## **KIDS OF MALAWI UK – ANNUAL REPORT 2021**
_Recipient of KOM’s first grant programme: Kenedy Kachingwe with a patient and his mother_
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Our second year of operation saw us successfully starting to deliver on our mission. Despite ongoing COVID setbacks, our first grant programme went live and the summer saw us begin to deliver our THET Mother & Child supported anaesthesia training project. Both projects have received great feedback. In addition, we were also accepted on to the THET Health Partnership Capacity Development Programme. We are looking forward to 2022 as a year where we can build on our success to date, develop our strategy and so help more and more children in Malawi.
## **A) Overview**
Kids of Malawi aims to improve the health of children in Malawi through staffing, training, supply provision and research at Malawian Health Care Centres, starting with Kamuzu Central Hospital. The specific activities that the charity undertakes are:
- Raising awareness of health care issues faced by children in Malawi: The charity aims to put on events to highlight the issues of children in Malawi. We ask healthcare workers to share experiences through talks, blogs and articles to show how simple measures can radically improve health care delivery in Malawi. This is done in the UK primarily
- Issue grants to healthcare organisations in Malawi to provide health care services, training and supplies: This is one of the main activities of the charity. Each year the charity sets priorities for grant programmes. We seek to raise funding for the grant programmes through traditional fundraising routes (e.g. events, sponsorship and funding for specific activities such as nurses)
- Development of training materials for healthcare staff: where we feel we can improve training of healthcare staff through commissioning the development of training materials.
- Issue grants for research on improving healthcare in Malawi
In 2021, we started delivering our first grant programme to healthcare organisations and were about to deploy our THET Mother & Child grant focused on training.
## **B) Charitable activities**
## **i) Kids of Malawi UK - Grant programme**
In 2020, the trustees evaluated the options for our first grant programme and concluded on supporting nursing provision in Malawi.
The focus of the first grant programme was a Healthcare Service Grant (as set out in the KOM UK Operating Manual). Currently one nurse can be responsible for up to 60 sick children in Malawian hospitals. In such circumstances it is barely possible to give routine drugs. Routine observations and nursing care which are essential to care may not be done. This can result in serious consequences. These grants provide funding for additional nursing staff, medical staff, anaesthesia staff, or other support staff needed to improve quality of care.
Our first grant sponsored Mr Kenedy Kachingwe. Kenedy had been working as a paediatric surgery quality improvement nurse in Kamuzu Central Hospital since 2017, but his funding had run out. Because of government nursing rotations it is difficult to keep specialist skills within the unit, and
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Kenedy provided this continuity of care. The KoM UK grant award allowed Kenedy to remain in and develop the specialist surgical nurse post for 12 months from January 2021 to January 2022.
Kenedy was an essential link between the nursing, surgical, medical, nutrition and radiology teams. Due to a lack of a consistent nursing staff, basic observations were not being done and investigations not followed up. Kenedy did much more than be a good, consistent and reliable member of the team. His contributions were:
- To oversee scores of procedures each week
- These included dressing changes, wound cleaning and other technical procedures, such as rectal washouts.
- Advocacy role to the parents
- They could ask him questions and express difficulties and concerns that they were sometimes reluctant to express to the medical team.
- Administer the social fund
- In this role he assessed the financial needs of families and offered them small grants to assist with out of pocket expenses incurred during their hospital stay.
- Oversee the nurse-led care of gastroschisis
- This is a condition where babies are born with a defect next to the umbilicus and the bowels protruding outside of the abdomen. Kamuzu Central hospital had a near 100% mortality rate (in high income settings mortality is unusual; 1.4% mortality rate). As part of a multicentre research project with Kings College Hospital, the hospital trialled bedside management allowing the bowels to be returned to the abdomen without surgery. These children require a high level of nursing care which government nurses are unable to give and Kenedy would augment this care. Also as the districts learnt of the first few survivors more and more patients arrived. It was not possible for the single surgeon to manage all of these so a few nurses were trained in resuscitation and care of the child. Kenedy was the nurse who performed most of this work. KCH has seen improvement in the mortality rate thanks to this new approach and having Kenedy in the team.
