Malawi launches WHO PEN-Plus plan to reduce burden of NCD

Non-communicable diseases (NCDs) are contributing 35 percent of the disease burden in Malawi, the Ministry of Health and Partners in Health (PIH) have disclosed.

They made the sentiments in Lilongwe during the launch of a plan to operationalize the World Health Organization Package of Essential Non-Communicable Diseases Plus (PEN-Plus), effectively kick-starting the process of bringing the treatment of severe non-communicable disease (NCDs) to rural facilities across the country.

Dr Chiyembekezo Kachimanga, Chief Medical Officer

The launch took place in Lilongwe and attracted both local and foreign health specialists and stakeholders. Some foreign health experts participated virtually.

The ministry and PIH touted the operationalization of PEN-Plus as a critical step towards addressing the suffering occasioned by NCDs.

WHO PEN-Plus, according to Ministry of Health and PIH, addresses the gaps in NCDs care through decentralized, integrated outpatient services at first-level hospitals throughout countries in Sub-Saharan Africa.

The gap is reportedly evident particularly in chronic care for more severe conditions (sickle cell, type 1 Diabetes, Rheumatic Heart Disease), complex NCDs, especially in rural areas where care is harder to access.

Part of the audience

The Malawi PEN-Plus operational plan, described as representing the country’s ongoing efforts to expand comprehensive NCD services, includes, among others, an updated situational analysis of NCDs in the country, an outline of progressive decentralization of PEN-Plus and a practical plan for how Malawi can scale up PEN-Plus services.

In his remarks, the Deputy Director for Clinical Services responsible for NCDs, Injuries and Mental Health in the Ministry of Health, Dr. Jones Kaponda Masiye, lobbied for continued multi-stakeholder collaboration so that the plan would be implemented successfully

“We have noted that most people suffering from NCDs, actually have more severe conditions such as sickle cell anaemia, type 1 diabetes and rheumatic heart disease that require specialized treatment. But these people live in districts and that means they have to go to specialized facilities such as central hospitals which are very few in the country.

“So we want NCDs specialized treatment at district hospitals so that these people are assisted right there. This is what we call PEN-Plus. We cannot continue moving patients around. Some live very far in hard to reach places. And lives are lost in the process,” said Dr. Masiye.

Apparently, government in partnership with PIH, are already running an advanced PEN-Plus clinic in Neno district on pilot basis, which, according to Dr. Masiye, has proven that it is possible to implement the initiative across the country.

As a result, Dr. Masiye said the initiative will also be piloted in Neno, Karonga and Salima districts and then later be rolled out in all the districts across the country in the “soonest time possible”.

“It is not an overnight process. First, we will have to identify and train staff in district hospitals so that they know how to manage these chronic illnesses. We are happy with the positive attitude of various stakeholders which we believe will help to successfully operationalize the Malawi PEN-Plus plan,” he said.

On his part, PIH Chief Medical Officer, Dr. Chiyembekezo Kachimanga, concurred with Dr. Masiye, saying operationalization of WHO PEN-Plus is long overdue in Malawi.

“As PIH, we are proud that, through the partnership with government, we have become a reliable source of information, experience and lesson sharing leading to the birth of something which will be big.

“As we speak, we have already identified a donor who will finance the pilot PEN-Plus in Karonga and Salima districts in preparation for the later setting up of clinics across the country. Government must be commended for moving fast to ensure that there is increased access to NCD care in the country. This pace must be maintained,” said Dr. Kachimanga.

Kachimanga, however, mentioned that Noel Kasomekera, the Technical Advisor for the NCDI & MH unit PIH is still working on resource mobilization, partnership, collaboration and governance from different ministries and stakeholders to ensuring that the PEN-Plus operational plan is implemented with consideration of all Malawians.

PIH is a non-profit global health organization that fights injustice by bringing the benefits of modern medical science to the most vulnerable communities around the world.

It started working in Malawi in 2007. It is known locally as Abwenzi Pa Za Umoyo (APZU). PIH/APZU works in partnership with the Ministry of Health in the rural district of Neno to provide comprehensive care for about 150,000 people.

Nevertheless, it is also implementing a World Diabetes Foundation Project across the country but with main focus in the southern region of Malawi.

PIH supports the Ministry of Health in the implementation of clinical programs, community health and social support programs, monitoring and evaluation, data management systems, and infrastructure improvements for 14 health facilities in Neno District.

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