Author: Moses Nyambalo Phiri

  • Malawi Public Health Institute Conducts Monitoring Exercise for COVID-19 Response Project.

    Malawi Public Health Institute Conducts Monitoring Exercise for COVID-19 Response Project.

    MERHSP National Monitoring.

    Nthisi Distirct Hospital, Malawi – May 12th, 2025.
    by
    Moses Nyambalo Phiri in collaboration with Regina Mankhamba and Settie Kanyanda.

    The Public Health Institute of Malawi (PHIM) is currently undertaking a nationwide assessment across all districts to evaluate the implementation of the Malawi COVID-19 Emergency Response and Health Systems Preparedness (MERHSP) project, the World Bank.

    This exercise aims to assess the project’s progress, achievements, and challenges, while identifying key lessons learned throughout its execution to strengthen future public health responses.

    The findings from this comprehensive monitoring exercise  will play a crucial role in refining Malawi’s public health strategies, addressing gaps, and fortifying healthcare infrastructure to respond effectively to future health emergencies. By monitoring  operational successes and challenges, PHIM aims to enhance national preparedness and resilience against infectious diseases, improving overall health outcomes for the population.

    South West team conducting interviews at Chiradzulu district hospital.

    The monitoring exercise categorically aims to:

    (a) To Strengthen District Community Health Initiatives

    PHIM has facilitated the distribution of bicycles and motorcycles to support Health Surveillance Assistants (HSAs) in reaching remote areas more efficiently. This effort enhances healthcare accessibility, particularly for communities in hard-to-reach locations. In addition, districts are hosting monthly community dialogues focused on COVID-19 vaccination and prevention measures, promoting informed health choices among residents and fostering trust in the healthcare system.

    (b) Promoting Infection Prevention and Control (IPC) Measures

    The monitoring exercise shall identify notable improvements in infection prevention and control practices. Districts have established IPC guidelines and standard operating procedures (SOPs), ensuring consistent and effective infection control protocols. Healthcare staff across district and health center levels have undergone training in IPC guidelines, and these guidelines have been widely disseminated among healthcare workers. This initiative strengthens the capacity of healthcare facilities to mitigate the spread of infectious diseases, including COVID-19.

    (c) Strengthening District Administration capacity in responding to medical emergencies

    A significant development in healthcare logistics has been the provision of ambulances and Rapid Response Team (RRT) utility vehicles. These were secured through the World Bank COVID-19 Project, enabling districts to respond swiftly to medical emergencies and improving patient transport systems. The deployment of these vehicles enhances emergency care and enables healthcare workers to offer timely interventions in urgent cases.

    (d) To Build District Capacity in Case Management Efforts

    To enhance the healthcare system’s ability to manage COVID-19 cases, clinical staff have been trained in case management protocols. The establishment of patient referral systems and guidelines has improved the coordination of healthcare services, ensuring efficient care for both COVID-19 and non-COVID-19 patients. Additionally, clinical and support staff working in District Cholera Isolation Wards have undergone mentoring in cholera case management over the past year, strengthening their ability to handle outbreaks effectively.

    (e) To Strengthen the Capabilities of the National Reference Laboratories

    At the national level, genomic sequencing has emerged as a crucial area of focus. The monitoring  identified  that genomic sequencers are available, and personnel have been trained to conduct genomic sequencing. This progress enhances Malawi’s ability to track variants of COVID-19 and other pathogens, supporting more informed public health decisions.

    (f) To Strengthen Reporting from the Expanded Program on Immunization (EPI)

    Districts report an adequate supply of COVID-19  vaccines and personal protective equipment (PPE) to support ongoing immunization efforts. Ensuring that vaccines and protective gear remain available is essential for maintaining the momentum of the country’s vaccination program and safeguarding frontline workers.

    (g) Strengthen Healthcare Infrastructure and Capacity

    Beyond operational improvements, the exercise scrutinises healthcare infrastructure and capacity at district facilities. Specific areas under review included:

    • Essential Equipment Availability: The exercise  examined the presence of critical medical equipment and trained personnel. A key focus is the capacity of facilities to administer oxygen to patients without facing accessory-related challenges.
    • Surgical SOP Implementation: The presence and application of Surgical SOPs for COVID-19 patients are being reviewed to determine their effectiveness in patient management. Healthcare providers are assessing how these SOPs have contributed to improving clinical outcomes.

    (h) Improve Logistical and Infrastructure Developments

    The exercise  also explored the progress of logistical and infrastructural improvements under the Malawi COVID-19 Emergency Response and Health Systems Preparedness project. This includes:

    • Hospital Rehabilitation Efforts: Central hospitals designated for COVID-19 case management have undergone rehabilitation, and the monitoring exercise  is tracking the completion of these efforts and any ongoing construction projects.
    • Supply and Resource Distribution: The availability and distribution of critical resources—such as motorcycles for healthcare workers and the consistent supply of COVID-19 vaccines and PPEs are being assessed to ensure uninterrupted healthcare service delivery.

    As the  monitoring of the project continues, PHIM encourages stakeholders, healthcare professionals, and the general public to remain engaged in supporting these initiatives. Updated reports and insights will be shared in subsequent briefings to ensure transparency and collective action in strengthening Malawi’s health systems.

  • PHIM Enhances Chitipa and Karonga Preparedness and response capability for Cholera, Mpox, and Marburg.

    PHIM Enhances Chitipa and Karonga Preparedness and response capability for Cholera, Mpox, and Marburg.

    Cholera, Mpox, and Marburg Training.

    Chitipa, Malawi – March 7th, 2025.
    by
    Moses Nyambalo Phiri in collaboration with Chriswell Nkoloma and Settie Kanyanda.

