Annual Report 2018 - Luke international · HIS Developers: Mr. Duke Caeser, Mr. Justin Manda, Mr. Takondwa Makawa, eIDSR Project Coordinator: Mr. Peter Phiri System Analyst: Ms. Chisomo

Annual Report 2018

Vision: “To restore human’s health and dignity” Website: www.lukeinternational.no

Table of Content 1. LIST OF ABBREVIATIONS ........................................................................................................... 3

2. ACTIVE MEMBERS: .................................................................................................................... 4

3. OVERVIEW OF KEY IMPACT OF LIN IN 2018 ............................................................................... 5

4. DESCRIPTIONS OF KEY ACHIEVEMENTS IN 2018 .......................................................................... 6

WORK AREA 1: HEALTH INFORMATION SYSTEMS STRENGTHENING .................................................. 6

WORK AREA 2: RESEARCH AND CAPACITY BUILDING PROGRAM .................................................... 12

WORK AREA 3: COMMUNITY DEVELOPMENT: ............................................................................... 14

REGIONAL DEVELOPMENT ................................................................................................................... 18

ORGANIZATIONAL DEVELOPMENT....................................................................................................... 19

5. FINANCIAL STATEMENT IN 2018 .............................................................................................. 20

6. OUR PARTNERS ...................................................................................................................... 21

7. OUR ADVISORS ...................................................................................................................... 22

8. CONTACT INFORMATION ......................................................................................................... 22

©Luke International, 2018

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1. List of Abbreviations ANC Antenatal Care ART Anti-retroviral Therapy BHT Baobab Health Trust BSWF Bjørgaas Social Welfare Foundation CBO Community Based Organisations CDC Centers for Disease Control and Prevention CHIS Community Health Information System CMED Central Monitoring and Evaluation Division DHIS District Health Information System EBRS Electronic Birth Registration System EDRS Electronic Death Registration System eIDSR Electronic Integrated Disease Surveillance and Response EMR Electronic Medical Records EP&D Economic Planning and Development GoM Government of Malawi HIS Health Information System HIV Human Immunodeficiency Virus HSAs Health Surveillance Assistants HTS HIV Testing Services ICT Information Communications Technology ID Identification LIMS Laboratory Information Management System LIN Luke International M&E Monitoring and Evaluation MHM Menstruation Hygiene Management NAC National AIDS Council OPD Outpatient Department PACS Picture Archiving and Communications System TWG Technical Working Groups VIP Ventilated Improved Pit WASH Water, Sanitation and Health WHO World Health Organisation


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2. Active Members: Malawi Office Members (40):

Malawi Local Board of Trustees (4): Chairman: Rev. Hans Tore Leithe Board Members: Prof. Yohane Nyasulu, Rev. (Major) Highson Gondwe, Dr. Joseph Kwong-Leung Yu, Dr. Rose Nyirenda

Management and Administrative Team (6):

Malawi Country Representative: Ms. Hsin-yi Lee Administrator / Project Coordinator / Board Secretary: Ms. Rebecca Mtegha Project Account: Mr. Simon Gondwe Finance Officer & Finance Assistant: Mr. Wezzie Siwale, Mr. Watson Mukumbwa (up till July 2018), Mr. Dickson Mkandawire (joined September 2018) Administrative Assistant: Ms. Michelle Cement

Health Information System Development and Deployment Department (13):

HIS Technical Coordinator: Mr. Temwanani Chinula HIS Specialist (Kuunika): Mr. Jack Msonkho (January-August 2018), Mr. Rajab Billy HIS Developers: Mr. Duke Caeser, Mr. Justin Manda, Mr. Takondwa Makawa, eIDSR Project Coordinator: Mr. Peter Phiri System Analyst: Ms. Chisomo Njala HIS Deployment Officers: Mr. Francis Mafupa, Mr. Dean Kakatera, Ms. Maggie Nkhoma, Mr. Alie Chibwe, Mr. William Mbowe HIS Assistant: Ms. Doris Jere

Research and Capacity Building Department (2):

Technical Advisor/ PhD Student: Mr. Joseph Wu Research Intern: Isaach Ndemera

Community Development Department (4):

