Wandikweza

Wandikweza is a locally led Malawian organization strengthening last-mile maternal, newborn, child, and adolescent health systems so that care reaches families in the most remote and underserved communities, where distance, cost and health system constraints often prevent timely access to life-saving services. Wandikweza was founded on a simple belief: health care should not begin at the facility when complications arise; it should begin at home, where pregnancies are first recognized, where children first fall sick and where health-seeking decisions are made.

To address this gap, Wandikweza developed the Proactive Doorstep Care (PDC) model, an integrated community-to-facility health system that moves essential health services closer to households while strengthening government health system. The model is designed as a continuum of care that starts at the household and extends to emergency care, ensuring that no woman or child is left behind due to geography or economic status.

At the household level, families are supported to recognize pregnancies early, seek antenatal care in the first trimester, practice good nutrition and identify danger signs during pregnancy, childbirth and childhood illness. This early engagement creates the foundation for prevention, early detection and timely care-seeking.

At the community level, Community Health Workers (CHWs) conduct household visits, register pregnancies, screen children for common illnesses such as malaria, pneumonia and diarrhea, monitor nutrition, provide health education and refer patients to skilled care when needed. CHWs form the foundation of the system because they are trusted community members who bring health services directly to families.

The next layer is Midwives on Wheels (MoWs), government-trained midwives who provide skilled maternal and newborn care within communities. They conduct antenatal and postnatal care visits, support high-risk pregnancy identification, provide family planning services and ensure close monitoring of mothers and newborns during the critical first days after delivery.

To expand access to integrated primary health care services, Wandikweza operates Mobile Outreach Clinics that bring clinical teams and essential services including antenatal care, immunization, family planning, child health services and cervical cancer screening, closer to remote communities on scheduled outreach days.

These community-based services are connected to health facilities, which provide comprehensive obstetric and newborn care, supervision of community health services and management of complicated cases. By shifting routine and preventive and follow-up services into communities, health facilities are decongested and able to focus on emergencies and complicated cases.

At the top of the system is the Maternity Rapid Response System (MRRS), which coordinates emergency referrals and transport, especially for obstetric and newborn emergencies, ensuring that when complications arise, women and newborns can reach life-saving care in time.

Through this integrated system, Wandikwezais building operational infrastructure that helps the government health system function more effectively at community level. Wandikweza works closely with District Health Offices, government health workers and community structures to ensure alignment with national health priorities and long-term sustainability.

Wandikweza’s work focuses on the full life cycle of care: access to contraception, early antenatal care, skilled delivery, postnatal care, child health services, nutrition, immunization and adolescent health services. Wandikweza addresses the entire continuum, from prevention to emergency care, to help reduce maternal and child deaths, improve nutrition outcomes and increase access to essential health services.

Ultimately, Wandikweza exists to ensure that where a woman lives does not determine whether she survives pregnancy and where a child is born does not determine whether they reach their fifth birthday. Wandikweza's work is building a health system that reaches every household, every pregnancy, every child, starting where care matters most: at the doorstep.