Addressing healthy settings in Malawi
The SCHI Healthy Settings programme is focussed on addressing the social determinants of health. The World Health Organisation defines these as “the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels”. These issues affect the every day lives of Malawians living in rural and urban areas however they are often overlooked in the development and management of health services (both preventative and curative) due to limited resources and specific focus on particular diseases.
The SCHI, in partnership with the Ministry of Health is piloting the concept of the healthy settings approach in Chikhwawa District. The concept of healthy settings is supported by the Health Sector Strategic Plan (2011 – 2016), as a means to address the current limitations of preventive health services at community level and ensure the delivery of the Essential Health Package. Environmental health is key in implementing this system through the District Health Office, particularly the Health Surveillance Assistants who are community based health workers interacting with villages on a daily basis.
Successful improvements in disease prevention have been limited in Malawi in the last 20 years. Despite an understanding that many of the diseases causing morbidity and mortality are preventable, and consistent focus on education and behaviour change at community level, there has been little improvement in many health statistics. This may be due to a number of barriers and challenges at village level many of which have been identified in previous SCHI programmes. These include:
With all of this in mind, the SCHI will be implementing a healthy settings programme which will aim to tackle the social determinants of health and take into consideration these key obstacles to village development throughout the programme.