Community Project Manager: Ms. Sharon Yang Community Project Coordinator: Ms. Tina Dzama Thole Community Project Officer: Mr. Patrick Hara, Ms. Dyana Kapa

Supporting Department (11):

Procurement and Logistics Officer: Ms. Rose Singini Assistant Guesthouse Manager: Ms. Elizabeth Kawenjerere Office Assistant: Ms. Shuwaz Nkhoma Chef: Ms. Mercy Chimpeni Dormitory Supporting Officers: Ms. Mary Mkandawire, Mr. Edward Shaba, Mr. Felix Nyrongo, Mr. Robert Sinwaka Drivers: Mr. Innocent Msumba, Mr. Charles Mhango, Mr. Samuel Nyirenda, Mr. Lyton Mkumbwa


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3. Overview of Key Impact of LIN in 2018


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4. Descriptions of Key Achievements in 2018

WORK AREA 1: HEALTH INFORMATION SYSTEMS STRENGTHENING

1 Nkhatabay District Hospital 2 Rumphi District Hospital 3 Karonga District Hospital 4 Ekwendeni Mission Hospital 5 St. John's Mission Hospital 6 Mzimba South District Hospital 7 Chintheche Rural Hospital 8 Chitipa District Hospital 9 Chilumba Rural Hospital 10 Embangweni Mission Hospital 11 Mzuzu Central Hospital 12 Mzimba North District Hospital 13 Kaporo Health Centre 14 Lunjika Health Centre 15 Bolero Rural Hospital 16 Kaseye Health Centre 17 St. Annes Health Centre 18 Chambo Health Centre 19 MACRO Mzuzu 20 Likoma District Hospital

Geographic Coverage


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Module Name Description ART: Antiretroviral Therapy HIV patient clinical management; cohort data reporting; OPD: Outpatient Department Patient registration, diagnosis and treatment ANC: Antenatal Clinic Pregnant women Antenatal Care management HTS: HIV Testing Services HIV testing and counseling services PACS: Picture Archiving and Communications Systems

Medical images (e.g. X-Rays) storage & communication

LIMS: Laboratory Information Management System

Lab specimen registration, test processing and results reporting

Project Highlight: Improving Quality of Care and Health Impact through Sustainable, Integrated, Innovative Information System Technologies in Malawi. The project is funded by the Centers for Disease Control and Prevention (CDC) of the United States of America (USA) through the Baobab Health Trust (BHT) in Malawi. LIN received the 8th EMR roll-out and maintenance funding (FY18-19). The approved funding for the period the 1st April 2018 to 31st March 2019 financial year was $641,747.00.

2018-2019 CDC Project Scope of Work 2018 Key Outputs 1. Scaling up to new four (4) sites in the Northern

Region with National ART & OPD 2. Deployment of HIV Testing Services (HTS) module

and ANC modules in accordance to scale up plan. 3. Deployment of Stock Management (4 new sites,

plus 14 existing sites) module in accordance to the scale-up plan.

4. Maintenance of the Laboratory Information Management System.

5. Capacity building on data management, utilization and quality improvement.

6. Deployment and Maintenance of Electronic Death Registration (eDRS) (target 6 districts)

7. Maintenance and support of Electronic Birth Registration (eBRS) in 7 Districts.

8. Support and Maintain all health facilities in the North with the National EMR System

Continuous support is being offered to fourteen (14) sites with the management of over 96,035 ART patient data, of which 2,216 were newly registered in this past quarter.

Supporting eight (8) eBRS facility sites; completed system upgrades in 7 sites working together with BHT.

eDRS pilot: Completed deployment in Chitipa DC & Karonga DC.

LIMS: Completed deployment of LIMS at Mzimba South District Hospital; system live on 29th May 2018.

Completed deployment of ANC and HTS modules in fourteen (14) EMR sites, 262 health workers trained in the newly deployed modules.

