More Than a Friendly Neighbor

On a 100-degree day in October—the peak of dry season in Neno District, Malawi—Eliza Kazembe sat in the shade alongside her family’s home and said it felt like she’d been pregnant forever.

“She’s akuyembekezera kuchira,” Anga Sawasawa said, explaining that the Chichewa phrase translates to “waiting for delivery.”

Kazembe, 17, was nine months pregnant, a condition made clear as much by the swell of her belly as by the look of tired determination in her eyes. But she also was smiling, displaying a cheerful nature that shone through despite the heat, the fatigue, and the waiting.

“I’m excited,” Kazembe said. “Everything has been good.”

She had plenty of support around her. Kazembe lives with her mother and sister at their home in Kamdzandi Village, a community filled with ancient baobab trees—all bare of leaves and dry at that time of year—and not far from Lisungwi Community Hospital. The hospital is supported by Abwenzi Pa Za Umoyo, as Partners In Health is known in Malawi.

Sawasawa is PIH’s site supervisor for community health workers (CHWs) in the Lisungwi area. She oversees 104 CHWs, and said all of them support pregnant women in their communities every day, helping them have safe, healthy pregnancies and deliveries.

“Maternal health is included in our training,” Sawasawa said.

CHWs are the foundation of Partners In Health’s work in Malawi and 10 other countries. They conduct regular household visits to neighbors in their communities and provide vital support, resources, education, and access to health care.

Today’s visit to Kazembe’s home was an embodiment of that support. Leading the visit was Grace Mgaiwa, the CHW dedicated to Kazembe. PIH in Malawi uses a household model for CHWs, in which every home that receives care or support in Neno District has a designated CHW. Mgaiwa, 35, has been a CHW since 2017 and regularly visits 22 homes in Kamdzandi Village, which is where she was born and still lives. Mgaiwa is a mother of five children herself, all daughters, and lives just down the road from Kazembe.

Mgaiwa said she regularly helps Kazembe access services at Lisungwi Community Hospital, including three prenatal care visits during Kazembe’s pregnancy. And during her regular home visits, Mgaiwa provided information about nutrition, blood pressure, potential health concerns during pregnancy, and how to prepare for labor and delivery.

“I learned a lot,” Kazembe said. “And I know that when I have any signs (of labor), I have to rush to the hospital.”

Delivering a baby in a health facility, rather than at home, greatly improves the health outcomes for mothers and babies. It ensures that they have access to experienced health personnel, medicine, diagnostic equipment, blood banks and even resuscitation services, if necessary.

In September 2019 alone, staff for PIH in Malawi recorded 440 facility-based deliveries and conducted 1,579 antenatal care visits across Neno District, where PIH serves more than 140,000 people.

For Kazembe, her preparation and patience paid off: She safely gave birth to her son, Prince Chimpaka, on Oct. 24 at Lisungwi Community Hospital.

But that doesn’t mean Mgaiwa’s visits will stop—on the contrary, it means Mgaiwa’s daughters might soon have a new friend to play with, just down the road.