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Save the Children Saving Newborn Lives Program

Trip Report SITES: Mchinji and Lilongwe, Malawi TRAVELERS: Joy Lawn, Senior Advisor for Policy and Research

Steve Wall, Senior Advisor for Neonatal Health Shyam Thapa, Associate Director for Policy & Research

TRAVEL DATES: Thapa (February 10-19, 2007) Lawn (February 13-17, 2007) Wall (February 12-17, 2007)

I. Executive Summary

Following the SNL Program Managers’ meeting in Jo’burg, Thapa, Lawn and Wall traveled to Malawi. Working closely with the Save the Children/Malawi office staff, the three assisted MoH, UNICEF and other stakeholders in organizing a workshop on identifying and developing a comprehensive strategy and design for a home- and community-based newborn health intervention at scale. In addition, Thapa visited the MaiMwana Project site (Mchinji) and followed up on research management and other related issues.

II. Key Persons Contacted

See attached (Annex 1)

III. Purpose of the trip

1. To follow up with the MaiMwana Project particularly on operational issues 2. To participate in the preparation and co-facilitation of a workshop and assist

the MoH and other stakeholders in designing a community-based newborn health project at scale

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IV. Activities/Accomplishments 1. MaiMwana Project

Thapa, together with Geroge Chiundu, visited the MaiMwana site in Mchinji, about an hour’s drive from Lilongwe, to meet with MaiMwana staff. Several staff there provided briefing on various aspects of the program. Thapa and George also visited a women’s group. Three of the five staff that were the victims of a tragic accident (in June 2006) have recovered fully and two are still recovering. Tambosi Phiri, Sonia Lewycka and Mikey Rosato, currently away in the UK, are expected to return to Mchinji soon. Following the Project site visit, Thapa met with four senior MaiMwana staff -- Peter Kazembe, Charles Mwansambo, Ian Khwiya and Sipho Jale -- at Kamuzu Central Hospital in Lilongwe. The purpose of this meeting was to discuss key management and research issues pertaining to the way forward for the MaiWwana Project. One of the issues concerned the plan for interim data analysis and review by the DSMB. The MaiMwana team reported that about 70% of the data has already been entered and the rest is in process. The first DSMB is planned for April or June, depending on the pace of data entry and analysis of data. The other points discussed have been summarized in a separate memo (Annex 1, not included in this version). 2. The Newborn Health Workshop Prior to the workshop, we also met with the PMNCH mission that was visiting Malawi to asses the strategic role of PMNCH for scale-up efforts in the country. We also visited WHO and UNICEF offices for reviewing the agenda and respective roles in the workshop. Because of competing activities going on with the Ministry of Health, the newborn health project design workshop was limited to two days, February 15-16. The detailed agenda is attached (Annex 2). The three objectives of the workshop were: (i) to scan the existing situation, coverage of care and trends to identify opportunities and gaps for saving 16,000 newborns that die in Malawi each year,

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linking with the SWAp and existing health system; (ii) to identify key building blocks for the delivery of a package to promote healthy home behaviors, and deliver an effective, sustainable postnatal care package (what, who, how, and supervision); and (iii) to agree on the next steps to detail the package and develop and test it in practice and maximize effective scale-up. The workshop was attended by about 40 individuals, with the representation of a broad range of stakeholders, including the MoH, UNICEF, WHO, UNFPA, the visiting delegates of the PMNCH, Save the Children, and other professional organizations (Annex 3). The workshop was declared open by the Principal Secretary in the Ministry of Health, together with the highest-level representatives of UNICEF, WHO and Save the Children/Malawi. The UNICEF representative, head of programmes and head of health attended virtually the entire workshop. There was a big turnout of UNICEF health technical staff and Luwei Pearson from UNICEF ESARO. Realtionships with UNICEF were very good with high level of agreement on package content and way forward. Joy provided an overview of the Malawi newborn health situation and Steve presented an overview of the lessons learned from the SNL-supported projects in India, Bangladesh, Pakistan and Nepal. Other presentations on the first day included newborn policy analysis and options in Malawi, the SWAp framework and current status, the Road Map for Malawi, and IMCI and ACSD frameworks. The team that visited Godchuroli also provided an overview of the visit and subsequent developments. The key elements of a draft proposal that had been developed in consultation with Abhay Bang during the India visit were also presented. Following these presentations on the first day, three working groups were formed to review and provide feedback on the possible package design in terms of the following aspects: what, linkages with other programs, who, where, when and how. Despite the limited time there was a good level of consensus on the major issues: Who? – through the existing extension worker, the HSA, but this would mean that the new 6000 HSAs to be recruited and trained should include enough females (majority are currently male) to do this work. Supervision should be through health centers and community nurses and management through existing district teams What and when? – The HSA would undertake home visits ANC and PNC (numbers to be decided after more formative research but provisionally 3 ANC and 4 to 6 PNC