- Training of other nurses and junior doctors
- Kenedy was the only continuity in the paediatric surgical team other than the consultant. Over four years he developed experience and knowledge which he shared with his colleagues. He acted as a point of referral, a source of information and training to the other paediatric teams and nurses, as well as the junior doctors that would rotate through paediatric surgery. He was trained to be trainer on the gastroschisis research project, and led sessions teaching teams from district hospitals about the care of these children
## **ii) THET Mother and Child Grant**
In March 2020, Kids of Malawi UK won a grant from THET’s Africa Mother and Child Grants Programme, which is supported by the Johnson and Johnson Foundation. This grant allows us to deliver Paediatric Anaesthesia training for Anaesthetic Clinical Officers (ACOs) at Kamuzu Central Hospital, Malawi and is worth around £40k. The programme has been designed with Kijabe Hospital in Kenya who will provide onsite training for these ACOs.
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Through the course of 2020/21, THET and Johnson and Johnson Foundation have shown amazing flexibility on the grant programme as COVID impacted our ability to (i) send UK volunteers to Malawi to provide training for ACOs and (ii) work with Kijabe Hospital.
We were eventually able to start the grant programme in June with Dr Jonty Dean becoming our first volunteer to visit Kamuzu Central Hospital to help train ACOs. Jonty published an interesting blog on his time in Malawi on our website (available here). Some key stats from his session in Lilongwe:
- 4 ACOs trained
- 70 training days delivered
- 140 children that have been treated by trained ACOs
- 25 specialist paediatric anaesthetic interventions (e.g. caudal analgesia) carried out by the trained ACOs
We have a second volunteer in Malawi from Jan 2022 to continue delivery of this programme.
## **iii) THET Health Partnership Capacity Development Program**
**- - - - - (https://www.thet.org/get involved/health partnership capacity development programme/)**
In July 2021, our partnership with Malawi was accepted on to the THET Health Partnership Capacity Development Programme. This is a 2-year programme aimed at building and strengthening health partnerships. Through this programme we have gained insights into changing global health systems, principles of successful partnerships and key elements for sustainable change. By learning alongside like-minded people and organisations we have begun to explore and grow our network and reach. Using this knowledge and mentorship, we are looking to build upon our strategic plan and prepare for future projects over the next year.
## **D) Overall financial position**
Our financial year runs from Apr 2020 – Mar 2021 and our annual return to the Charity Commission relates to this period. For our financial year 2020/21, our closing balance was approximately £10k. This reflects a period where we made our first grant but, otherwise, maintained a steady approach to fundraising and expenditure as much of the year was impacted by COVID19.
## **Income**
For the year so far, our income has come from two sources:
- Direct debits: 95% of income
- Individual donations: 5% of income
In line with Charity Commission guidance, we do not propose auditing or getting independent verification of this year’s financial accounts.
## _**Other expenditure**_
Outside our grant making activity, our only expenses related to maintenance of the website.
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## _**Full year 2021**_
After our financial year closed in April 2021, we started the THET Mother & Child grant programme and received income related to this in the summer. We will report on this income and expenditure related to the THET grant in the 2022 annual report.
## _**Year Ahead**_
In the coming year we will complete the THET Mother & Child grant programme and report on it. We will also invite applications for new KoM grant awards, e.g. to continue to support a specialist surgery nurse at KCH.
As part of the THET Health Partnership Capacity Development Program, we will work with key stakeholders in Malawi to set priorities for the medium and long term and understand the place of KoM UK in delivery of those goals. This will allow us to develop our fundraising and spending strategies in line with the needs of children requiring medical care in Malawi.
