Homepage Marjolein Berings

Since 11 October 2006 I work for the Christian Health Association of Malawi in Lilongwe, Malawi.

My position is part of the Joint Capacity Building Programme, a comprehensive programme that is supported by two Dutch NGDO's: ICCO and Cordaid.

Below, I describe my responsibilities for CHAM in more detail, in the diary above I describe my experiences in my work and private life in Lilongwe.

CHAM is an ecumenical, not for profit non-governmental umbrella organization of Christian owned health facilities. CHAM is owned by two mother bodies namely Malawi Council of Churches and the Episcopal conference of Malawi. CHAM has a membership of 169 health facilities spread across the country. Out of these facilities 18 are hospitals, 18 community hospitals, 1 mental hospital and 132 health centres. 90% of these health facilities are located in the rural settings of the country. Apart from the health facilities, CHAM has 10 training colleges. CHAM produces about 77% of the nursing personnel in Malawi (all nurse-midwife technicians). In terms of health service provision, CHAM offers about 37% and to this end it is a key partner in health service delivery.

CHAM has been instrumental in the health sector and is participating in all reforms being implemented by Ministry of Health. The reforms include the delivery of the Essential Health Package (EHP) through service level agreements. CHAM is also a signatory to the Sector Wide Approach (SWAp), an overarching strategy that is used in implementation of the EHP.

Over the years, CHAM has taken on additional responsibilities of providing technical support, advocacy and negotiation, grant administration, capacity building, resource mobilization, policy and standard setting, responding to emergencies such as hunger and adviser to member churches. As an umbrella organization CHAM Secretariat acts as a mouthpiece and bridge for its members.

The vision of the Christian Health Association of Malawi (CHAM) is to provide holistic, quality, affordable and sustainable health services to all people in Malawi by the year 2010 as inspired by the healing ministry of Jesus Christ – ‘Heal the sick, raise the dead, cleanse those that have leprosy, drive out demons. Freely you have received, freely give' (Mathews 10:8).

The health care sector in Malawi struggles with some huge problems, such as the impact of the HIV and AIDS epidemic and a deficiency in human resources. More than 14% of the population is HIV infected; in urban areas even 25%. Concerning human resources: up to 60% vacancies exist for established posts in some health institutions. Only 1 doctor and 18 nurses are available per 62.500 residents (compare: this would be 87 doctors and 165 nurses in the Netherlands). Among other reasons this is due to low salaries, migration, deficiencies in education possibilities, motivation, etc.

Through the Joint Capacity Building Programme and the development of Planning, monitoring, and evaluation systems I am contributing to CHAM's efforts in improving health delivery services in Malawi.

More information on CHAM can be found at our new website: www.cham.org.mw

To improve capacity for further development of the Malawian health care system ICCO, Cordaid, and twelve historical partners have developed the Joint Capacity Building Programme (JCBP). The goal of the programme is to improve the quality of health services of CHAM institutions through

In the JCBP the twelve partners work together to accomplish these goals: CHAM Secretariat, COM, the Catholic Health Commission, Livingstonia Health Synod, Nkhoma Health Synod, and seven hospitals. Jointly, they perform many different activities, including:

Amongst others, through technical assistance on the programme management of this programme, through assessments of learning needs, through providing of training and coaching, and through planning facilitation in Human Resource Development initiatives I am aiming to contribute to Capacity Building in the health care sector in Malawi.

To plan, monitor, evaluate, budget and coordinate the different activities of CHAM, a new Monitoring and Evaluation section was established at CHAM secretariat in 2006. The section also has an important role for improving programme quality through attention to the design, monitoring, evaluation and reporting of all programmes and projects of CHAM secretariat.

Currently, the unit exists of two M&E officers, both with major responsibilities in programme management as well. The unit has the following key-tasks:

Amongst others, through participatory facilitation of (strategic) planning, monitoring, and evaluation workshops and through the development of PME systems I am aiming to contribute to improved PME practices that not only support accountability, but especially enlarge the learning capability of CHAM.



