title: Implementation of Policies and Strategies for Control of Noncommunicable Diseases in Malawi: Challenges and Opportunities.
abstract: Malawi is a Sub-Saharan African country experiencing the epidemiological transition from predominantly infectious to noncommunicable diseases (NCDs) with dramatically increasing prevalence of lifestyle-related diseases such as obesity, hypertension, and diabetes. Malawi's 2011-2016 Health Sector Strategic Plan included NCDs, and an NCD Control Program was established with subsequent development of a National Action Plan for prevention and management of NCDs launched in 2013. The current study was designed to identify gaps in implementation of NCD control program policies and action plan strategies by describing current efforts toward prevention and management of NCDs in Malawi with emphasis on challenges and opportunities. Semistructured questionnaires were used to collect quantitative and qualitative data from Malawi Ministry of Health personnel (senior officers, service providers, health education officers, and nutritionists) in 10 health districts and 3 central hospitals. Frequencies were generated for quantitative data. Qualitative data were used to generate themes and most common responses. Results showed that current services focus on facility-based NCD screening and clinical services rather than active screening, prevention, and community awareness and outreach, although respondents emphasized the importance of prevention, lifestyle education, and community outreach. Respondents indicated inadequate resources for NCD services including financial capital, human resources, equipment and supplies, and transportation. While Malawi has begun to address NCDs, policy and practice implications include (a) better integration of services within the existing infrastructure with emphasis on capacity building; (b) greater implementation of planned NCD activities; (c) a stronger, more comprehensive data management system; and (d) innovative funding solutions.
authors.affiliation: Family Health International (FHI 360), Lilongwe, Malawi.
authors.forename: Phindile Chitsulo
authors.initials: PC
authors.lastname: Lupafya
authors.affiliation: Clinical Services Department, Ministry of Health, Lilongwe, Malawi.
authors.forename: Beatrice L Matanje
authors.initials: BL
authors.lastname: Mwagomba
authors.affiliation: Virginia Tech, Blacksburg, VA, USA khosig@vt.edu.
authors.forename: Kathy
authors.initials: K
authors.lastname: Hosig
authors.affiliation: Virginia Tech, Blacksburg, VA, USA.
authors.forename: Lucy M
authors.initials: LM
authors.lastname: Maseko
authors.affiliation: United Nations Population Fund, Lilongwe, Malawi.
authors.forename: Henry
authors.initials: H
authors.lastname: Chimbali
mesh_terms: D057191:Capacity Building / Q000458:organization & administration; D002908:Chronic Disease / Q000517:prevention & control*; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D003906:Developing Countries; D006291:Health Policy; D006295:Health Resources; D006801:Humans; D008295:Malawi; D012307:Risk Factors; D011049:Social Control Policies / Q000458:organization & administration*; D011795:Surveys and Questionnaires
keywords: Malawi; community outreach; management; noncommunicable diseases; prevention; screening; service integration