In Malawi, New Training Module Teaches Health Surveillance Assistants About the Impacts of Climate Change on Health

19 July 2017

Health Surveillance Assistants (HSAs) provide essential health services to communities in Malawi.

In Malawi, Health Surveillance Assistants (HSAs) serve an important function as a link between health systems and communities. In recognition of HSAs’ critical role in increasing community health resilience to climate change, the Global Framework for Climate Services (GFCS) local leadership team, the Health and Climate Change Core Team (HCCCT), recently incorporated Climate Change and Health into the HSA training curriculum through an added module that addresses the links and risks of climate change and health.


HSAs have played a role in the Malawi healthcare system since the 1960s. Originally recruited as temporary “smallpox vaccinators” and “cholera assistants” in the 1960s and 1970s, and later playing a key role in HIV/AIDS outreach, HSAs have become a permanent fixture within local healthcare delivery systems. Today, there are over 9,000 HSAs in Malawi providing a wide array of services to promote health at the local level, including health education, disease surveillance, immunization, sanitation assessments, collection of vital statistics, HIV care, family planning, and malaria prevention.


As crucial actors in gathering and distributing health information on the ground, HSAs can play a key role in building resilient communities, and health systems that are resistant to the health impacts of climate change. In December 2015, GFCS supported a workshop to train Chikwana and Nsanje health workers on the impacts of climate change on health. From the discussions at the meetings, it became very clear that to reduce the impacts of climate change on health, health workers must be included in both shaping and implementing adaptation and mitigation strategies.


The Climate and Health module added to the HSA training curriculum in March 2016 provides an overview of climate-related health risks and possible actions HSAs can take to decrease these risks, such as promoting proper personal hygiene, providing emergency medical services, and promoting use of insecticide-treated nets (ITNs). This added module marks an important step towards sustainable community-based capacity building efforts in Malawi. The Health Surveillance Assistants are the first point of contact between communities and the national health system, and it is expected that over 9,000 HSAs will be exposed to this material.