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plus extra for LBW). At this point in the discussion Dr Namatie and others felt that neonatal resus at home would not be in the first stage, and the focus for the intrapartum period would be on using TBAs to increase skilled attendance (an eg of TBAs being paid for referral to facility in labour was given) and on improving EmOC and resus at facilities. Resus at home without going back to training TBAs seemed to give mixed messages. The HSAs would generally not be at delivery so would not be an option for resus. In terms of increasing access to management of neonatal infections, the HSAs are apparently to be trained in the new IMCI algorithm for young infant care but would refer babies with infections. There may be an option of training the HSAs in the “Where there is no referral module” but this would need piloting and process data and policy change. The second day of the meeting focused on the question: in order to guide and accelerate the scaling up of the package, what do we need to do and what do we need to know? The sub-questions discussed were: what policy and programmatic questions needed to be answered; what level of evidence is warranted; what is the duration of the evidence-generation (pilot) project; in which districts should the project be undertaken; who are the potential partners; and who will do what? The final session focused on identifying the next steps. The main points discussed, and tentatively agreed upon, included: • Sites: Thyolo, Dowa, and Chitipa districts, representing three regions of the

country, should be selected as the evidence-base districts for the newborn health intervention package These three are among the 10 districts where c-IMCI program is being accelerated. Thus, the three will be the “study” districts where close monitoring and evaluation activities will be undertaken.

• Remit: The study should be designed to answer specific operational questions and should represent the whole district, collaborating closely with the DHO in each district. The main policy questions to be addressed should include the use of antibiotics by the community health workers (HSAs and midwives), feasibility, content, netcost and sustainability of resuscitation at the community level, and the frequency and timing of postnatal visits at home.

• Linkages to health system and scaling up: Given the focus on sustainable impact at scale, it was agreed that the study would need to be implemented within the

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larger health delivery system with the cadre of providers that have been formally approved. This means that the project should try to mobilize, and test the effectiveness of, HSAs and community nurse-midwives, among others.

• Process: The formation of a Newborn Working Group representing various organizations as partners. The MoH RHU was designated as the coordinator for the Working Group. The first task of this group is to develop the terms-of-reference. It would be best if the protocol could be developed before the mid-term review of the SWAp, so that the plan may be presented at the SWAp meeting.

• Measurement: Specific indicators or design issues were not discussed, but it was felt that the Working Group should: (a) produce recommendations for review and vetting by the stakeholders; (b) address the question of duration for the “study” which would largely depend on “what” are being measured (e.g., neonatal mortality or other proximate behavior-change communication indicators); and (c) identify specific roles and responsibilities for the key partners, with specific timelines of activities.

After closure of the workshop, representatives of UNICEF (Dr Eliab Some and Luwei Pearson), MoH (Dr Martias Joshua), and Save the Children (Paul Mecartney, Jeanne Russell, and Shyam Thapa) met to review the outcome of the meeting. The following points were discussed: a) The workshop report with specific recommendations for action would need to be

submitted to the Ministry for review and vetting by the senior management team so that the other directors are onboard. This process will begin after SC prepares and submits the report to the Ministry by the end of February.

b) SC would need to recruit a full-time research manager for the project in order to move it forward in a coordinated and timely manner.

c) SCSNL could simultaneously begin assisting in the development of the project/study proposal. In the meantime, UNICEF could begin preparation at the district level.

d) The pace and extent of the filling of the HSA and community nurse-midwife positions in the three evidence-base districts, and the number of female HSAs there. If at least 70% or so of the staff working at the community level are not

