Healthcare at the Doorstep.
Ending preventable maternal and child deaths among families living in extreme poverty through community based healthcare, innovation and collective action.
In Malawi, maternal and newborn mortality remain among the highest in the world despite progress over the past decades. The maternal mortality ratio in Malawi is approximately 381 deaths per 100,000 live births, well above the Sustainable Development Goal target of 70 and far higher than in high-income countries, where deaths from pregnancy and childbirth have become rare.
​
Under-five mortality in Malawi also remains elevated, with nearly 38 deaths per 1,000 live births and a significant portion occurring in the neonatal period, when access to skilled care is most critical.
​
These outcomes reflect systematic barriers that prevent rural families, especially those living in extreme poverty, from accessing essential maternal, newborn and child health services. Long distances to health facilities, high transport costs, lack of awareness, weak referral systems and recurrent climate shocks delay or deny care at critical moments, contributing to preventable deaths and deepening health inequities across the country.
​
Wandikweza exists to close this last-mile gap in Malawi’s health system by delivering proactive, community-based maternal and child health services directly to households that are currently missed by traditional facility-based care.
We advance six United Nations Sustainable Development Goals:
Our Vision
A Malawi where all mothers, children and families thrive.
Our Mission
Transforming access to maternal, newborn, child and adolescent health care in Malawi’s hardest to reach communities by strengthening last-mile health systems that connect households, frontline workers and public facilities.
​
Our Goal
To reach a cumulative total of 3 million individuals by 2030, ensuring each person receives at least one meaningful service contact through Wandikweza’s Proactive Doorstep Care (PDC) platform across seven districts in Malawi.
Our Model
Proactive Doorstep Care (PDC), a scalable, government-aligned model reducing preventable maternal and child deaths by shifting care from crowded facilities to communities.
The model is designed to decongest facilities by shifting preventive, routine and follow-up care into communities, while reserving the health centre for more complex, referred or specialized cases.
Wandikweza’s Proactive Doorstep Care (PDC) model is designed to end preventable maternal and child deaths among families living in extreme poverty in Malawi’s hardest-to-reach communities. It deliberately targets households that are routinely left behind by the traditional health system due to cost, distance, limited awareness and recurrent natural disasters. Through PDC, mothers, newborns, under-five children and adolescents receive continuous, proactive care from pregnancy through a child’s fifth birthday, ensuring that the poorest and most vulnerable families are reached early, consistently and with dignity.
PDC Model Breaks
CIRCLE OF VULNERABILITY
​
Isolation
Limited Access Delayed Care Emergencies
High Costs Instability
DOORSTEP CARE
CIRCLE OF RESILIENCE
Prevention
Healthy Outcomes Savings
Stability
Stronger Communities
Where we work
Wandikweza works in Malawi’s most remote rural communities, where families living in extreme poverty face severe barriers to accessing healthcare. Many villages are located more than five kilometres from the nearest health facility, requiring two to four hour walks each way, across difficult terrain and roads that become impassable during the rainy season. For households surviving on less than two dollars a day, transport costs and lost income make seeking care unaffordable, forcing families to delay or forgo treatment until emergencies arise.
​
These challenges are compounded by gaps in the health system, including understaffed facilities, limited operating hours, shortages of skilled birth attendants and weak emergency referral systems. In this context, preventable conditions often become life-threatening.
