Wandikweza builds last-mile health systems that ensure women and children are reached with care before complications arise.
Health systems are built around facilities, yet most families live far from them. As a result, care often comes too late.
Care does not reach people in time. Health systems are fragmented and facility-centered.
Services are disconnected across levels, concentrated at facilities and not reaching households early.
Wandikweza addresses this structural gap by shifting preventive, routine, and follow-up care from facilities to households through Proactive Doorstep Care (PDC) embedded within government systems and designed for scale.
PDC is a coordinated system. Caregivers, Community Health Workers, Community Midwives, outreach mobile services, health facilities and emergency response are connected into one continuum of care, ensuring early identification, continuous support and timely referral when needed.
Wandikweza works in rural Malawi alongside women, adolescents, caregivers and frontline health workers, communities where distance, cost and delayed access too often determine outcomes. By redesigning how care reaches households and strengthening public systems, Wandikweza is enabling scalable, sustainable health system transformation.
What each family receives through Proactive Doorstep Care
Through Proactive Doorstep Care, each family is supported by a connected system that delivers care early, continuously and in coordination across all levels of the health system.
Together, these components form one connected system, ensuring care is delivered early, continuously and in time.
1. Early Identification and Registration
Families are identified early, specially during pregnancy and registered into the system, ensuring care begins as early as possible and continues consistently.
4. Referral and Care Coordination
Families are actively linked to higher levels of care through coordinated referral, ensuring they reach the right service at the right time and receive continuous support across the system.
2. Continuous Doorstep Care and Support
Each family receives ongoing, household-level care, personalized support from Community Health Workers, skilled maternal & Newborn care from Midwives on Wheels and structured follow-up across the health system.
5. Disaster Preparedness and Emergency Response
Families are supported during floods, storms, and other shocks through early warning, rapid referral for maternal and newborn emergencies, and coordinated transport to the nearest functional health facility.
3. Access to Mobile and Facility-Based Care
Families are connected to mobile outreach and health facilities for services that cannot be delivered at home, ensuring timely access to clinical care, diagnostics and treatment when needed.
6. Health Education and Preventive Support
Families receive ongoing, culturally grounded health education that supports informed decision-making and early care-seeking. Helping families recognize risks early, adopt preventive practices, and engage with the health system in a timely and consistent way.
Our integrated Proactive Doorstep Care system
Caregivers and Families
Caregivers and families are the foundation of Proactive Doorstep Care, playing a central role in health, early decision-making and care-seeking. Through continuous engagement and support, they are equipped to recognize risks early, adopt preventive practices and engage with the health system in a timely and consistent way ensuring that care begins at the household and continues across the full health journey.
Community Health Workers
Community Health Workers (CHWs) are trained members of the communities they serve, providing trusted, culturally grounded care at the household level. They support families with essential health services, early identification and follow-up, ensuring continuity of care across the health journey.
Midwives on Wheels
Midwives on Wheels are skilled, community-based midwives who deliver maternal care at the household level in hard-to-reach areas. They provide antenatal care, birth preparedness, early risk identification and postnatal follow-up, ensuring timely referral and continuity of care when needed.
Mobile Outreach Clinics
Mobile outreach clinics extend the health system to remote communities, delivering integrated services closer to households located far from health facilities. Staffed by trained health professionals and equipped for essential services, they reduce distance barriers and ensure timely access to care.
Health Facilities
Health facilities provide skilled and advanced care within the system, managing deliveries, complications, and referred cases. They serve as the clinical backbone of care, ensuring that women and children receive higher-level services when needed, while supporting continuity across the system.
Maternity Rapid Response System (MRRS)
The Maternity Rapid Response System (MRRS) ensures timely referral and transport for maternal and newborn emergencies. By coordinating communication, transport, and facility readiness, it connects households to lifesaving care, reducing delays when complications arise.
Our approach works
Behind every result is a woman or child reached by a system designed to deliver care early, consistently and in time.
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of women of reproductive age (15-49
years) with access to modern
contraceptive method
of pregnant women register in their first trimester and receive syphilis testing
of births are attended by a skilled health professional
of children with symptoms of malaria, diarrhea, or pneumonia are assessed within 24 hours
The future of health systems is reaching people where they are.
The System Gap
Health systems have long been built around facilities, yet many families, especially in rural areas, live far from them. This structural gap means that preventive care is often missed, risks go undetected and care is delayed until complications arise.
As a result, women and children are frequently reached too late, despite services existing within the system.
The System Shift
Wandikweza addresses this gap by shifting preventive, routine and follow-up care from facilities to households through Proactive Doorstep Care.
This approach connects Community Health Workers, Community Midwives, outreach mobile services, health facilities and emergency response into one coordinated system, ensuring early identification, continuous care and timely referral when needed.
Instead of reacting to complications, the system is designed to reach families early and consistently, improving outcomes while strengthening the efficiency of the broader health system.
How We Improve Maternal and Child Health At Scale
Collective action to end preventable deaths
By 2030, Wandikweza aims to reach a cumulative 3 million people with at least one meaningful maternal, newborn, child, or adolescent health service through Proactive Doorstep Care, across seven districts in Malawi.
This is achieved by working in close partnership with government to deliver care at scale, strengthen public health systems and ensure services reach households early and consistently.
Through coordinated action across communities and the health system, Wandikweza is contributing to a future where preventable maternal and child deaths are no longer a consequence of distance, cost or delayed access.
Where System Design Improves Outcomes
Wandikweza builds last-mile health systems that improve maternal and child health, delivering care to households at scale through integrated, government-aligned systems.
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