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deployed, then the study might not be able to determine whether it was the ineffectiveness of the package or inadequacy of providers providing the interventions that affected the overall outcomes. The Ministry might be able to assign higher priority to filling the positions in the study districts; this would need to be followed up.

e) Newborn health program is under the RHU at the Ministry while HSAs are under a different department. This means a higher level coordination at MoH is warranted in order for all the Ministerial-level coordination activities relating to newborn to be managed effectively.

f) The Working Group on the study protocol would perhaps need to specify the minimum criteria requirements for the study. Whether the Primary Health Center should be the sampling unit for the study needs to be determined.

g) Finally, a quick costing exercise would need to be carried out so that the potential donor agencies -- UNICEF and SCSNL among others -- could assess what is feasible and doable financially.

Next Steps for SCSNL The following steps are necessary for SCSNL to move the initiative forward:

1. Recruitment of a qualified person to serve as manager/liaison particularly for the study;

2. Defining the operatrions research questinos and development of a study protocol, which should also include assessment of the sample size and the sampling unit;

3. Development of the minimum staffing and roles and other criteria that are required for the study;

4. Assist the MoH in developing the terms-of-reference for the Newborn Health Working Group; and

5. Work with UNICEF in conducting a costing exercise for work in the three districts, then identify the components that can be supported by SCSNL.

Overall, despite the competing activities especially with the MoH, the workshop was

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able to have the participation of all the key stakeholders was very well attended and made concrete progress. The Principal Secretary and other senior-level staff in the MoH were committed to giving newborn health the priority it needs, within the frameworks of the Road Map, IMCI/ACSD, and the SWAp. Another 1-2 additional days would have helped the workshop especially in sorting out some of the details. However, the key areas were discussed in a wide group and the formation of a Newborn Health Working Group provides the framework within which further more detailed progress can be made. The workshop has provided momentum to all for moving forward. In this context, Save the Children has much to accomplish and contribute. The Country Office needs technical support in a timely and rapid manner. The development of the draft study protocol needs to begin soon. This and other needs need to be followed with the Country Office. Jeanne Russel, Evelyn and Thapa met and discussed the following points:

• Timeline: It might be too ambitious to aim at having the protocol ready for the SWAp meeting,, as UNICEF had suggested during the workshop.

• Geog remit: The inclusion of Chipita as a study district could turn out to be expensive especially in light of travel cost involved. We wondered whether there might not be a way to propose to the MoH and others in the Working Group as well as the stakeholders a phased-in approach in which the proposed project in Chipita would be deferred until the next phase and the initial focus be on Thyolo maybe simultaneously with Dowa.

• Cost: It is important that SCSNL has good a estimate of the cost of the study for each of the districts. Depending on the cost estimate, SCSNL/Malwai would have, for instance, the option of either selecting certain components for all the study districts or focusing on just one district. We discussed the possibility of initiating preliminary costing exercise in the nearby Dowa district, possibly with assistance from UNICEF.

• Design and sample size: It is important to initiate the background work for the study protocol. SCSNL HQ will find out from Simon Cousens if he could be available to review and assist in the task of sampling under different scenarios. Meanwhile, SNL/Malawai is initiating the advertisement for a research manager for the study.

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• MaiMwana presents a great learning opportunity for the SC/Malawi staff. In Thapa’s opinion, particularly the SCSNL/MaiMwana staff need to learn from what is being learnt already. To this end, it might be worthwhile to send the SNL-specific staff to MaiMwana for at least two weeks to learn the “nuts and bolts” of program development at the grass-root level. Each staff should generally learn about all aspects of the study, but at the same time each member should be given one aspect to pay special attention to, such as community mobilization, home visit, data collection and management, monitoring, feedback to the villages. Afterwards, Thapa spoke to Charles about this and he was agreeable to the proposition. This may be a great mechanism for the SC/Malawi staff to learn, and sharpen their knowledge and skills, about newborn health interventions.