EMR Modules in Health Facilities supported by Luke International

Electronic Medical Records System Overview


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The Epidemiology department of Ministry of Health is responsible for surveillance of key epidemic-prone diseases such as cholera, Ebola and ensuring timely response on reported cases. Luke International works with its partner, Baobab Health Trust, to improve and strengthen the integrated disease surveillance and response (IDSR) in Malawi through technology interventions at various levels of the health system. The intervention include the eIDSR mobile application at the community level for cased based surveillance and information management during outbreak responses; ARGUS mobile application for weekly IDSR report submission from facility level; syndromic and active surveillance through automatic extraction of notifiable diseases diagnosis and selected syndromes recorded through facility level OPD modules to a central dashboard; and integration to national level health information system (DHIS2).

Project Highlight: UNICEF Programme Cooperation: Improved Community Health, Nutrition, HIV, Protection and Disease Surveillance. This is a pilot project sponsored by UNICEF to implement a mobile health (mHealth solution) developed by World Health Organization (WHO) to strengthen Malawi’s integrated diseases surveillance and response (IDSR) system and aiming to deploy in 10 districts of Malawi (Phalombe, Chikwawa, Nsanje, Mangochi, Karonga, Nkhata Bay, Dowa, Lilongwe, Salima, Thyolo) to generate weekly IDSR reports by the end of the project. The key objective is to establish SMS connection between health care workers from 184 health facilities from the 10 pilot districts for weekly IDSR report through piloting of WHO supported ARGUS solution and its integration with eIDSR system and DHIS2 in Malawi. The project period is running from August 2017 to July 2018. LIN is working in collaboration with Baobab Health Trust on the project implementation. Total project fund from UNICEF is MKW 122,555,253.00. (Equivalent USD $ 167,883.91)

Electronic Integrated Disease Surveillance and Response


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2017UNICEF Project Scope of Work 2018 Key Outputs 1. Establish SMS reporting connectivity 2. Procure and distribute mobile devices for HSAs 3. Development of mobile application and provide

technical support 4. Establish National internet connectivity at

epidemiology units

Conducted Argus training workshops and in total 220 health care workers are equipped the Argus application for weekly IDSR reports.

Finished the SMS service setting for Argus application and the system is functioning to receive and populate weekly IDSR reports.

Finished the procurement procedure, 200 phones were procured and delivered to health care workers including district and national IDSR focal people.

Produced the physical registration log for all phones and serial number and IMEI numbers are registered prior to distribution.

The Argus national server and system has been set-up: The Malawi eIDSR team is on board for Argus solution deployment and trouble shooting. The server and system was set-up with local capacities including MoH staff.

Technical meeting with CMED and DHIS2 team in Malawi of re-/deploy the IDSR Weekly Report Forms in DHIS2 and introduction of Argus project

Additional internet bandwidth installed at CHSU.

Within the MOH, LIN works with different department and offices, specifically maintaining active communication and partnership with the Central Monitoring and Evaluation Division (CMED) under the Department of Planning, the Epidemiology Department, HIV and AIDS Department, Quality Management Unit, Community Health Section and ICT Department. LIN continues to actively participate in the various technical working groups related to Monitoring and Evaluation (M&E), Data Standards, Health Information System Architecture, mHealth and Community Health.

Health Information System Strengthening from Community to National Level


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Project Highlight: Kuunika- Data for Action Project. This is a four-year project, funded by Melinda and Bill Gate’s Foundation and implemented by four consortium members (Lighthouse Trust, I-TECH, Baobab Health Trust and Luke International) to strengthen data systems and data use in high HIV-burden districts in Malawi. While the immediate focus of this effort is improving the performance of HIV programs, the data system and data use interventions of the GoM plans are applicable across the health system, and would inform the GoM and other partners on the use-cases and best practices of effective data system interventions and data use practices across the health system. LIN’s main scope of work under the Kuunika Project will focus on strengthening community level data systems, including the pilot of the mobile HIV Supervision Application, strengthening non-biomedical HIV data reporting (prevention and health education services), and assisting in system integration for various national level information systems. The allocated budget for LIN in the first project period (ending June 2018) is $272,238, and subsequent project period (ending June 2019) is $339,097.00.

2018Kuunika Project Scope of Work 2018 Key Outputs

1. Develop the electronic mobile supervision tool for quarterly HIV/TB supervision.

2. Develop data exchange process between EP&D system and DHIS2

3. Implement the mobile solution for non-biomedical HIV data submission (Local Authority HIV/AIDS Reporting System)

4. Defining data element and information flow between community level and facility level for HIV related health services.

