Saving moms & babies in Mangochi district through community-based antenatal care.

Maternal and neonatal mortality remain stubbornly high in Malawi, with progress stalled as long distances to healthcare facilities keep many pregnant women from accessing the skilled antenatal care that can prevent fatal complications. This barrier of distance to healthcare is particularly acute in the large, rural district of Mangochi. 

With new funding from a ViiV Healthcare Positive Action Program grant, Gilead Sciences and a private donor, GAIA mobile clinics are working to change this, bringing quality antenatal and postnatal care to 15 hard-to-reach community sites each week – sites that are on average 13 kms from the nearest health facility (one site is 27 kms from the nearest health facility). Two clinics were launched in Mangochi, our newest district, in 2022 and a third was added this year, along with a strengthened suite of antenatal and postnatal services, including a portable ultrasound that is providing critical diagnostic help to clinicians and reassurance to clients. 

During antenatal visits, GAIA’s skilled staff provide essential antenatal services: monitor clients’ weight, hemoglobin and urine levels; provide malaria prophylaxis; test for syphilis, HIV, and Hepatitis-B; screen for tuberculosis and gestational diabetes; check the fetal heartbeat; and vaccinate for tetanus. Clients who test positive for HIV are immediately connected to treatment in order to prevent mother-to-child transmission.

These services are filling a clear need: in 2024, GAIA’s Mangochi clinics provided almost 2700 antenatal visits (more than double the number provided the previous year) and more than 92,000 total clinic visits. One month after launch in May of this year, the newest Mangochi clinic had as many clients as the other two clinics – clear evidence of the demand for community-based health services in these rural communities.

Esther, a 26 year old mother of two, living in Sosola village, 15 kilometers away from the only health center providing antenatal care in this remote area, illustrates the importance of community-based care. During her previous two pregnancies, Esther could not start antenatal care until the third trimester due to the prohibitive cost of transportation to the nearest health facility. During this third pregnancy, she started antenatal care in her first trimester at the GAIA mobile clinic which opened near her home. Early review of GAIA’s 2024 antenatal care data supports this anecdote, showing that 56% of pregnant GAIA clients initiated ANC in the first trimester compared to only 36% at district health facilities. Early initiation of antenatal care is critical for identifying and preventing pregnancy-related complications and improving mothers and their babies’ health outcomes. 

Esther expressed her relief and gratitude for the clinics, noting “Now I don’t need to travel long distances to the health facility and I go back home in time to carry out other household chores.” And with antenatal care integrated within primary care at GAIA mobile clinics, she can take care of her two other children’s health needs in the same visit.

Meeting clear need and having real impact: antenatal care is just one of the areas where GAIA mobile clinics are transforming the health landscape for rural women in Malawi.

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¹  At 381 deaths per 100,000 live births, maternal mortality in Malawi is significantly higher than the Sustainable Development Goal (SDG) of 70; and neonatal mortality has stalled at 22 per 1,000 live births (versus SDG goal of 12).

² Also known as prenatal care.