Malawi: Our Impact

Ummuro Adano

Donors, national governments, civil society, and international partners are grappling with three realities in the domain of HIV and AIDS today: (1) the need to accelerate country ownership and leadership of HIV and AIDS programming; (2) diminishing donor resources; and (3) the need to strengthen local implementing organizations and institutions to sustain the AIDS response in terms of: access to prevention, treatment, care, and support services; addressing stigma, discrimination and human rights abuses that key populations continue to face in many parts of the world; and supporting orphan

Erik Schouten presents data on Option B+ in Malawi. {Photo credit: Sara Holtz/MSH.}Photo credit: Sara Holtz/MSH.

A Conversation with Dr Erik SchoutenWhen considering which public health intervention is best for a country or region for prevention of mother-to-child transmission (PMTCT) of HIV, the World Health Organization (WHO) provides a set of guidelines that provide options for various settings.

Community health workers in Malawi, with the mobile phones they are using to receive health information. {Photo credit: MSH.}Photo credit: MSH.

In the rural Salima district of Malawi, where the closest health facility is more than a day’s walk away, community-based health workers provide the first and often only line of care to families who need health services. While it is essential that these health workers remain up-to-date on current medical norms and knowledge, this proves challenging considering that most villages in Salima do not have electricity, let alone internet.Mobile phone technology has become a valued tool to connect rural health workers with the information they need.

As the international community gathered for the XIX International AIDS Conference last week, HIV & AIDS experts and key organizations voiced their support for a new approach to preventing mother-to-child transmission of HIV: Option B+. Option B+ calls for antiretroviral therapy (ART) for life for all HIV-positive pregnant women, regardless of CD4 levels.The government of Malawi, with the support of MSH, adapted the World Health Organization (WHO) guidelines on preventing mother-to-child transmission, to the needs of Malawi.

A Malawian woman receives a Depo-Provera injection through the CFPHS project. {Photo credit: MSH.}Photo credit: MSH.

Since 2007, the USAID-funded Community-based Family Planning and HIV & AIDS Services (CFPHS) project has partnered with the ministry of health and local organizations in Malawi to expand access to integrated family planning and HIV & AIDS services in rural areas through a network of community health workers.The CFPHS project, led by Management Sciences for Health (MSH), has had marked success, increasing contraceptive use from 20,000 to 39,000 couples in two years.A 2004 health survey in Malawi showed that the contraceptive method of choice for about 60 percent of married women was the

Malawi. {Photo credit: MSH.}Photo credit: MSH.

In 2009 and 2010, Malawi developed a national strategy to prevent more than 25,000 child deaths per year by using zinc to treat and prevent diarrhea. The government of Malawi and BASICS Benin, funded by USAID and led by MSH, with support from UNICEF and the World Health Organization (WHO), have oriented more than 2,000 communications officers and their supervisors to a national strategic communications plan for the use of zinc and trained nearly 4,000 health workers in the administration of zinc.

Rudi Thetard. {Photo credit: MSH.}Photo credit: MSH.

Pervasive, chronic poverty has devastated every sector of Malawi for decades—contributing to a faltering economy and applying enormous pressure on an overextended and under resourced government.  A fragile health care infrastructure is aggravated by the poverty problem and has increased the prevalence of HIV & AIDS, tuberculosis, malaria, malnutrition, and other epidemics. Malawi has some of the worst health indicators in the world.

Mr. Kalima Danger and his wife, Mrs. Mkalira Kalima, were both tested and learned of their HIV-positive statusThe Salima district of Malawi is underserved by health facilities. The US Agency for International Development (USAID)-funded Basic Support for Institutionalizing Child Survival (BASICS) project decided it was necessary to implement village-to-village HIV testing and counseling in the Traditional Authority Msosa, Salima district, to bring HIV testing and counseling closer to people in the rural villages.

Management Sciences for Health is pleased to announce publication of the "Evaluation of Malawi's Emergency Human Resource Programme."  The report documents the results of six years of efforts by the Government of Malawi and its partners, Britain's Department for International Development (DFID), and the Global Fund to Fight AIDS, Malaria and Tuberculosis, to overcome its human resources in health crisis.The Emergency Human Resource Programme (EHRP) was launched in 2004 to address this crisis, largely caused by an acute shortage of professional workers in the public health sector.  In

As a partner in the Knowledge for Health project (K4Health), MSH is leading the implementation of a one-year knowledge management “demonstration” project in Nkhotakota and Salima districts in Malawi. The project aims to improve the exchange and use of family planning/reproductive health (FP/RH) and HIV & AIDS knowledge among managers and service providers at the national, district, and community levels to improve FP/RH and HIV & AIDS services. Eighty-three percent of Malawi’s population lives in rural areas.

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