5. Implement the mobile solution for community-level HIV-related services.

Quarterly HIV/TB supervision mobile app and Data Staging Area developed with alpha release in October 2018.

HMIS Dashboard mobile app completed and released on Google Play Store; the app is being used in Data Use Campaign to promote data use at facility level.

Completed CMED Web Portal (a repository for all relevant M&E and HIS documents of MoH)

Supporting MOH CMED and Community Health Section to review and design “Community Health Information System” (CHIS) in line with the Community Health Strategy Activities, including: completed community health Indicators handbook: 149 community health indicators selected for the final indicator handbook; situational analysis of Village Health Registers, and consultation review at District level for the design of community health register.

Support the National AIDS Commission and Local Government to finalize revision of the Local Area HIV/AIDS Reporting Form (LAHARF)

Introduction and orientation of revised LAHARF in all districts

Supported on mHealth Technical Working Group meeting held on 20th February 2018.


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Mobile Application Products HIV/TB Integrated Quarterly Supervision App (Alpha release)

App Specifications App Features

HMIS Mobile App App Specifications App Features

Android based mobile application, built on DHIS2 Data Capture.

Open Source Interoperable with national instance of

DHIS2 and Department of HIV Management Information System

Data entry (online & offline) Data validation rules built in Historical data views (view data from last

supervision) Tally Pad function Approval of report through signatures

Easy access to data in National DHIS2 through dashboards and filters

Users able to analyze and view data in different formats (tables, charts, maps)

Android based mobile application, built based on HISP Tanzania product

Open Source Interoperable with national instance of

DHIS2


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Work Area 2: Research and Capacity Building Program LIN is implementing several research projects supporting the research and capacity building programs, but is also actively engaged in research and training activities being implemented through partnerships with academic institutes worldwide. Project Highlight: Mzuzu Central Hospital made a successful proposal for the study “Phase 1 Pilot Cryptococcal Antigenemia (CRAG) Screening Program among HIV-Infected Patients in Malawi. The protocol was developed in collaboration with CDC Atlanta Foundation, CDC Malawi, MOH and Department of HIV and AIDs. Study implementation sites include: Jenda Rural Hospital, Dedza District Hospital, Bangwe Health Centre and Thyolo District Hospital. LIN is the grant holder for the project, providing logistic, financial management support. The total approved budget is $ 90,119.00.

Project Scope Key Output in 2018 Eligible HIV infected patients identified in the

pilot sites will receive CD4 and point-of-care CrAg testing (for patients with stage 3-4 disease and/or CD4 count <200).

Asymptomatic CrAg+ patients will be placed on pre-emptive antifungal therapy.

The pilot program and research findings will help the Malawi government better understand the operational challenges and potential benefit of CrAg screening, as well as methods of optimization to inform future program implementation.

Study protocol developed and received ethical clearance from the Malawi National Health Sciences Research Council (NHSRC).

Stakeholders meetings conducted at facility and national level.

Study training conducted from 15th to 17th August, 2018 with 29 participants. Eight site coordinators identified and trained.

Conducted site orientations and site supervisions since project initiation.

Over 500 patients enrolled in the study (as of October, 2018).

Health research cooperation projects are being implemented with colleagues from the Mzuzu University, Mzuzu Central Hospital, University of Livingstonia and National Taiwan University (NTU) in 2018. These studies include the following topics: A comparative evaluation of four methods for rapid diagnosis of Cryptococci Meningitis in HIV infected

patients in Northern Malawi -collaboration with Mzuzu Central Hospital. Menstrual Hygiene Management Baseline Survey for Community Development Department –

collaboration with Mzuzu University Centre of Excellence for Water and Sanitation. Mosquito borne diseases study in Malawi- collaboration between interns from National Taiwan

University and the University of Livingstonia. LIN provided mentorship for local researchers and medical personnel with strong research interest. The

Livingstonia University and Gordan Memorial Hospital initiated implementation research activities looking into “Youth Friendly Health Services” at the hospitals and health facilities. LIN continues to promote locally driven research through these initiatives.

