First hospital in Malawi is accredited to international standards

Hospital workers from the Blantyre Adventist Hospital (BAH) in Malawi celebrate their Cohsasa accreditation with a parade through the streets of the industrial city.

This milestone confirms that BAH, a 45-bed acute multi-specialist hospital, complies with internationally recognised standards aligned with the principles of the International Society for Quality in Health Care (ISQua).

The significance of the achievement was underlined when BAH’s Chief Executive Officer, Kirby Kasinja, travelled to Cape Town to receive the accreditation certificate in person.

Jacqui Stewart, CEO of Cohsasa presents the accreditation certificate to CEO of Blantyre Adventist Hospital, Kirby Kasinja.

Project manager, quality advisor and surveyor, Firdousa Ajouhaar, presents accreditation certificates for individual departments in the hospital.

Patrick Gausi, quality and operations director at BAH, said the COHSASA programme led to improved communication, better clinical outcomes, higher patient satisfaction, and stronger financial sustainability.

Malawi’s Ministry of Health Department spokesperson, Beston Chisamile, publicly commended BAH and said he intended to encourage Malawi’s 800 public health facilities to undergo similar quality assessments.

From modest beginnings to national benchmark

Blantyre Adventist Hospital began in 1956 as two outpatient clinics, one dental and one medical. The first surgical procedures were performed in 1962 by a South African surgeon and two Malawian colleagues.

In April 1974, Dr Elton Stecker and his wife, Dr Rheeta Stecker, opened the hospital to a limited number of inpatients. At the time, the facility consisted of just three rooms, with average occupancy of one patient per week.

As services expanded, admissions came to include medical, surgical, maternity and paediatric care. Over time, BAH became a preferred hospital for residents of Blantyre, including senior government officials and national leaders such as Dr Hastings Kamuzu Banda, Malawi’s first president.

Today, BAH is widely regarded as one of the country’s leading hospitals, offering paediatric and neonatal intensive care as well as adult ICU services.

Quality improvement in practice

Patrick Gausi, quality and operations director at BAH, said the Cohsasa programme had led to marked improvements in internal communication and teamwork.

“Involving non-medical staff in quality committees gave them a much clearer understanding of how clinical services operate and what systems are involved,” he said. “That insight translated directly into stronger communication across departments.”

A central requirement of the Cohsasa programme is the implementation of quality improvement project (QIP)in all departments. At BAH, one of the most impactful projects focused on improving outcomes of cardiopulmonary resuscitation (CPR) in the intensive care unit.

During the baseline evaluation period between January and March 2023, only 18% of CPR attempts in the ICU of the hospital were successful. The project team set a clear goal: to increase the CPR success rate among ICU patients from 18% to 60% by June 2023.

Using a fishbone analysis, the team identified several critical gaps. Staff lacked adequate skills in chest compressions, the ventilation procedure and use of a defibrillator. Alarm response times were slow, and there was no standardised checklist for the resuscitation trolley.

“All staff, including ambulance drivers, were trained in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS),” Gausi explained. “We also addressed equipment and process gaps. As a result, we are now consistently sustaining CPR success rates above 90%.”

At the conclusion of the project, the project lead said

“This improvement was a breakthrough for the ICU nursing team and the hospital as a whole. It reinforced the importance of strong knowledge and practical skills in BLS and ACLS for successful resuscitation”.

Measurable gains across the hospital

Gausi said the benefits of the Cohsasa programme extended well beyond a single project.

Patient satisfaction has improved significantly. Prior to accreditation, satisfaction levels stood at 73%. By the final quarter of 2025, this had risen to approximately 96%, with the hospital aiming to sustain rates above 90% into 2026 and beyond.

Risk management processes have been strengthened, contributing to a safer environment for patients and staff. A notable cultural shift has also taken place. “Initially, staff were reluctant to report errors,” Gausi said. “Now there is openness and transparency.”

Patient complaints have also dropped sharply. After complaint hotline posters were introduced, the hospital initially received around 20 calls a day. “Now, a whole week can pass without a single call,” Gausi noted.

Operational performance has improved alongside clinical quality. Demand for BAH’s services has increased, particularly in theatres, where patient volumes are high. The hospital has also achieved 100% liquidity throughout 2025 following a quality improvement project focused on cost control, stock management and the focused and prudent use of resources.

“The investment in the Cohsasa programme was worth it,” Gausi said. “High bed occupancy strengthens our financial sustainability, and accreditation helps us communicate the quality of care we offer.”

When BAH celebrated its accreditation in December, staff and supporters marched through the streets of Blantyre with banners, balloons and a marching band. The Ministry of Health minister and directors from across the health sector were invited to witness the event.

The team that worked together to make Cohsasa accreditation possible.

The celebration reflected more than a certificate. It marked BAH’s emergence as a national and regional benchmark for quality health care. Now hospitals from within and outside the country are seeking benchmarking services at the hospital.