Church-based ministry to people with disabilities in Malawi: a case study and program evaluation

Background: The Malawi Disability Program is a congregation-led ministry located in Malawi. At the time of data collection, the program served over 1,548 People with Disabilities (PWD) and caregivers with 757 volunteers. It consists of an adapted worship service called ‘Worship at the Cross’ designed to encourage participation for people with both physical and learning disabilities. In some congregations, the ministry also includes a Home-Based Care Program that directly supports family caregivers of children with disabilities using a community-based rehabilitation model to achieve physical, social, educational, and spiritual goals and provide regular encouragement. The purpose of this program evaluation was to measure the impact of this effort. Methods: Structured interviews and surveys were performed, incorporating input from volunteers, caregivers, PWDs and church leaders at 14 congregational sites in central and southern Malawi. Approximately 10% of PWDs or caregivers of children with disabilities in the selected sites (n=64) and 10% of volunteers (n=80) completed an individual survey, all 14 congregational pastors or church leaders were interviewed, and 47 Home-Based Care Program households agreed to participate in a home assessment. Results: Most caregivers and adult PWD’s (97%) agreed that Worship at the Cross increased their acceptance in the community, and 86% reported community members now treat them like their respective age. With the Home-Based Care Program, 82% of caregivers felt confident performing home-based exercises with their child and 77% stated that their child had improved, noting improvements in mobility, performance of tasks and self-care, social interaction, and understanding. Among volunteers, 98% stated they were now more comfortable sharing their faith and 84% reported praying with children during most home visits. Conclusions: In addition to the physical impact of the Home-based Care Program, there are opportunities to measure mental health outcomes and provide further training for both volunteers and caregivers on how best to provide mental and spiritual support to adults and children with disabilities. Regardless, the results demonstrate the Malawi disability program continues to reach a vulnerable population with the saving news of the Gospel as well as providing physical, emotional, and social support.