Trained health workers for quality health care
Amref Health Africa (UK and Malawi) is partnering with the Medical Council of Malawi to train health workers to deliver quality health services that are efficient, effective and equitable for communities in four districts in Malawi.
In Malawi, Health Surveillance Assistants (HSAs) play a foundational role in primary health care (PHC).
The HSA workforce was created in the 1950s to deliver mass public vaccination campaigns and are now a primary care workforce serving as a link between a health facility and the community.
What are HSAs?
Each HSA is responsible for 1,000 people, though the actual size of their catchment populations is often more than this. They are recruited centrally as a core health worker cadre.
Their tasks include community health, family health, environmental health, prevention and control of communicable diseases, and community case management, including HIV, malaria, diarrhoeal diseases, pneumonia, and undernutrition.
Their work at the community level is critical to achieve Universal Health Coverage (UHC), but for decades, HSAs have struggled to professionalise – an important step for the delivery of quality health care to communities.
Meet Fanizo Simenti
Fanizo Simenti is a trained Health Surveillance Assistant (HSA), and for the people from villages in his district (he is responsible for 21 in total) he is usually the only health worker they will have access to. He’s become known as the "village doctor".
Essential services
Simenti provides preventive services like infant and child immunisation under the National Expanded Program on Immunisation, and treatment for illnesses such as malaria, pneumonia, diarrhoea, and eye infections in children under five. He also monitors their growth and nutrition, teaching parents how to care for their children. The services he provides are essential.
Providing services to communities
"Each [of the 21 outreaches] has its day in the month," Fanizo explains. Covering such a wide area by bicycle is no easy task - but without a bicycle or other form of transport it would be simply impossible. The logistical and training support that Fanizo gets means that he can deliver quality services to 21 different communities.
What is Amref doing to help train health workers in Malawi?
Amref Health Africa UK, in partnership with Amref Health Africa in Malawi, has identified an opportunity to collaborate with the Malawi Ministry of Health and Medical Council of Malawi to deliver a programme to support the recruitment, training and continuous education of HSAs to up-skill and motivate the workforce in four districts.
What will the programme deliver?
Running from April 2025 to January 2026, the programme aims to develop and digitise an Individual Performance Management System framework for Health Surveillance Assistants and pilot its implementation in four districts.
The programme will also develop a robust Continuous Professional Development (CPD) system and online training programme for HSAs.
Thank you to Global Health Partnerships and the UK Government Department of Health and Social Care for their support of this programme made possible through their funding of the Global Health Workforce Programme.