_THET Mother & Child Grant volunteer, Dr Jonty Dean, with ACOs in Kamuzu Central Hospital._
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|**KIDS OF MALAWI**|||**1183319**||
|---|---|---|---|---|
||**Receipts and payments accounts**|||**CC16a**|
|**For the period from**|Period start date
01/04/2021|**To**|Period end date
31/03/2022||
## **Section A Receipts and payments**
**Unrestricted Endowment Restricted funds Total funds Last year funds funds to the nearest to the nearest £ to the nearest £ to the nearest £ to the nearest £ £**
## **A1 Receipts**
|Donations|**3,740**||**-**||**-**||**3,740**||**4,250**|
|---|---|---|---|---|---|---|---|---|---|
|Grant income|**-**||**27,218**||**-**||**27,218**||**-**|
||**-**||**-**||**-**||**-**||**-**|
|**_Sub total_**_(Gross income for AR)_|**3,740**||**27,218**||**-**||**30,959**||**4,250**|
|||||||||||
|**A2 Asset and investment sales, (see**
**table).**||||||||||
|N/A|||**-**|||||||
||**-**||**-**||||||**-**|
|**_Sub total_**|**-**||**-**||||||**-**|
|**_Total receipts_ **
**A3 Payments**|**3,740**|||||||||
||||||||||**4,250**|
|||||||||||
|Grant spending|**-**||**9,695**||**-**||**9,695**||**5,032**|
|Admin|**137**||**-**||**-**||**137**||**112**|
||**-**||**-**||**-**||**-**||**-**|
|**_Sub total_ **|**137**||**9,695**||**-**||**9,832**||**5,144**|
|**A4 Asset and**|**investment purchases,**||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|**(see table)**|||||||||||||
|**N/A **||||**-**|||**-**||**-**||||
|||**-**||**-**|||**-**||**-**||||
||**_Sub total_ **|**-**||**-**|||**-**||**-**||**-**||
||||||||||||||
||**_Total payments_ **|**137**||**9,695**|||**-**||**9,832**||**5,144**||
||||||||||||||
|**_Net of receipts/(payments)_**||**3,604**||**17,523**|||**-**||**21,127**||**- 894**||
|**A5 Transfers**|**between funds**|**-**||**-**||**-**|||**-**||**-**||
|**A6 Cash funds last year end**||**-**||**-**||**-**|||**-**||**-**||
|**_Cash funds this year end_**||**3,604**||1
**17,523**|||**-**||**21,127**||**- 894**||
CCXX R1 accounts (SS)
25/01/2023
**Section B Statement of assets and liabilities at the end of the period**
|**Categories**
Signed by one or two trustees on
behalf of all the trustees
**B5 Liabilities**
**B3 Investment assets**
**B4 Assets retained for the charity’s**
**own use**
**B1 Cash funds**
**B2 Other monetary assets**|**Details**
N/A
**_Total cash funds_**
(agree balances with receipts and
payments account(s))
N/A
**Details**
**Details**
N/A
THET AGP grant award
**Details**
**Details**
Cash in bank
Signature|**Unrestricted**
**funds**
**Restricted funds**
**to nearest £**
**to nearest £**
**13,769**
**17,523**
**-**
**-**
**-**
**-**
**13,769**
**17,523**
Agreement Error
OK
**Unrestricted**
**funds**
**Restricted funds**
**to nearest £**
**to nearest £**
**-**
**-**
**-**
**-**
**Fund to which**
**asset belongs**
**Cost (optional)**
**-**
**-**
**Fund to which**
**asset belongs**
**Cost (optional)**
**-**
**-**
**-**
**Fund to which**
**liability relates**
**Amount due**
**(optional)**
Restricted
**17,523**
**-**
Print Name
Sarah Morgan
Shantha Shanmugalingam|**Endowment**
**funds**
**to nearest £**|
|---|---|---|---|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||OK|
||||**Endowment**
**funds**
**to nearest £**|
||||**-**|
||||**-**|
||||**Current value**
**(optional)**|
||||**-**|
||||**-**|
||||**Current value**
**(optional)**|
||||**-**|
||||**-**|
||||**-**|
||||**When due**
**(optional)**|
||||**June 202**|
|||||
|||||
||||Date of approval|
||||25/01/2023|
||||26/01/2023|
|||||
CCXX R2 accounts (SS)
25/01/2023
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