Citizen Hearings were held in Blantyre and Kasungu with 3,000 participants involved. The first hearing was in Kasungu, where WRA partnered with World Vision International, Ministry of Health – Kasungu District Health Office, and the National Initiative for Civic Education (NICE). The Hearings built on existing structures that villagers use to work with Members of Parliament and Councilors to present their needs in health care including maternal health care. Their voices make it to parliament and District Assembly and the meeting was attended by the Member of Parliament for the area, Chief Wimbe, Kasungu District Health Officer, and Ward Councilor for the area.

The second hearing in Blantyre was held at Senior Chief Somba’s headquarters; WRA partnered with Blantyre District Health Office and World Vision International to run the event. Present at the hearing were Blantyre District Health Officer, Ward Councilor, and Senior Chief Somba. The Blantyre Hearing was broadcast live on Zodiak Broadcasting Station (Radio). Listeners from all over the country participated and contributed to the hearing though text messages.
 

 
A health facility will be constructed in these 5 years - if not never vote for me again
— Signed Honorable Madalitso Kazombo, Member of Parliament for Kasungu East Constituency
 

RESPONSES AND RECOMMENDATIONS

At both hearings, citizens expressed dissatisfaction on poor fulfillment of promises and commitments, including those that were made
last year during campaigns. At the Kasungu hearing, citizens engaged the Member of Parliament to track progress on promises he made to build a health center in the area. The District Health Officers in both districts were taken to task to answer to various concerns by the communities.

The issues were:
1. Poor services provided by health workers. This is mainly due to understaffing leading to high patient-midwife ration.
2. Lack of supplies and misuse of supplies. Drugs meant for Government facilities are sold in private clinics
3. Clinicians employed by Government focus more in running their Private clinics
4. Lack of infrastructure – buildings were yet to be constructed
5. Long distances to health facilities to access medical care
6. Poor roads infrastructure
7. Lack of other essential basics like fresh water leading to poor sanitation at health facilities and waiting homes

Deliberations centered on finding lasting solutions to address the presented issues. Citizens voiced out what mechanisms they feel should be adopted to provide the solutions.

Both hearings arrived at the following recommendations:
1. Citizens will engage Government to make sure it prioritizes their needs which include construction of health facilities and improving road network
2. Citizens will engage local authorities (District Assembly and District Health Office) to make sure that action plans that were developed after consulting the citizens, are implemented
3. Political leaders (Members of Parliament) and Local Leaders(Chiefs) will promote citizen-led accountability by providing guidance to their subjects and followers
on how to engage Government and track on promises and commitments
4. Local leaders promised to establish, strengthen, and empower accountability structures (Citizens Forums, and Hospital/Health center Advisory Committees) to effectively engage government and be involved in maternal and newborn health policies and plans that are targeted at them.

Area specific recommended actions:

Kasungu
1. The hospital should be constructed in the area as soon as possible.
2. MP, Councilor, Chiefs and DHO’s office should make a follow up and engage the DC’s office
3. MP and Councilor should be coming to the area so often so that they are being engaged by the community on their campaign promises and on their development needs.
4. The community is ready contributing more towards development projects in the area.
5. MP said enough is enough; the area needs a health facility. He will make sure that the heath facility is constructed in the area in his tenure of office. Failure to do so, people should not vote for him as a member of parliament of the area again. The MP signed for his statement in presence of members of the community and stakeholders that were present during the citizen hearing campaign

Blantyre
1. Mpemba Health Center should have an ambulance and adequate resources
2.Health workers should start working at stipulated civil service working hours
3. DHO should deploy adequate staff to the health center and there should be a staff on call during weekend or public holidays.
4. A Health center Advisory Committee will be elected as soon as possible to follow up drugs and all activities at the facility
5. DHMT should conduct supervisory visits to the health center
6. Every community member mainly men should take part in safe motherhood issues; we should all encourage pregnant mothers to seek health care in time.
 

WATCH: Senior Chief Somba spoke out for Citizen Participation at the Hearing

It is important to involve citizens when addressing their needs, and when implementing the plans. They are the ones who know exactly what they need. Involve them
— Senior Chief Somba, Blantyre
As citizens we should make Government accountable on maternal health goals adopted. As a politician, I will lead the citizens in persuading Government to deliver on its commitments
— Honorable Madalitso Kazombo, Member of Parliament for Kasungu East Constituency
Citizens need to organize yourselves and form a Health-center Advisory Committee (HAC) that will engage my office on maternal and newborn health issues
— Dr. Matchaya, Blantyre District Health Officer

Read the full Malawi Country Report from the Global Citizens' Hearing Report now.