Fighting TB treatment defaulters in Boarder districts

By Lifu Litete:

They take advantage of Malawi’s porous border system to access medical care in Malawi Boarder district health facilities. The treatment is for illnesses like Malaria, Tuberculosis and HIV care.

These are foreign nationals from neighbouring countries like Mozambique and Zambia.

For Nsanje district, the situation is now worrying as those accessing Tuberculosis treatment are defaulting treatment mid-way through after being put on medication.

The situation is further complicated as these foreign nationals conceal their identity by lying about their home villages which now makes it difficult for health personnel from the District health office to track them once they default TB treatment.

This has now forced the district health office to embark on cross-border meetings with fellow health personnel from the Mozambican government.

‘It’s really a worrying trend as we are spending a lot of money to treat these patients who midway through after noting some improvement they default treatment’, said Nsanje Acting Director of Health and Social services Gilbert Chapweteka.

According to Chapweteka it is now encouraging that the Mozambican government is cooperating by providing information of some of the defaulters.

‘We are making significant progress with our Mozambican counterparts. We have had several meetings where we are drawing a roadmap on how best we can overcome this problem’, said Chapweteka.

According to Chapweteka the recent travel restrictions due to Covid 19 has affected the talks between officials from the two countries but still there is significant progress that has been made.

Nsanje’s case is not an isolated one as other Boarder districts across the country are also facing a similar problem of foreign nationals defaulting TB treatment.

At a recent SADC Health Ministers meeting that Malawi hosted in November this year, delegates to the meeting proposed on the need for the introduction of an agreement between member states where patients in boarder districts would be accepted to access health care in nearest heath facilities regardless of their nationalities to reduce cases of patients defaulting treatment as it was observed that most of the default cases are due to fear of being discovered that one is a foreign national accessing treatment illegally.

‘As a country we want to take advantage of Malawi’s SADC Chairmanship to address this challenge. People who live in the Boarder districts are the same so it won’t make any sense to be side-lining them when it comes to accessing health care especially for illnesses like TB’, Sid Ministry of Health spokesperson Adrian Chikumbe.

According to Chikumbe this is in line with the Universal Health Coverage where no one should be denied access to health care.

‘As a nation we are planning of introducing a contingency budget for all our boarder district health facilities that would cater for those coming from neighbouring countries to access treatment into the country. Tentatively we are thinking of increasing funding allocation to these district health facilities with 10 percent from their normal allocations.

According to Chikumbe the increased funding allocation would help facilitate tracking mechanisms for patients coming from outside the country to access TB treatment in Malawi.

‘Just like we do locally where one accessing TB treatment at a local facility A gets a transfer when they move out of that location to another location, the same will also be happening with those foreign nationals where they would be issued with International transfers to get such treatment at any health facility of their choice so that we reduce the default rate’, said Chikumbe.

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