		Planning, Monitoring, Evaluation, and Capacity Building Introduction Since 11 October 2006 I work for the Christian Health Association of Malawi in Lilongwe, Malawi. My position is part of the Joint Capacity Building Programme, a comprehensive programme that is supported by two Dutch NGDO's: ICCO and Cordaid. My work is mainly concentrated on two topics: Planning, monitoring, and evaluation Capacity building and human resource development Below, I describe my responsibilities for CHAM in more detail, in the diary above I describe my experiences in my work and private life in Lilongwe. *Background* CHAM is an ecumenical, not for profit non-governmental umbrella organization of Christian owned health facilities. CHAM is owned by two mother bodies namely Malawi Council of Churches and the Episcopal conference of Malawi. CHAM has a membership of 169 health facilities spread across the country. Out of these facilities 18 are hospitals, 18 community hospitals, 1 mental hospital and 132 health centres. 90% of these health facilities are located in the rural settings of the country. Apart from the health facilities, CHAM has 10 training colleges. CHAM produces about 77% of the nursing personnel in Malawi (all nurse-midwife technicians). In terms of health service provision, CHAM offers about 37% and to this end it is a key partner in health service delivery. CHAM has been instrumental in the health sector and is participating in all reforms being implemented by Ministry of Health. The reforms include the delivery of the Essential Health Package (EHP) through service level agreements. CHAM is also a signatory to the Sector Wide Approach (SWAp), an overarching strategy that is used in implementation of the EHP. Over the years, CHAM has taken on additional responsibilities of providing technical support, advocacy and negotiation, grant administration, capacity building, resource mobilization, policy and standard setting, responding to emergencies such as hunger and adviser to member churches. As an umbrella organization CHAM Secretariat acts as a mouthpiece and bridge for its members. The vision of the Christian Health Association of Malawi (CHAM) is to provide holistic, quality, affordable and sustainable health services to all people in Malawi by the year 2010 as inspired by the healing ministry of Jesus Christ – ‘Heal the sick, raise the dead, cleanse those that have leprosy, drive out demons. Freely you have received, freely give' (Mathews 10:8). The health care sector in Malawi struggles with some huge problems, such as the impact of the HIV and AIDS epidemic and a deficiency in human resources. More than 14% of the population is HIV infected; in urban areas even 25%. Concerning human resources: up to 60% vacancies exist for established posts in some health institutions. Only 1 doctor and 18 nurses are available per 62.500 residents (compare: this would be 87 doctors and 165 nurses in the Netherlands). Among other reasons this is due to low salaries, migration, deficiencies in education possibilities, motivation, etc. Through the Joint Capacity Building Programme and the development of Planning, monitoring, and evaluation systems I am contributing to CHAM's efforts in improving health delivery services in Malawi. More information on CHAM can be found at our new website: www.cham.org.mw The Joint Capacity Building Programme To improve capacity for further development of the Malawian health care system ICCO, Cordaid, and twelve historical partners have developed the Joint Capacity Building Programme (JCBP). The goal of the programme is to improve the quality of health services of CHAM institutions through improved skills and staff motivation, improved accessibility of health services, improved management and systems, and strengthened pro-active engagement with key stakeholders. In the JCBP the twelve partners work together to accomplish these goals: CHAM Secretariat, COM, the Catholic Health Commission, Livingstonia Health Synod, Nkhoma Health Synod, and seven hospitals. Jointly, they perform many different activities, including: On improved skills and staff motivation: the development of an HRD and CPD programme, disbursement of doctors’ incentives packages, the set up and maintenance of an electronic knowledge base, the continuation of the clinical officers upgrading project, disbursement of scholarships for master programmes, training and upgrading of staff, and setting up a revolving fund for soft loans. On improved accessibility of health services: to review and mainstream policies on HIV/ AIDS and gender, to set up a gender sensitive performance appraisal and reward system, and to develop a model for equitable health services in community health and HIV/ AIDS. On improved management and systems: to set up a management development programme including coaching, disbursement of scholarships on management degrees, to scale up a joint development supervision system, to develop quality assurance system, to train internal quality auditors to continue and scale up the Financial Management Improvement Project (FMIP), to conduct a feasibility study for IGA’s in the health sector, and to develop an information management system. Finally, on strengthened pro-active engagement with key stakeholders: to engage in participatory district planning and implementation, exchange visits, workshops, and to set up hospital communication plans. Amongst others, through technical assistance on the programme management of this programme, through assessments of learning needs, through providing of training and coaching, and through planning facilitation in Human Resource Development initiatives I am aiming to contribute to Capacity Building in the health care sector in Malawi. Monitoring and Evaluation To plan, monitor, evaluate, budget and coordinate the different activities of CHAM, a new Monitoring and Evaluation section was established at CHAM secretariat in 2006. The section also has an important role for improving programme quality through attention to the design, monitoring, evaluation and reporting of all programmes and projects of CHAM secretariat. Currently, the unit exists of two M&E officers, both with major responsibilities in programme management as well. The unit has the following key-tasks: Coordination of planning and reporting of the activities of all secretariat employees Building capacity and providing technical assistance on project and programme PME Developing an M&E plan that stimulates the learning capacity of PME Reviving the Health Management Information System (HMIS) and producing statistical reports Amongst others, through participatory facilitation of (strategic) planning, monitoring, and evaluation workshops and through the development of PME systems I am aiming to contribute to improved PME practices that not only support accountability, but especially enlarge the learning capability of CHAM. Further information about: Malawi CHAM ICCO Cordaid