• We also discussed, albeit briefly, a new project funded by the UK Health Foundation in three districts – Kasungu, Lilongwe, and Salima – with the aim of improving the quality of maternal and neonatal health services. The project has three key partners including the Institute of Child Health (responsible for evaluation), Institute of Health Care Improvement (responsible for quality of care at the hospitals and, eventually, the Primary Health Centers), and Women and Children First (responsible for community mobilization). This is a three-year project with the possibility of a two-year extension at the end. Because it does not specifically aim at postnatal home visits and related access to newborn care within the first few days of life, this project that aims to cover 2.5 million population could be a great complement for SCSNL/Malawi. SCSNL/Malawi could dovetail with the project by providing the postnatal home-visit component. The Malawi-based staff (Roger LeCompte and Bejoy Nambiar) of this Health Foundation Project have expressed willingness to consider partnering with SC/Malawi. Of course, this would have to be discussed with Anthony Costello as well. As agreed, Thapa will follow up with Anthony Costello and, in the meantime, the Malawi-based Health Foundation Project staff are expected to provide a detailed briefing to SCSNL/Malawi. If this partnership works out, it could indeed be yet another great stride for SCSNL/Malawi toward impact at scale -- without having to go through the lengthy process of project development, approval and setup. ♦

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Annex 2 – Agenda of the Newborn Health Workshop

Improving Newborn Survival in Malawi 

15th – 16th February 2007 Objectives of the meeting

1. To scan the existing situation, coverage of care and trends to identify opportunities and gaps for saving the 16,000 newborns who die in Malawi each year, linking to the SWAp and existing health system

2. To identify key building blocks for delivery of a package to promote healthy home behaviours and to deliver an effective, sustainable postnatal care package (what, who, how, supervision

3. To agree on the next steps to detail the package, develop and test it in practice and

maximise effective scale up Venue - The Capital Hotel, Lilongwe

DAY 1 - Thursday, 15 February 2007

08h00 Coffee and tea

08h30 Welcome

(Official opening postponed until 2pm )

Chair Dr. D. Namate (Director of Health and Technical Services – MOH) Fannie Kachale (Acting Deputy Director,

Clinical Services – RHU MOH)

08h45 Group introductions and announcements Evelyn Zimba (Programme manager for Newborn health, Save the Children)

09h00 Goals and objectives of Design Workshop Dr. Fannie Kachale

09h10 Objective 1: Scanning the situation for Malawi’s newborns, current coverage, trends and gaps An overview of newborn health in Malawi Q&A Presentation on Neonatal Mortality in Malawi and Policy Options (10 min)

Chair Dr. D. Namate Dr. Joy Lawn, (Senior Research and

Policy Advisor, Newborn health, Save the Children)

Girmay Haile (Head of Section Social Policy, Advocacy & Communication)

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Q&A

10h00 TEA BREAK

10h15

Objective 1: Scanning Malawi’s policy and program environment for opportunities to scale up newborn care linked to the SWAp

The SWAp – opportunities for newborn care

scale up (10 min)

The Road Map (10 min)

IMCI and ACSD/c-IMCI (10 min)

Volunteer Counselor/home visitor Model-Mai

Mwana (10 min)

Co-chair Dr. D. Namate and Dr Juan Ortiz (Deputy Country Representative, UNICEF)

(after each talk pause for clarifications but hold major discussion for end of this session) Dr. Ann Phoya, Director SWAp Fannie Kachale

Kelvin Nindi, IMCI Secretariat, MOH

Sipho Jale / Dr. Charles Mwansambo

11h00 Plenary discussion of key opportunities and remaining gaps

Facilitated by Fannie Kachale and Jeanne Russell (Deputy Country Director, Save the Children)

11:30 Learning and adaptation from newborn care packages MOH reports of visits to SEARCH Policymakers visit to India & Pakistan (10 mins) Possible package design based on SEARCH visit

proposal (20 mins)

Evidence and experiences from India, Bangladesh, Pakistan and Nepal (30 mins) Plenary discussion regarding adaptation to the Malawian context

Chair: Dr. Some, UNICEF

Dr Namate, / Dr. M. Joshua Zonal Health Officer Central East

Dr. Noor Alide – District Health Officer, Thyolo

Dr Steve Wall (Senior Newborn Health

Research Advisor, Save the Children)

Facilitated by Dr Some and Mr Nindi

13h00 LUNCH

14h00 Official Opening Facilitated by Dr. D. Namate Aida Girma, UNICEF Country

Representative Dr Matshidiso Moeti, WHO Country

Representative Paul Mecartney, Save the Children

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Country Office Director Mr. Kang’ombe – Principal Secretary for

Health

14h30 Objective 2: Defining the building blocks of the package: Group work to review and provide feedback on the possible package design in terms of:

What (package content) Linkages with other programmes, e.g.,

maternal health programs, ACSD/c-IMCI, PMTCT and paediatric HIV/AIDS (how to operationalise a continuum of care with linkages between key packages and between home and facility)

Who (delivery of the package) Where? When? How (Training, supervision, logistics

management, etc.)

