Fanizo Simenti – who goes by Simenti – is a Community Health Worker so respected that his community calls him “doctor”. The health workforce in Malawi is so stretched that Simenti is responsible for the wellbeing of 4,300 people. For pregnant mothers and families in rural areas, Community Health Workers like Simenti are their first and sometimes only source of consistent healthcare.
Simenti begins his day long before the intense sun rises over the fields of Central Malawi. In the summer, the sun comes up before six in the morning, so Simenti wakes early to beat the heat and make sure he’s on time for his rounds.
Today, he’s heading – by bicycle – to Katenje, a village about twenty kilometres away in Kasungu District. “I do this several times a week,” he explains, loading up his bike with a coolbox full of vaccines before setting off from the health facility where he’sbased. “I take the vaccines in the morning to the outreaches [drop-in clinics] and bring them back [to the health centre] in the evening”.
He’s hot and breathless as he nears Katenje. His destination is a familiar spot: a small gathering area under a huge lemon tree surrounded by clusters of thatched brick-walled houses. A few plastic chairs and tables borrowed from nearby families serve as waiting and consulting rooms. Goats wander by looking for shade, dogs curl up in a cool corner, and mothers seated on the ground chat as they wait for the clinic to begin. Toddlers chase each other around, their squeals blending with the women’s chatter.
“This is our monthly outreach clinic,” says Simenti. “We have about 21 outreach sites across this district, each with its own scheduled day”. Outreach days are Simenti’s busiest, and with 21 clinics to run every month, covered by just a handful of Community Health Workers, the pace is intense.
Simenti hails from the capital, Lilongwe. Originally he dreamed of becoming a teacher. But then he learned of the need for health workers operating within communities, and his plans changed.
In Malawi, 83% of the population of 19 million people lives in rural areas, with extremely limited access to doctors and nurses. The World Health Organization (WHO) classifies Malawi as a global health workforce crisis country: there are only about 0.2 doctors and 3.4 nurses or midwives for every 10,000 people (WHO, 2014). This stark shortage means that for many rural families, Community Health Workers (CHWs) like Simenti are the only link they have with the formal health system.
Supported by Amref Health Africa to build his skills, Simenti’s responsibilities are wide-ranging. Known locally as the “village doctor,” he provides preventive and curative services for children under five, including care for malaria, pneumonia, diarrhoea, eye infections; as well as monitoring growth and nutrition status, giving parents vital education on how to keep their children healthy. And he vaccinates children to protect them from deadly diseases. In 2022, Malawi had its first polio case in 30 years. It also faces recurring outbreaks of typhoid fever, measles, COVID-19, and cholera. All these illnesses are preventable with the right vaccines, but that only works if vaccines can reach the people who need them most. That’s why, when Simenti sets off from the health facility where he is based, he often has a coolbox strapped to his bike.
Besides running outreaches, home visits are also crucial. Part of Simenti’s role includes going to houses to spread health information and check in with pregnant women, new mothers, and babies. By catching warning signs early, he helps prevent minor risks from becoming life-threatening crises.
“I have a vital role which mediates [between] the health centre and the community,” Simenti explains. “We are bringing essential health services close to the family.”
“I love the community,” he adds. “When I call a meeting to discuss health issues, people come.”
Simenti is one of almost 500 Community Health Workers (CHWs) to have been trained by Amref under a partnership with Pfizer. To date, these CHWs have delivered integrated family health services to nearly half a million people. This includes antenatal care for nearly 30,000 women and immunisations for 70,000 children below the age of five.
In Malawi, one CHW may be responsible for more than 1,000 households, far exceeding the government’s goal of one CHW for every 500 individuals. Some areas rely on volunteer CHWs who haven’t had any formal training at all.
Simenti himself serves more than 4,300 people. He credits the ongoing support and training provided by Amref with giving him the confidence to handle everything from sick children to pregnant women in need of urgent referral. But he also knows that, whatever he does, it’s not enough. “I pray that more people can be trained,” he says. “If there were ten of us, we could sit together and discuss what we’ve learned, and the community would really benefit.”
That’s why Amref Health Africa is working hard to train more dedicated Community Health Workers like Simenti, and to establish more integrated outreach clinics in remote areas like Katenje, ensuring vital services are within reach of those who need them most.
Simenti is one of almost 500 Community Health Workers (CHWs) to have been trained by Amref under a partnership with Pfizer. To date, these CHWs have delivered integrated family health services to nearly half a million people. This includes antenatal care for nearly 30,000 women and immunisations for 70,000 children below the age of five.
In Malawi, one CHW may be responsible for more than 1,000 households, far exceeding the government’s goal of one CHW for every 500 individuals. Some areas rely on volunteer CHWs who haven’t had any formal training at all.
Simenti himself serves more than 4,300 people. He credits the ongoing support and training provided by Amref with giving him the confidence to handle everything from sick children to pregnant women in need of urgent referral. But he also knows that, whatever he does, it’s not enough. “I pray that more people can be trained,” he says. “If there were ten of us, we could sit together and discuss what we’ve learned, and the community would really benefit.”
That’s why Amref Health Africa is working hard to train more dedicated Community Health Workers like Simenti, and to establish more integrated outreach clinics in remote areas like Katenje, ensuring vital services are within reach of those who need them most.
Donate today to train more health workers like Simenti: 287CHF could provide a Community Health Worker (CHW) conducting outreach clinics in a remote region with a bicycle, shortening their commute and enabling them to support more families.