Teaching and research capacity building in local universities have also been carried out.

Local Collaborative Research and Teaching


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Mzuzu University Department of Biomedical Sciences Level 4 student independent research projects covering areas in: Maternal Health, Child Health, HIV/AIDS, Infectious Disease, Malaria, TB, Quality Assurance, Reproductive Health, and Non-communicable Disease (NCDs)

LIN provided lecturers to Mzuzu University Biomedical Science Department to deliver courses “Introduction to Health Information Systems” and “Epidemiology”. Also, supporting at the University of Livingstonia, Department of Public Health, delivering courses for “Epidemiology”.

LIN continued working with the National Taiwan University and National Yang-Ming University from Taiwan for the international medical and public health internship program. LIN Malawi office hosted 12 (twelve) medical students from National Yang-Ming University who completed four weeks global health internship from March to May, 2018. LIN also served as the host institution for National Taiwan University and University of Southern California Master for Public Health Program, with 2 master’s level student conducting field placement in Malawi. In July, we hosted 5 medical students and 3 public health students from National Taiwan University. One PhD student from University of Amsterdam is attached to LIN to conduct research on health information system strengthening in Malawi.

In May 2018, LIN facilitated a study tour for four delegates from Malawi to visit several hospitals in Taiwan. The delegates included the Director of Quality Management, Ministry of Health, GoM, Director of Mzuzu Central Hospital, the Executive Director of Baobab Health Trust and the Project Coordinator from LIN. The main objective of the visit was for delegates to observe firsthand field work using technology to support the function for Quality Assurance (QA) and Quality Improvement (QI) using health information systems (HIS) and information technology innovations. This is part of an effort and outcome through a series of discussions between LIN and Mzuzu Central Hospital, where there is the will and intention to develop Mzuzu Central Hospital as a demonstration site to see how health information systems and IT solutions may be strengthened and integrated to support quality initiatives. The delegates visited Pingtung Christian Hospital,

Chi-Mei Medical Center and Kaohsiung Chang-Gung Memorial Hospital. Presentations on HIS and QI were made at each hospital, and an action plan for future development at Mzuzu Central Hospital was developed at the end of the visit.

Photo 1. Delegates from Malawi visit Pingtung Christian Hospital attending a presentation on Quality Improvement and IT innovations.

Global Health Internship and Capacity Building

Study Tour and Exchange Visits for Learning & Strengthening Collaboration


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Publications by LIN staff in the year 2018: 1. Joseph Wu TS, Kagoli M, Kaasbøll JJ, Bjune GA. (2018) Integrated Disease Surveillance and Response

(IDSR) in Malawi: Implementation gaps and challenges for timely alert. PLoS One. 13(11): e0200858. doi: 10.1371/journal.pone.0200858.

2. Mastellos N, Tran T, Dharmayat K, Cecil E, Lee HY, Wong CCP, Mkandawire W, Ngalande E, Wu JT, Hardy V, Chirambo BG, O’Donoghue JM. (2018) Training community healthcare workers on the use of information and communication technologies: a randomized controlled trial of traditional versus blended learning in Malawi Africa. BMC Med Edu. 18(1):61. doi: 10.1186/S12909-018-1175-5.

WORK AREA 3: COMMUNITY DEVELOPMENT: The goal is to develop programs that can motivate and restore people to empower themselves; take responsibility for your own life, and programs that prevent HIV / AIDS among young people. This is done in cooperation with the Churches, schools and community-based organizations (CBOs). In 2018, LIN continually works with the Bjørgaas Social and Welfare Foundation (BSWF) from Taiwan to support community projects in Mzuzu and Nkhatabay area.

I. Education: Project Scope Key Output in 2018 Provide scholarship and

educational support to vulnerable girls/boys in the communities to continue their studies

In total 164 students benefited from the scholarship program. The beneficiaries include 115 current students (44 from primary schools, 57 from secondary schools and 14 from the universities) studying in 55 schools and 49 graduates who completed their studies in June.

80% of students LIN supported attained good academic results.

Uniforms and stationary have been provided to all the beneficiaries enrolled in primary and secondary schools.

Regular school visits in every term to strengthen the connection with head teachers and teachers to have access to information regarding our beneficiaries.

