Establishing The First Surgical Network In Malawi: A Collaborative Approach To Strengthening Surgical Care In Mission Hospitals

Access to surgical care remains a major challenge in Malawi, particularly in mission hospitals, which provide essential healthcare to underserved communities. Fragmentation of services, lack of specialized personnel, and inconsistencies in equipment and protocols have contributed to inefficiencies in surgical service delivery. Recognising these challenges, the Church of Central Africa Presbyterian (CCAP) has initiated Malawi’s first-ever Surgical Network, linking five mission hospitals—Ekwendeni, Embangweni, David Gordon Memorial, Nkhoma, and Mulanje. We describe the formation of the CCAP Surgical network involving standardisation of surgical protocols, equipment and best practices. Creating a coordinated referral system allowing movement of specialists and patients between hospitals, establishment of private surgical clinics within each hospital to generate revenue for sustainability of the hospitals. In this surgical Network Model each hospital will act as a regional hub, with Nkhoma Hospital serving as the initial referral center for complex cases. Equipment Standardization, unified procurement and maintenance plans will ensure that all network hospitals have access to standardized surgical tools and equipment. As part of capacity building, the network will implement surgical training programs for general surgeons, nurses, and anesthetists, alongside a residency training program at Nkhoma Hospital. The expected impact and outcomes include Increased access to specialized surgical services across the five mission hospitals, reducing the need for patient referrals to overburdened government facilities. Reduction in surgical disparities by offering both affordable and premium surgical care, ensuring financial sustainability while maintaining a mission-driven approach. Creation of a replicable model for faith-based hospital networks to sustainably improve surgical care in resource-limited settings. The CCAP Surgical Network represents an innovative, scalable, and sustainable model for strengthening surgical care through inter-hospital collaboration, resource optimization, and revenue diversification. By establishing Malawi’s first surgical network, we demonstrate how mission hospitals can evolve to meet the changing surgical landscape, ensuring equitable, high-quality care for all.