Malnutrition treatment comes closer to homes in Dedza

Daniel Mandevu starts each day knowing that families in remote parts of Bembeke, Dedza district, rely on Nadzikhale Village Clinic as their first access point to essential healthcare.

Mandevu has particularly seen firsthand how the village clinic’s integration of management of severe wasting treatment without complications into the Integrated Community Case Management (ICCM) – an initiative that supports community health workers to treat uncomplicated malaria, pneumonia and diarrhea in children – is transforming lives.

Before the integration, mothers had to walk long distances with their children to Bembeke Health Centreto access care for severe acute malnutrition (SAM), which required weekly visits to replenish ready-to-use therapeutic food (RUTF).

“Many caregivers found it difficult to manage the weekly trips. The long distances demanded transport money and more time away from home, causing some to miss appointments and putting children at greater risk,” says Mandevu.

"With the integration, caregivers now access RUTF and weekly routine medical assessments within their community. Only patients with complications are referred to the health centre or district hospital.”

When running the village clinic, Mandevu begins by welcoming caregivers, then screening children for severe illness and referring those found with danger signs for further medical attention. After a brief health talk, he conducts nutrition checks by taking middle upper arm circumference (MUAC), height and weight measurements to monitor each child’s recovery.

“Children who do not show signs of recovery are given RUTF and scheduled to return for review the following week,” he says.

With funding from Children’s Investment Fund Foundation (CIFF), UNICEF supported the health workers’ capacity building on RUTF management and supplied secure storage boxes to protect the stock. HSAs work with members of community health committees to ensure oversight of the RUTF, with both parties present when opening or closing the two-lock RUTF boxes.

Coupled with technical mentorship and supportive supervision, the integration is enabling frontline health workers like Mandevu to improve the quality of primary healthcare in communities.

Stella Chale, who now gets RUTF for her two-year-old daughter Trinity just few minutes away from home, says accessing severe wasting treatment at the village clinic has eased the financial burden on her family. Trinity was previously admitted for SAM treatment at Bembeke Health Centre.

"Accessing RUTF for my child together with care for all other common illnesses at the village clinic has saved me a lot of money because travelling to Bembeke Health Centre is costly," she says.

The village clinic has also strengthened follow‑ups for children recovering from severe acute malnutrition. Previously, many caregivers stopped visiting the health centre once a child appeared to improve, leading to missed treatment and stalled recovery.

At another clinic in Msesa Village in the same district, families tell similar stories.

“Treatment of severe wasting is now only a short walk away. My child is getting much better now. Having RUTF close to home has made life much easier,” says Enifa Libelito from a nearby Mkungumbe Village.

Enifa’s three-year-old daughter Diana had previously been referred to Bembeke Health Centre for severe acute malnutrition treatment, but the two-hour journey often prevented her from completing the recommended sessions.

The HSAs work with volunteers who conduct nutrition screening around the communities to extend the programme’s reach. They support in identifying malnourished children in the community and refer them to village clinic to receive RUTF. HSAs provide mentorship to volunteers as a way of building their capacity to correctly identify malnourished children and deliver nutrition messages.

Judith Jalakasi, a community volunteer, says she is empowered to identify children at risk of malnutrition early and encourage families to seek care.

"Previously, many children reached Bembeke Health Centre only after becoming seriously ill because it is very far," says Jalakasi. "During my routine community visits, I can identify children who need medical attention, counsel caregivers and refer them before the situation becomes critical."

According to Brian Sibande, Dedza District Integrated Management of Childhood Illness Coordinator, village clinics have strengthened collaboration between community health workers, community volunteers and health facilities, ensuring children receive timely care closer to home.

For mothers like Enifa and Stella, the greatest impact is measured in healthier children, lower out of pocket health care costs, and easier access to healthcare.

By bringing quality primary healthcare within walking distance, village clinics are ensuring that distance is no longer a barrier to life-saving health and nutrition services in rural Dedza.