Rewards save women, babies

When Balaka District emerged the first prize winner in the 12th cycle of Results-Based Financing for Maternal and Neo-natal Health (RBF4MNH), health workers in the district were ecstatic.

For the district health management team, the feat was not just about attaining the deserved status for rolling back the number of preventable deaths of women and children.

The health workers, who had lost the coveted accolade to Mchinji by a whisker, had earned cash rewards to motivate them to sustain their star performance.

Faliot Mnkhwakwatu, who sits on RBF4MNH desk at Balaka District Health Office, says a “carrot dangled” on the health workers’ noses motivates them to go an extra mile in ensuring no woman and child dies of preventable and treatable conditions.

He says: “The cut for the facility has enabled us buy oxygen concentrators, paediatric beds, resuscitators and gloves which were in short supply.

“But the portion shared among health workers propels us to work harder.”

Improved services

He reckons health services are improving because the incentives create competition among health workers.

According to RBF4MNH deputy director Reagan Kaluluma, the health facilities and workers get the rewards when they meet verifiable outcomes agreed from the start.

He explains: “The initiative contributes to the reduction of maternal and neonatal mortality and morbidity through the use of incentives.

“This leads to improved maternal and neonatal health services, increased results at health facility level and creation of awareness and means for pregnant women to come on time to access services.”

Gradually, improved service provision in participating facilities is improving health-seeking behaviour among Malawians.

The country has high rates of maternal and neo-natal deaths.

The Malawi Demographic and Health Survey shows pregnancy-related conditions claim almost 675 lives in every 100 000 live births.

When it comes to child health, nearly 31 children die in every 1000 live births.

The rewards-based intervention is a three-pronged affair.

First, it seeks to change themindset of women to deliver at hospitals where skilled and motivated staff as well as quality care is accessible.

It also invests in improved infrastructure and adequate resources for maternal health services.

Throughout, it motivates health personnel with rewards to improve service delivery especially in the maternity section and change attitude towards patients in general and pregnant women in particular, thereby motivating more pregnant women to deliver at the hospital.

Research shows quality of care has almost doubled up from 38 percent to 68 percent since the programme started in 2012.

Actually, fewer women are dying giving birth in the country.

Minister of Health Peter Kumpalume says the initiative has greatly improved maternal and child health services in the country.

Speaking during the release of results marking completion of Cycle 12, he said: “As minister, I am proud because of the quality services this initiative provides. We must make sure these programmes are always up to standard to satisfy the patients and donors.”

Dedicated staff

He commended nurses, midwives and other health workers for their tireless effort despite numerous challenges, including a high disease burden, shortage of essential drugs and high vacancy rates.

“You meet many challenges but you still go to work daily. Thank you for the sacrifice,” he told the health workers.

Paramount Chief Gomani V, who leads the RBF4MNH advocacy team, concurs with the minister.

“By reaching cycle 12, it shows we have come a long way. A lot of people have benefited. Many are still benefiting. I encourage the team and all stakeholders to continue the good fight,” says the supreme traditional leader among the Maseko Ngonis of Balaka, Ntcheu, Mwanza and Dedza.

Major winners

Over K1.7 billion was pumped into various RBF4MNH projects in 2016.

Among the outstanding health facilities that received the cash prizes, Kapiri Health Centre emerged the best facility. Mua came second, with Bwanje and Nsipe third and fourth, respectively.

Balaka has outclassed Dedza, Mchinji and Ntcheu for a record tenth time!

RBF4MNH is a government initiative funded by the German and Royal Norwegian governments to stimulate provision of improved health care and support to poor pregnant women and children. n