Conducted home visits by project officer to beneficiaries with poor performance to discuss the challenges and difficulties beneficiaries and their families faced and provided guidance and advices.

Research Publications


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II. Health Project Scope Key Output in 2018 Increase the access to water and

sanitation facilities in primary schools and vulnerable communities

Partnering with Malawi Water Project, 60 biosand filters are installed to households in lakeshore communities, including Kawanga, Kadezu and Chisu, to increase their access to clear, and follow-ups are conducted to ensure the proper use and working of filters.

Organized one four-day Community-led Total Sanitation (CLTS) training for 10 health surveillance assistants (HSAs) with Nkhata Bay WASH Department. After training HSAs, Community Triggering is implemented in 10 villages by HSAs with the aim of improving the level of sanitation in Kawanga and Kandezu area.

5 visits to lakeshore communities have been conducted by the project officer for project monitoring and evaluation, organizing WASH meetings and strengthening the capacities and functions of WASH committee in Kawanga Village to supervise the use of biosand filters, promote WASH practices and document WASH –related issues.

Worked with Water Board of Nkhata Bay District Bay to respond to the Cholera outbreak that took place in late 2017 by providing support to organize hygiene awareness events, which successfully reached out to total 11 lakeshore villages with 1,693 participants.

Constructed 2 new Ventilated Improved Pit (VIP) toilets and renovated 4 existing toilets for Katoto Primary School, benefiting 2,650 students.

Promote the menstrual hygiene management (MHM) in Doroba and Msazi communities

74 reusable sanitary pads have been distributed to 20 girls and 18 women in Msazi, and 100 pads have been distributed to 30 girls in Doroba. With joint efforts of MHM Committee and mother’s group in both communities, they outreached to 15 out of 17 villages in Msazi and 11 out of 12 villages in Doroba for menstrual hygiene promotion and introduction of pads.

Organized 2 trainings in May with 40 participants in Msazi and Doroba. The topics covered MHM, discussion on cultural practices and recall of reusable sanitary pad making, and action plans have also been formulated.

In 2018, the results of baseline study collaborated with the Center of Excellence in Wash and Sanitation in Doloba and Msazi Primary Schools was published. 23 school girls and 146 women took part in the survey, as well as other stakeholders, including representatives from schools, PTAs and mothers’ groups, to understand their knowledge and behaviors related to menstruation. According to the research results, gaps in the


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area of MHM are identified and interventions at both community and school levels are proposed, including raising the awareness, providing trainings on MHM, engaging broader stakeholders and improving the access to water and sanitation facilities

Support local sports club-PLAY Malawi to promote health and physical education for children and youth

312 students are enrolled in the Sports program carried out by Play Malawi and 15 schools have been reached to strengthen sports and physical education with 50 sports teachers. Play Malawi organized local table tennis and lawn tennis tournaments in Mzuzu in July and brought 17 players from Mzuzu to take part in national lawn and table tennis tournaments in Lilongwe in August. Moreover, LIN assisted to organize several networking and organizational strengthening activities are organized for Play Malawi.

III. Economic Empowerment Project Scope Key Output in 2018 Support 2 CBOs (Chitatata 2 and

Kanyika) in Mzuzu Area to strengthen and expand their income-generating business

Provide individual business support to former CBO members or assistance to CBOs that Luke International previously worked with

Supported Chitatata 2 (Group of widows established in 2014) to carry out chicken business through discussion, developing business plan and training. The group is able to share the profits to its members for the second time.

Supported Kanyika (Group of people with physical challenges became a partner with Luke International in 2015) to expand their tailoring and knitting business through identification of bestselling product types, cost analysis, quality control and business development strategies. The group is able to share the profits to its members for the first time. Moreover, Luke International assisted to construct a toilet with seat designated for people with disabilities.

Assisted Chitatata 1, the widow’s group that Luke International previously supported, to construct a toilet for the nursery school Chitatata 1 established.

Provided business development guidance, startup capital and microloan to Iness Moyo, a former CBO member, to open a grocery shop in her community. Now she is able to earn regular income to support her family.


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Photo 1—New toilet and urinal are constructed at Katoto Primary School in Mzuzu.

