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Journal Article
|Research

Bringing care to the community: expanding access to health care in rural Malawi through mobile health clinics

Geoffroy E, Harries AD, Bissell K, Bvumbwe A, Tayler-Smith K, Kizito W
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Abstract
SETTING
Malawi has chronic shortages of health workers, high burdens of human immunodeficiency virus (HIV) infection and malaria and a predominately rural population. Mobile health clinics (MHCs) could provide primary health care for adults and children in hard-to-reach areas.

OBJECTIVES
To determine the feasibility, volume, and types of services provided by three MHCs from 2011 to 2013 in Mulanje District, Malawi.

DESIGN
Cross-sectional retrospective study.

RESULTS
The MHCs conducted 309 492 visits for primary health care, and in 2013 services operated on 99% of planned days. Despite an improvement in service provision, overall patient visits declined over the study period. Malaria and respiratory and gastro-intestinal conditions constituted 60% of visits. Females (n = 11 543) significantly outnumbered males (n = 2481) tested for HIV, yet males tested HIV-positive (27%) more often than females (14%). Malaria accounted for 26 421 (35%) visits for children aged <5 years, with a significant increase in the rainy season. Implementation of rapid diagnostic testing was associated with a decline in numbers treated for malaria. Antibiotic stockouts at government clinics were associated with increased MHC visits.

CONCLUSION
MHCs can routinely provide primary health care for adults and children living in rural Malawi and complement fixed clinics. Moving from a complementary role to integration within the government health system remains a challenge.

Countries

Malawi

Subject Area

models of careaccess to health care

Languages

English
DOI
10.5588/pha.14.0064
Published Date
21 Dec 2014
PubMed ID
26400705
Journal
Public Health Action
Volume | Issue | Pages
Volume 4, Issue 4, Pages 252-258
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Bringing care to the community: expanding access to health care in rural Malawi through mobile health clinics | Journal Article / Research | MSF Science Portal