surgery • Three for nurses • Two for Clinical officers • One for a radiographer • One for management - Human Resource officer Service developments in antenatal and high dependency nursing will require four further nurses plus accommodation. Mulanje Mission Hospital

23. Projected Income 2014/15 Total MK 959m ($2.4m) Mulanje Mission Hospital

24. Main donors in 2014/15 • Edinburgh Medical Missionary Society • English Reformed Church – Amsterdam • Blacksburg and Pittsburg churches, USA • Church of Scotland • ICCO, Netherlands • Plan International • Presbyterian World Service & Development, Canada • Presbyterian Church USA • Presbyterian Church in Ireland • Bond University, Australia • ….and many other organisations and individuals Mulanje Mission Hospital

25. Projected Expenditure 2014/15 Total MK 952m ($2.4m) Mulanje Mission Hospital

26. PHC Programmes: Total MK108.1m ($0.27m) Mulanje Mission Hospital

27. Main challenges • Financial management in a difficult climate, govt funding + donations decreasing, inflation ≈30% • Maintaining drugs and clinical supplies • Scaling up disease control programmes • HIV/AIDS, palliative care, TB, malaria, schistosomiasis, water and sanitation • MCH – ANC, FP, reducing teenage pregnancy • CDM - responding to increasing diabetes and HT • Improving quality of care, esp surgical post op care • Reliable power and water supplies • Providing accommodation for staff • Providing staff training opportunities • Maintenance of infrastructure and equipment Mulanje Mission Hospital

28. For further information, a copy of this presentation and much more.......... www.mmh.mw Mulanje Mission Hospital

29. Thank you for listening! Zikomo very much! Thank you kwambiri! Mulanje Mission Hospital