    In a proactive approach to enhance the country’s response to public health emergencies, the Public Health Institute of Malawi (PHIM), with support from AMREF, conducted crucial training sessions in  Karonga and Chitipa districts. These sessions focused on cholera, Mpox, and Marburg.

    These activities aim to ensure that healthcare workers can effectively manage cases, strengthen surveillance and contact tracing, improve laboratory diagnostics, and educate communities on preventive measures for Mpox, Marburg, and Cholera.

    From May 6th to 7th, 2025, Public Health Emergency Management Committees and District Rapid Response Teams in the two districts were refreshed on their roles and responsibilities. Subsequently, from May 8th to 14th, frontline healthcare workers, including clinicians, nurses, health surveillance assistants, laboratory staff, and data clerks, received specialized training on sample collection, clinical case management, data reporting etc.

    Mr. Chriwell Nkoloma presenting on Mpox Global Overview and Malawi Situation to the Chitipa DRRT.

    Officers from the national level, comprising experts from various pillars such as Case Management, Surveillance, Laboratory, IPC, Vaccination, RCCE, and Points of Entry, facilitated the PHEMC and DRRT meetings. District-level staff then conducted further orientations for healthcare workers at the facility level, with participation from the Department of Animal Health and Livestock development personnel.

    The training of frontline health care workers was conducted in 5 sessions for Karonga and 4 sessions for Chitipa, with 181 and 125 participants, respectively.

    Hester Mkwinda Nyasulu, Amref Country Director – Malawi.

    “Karonga and Chitipa districts are the first ever districts to have their frontline health workers trained on Mpox and Marburg, so the future plan is to reach out to all the districts in Malawi with this training.” Remarks from Hester Mkwinda Nyasulu, Amref Country Director – Malawi.

  • Mpox Situation in Malawi

    Mpox Situation in Malawi

    MPOX – Malawi Situation.

    National Public Health Emergency Operations Centre (PHEOC), Lilongwe, Malawi – May 17th, 2025.
    by
    Moses Nyambalo Phiri in collaboration with Grace Funsani, Noel Khunga, Chriswell Nkoloma and Settie Kanyanda.

    In Lilongwe, Malawi, a new Mpox case was confirmed on May 23rd, 2025, bringing the total number of cases to twelve since April 17th, 2025. The patient is a 27-year-old male residing in Area 9, TA Malili, Lilongwe district. He reported to Bwaila hospital on May 21st, 2025, experiencing fever, headache, and a skin rash. No underlying medical conditions were noted. A sample was collected the same day and sent for testing, which confirmed Mpox infection. The patient has no history of international travel. His occupation remains unknown, and investigations are ongoing to determine the source of infection and trace contacts.

    The Lilongwe district has taken immediate action, including collecting samples (swabs from blisters) for laboratory testing. The patient is currently under home isolation. The District Rapid Response Team (DRRT) plans to conduct contact tracing and further investigations to establish the possible source of infection.

    The Public Health Institute of Malawi (PHIM) is actively involved in managing the situation. They have activated the Incident Management System (IMS) and are employing a multi-sectoral approach, including the One-Health approach, for disease surveillance. Functional Rapid Response Teams are in place at both national and district levels, supported by a trained National Emergency Medical Team and surge team. PHIM continues to monitor the situation and will provide updates as new information becomes available.

    “The first case was recorded in Lilongwe district on April 16, 2025. Later additional cases were registered.  All the cases are males within the age range of 2 to 38 years: a 30-year-old from Phwetekere- Area 36, a 33-year-old from Kawale 2, 38 year-old from Chilinde, a 35 year-old from Area 36, Kandikole, an 18 year-old from Area 36, Tumbwe, Traditional Authority (TA) Tsabango, Lilongwe district, and a two year-old child from Michesi 1 village, TA Mponda, Mangochi district.Three cases from Lilongwe have recovered and have been discharged from clinical care, while the other three are still under clinical care . No death has been reported.”

    Grace Fusani – Mpox Incident Manager, PHIM.

    What response activities have so far been undertaken ?

    Cases
    Malawi Mpox Outbreak

    PHIM has activated its Incident Management System (IMS) for Mpox and is working with various sectors, including animal health, civic education, and disaster management, using One Health Approach

    Mpox Suspect in Lilongwe

    1. Surveillance.

    Rapid Response Teams (RRTs) have been deployed to conduct contact tracing and investigate cases. Surveillance systems have been enhanced at the community level, health facilities, and points of entry (PoEs).

    The district team are being trained on Mpox through a collaborative effort involving Amref Health Africa, the US CDC, and the World Bank, which have provided the necessary resources. Initial training, supported by Amref Health Africa, has been conducted in the Chitipa and Karonga districts. This district level training will be extended to all districts to ensure comprehensive staff preparedness covering critical areas such as Mpox Etiology and Virology, Transmission Pathways, Prevention and Control Measures, and Clinical Management etc.

    Chitipa -Mpox District Training 7/May/2025.

    2. Case Management.

    Case management guidelines have been developed and distributed, and isolation facilities have been identified.

    Kamuzu Central Hospital – Toilets Supported by Amref
    Kamuzu Central Hospital – Isolation Unit Supported by WHO
    Kamuzu Central Hospital – Toilets Supported by Amref

    3. Labolatory.

    Samples from suspected cases are being tested using PCR, and genomic sequencing of the Mpox virus is underway.

    Mpox sample testing in the national laboratory

    Essential medicines and PPEs have been distributed to districts and Messages about Mpox prevention are being disseminated in local languages through various channels, including posters, social media, leaflets, and audio recordings. PHIM is working to address these challenges and will continue to provide updates on the situation.