Apart from curative care Mua Mission Hospital has extensive programmes in preventive health care, both at the hospital and as outreach programmes, going into the villages. Health education is part of each of these programmes, so that patients are taught about water sanitation and hygiene as a matter of course.
Every Monday and Friday pregnant women are received at the antenatal clinic. They are registered, get at least four physical check-ups before delivery and are vaccinated. They are tested for HIV and syphilis several times during the pregnancy, based on risk assessment. In case of HIV the expectant mother is treated to prevent mother-to-child transmission. The women (around 250 per month) are encouraged to bring their husbands. They are provided with individual counselling or take part of groups for counselling and health education. Preventive medication (e.g. iron tablets) is prescribed to encourage a healthy pregnancy. To prevent malaria, mosquito nets are distributed. Women with Anti-Retro-Viral Diseases (HIV/AIDS) receive the treatment from the Anti-Retro-Viral Therapy Clinic (ART) during the antenatal clinics. The greater part of all these services is free of charge.
In future Mua Mission Hospital hopes to take antenatal care clinics into the villages. Some women are not coming for check-ups because the distance to their homes is too far.
Under Five Care
The under-five clinic at Mua Mission Hospital is open 5 days a week. Outreach clinics are carried out on a monthly basis at under-five shelters in the villages. On average 1,500 children per month are in attendance of this clinic. The under-five clinic takes care of immunization of children up to the age of five years. The growth of the children is monitored and nutrition assessment is carried out. Undernourished children are referred to the Nutrition Rehabilitation Unit.
I work in Mua Mission Hospital because….. I want to help children
HIV testing is free of charge and can be done on a voluntary basis (people, often couples, come to the Voluntary Counselling and Testing department (VCT) out of themselves for testing). Clinical officers can also refer patients to the VCT. Sometimes Medical Officers send patients for testing and counselling in case of certain illnesses (like TB). In total 750 clients are coming for testing services per month, of whom on average 12 clients are actually diagnosed with HIV.
Patients who have tested positive on HIV/Aids (around 1,500 on a monthly basis) are treated in the ART: Anti-Retro-Viral Therapy Clinic. This clinic takes care of viral load monitoring, prevention of Mother to Child Transmission and PEP Post Exposure Prophylaxis.
The ART Clinic is also in charge of a Teen Club for HIV positive teenagers. These teenagers meet in groups with trained staff for counselling. The ART Clinic also organises community based support groups, where patients support each other emotionally and counsel each other on medicine adherence, nutrition and how to keep healthy.
All these services are free of charge.
Unfortunately undernourishment is still prevalent in the Mua Mission Hospital catchment area. The hospital has an extensive programme to tackle this problem. The hospital gives outpatient therapeutic care, in which undernourished children are given food supplements to take home (around 50 admissions per month). These children are reviewed by trained staff every two weeks. The hospital also carries out a supplementary feeding programme for pregnant women and lactating women and children. Nutrition care support and treatment is also carried out for adults with malnutrition.
In the NRU (Nutrition Rehabilitation Unit) severe malnourished children (also around 50 per month) are admitted for clinical review. After stabilisation in the paediatric ward they will be kept at the NRU for observation and further treatment. When discharged from NRU they are referred to the outpatient therapeutic programme.
Palliative care services
Palliative care is relatively new to health care in Malawi. A Malawian NGO (Palliative Care Association of Malawi (PACAM)) has recently given training sessions to the staff of Mua Mission Hospital about how to assists patients on palliative care. Now the hospital carries out a weekly palliative care clinic with an average of 40 patients per month. The hospital wants to extend and strengthen palliative care at home, as many palliative patients are not able to visit the hospital themselves. Therefore volunteers have been trained to care for home based patients. Services for palliative care are free of charge.
Youth friendly health services
Mua Mission Hospital supports youth groups that meet regularly for peer counselling and discussions on Health Education, Sexual Reproductive Health, HIV/AIDS, early pregnancy, sanitation and hygiene and nutrition. A shelter will be built for these youth groups so that they can meet frequently. The programme aims also to help drop outs of school with training of skills (e.g. carpentry or tailoring). The programme is funded by the District Health Office.
IDSR Integrated Disease Surveillance and Response
Mua Mission Hospital is responsible for ongoing active disease surveillance on diseases of public health importance, e.g. measles, malaria, dysentery, acute flaccid paralysis and neonatal tetanus. The hospital is in charge of the investigation of outbreaks of these kind of diseases. The hospital writes and sends weekly, monthly and quarterly reports to the District Health Office.