
Model Rural Health System
Working in collaboration with the Ministry of Health Community Health Unit, Zimba District Health Office, Healthcare Facility staff, volunteer doctors, On Call Africa staff and communities we have co-designed a model rural health system, which we are piloting in Kanyanga and Chalimongela Rural Health Posts and looking to build evidence of impact of a holistic health system strengthening programme that could be adopted by Ministry of Health.
Following an extensive and collaborative design process we have identified the biggest challenges at both facilities and come up with clear quality improvement roadmaps. Interventions will be designed and delivered by Zimba District Health Office, facility staff and community members with On Call Africa’s Support.
Overview
The Chalimongela Rural Health Post is located in Zimba District, 135km from the nearest doctor at Zimba Hospital. The health post serves a population of over 7,000 people across a large catchment area, some villages are over 30km from with no means of transport.
The health post is staffed by 2 nurses and a Community Health Assistant. The team offer monthly outreach services to communities which are supported by 7 Community Health Workers that have had extensive training in primary care delivery from On Call Africa.
Following a 4 month assessment period this detailed report was produced. A summary of findings can be found below.


Following this assessment phase, On Call Africa, Ministry of Health, Chalimongela Rural Health Post staff and community members developed the following roadmap for improving the functionality of the health system:

Our role
On Call Africa works with the Rural Health Post to identify its biggest challenges and assess needs both at the facility, and within the communities in it’s catchment area. We have placed volunteer doctors in the facility, where they work alongside existing nurses and Community Health Workers offering diagnosis and treatment, and supporting outreach activities, while conducting assessments, mapping and developing clear implementation plans for On Call Africa, Ministry of Health and partners to take forward. We also work with partners to deliver public health interventions that meet the individual health needs of each community.
On Call Africa have trained Community Health Workers from within these communities to strengthen the existing health systems. Ensuring patients have access to medical advice, and referrals when needed.
As of March 2022, the following activities have been completed:
- Capacity building of staff
- Health promotion planning completed
- NHC training planned
- Community Lead Total Sanitation (CLTS) training delivered to 21 community champions and teachers, resulting in an increase of pit latrine coverage and current pit latrines reaching the Ministry of Health standards.
- Solar powered pump, tank and tank stand installed to enable reticulated water at all points of care
