Friday, August 12

Fighting TB treatment defaulters in Boarder districts

They take advantage of Malawi’s porous border to access medical care in Malawi border district health facilities. The treatment is for illnesses such as malaria, tuberculosis and HIV care.

These are foreign nationals from neighbouring countries such as Mozambique and Zambia.

For Nsanje district, the situation is now worrying as those accessing tuberculosis treatment are defaulting treatment midway 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 makes it difficult for health personnel from the District Health Office (DHO) to track them once they default TB treatment.

This has now forced the DHO to embark on cross-border meetings with counterpart 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 default on treatment midway through after noting some improvement,” said Nsanje Acting Director of Health and Social Services Gilbert Chapweteka.

But he added that the DHO is encouraged by the Mozambican government’s willingness to cooperate 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,” Chapweteka said.

He added that the recent travel restrictions due to Covid-19 have affected the discussions between officials from the two countries but significant progress has still been made.

Nsanje’s case is not an isolated one as other border districts across the country are 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 an agreement between member states where patients in border districts would be accepted to access health care at the nearest heath facility 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 border districts are the same, so it won’t make sense to be side-lining them when it comes to accessing health care especially for illnesses like TB,” Ministry of Health spokesperson Adrian Chikumbe said.

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 border district health facilities that would cater for those coming from neighbouring countries to access treatment in the country. Tentatively we are thinking of increasing funding allocation to these district health facilities with 10 percent from their normal allocations,” he said.

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 gets a transfer when they move out of that location to another, 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,” Chikumbe said.

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