Photo 2—Kanyika members attending their business review meeting to discuss and learn more about costing, pricing, recording, sales and marketing, and financial procedures.

Photo 3— Installation of Biosand filters in households in the lakeshore communities to increase access to clean water.

Photo 4— Women in Msazi Community brainstorming on group discussion during Menstrual Hygiene Management training.

Photo 5—LIN CDP staff attended the WASH symposium to learn about SMART Approach (Simple, Market-based, Affordable and Repairable) to improve water and sanitation at the household level.

Photo 6—Awareness-raising campaign organized in response to the cholera outbreak in lakeshore areas.


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REGIONAL DEVELOPMENT In 2008, when LIN started its mission in Malawi, we observed the growing challenges of tracing HIV patients on treatment and cross the country borders to seek for better opportunities. The disruption of HIV care and lost-to-follow-up phenomenon is a critical issue to maintain the good health of people. Seeing the escalating challenges of cross-border patients (CBP), LIN initiated series of activities to tackle the issue in the Southern Africa region.

LIN and its partners started the Cross-Border Patients (CBP) Forums in 2009 recognizing the need for a knowledge-sharing platform on mobile population issues. In 2011, 2013, 2015, and 2017 the issue of CBPs and migrant health was presented at the 16th -19th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Satellite Sessions where LIN co-hosted. LIN participated in the 2013 UN High Level Dialogue on Migration and Development and presented a position paper on cross-border health concerns. Through the advocacy and discussions, LIN built contacts and partnerships with National AID Councils, MOH and international organizations working in the SADC region, and advocated for the need to use IT innovations to improve service delivery and continuum of care of migrants and mobile populations. Base on this background, the International Ogranisation of Migration (IOM) and LIN initiated a pilot project to demonstrate use case for the use of mobile technologies to improve referrals and information sharing in migration affected communities.

Project highlight: Strengthening community health systems using mobile technology under the SRHR-HIV Knows No Borders Project in Mwami-Mchinji in Malawi and Chipata in Zambia. This is a 1-year pilot program funded by International Organisation for Migration (IOM), with a period from 8th October 2018 to 8th September 2019. The SRHR-HIV Knows No Borders project (2016- 2020) is a consortium program supported by the Government of the Netherlands and implemented by IOM in collaboration with SCI and WITS SHP in six countries of the Southern African Development Community (SADC) including Lesotho, Malawi, Mozambique, South Africa, Swaziland and Zambia. The regional project is aimed at improving sexual and reproductive health and HIV (SRH-HIV) and related outcomes amongst migrants, adolescents, young people, sex workers and people living in migration affected communities. Luke International is engaged as a service provider to the consortium to pilot a mobile platform that may contribute to service delivery, data management, information access and client referrals and follow up from the community level to the facility level. The total available funding for the project is EUR 53,680.00.

Project Scope Progress in 2018 Conduct a rapid assessment in the cross-border

communities of Mwami-Mchinji in Malawi and Chipata in Zambia to inform design and implementation of the IT solution.

Design, develop, pilot test and implement the mobile solution for the cross-border communities.

Build capacity of project teams, beneficiary communities and health care providers and other stakeholders to effectively use the mobile technology.

Participate in relevant national technical working groups meetings and regional forums to create buy-in for the IT innovation.

Collect and analyze data, share lessons and best practices with the project and stakeholders.

Completed rapid assessment exercise in Mwami-Mchinji in Malawi and Chipata in Zambia in December.


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ORGANIZATIONAL DEVELOPMENT Luke International clocked 10 years of service in the country and celebrations were held at its Head Quarters campus in Mzuzu on 7th September 2018. It was a colorful day filled with memories, happiness and laughter. The atmosphere was lively and the support we received was tremendous. Programs included a look back at all the achievements that were done in the past 10 years through the screening of a short documentary, speeches from representatives of government officials and partners, poem recitals and performances by students from primary and secondary schools LIN works with, and finally, awards for long-serving employees.