(see group work sheet for details)

Facilitated by Dr Lawn and Dr Phoya Group 1- Dr Namate and Dr Susan Kambale

Group 2 – Dr Noor Alide and Dr. Juan Ortiz Group 3 - Fannie Kachale and Evelyn Zimba

1600 Break

1615 Group work continues

17h00 End of day

DAY 2 – Friday, February 16

08h00 Tea and coffee

08h30 Group feedback 10 mins per group 10 mins discussion after each group Plenary discussion 30 mins

Facilitated by Dr Some and Jeanne Russell

10h00 BREAK

10h15 Objective 3: Maximizing effective scale up: To be able to scale up this package what do we need to do and what do we need to know to guide and accelerate effective scale up? Context and some examples from other African

countries testing similar packages. Small group work

Facilitated by Dr Some and Jeanne Russell

Joy Lawn

Group 1 - Dr. Noor Alide and Dr Susan

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Questions to be answered by testing in the pilot area (eg package design, process, effects on behaviours and careseeking, impact, cost?)

Level of evidence required and possible evaluation designs

When? (When does the pilot begin and end?) Where? Who are the partners? Who will do what?

Kambale

Group 2 – Dr Joshua and Dr Juan Ortiz Group 3 - Fannie Kachale and Evelyn Zimba

13h00 LUNCH

14h00 Feedback from small groups Group feedback 10 mins per group 10 mins discussion after each group Plenary discussion 30 mins

Facilitated by Dr Some and Shyam Thapa

15h30 BREAK 15h30 What are the next steps?

Facilitated by Fannie Kachale

16h00 Closing remarks Dr M. Joshua/Fannie Kachale MOH UNICEF - TBD Paul Mecartney

16h15 End of workshop

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Annex 3: List of Participants of Improving Newborn Survival in Malawi Workshop DATE: 15th & 16th February 2007; VENUE: Capital Hotel

NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

1. Kistone Mhango PHC Director

Ekwendeni Mission Hospital P.O.Box 19 Ekwendeni

Cell: 08 333499 Tel: 01 339235/246 Fax: 01333 059 ekwephc@sdnp.org.mw

2. Dr. Dorothy Namate Director of Clinical services

Ministry of Health Box 30377 Lilongwe

Cell: Tel: 01 789 400 Fax: 01 789 365 E-Mail: namated@sdnp.org.mw

3. Dr. Somanje Director of Preventative Health Services

Ministry of Health Box 30377 Lilongwe

Cell: Tel: 01 789 400 Fax: 01 789 365 E-Mail:

4. Mr. Kelvin Nindi National Program Officer - IMCI

Ministry of Health Box 30377 Lilongwe

Cell: Tel: 01 789 400 Fax: 01 789 365 E-Mail:

5. Dr. Chisale Mhango Director

MOH – RHU Lilongwe

Cell: Tel: 01 751 552 Fax: 01 751 539

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

E-Mail:

6. Dr. Ann Phoya Director – SWAp

Ministry of Health Box 30377 Lilongwe

Cell: Tel: 01 789 400 Fax: 01 789 365 E-Mail:

