Malawi's cadre of government community health workers, known as Health Surveillance Assistants, whose origins trace to the 1950s, when workers performing the same community role were called public vaccinators and later smallpox vaccinators, and who have operated under the Health Surveillance Assistant title since the 1960s as part of Malawi's community-based health care delivery platform. Their responsibilities evolved over decades from disease surveillance toward health promotion and prevention, and in 2008 Health Surveillance Assistants took on curative duties for the first time when Malawi adopted integrated community case management, expanding the workforce to help reach universal coverage of key child health interventions; by 2011 Malawi employed some 12,000 Health Surveillance Assistants nationwide. The programme is credited as a major contributor to Malawi's sharp reduction in child mortality, which fell from 222 deaths per 1,000 live births in 1990 to 92 per 1,000 by 2010, and in 2017 the government built on the cadre by launching a National Community Health Strategy aimed at expanding the workforce's capacity to deliver lifesaving care and prevention education.
Facts
Program StatusActive; Health Surveillance Assistants remain a formal, salaried cadre of the Ministry of Health. 1 Sponsoring BodyThe Ministry of Health of Malawi (HSAs are salaried MOH employees). 1 Target PopulationCommunities of about 1,000 people per Health Surveillance Assistant, nationwide. 2 Health GoalDevelop a workforce able to provide lifesaving interventions for serious childhood illnesses and educate communities about disease prevention. 3 Geographic ScopeNationwide across Malawi. 3 Measured ResultsHealth Surveillance Assistants administer approximately 80 percent of routine vaccinations in Malawi. 1 Program status (class) Classification
Program KindVaccination or Immunization Program 1 Connections
Associated With
Source PMC: Malawi Health Surveillance Assistants as Vaccinators Case Study
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Sources
1. PMC: Malawi Health Surveillance Assistants as Vaccinators Case Study
National Center for Biotechnology Information (PMC)PMC case study, employment status sentence
salaried employees of the MOH
PMC case study, vaccination share figure
administer approximately 80% of routine vaccinations in Malawi
PMC case study, employment status sentence (status)
salaried employees of the MOH
Program classification, entity description sentence
Malawi's cadre of government community health workers, known as Health Surveillance Assistants, whose origins trace to the 1950s, when workers performing the same community role were called public vaccinators and later smallpox vaccinators, and who have operated under the Health Surveillance Assistant title since the 1960s as part of Malawi's community-based health care delivery platform.
Associated With: Health Systems and Policy, Page text
Malawi is one of only a few countries that relies on CHWs-called Health Surveillance Assistants (HSAs) in Malawi-to administer routine immunizations, and as such offers a unique example of how this can be done.
View the Source 2. PMC: Health Surveillance Assistants as Intermediates Between Community and Health Sector in Malawi
National Center for Biotechnology Information (PMC)PMC intermediates study, caseload figureQuote, PMC intermediates study, caseload figure
working mainly in health promotion and prevention for a population of about 1,000
3. CHW Central: Malawi Community Health Worker Program
CHW CentralCHW Central profile, program goal
develop a workforce capable of providing lifesaving interventions for serious childhood illnesses and educating about disease prevention
CHW Central profile, national scope statement
improve basic community health services throughout the country
Page text
Currently, HSA tasks at community level include: child (and mother) vaccination, growth monitoring, sanitation, water source protection and water treatment, disease surveillance, health and nutrition talks, provision of contraceptives and supervising traditional birth attendants and village health and water committees.
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