Our Three Convictions
These three convictions are the foundation of the Wandikweza model. They have guided our work since the organisation's earliest days and continue to shape every strategic, operational, financial, and governance decision we make. Together, they provide the framework that keeps our growth, partnerships, and implementation aligned with our mission to ensure care reaches families early, continuously, and in time.
Every decision Wandikweza makes from where to expand and how to build government ownership to how we support frontline health workers is guided by a set of core convictions.
These principles were shaped by early lessons from the communities we serve and have been continuously strengthened through years of implementation, evidence, and adaptation. Today, they remain the foundation of how we build and scale Proactive Doorstep Care.
CONVICTION ONE
Systems outlast programs
Wandikweza's goal is to build last-mile maternal and child health systems that government and communities can sustain.
From the moment a district is launched, a pathway to local ownership is built into the model. Every district has a sustainability plan and handover is guided by readiness and system performance. Success is measured by whether mothers, newborns and children continue to receive quality care after the organisation has stepped back.
CONVICTION TWO
Government co-ownership
is non-optional
The Government of Malawi is a core partner in Proactive Doorstep Care. From the first day of every district expansion, the system is built alongside District Health Offices and aligned with government structures, supervision and data systems.
CONVICTION THREE
Community trust is
non-negotiable
A health system that communities do not trust is a health system they will not use. Trust is built by people and it is the only foundation a last-mile health system can stand on.
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CHW selection is community-nominated always, without exception
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Village headmen are engaged before the first CHW is deployed
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Reliability is the primary trust mechanism
OPERATING BELIEFS
What we believe about how care works
These beliefs shape how Wandikweza builds trusted health systems every day. They guide the decisions of every leader, Community Health Worker, Midwife and team member, influencing how we serve families, strengthen partnerships and stay true to our mission when the easier path is to compromise.
ON REACH
The health system should go to people not wait for people to come to it
A system designed to be found reaches only the families who can find it. The families carrying the heaviest burden are the ones with the least capacity to navigate a system that requires them to arrive. Proactive means the system moves first, before the need becomes urgent, before the danger sign forms, before the family is in crisis.
Care should not depend on people reaching the system. The system should reach people early, continuously and in time.
Simone Woods
ON THE DOORSTEP
The doorstep is where prevention is still possible
By the time a complication arrives at a facility, the window for the simplest interventions has often closed. The danger sign was first felt at the household. The decision to seek care was made at the household. The moment that mattered happened before anyone from the health system arrived. We deliver at the doorstep because that is the only place where care can still arrive in time.
We deliver at the doorstep because that is where the health system must be.
Nicole Yang
ON BARRIERS
The barriers are design consequences not community failures
Distance, transport cost and the health knowledge the system has never delivered are not personal failings of the families who face them. They are the predictable consequences of a health system built around buildings rather than households. The families are not hard to reach. They were simply not who the health system was designed for.
She is not hard to reach. She is just not who the health system was designed for.
Simone Woods
ON EXIT
Exit is earned by a standard not determined by a timeline
The most common failure mode in health systems development is the exit that happens on a funder's schedule and not on a system's readiness. Wandikweza exits a district when the Assessment Tool scores confirm the system is functional, the government co-ownership trajectory is proven and the system can be trusted to reach families without Wandikweza's management.
A district that has not met the exit standard does not exit regardless of when the founding grant ends.
Nicole Yang
ON GOVERNMENT
Government is the co-owner
Wandikweza does not deliver a health system to the government but builds one with the government from the first day. The government co-manages, co-supervises, co-finances and co-reports. What is being built belongs to Malawi and Wandikweza's role is to build it so well that its absence is undetectable.
The measure of success is not how many people Wandikweza has reached. It is how many are still being reached after Wandikweza steps back.
Simone Woods
ON EVIDENCE
The learning agenda serves the sector, not just the organisation
Every district Wandikweza enters generates evidence about what it takes to build community trust in a new geography, about the government co-ownership milestones that predict long-term sustainability and about which elements of the system must stay exact and which can change without breaking it. That evidence is structured and shared with everyone who is asking the same question Wandikweza asked in 2016: How do we ensure that the families living furthest from care are reached before it is too late?
What a sustained building can teach should be available to everyone willing to learn from it.
Nicole Yang
ON RELIABILITY
A visit must happen on the scheduled day
Reliability is the primary trust-building mechanism between the health system and the communities it serves. A clinic that arrives when it said it would has done more for community engagement than any sensitisation campaign. Excellence at Wandikweza is the standard we hold in difficult conditions.
A health system that communities cannot rely on is not a health system.
Simone Woods
ON CONTINUITY
Episodic care is not the same as continuous care
Malawi's public health system provides essential services through health facilities, Health Surveillance Assistants and outreach programs that reach millions of people. These services are the foundation Wandikweza builds alongside. But even the most well-resourced outreach schedule cannot be everywhere at once, a danger sign does not wait for the next clinic date and a pregnancy does not progress on a monthly schedule. What Proactive Doorstep Care adds is the layer of continuous, household-level presence that bridges the gaps between them.
The distance between one outreach visit and the next is where most preventable complications begin. PDC is present in that distance.
Nicole Yang
BELIEFS ABOUT PEOPLE
What we believe
about the families
we exist to reach
The responsibility for closing the reach gap rests with the health system.
Our role is to help build a system that reaches people where they are, earns their trust and remains connected to them throughout pregnancy, childbirth and early childhood. Because no family should be left behind by the design of the system meant to serve them.
How Wandikweza speaks about the communities it serves reflects what we believe about them. These beliefs are not separate from our work, they are foundational to how we build.
The families we serve are not hard to reach. They are not defined by vulnerability, nor are they lacking agency, resilience or aspiration. They are the very people the health system exists to serve.
Many live in rural smallholder farming communities where distance, cost and fragmented services create barriers to care. Yet the challenge is not a lack of willingness to seek care. It is that the system has not consistently reached them early enough, continuously enough or close enough to home.
They are not hard to reach
They are just not who the health system was designed for. That is a design problem and it is the problem Wandikweza was founded to solve.
The barriers they face are not their failures
Distance, transport cost and the health knowledge the system has never delivered to where they live are design consequences not personal failings of the families who live with them.
They are the intended beneficiaries of the government system
Wandikweza does not serve communities outside the health system. It closes the gap between those communities and the government system that was always designed to reach them.
Their knowledge gap belongs to the system
We never say "limited health knowledge." We say: health knowledge the system has not yet delivered to where she lives. The difference is the entire argument for why the doorstep matters.
Dignity is the foundation of how we build
We are not building a health system for people who cannot help themselves. We are building the infrastructure that was always missing and that every person in every community has a right to have built for them.