7. Dr. Charles Mwansambo Pediatrician

Kamuzu Central Hospital P.O.Box 149 Lilongwe

Cell: 08 826946 Tel: 01 762025 - Home Fax: 01 756380 cmwansambo@malawi.net

8. Ms. Aida Girma Country Representative

UNICEF Box 30375 Lilongwe

Cell: Tel: 01 770 788 Fax: 01 773 162 E-Mail: agirma@unicef.org

9. Dr. Juan Ortiz Deputy Country Representative

UNICEF Box 30375 Lilongwe

Cell: Tel: 01 770 788 Fax: 01 773 162 E-Mailjortiz@unicef.org

10. Dr. Eliab Some Head of Health & Nutrition Section

UNICEF Box 30375 Lilongwe

Cell: Tel: 01 770 788 Fax: 01 773 162 E-Mail: essome@unicef.org

11. Lucy Kachapila UNICEF Cell:

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

Project Officer Box 30375 Lilongwe

Tel: 01 770 788 Fax: 01 773 162 E-Mail: lkachapila@unicef.org

12. Joyce Mphaya Project Officer

UNICEF Box 30375 Lilongwe

Cell: 08 891 561 Tel: 01 770 788 Fax: 01 773 162 E-Mail: jmphaya@unicef.org

13. Francesca Munthali Assistant Project Officer

UNICEF Box 30375 Lilongwe

Cell: 08 306 165 Tel: 01 770 788 Fax: 01 773 162 E-Mail: fmunthali@unicef.org

14. Stanley Chitekwe Project Officer

UNICEF Box 30375 Lilongwe

Cell: 09 964 548 Tel: 01 770 788 Fax: 01 773 162 E-Mail: schitekwe@unicef.org

15. Girmay Haile Head of SPAC

UNICEF Box 30375 Lilongwe

Cell: Tel: 01 770 788 Fax: 01 773 162 E-Mail: ghaile@unicef.org

16. Dr. Miriam Chipimo RH/ HIV Unit Head

UNICEF Box 30375 Lilongwe

Cell: Tel: 01 770 788 Fax: 01 773 162

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

E-Mail: mchipimo@unicef.org

17. Luwei Pearson Maternal & Newborn Health Program Coordinator for Regional Office of East & Southern Africa

UNICEF Box 30375 Lilongwe

Cell: Tel: 01 770 788 Fax: 01 773 162 E-Mail: lpearson@unicef.org

18. Katema Aschenaki Buzuneh Head of Health Unit

UNICEF Box 30375 Lilongwe

Cell: Tel: 01 770 788 Fax: 01 773 162 E-Mail: kbizuneh@unicef.org

Apologies

19. Fannie Kachale Acting Deputy Director

MOH- RHU Lilongwe

Cell: 08 586 485 Tel: 01 751 552 Fax: 01 751 539 E-Mail: fankachale@yahoo.co.uk

20. Diana Khonje Principal Reproductive Health Officer

MOH-RHU Lilongwe

Cell: 09 411 400 Tel: 01 751 552 Fax: 01 751 539 E-Mail: Dianakhonje90@yahoo.co.uk