The event was graced by the presence of representatives from the Ministry of Health HIV/AIDS Department and Quality Management Directorate, the Districts Health Officers and hospital directors for Northern Region Districts, the Education Division Management Office, Ministry of Youth Development and Sports Regional Council, Mzuzu University, and implementing partners such as Baobab Health Trust and the Kuunika Project Directors. LIN’s Managing Director, Mr. Hans Tore-Leithe, International Director, Dr. Joseph Yu, representative from the LIN International Board, Mrs. Kirsten Bjune, and advisor, Dr. Gunnar Bjune, also attended the event.

The celebrations were followed by a symposium in Lilongwe organized by LIN, titled” “Advancing Health Services through Technology, Innovation & Research: outlooks for the future developments in Malawi.” Partners and experts shared experiences and outlook to future for Luke International’s three working arms namely: health information systems strengthening, research and capacity building, and community development and empowerment targeting the most vulnerable groups The symposium was opened with a speech given by Dr Andrew Likaka, Director of the Department of Quality, Ministry of Health, highlighting that eHealth and scaling up of health information system are two main development goals for the government of Malawi. Invited speakers included representatives from Baobab Health Trust, Kuunika Project, HISP Malawi, Pingtung Christian Hospital and Chang-Hua Christian Hospital in Taiwan, and LIN’s technical staff members. A representative from the Norwegian Embassy was also present. Building on the network of partners, 10 years of implementing experience in Malawi, LIN continues to work towards developing a sustainable organization that will continue to serve the country.


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5. Financial Statement in 2018

Note 1: Items included in the financial statements are measured and presented using Malawi Kwacha, as functional currency of the primary economic environment in which the organisation operates. At the time of signing the financial statement the exchange rates were: Kwacha/US Dollar: 733.6577/1 Note 2: The financial report shows that designated funds income had a slight decrease in 2018 compared to the previous financial year. There were some huge opening balances for designated funds which covered some of the 2018 expenditure and because of most projects’ financial year do not correspond with the calendar year.


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6. Our Partners The listed development partners include: (from A to Z)

Baobab Health Trust, Malawi Bjørgaas Social Welfare Foundation, Taiwan Centers for Disease Control and Prevention, USA Centre for International Health, University of Bergen, Norway GIZ Malawi Imperial College London, UK Institute for Informatics at University of Oslo, Norway International Organization of Migration (IOM) I-TECH Malawi Kaohsiung Medical University, Taiwan Lighthouse Trust, Malawi Lund University, Sweden Ministry of Health of Malawi Ministry of Health and Welfare of Taiwan Mzuzu University, Malawi National Department of Health of South Africa National Taiwan University, Taiwan National Yang Ming University, Taiwan North Star Alliance (NSA) Norwegian Church Aid in Malawi Partner in Hope (PIH) Pingtung Christian Hospital, Taiwan SADC Secretariat UNICEF University of Southern California, USA University of Washington, USA University of Livingstonia, Malawi


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7. Our Advisors 1. Professor Anthony D. Harries

Senior Advisor of International Union against Tuberculosis and Lung Disease, Paris France

Honorary Professor at the London School of Hygiene and Tropical Medicine, UK

2. Professor Gunnar Bjune Professor Emeritus, Institute for Health and Society at University of Oslo

3. Professor Kung-Yee Liang Professor, Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, USA President, National Yang-Ming University, Taiwan

4. Professor Chang-Chuan Chan Dean, College of Public Health, National Taiwan University Director, Global Health Centre, College of Public Health, National Taiwan University

5. Professor Sven G. Hinderaker

Professor, Centre for International Health, University of Bergen, Norway

6. Asbjørn Eidhammer Retired; former Norwegian ambassador to Malawi. His career has mainly been in the Norwegian foreign service and in the Norwegian Agency for International Development.

7. Kirsten L. Bjune Retired; former physiotherapist, Church Administrator and development worker.

8. Contact Information Mailing Address: P.O. Box 1088, Mzuzu

Physical Address: Bloemwater Street (close to Beehive school), SOS Area, Mzuzu, Malawi

Email: [email protected]

Documents

Annual Report 2018 - Luke international · HIS Developers: Mr. Duke Caeser, Mr. Justin Manda, Mr. Takondwa Makawa, eIDSR Project Coordinator: Mr. Peter Phiri System Analyst: Ms. Chisomo