write an intervention program regarding health education about malaria, acute respiratory infection, vaccines, HIV.
The aim of this intervention is to:
-Prevention of disease
-recognition of disease
-creating linkages to health care system.
Program should focus on:
3-challenges and limitations
You have been working within a community-based organization (CBO), located in Kasungu District in rural, central Malawi. This organization has heard about a small grants program with a maximum award of $25,000 for one year (with the potential for renewal) to address pressing health care challenges in rural communities in Malawi. Your CBO solicits your help in writing a grant proposal to support efforts to improve maternal and child health (MCH) in Kachere, a village in Kasungu
Kasungu has a population of 627,4271 and most of the population engages in agricultural production, especially in tobacco and maize. In Kasungu, the Traditional Authority2 of Tedza, home to 39,081 people, is located 20 kilometers south of Kasungu Town off the paved road that connects Kasungu to Lilongwe, the capital of Malawi, which is two hours away. Kachere is a small village of 1,000 people, 15 kilometers from the center of Tedza, the small town of Chimanga. As an example of the challenges faced by women in Kasungu you meet Eva, a 27-year-old mother living in Kachere. Two of her six children have died: one of malaria and one of pneumonia. Two of her remaining children are malnourished and have frequent bouts of diarrhea. Eva is afraid that they also will die. She feels inadequate because of her inability to satisfy her children’s hunger, keep them healthy, and send them to school. Eva’s husband, Peter, leaves for extended periods to earn money as a casual laborer in Blantyre, Malawi’s commercial center in the south. Eva’s husband will return soon and will want to have sex again. She does not want more children right now and is also afraid that her husband might have HIV. Additionally, polygamy is common in Tedza and Eva fears that her husband will take a second wife with the money he is earning in Blantyre. Eva belongs to a savings and loans group with 10 other women, but she has been inactive for the last three months because of her husband’s absence. In the past, Eva contributed to the savings and loans group by asking her husband for money or doing casual day labor.
Eva’s community practices patrilineal customs, including men owning land and wives moving to their husband’s home villages. The majority of household decisions, apart from small household purchases, are made by men because they are considered the head of household. Eva is worried her husband will want to start growing tobacco, Kasungu’s main cash crop and Malawi’s largest export3. Tobacco is labor intensive and requires expensive inputs and Eva is concerned that growing tobacco will make her and her family more food insecure because of unstable market prices. Her family’s diet consists primarily of maize, much like others in her community.
There are several stakeholders in Eva’s community that are involved in development and health related activities:
1. Traditional Authority and local public services: Local community leaders, including the Village Head and Village Development Committee, are involved in deciding and enabling which development projects can take place in their community. Most of the public services like the local hospital, secondary school, and government offices are in the TA Tedza center, 15 km from Kachere. There is one health clinic in Chimanga with two nurses and one clinician5 who split their time between Chimanga and the hospital in Kasungu Town. The local primary school is 3 kilometers from Eva’s home.
2. NGOs and International Organizations: There is one international NGO and a couple of local NGOs operating in Tedza. The international NGO helps to facilitate the loans and savings group to which Eva belongs. There is also the community-based organization with which you have been in contact.
3. Religious groups: Eva’s local village church serves as a meeting place for non-governmental organizations to reach out to the community