21. Lilly Banda Maliro Reproductive Health Specialist

USAID Box 30455 Lilongwe 3

Cell: Tel: 01 772 455 Fax: E-Mail

Apologies

22. Aly Cameron USAID Cell: Apologies

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

HPN Team Leader Box 30455 Lilongwe 3

Tel: 01 772 455 Fax: 01 773 181 E-Mail

23. Catherine Chiphazi Child Health Advisor

USAID Box 30455 Lilongwe 3

Cell: 09 960 017 Tel: 01 772 455 Fax: 01 773 181 E-Mail: cchiphazi@udaid.gov

24. Esperanza Fundira Country Representative

UNFPA Box 30135 Lilongwe

Cell: Tel: 01 771 444 Fax: 01 771 402 E-Mail

Apologies

25. Dorothy Lazaro Program Officer

UNFPA Box 30135 Lilongwe

Cell: Tel: 01 771 444 Fax: 01 771 402 E-Mail

Apologies

26. Annie Chinombo Program Officer

UNFPA Box 30135 Lilongwe

Cell: Tel: 01 771 444 Fax: 01 771 402 E-Mail

Apologies

27. Dr. Matshidiso Moetie Country Representative

W.H.O. Box 30390 Lilongwe 3

Cell: Tel: 01 772 215 /755 Fax: 01 772 350

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

E-Mal: moetim@afro.who.int

28. Teleza Mwale Maternal & Child Health Officer

W.H.O. Box 30390 Lilongwe 3

Cell: Tel: 01 772 215 /755 Fax: 01 772 350 E-Mal: mwalet@afro.who.int

29. Dr. Susan Kambale Project Officer

W.H.O. Box 30390 Lilongwe 3

Cell: Tel: 01 772 215 /755 Fax: 01 772 350 E-Mal: kambales@afro.who.int

30. Desiree Mhango Director of Health Programs

CHAM Box 30378 Lilongwe

Cell: Tel: 01 775 404 Fax: 01 775 406 E-Mail

31. The Acting Registrar Nurses & Midwives Council Box 30361 Lilongwe

Cell: Tel: 01 772 044 Fax: 01 773 932 / 01931 E-Mail

32. Mrs. Jacintha Mtengezo

Nurses & Midwives Council Box 30361 Lilongwe

Cell:08 863 080 Tel: 01 772 044 Fax: 01 773 932 / 01931 E-Mail: jmtengezo@yahoo.co.uk

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

33. Mrs. Asernia J. S Banda

Women & Children First ( Perinatal Care) C/O Ntcheu DHO Ntcheu

Cell: 09 292 504 Tel: Fax: 01 235 459 E-Mail

34. Stewart Mwalabu The Health Foundation Manobec Complex P/Bag 418 Lilongwe 3

Cell: 08 206 892 Tel: Fax: 01 754 103 E-Mail:

35. George Chiundu NBH M & E Officer

Save the Children P.O.Box 30374 Lilongwe

Cell: 09 234662 Tel: 01 753888 Fax: 01 756257 gchiundu2001@yahoo.com

36. Dr. Martius Joshua Zonal Officer

Dowa District Hospital Dowa

Cell: 09 912 683 Tel: 01 282 222 Fax: 01 282 200 E-Mail

37. Dr. Noor Alide DHO Thyolo

Thyolo Hospital Box 21 Thyolo

Cell: 08 366 786 Tel: 01 473 411 Fax: E-Mail

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

38. Dr. Alexandra Piprek Zonal T/A

P/Bag 1 Mzuzu

Cell: 08 554 208 – Dr. Gonani Cell: Dr. Alexander Piprek : 09 158 676 Tel: Fax: 01 331 883 E-Mail: agonano@yahoo.com E-Mail: pipreka@yahoo.co.uk

39. Leonard Banda Acting Zonal Officer South West

Blantyre

Cell: 08 339 050 / 09 683 693 Tel: 01 872 130 Fax: 01 872 551 E-Mail: banda_leonard@yahoo.com

40. Mr. Jere DHO Mzimba

Mzimba District Hospital Box 131 Mzimba

Cell: 01 342 165 Tel: Fax: E-Mail

Apologies

41. Dr. Ellen Mbweza Kamuzu College of Nursing Box 415 Blantyre

Cell: 08 940 513 Tel: Fax: 01 756 424 E-Mail: embweza@kcn.unima.mw

42. Dr. Pat Walker College of Medicine Blantyre

Cell: 09 796 772 Tel: Fax:

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

E-Mail: pat.awalker@yahoo.co.uk

43. Mrs. Madalo Malemba

Malawi College of Health Sciences Box 30368 Lilongwe 3

Cell: 09 945 244 Tel: 01 756 777 Fax: E-Mail: madalomalemba@yahoo.com

44. Loveness Kaunda NBH Project Assistant

Save the Children Box 30374 Lilongwe

Cell: 09 957 054 Tel: 01 753 888 Fax: 01 756 257 E-Mail: lkaunda@llmw.savechildren.org

45. Steve Wall Snr Newborn Health Advisor

Save the Children Box 30374 Lilongwe

Cell: Tel: Fax: E-Mail: swall@dc.savechildren.org

46. Shyam Thapa Associate Director of Policy & Program Research

Save the Children Box 30374 Lilongwe

Cell: Tel: Fax: E-Mail: SThapa@dc.savechildren.org

47. Joy Lawn Snr research & Policy Advisor

Save the Children Box 30374 Lilongwe

Cell: Tel: Fax:

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

E-Mail: joylawn@yahoo.co.uk

48. Jeanne Russell Deputy Director - Programs

Save the Children Box 30374 Lilongwe

Cell: 08 206 848 Tel: 01 753 888 Fax: 01 756 257 E-Mail: jrusell@llmw.savechildren.org

49. Paul Mecartney Country Director

Save the Children Box 30374 Lilongwe

Cell: 08 206 828 Tel: 01 753 888 Fax: 01 756 257 E-Mail: pmecartney@llmw.savechildren.org

50. Rueben Ligowe NBH Program Officer

Save the Children Box 30374 Lilongwe

Cell: 08 508 538 Tel: 01 753 888 Fax: 01 756 257 E-Mail: rligowe@llmw.savechildren.org

51. Evelyn Zimba NBH Program Manager

Save the Children Box 30374 Lilongwe

Cell: 08 277 091 Tel: 01 753 888 Fax: 01 756 257 E-Mail: ezimba@llmw.savechildren.org

52. Maggie Kambalame NBH Project Officer

Save the Children Box 30374 Lilongwe

Cell: 08 308 064 Tel: 01 753 888 Fax: 01 756 257 E-Mail:

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

mkambalame@llmw.savechildren.org

53 Kumbukani Kuntiya WRA

Save the Children Box 30374 Lilongwe

Cell: 08 866 033 Tel: 01 753 888 Fax: 01 756 257 E-Mail

54 Ellious Chasukwa HAC

Christian Health Association of Malawi Box 30378 Lilongwe 3

Cell: 09 948 583 Tel: 01 775 180 Fax:01 775 406 E-Mail: echasukwa@cham.org.mw

55 Hilda Chapota HSSO

Maimwana Project Box 2 Mchinji

Cell: 08 393 486 Tel: 01 242 476 Fax: E-Mail:maimwana@malawi.net

56 Martha Mondiwa Acting Registrar

Nurses & Midwives Council Box 30361 Lilongwe

Cell: 09 407 207 Tel: 01 772 044 Fax: 01 773 932 E-Mail: nmcm@malawi.net

57 Sipho Jale Acting Project Manager

Maimwana Project Box 2 Mchinji

Cell: 08 879 285 / 09 705 995 Tel: 01 242 476 Fax: E-Mail: tsjale@yahoo.com

58 Michele Usuelli Cestas Cestas Cell: 08 591 895

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

Cesta Med. Coordinator Box 20479 Lilongwe 2

Tel: cestas@malawi.net Fax: E-Mail

59 Feliatas Siyameda Enrolled Nurse Midwife

Kamuzu central Hospital Box 149 Old Wing Lilongwe

Cell: Tel: 01 791 094 Fax: E-Mail

60 Dr. Sinyiza DHO

Mzimba district Hospital Mzimba

Cell: Tel: Fax: E-Mail

61 Mr. Enock Bonongwe Ministry of Women Lilongwe

Cell: Tel: Fax: E-Mail

62 Dr. Bejoy Nambiar THFC, Area 4 Manobec Complex Lilongwe

Cell: 08 748 486 Tel: Fax: E-Mail: b.nambiar@ich.uch.ac.uk

63 Elsie Chitedze Project Assistant

UNICEF Box 30375 Lilongwe

Cell: 08 868 905 Tel: 01 770 788 Fax: 01 773 162

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NO NAME &TITLE ORGANIZATION& ADDRESS CELL, TEL FAX, E-MAIL SIGNATURE

E-Mail: echitedze@unicef.org

Bernadette M.E.G Dalemans, Medical Director, Dept of Child and Adolescent Health and Development, WHO/Geneva; daelmansb@who.int Rober B. LeCompte, Quality Improvement; rlecompte@alumni.upenn.edu

Vincent Fauveasu, MD, Senior Advisor, Maternal Health, UNFPA Geneva Office; fauveau@unfpa.org Peter N. Kasembe, MBChB, Executive Director, Kumuzu Central Hospital/Baylor college of Medicine; pnkazembe@baylor-malwai.org Issac Chipofya, Deputy Country Director, Finance and Administration, Save the Children, Malawi; ichipofya@llmw.savechildren.org Sarah Macfarlance; macfarlance@globalhealth.ussf.edu Mamadou Hady Diallo, Senior Advisor, Country Support, PMNH, WHO/Geneva; diallohadym@who.int Bejoy Nambiar, Resident Advisor, ICH/Health Foundation Project, Malawi; b.nambiar@ich.ucl.ac.uk

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