Country Spotlight: Malawi

Country Overview

According to the Joint United Nations Programme on HIV and AIDS (UNAIDS), in 2015, only 67% of adults living with HIV in Malawi were receiving life-saving antiretroviral therapy (ART). In Malawi, 84,000 children, under the age of 15, are living with HIV. Approximately 58,000 HIV-positive women give birth annually, and without any intervention an estimated 17,400 infants will be born with HIV each year.

Our Work in Malawi

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) began collaborating with local partners in 2001 to initiate one of Malawi’s first programs to provide prevention of mother-to-child HIV transmission (PMTCT) services. Currently, EGPAF-Malawi provides technical assistance in the provision of adult and pediatric HIV prevention, care and treatment services to more than 150 Malawian Ministry of Health and faith-based facilities including 78 priority sites, district-level health teams, and community-based organizations (CBOs).

EGPAF-Malawi also participates in numerous national technical working groups focused on PMTCT, HIV care and treatment, tuberculosis (TB), human resources for health, sexual and reproductive health, program monitoring and evaluation, and quality assurance. EGPAF continually promotes solutions to reduce the pediatric HIV treatment gap through participation in a pediatric treatment technical working group.

Additionally, EGPAF-Malawi conducts operations research to better understand patient perceptions of HIV programs and increase opportunities to improve early infant HIV diagnosis, and use of PMTCT and HIV care and treatment services. Completed studies have focused on utilizing early infant HIV testing and diagnosis to enhance pediatric care and treatment; the acceptability of Option B+ among HIV-positive pregnant and lactating women and feasibility of its implementation among heath care workers; and on retention of women and children in the entire PMTCT cascade.

 

Key Projects in Malawi

Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative 

(2015 - 2017) This joint U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)/Children’s Investment Fund Foundation (CIFF) initiative galvanizes global focus to improve pediatric care and treatment and aims to double the number of children on life-saving ART over two years in high-prevalence settings. EGPAF-Malawi implements the ACT Initiative with funding from CIFF. This project complements EGPAF-Malawi’s HIV Service Delivery, Quality Improvement, and Health Systems Strengthening program, (see below) serving its same seven districts, and emphasizes pediatric HIV case detection, linkage of HIV-positive children to care and treatment services, and strong retention in care and treatment among HIV-positive children. Through this initiative, EGPAF expects to initiate over 3,000 HIV-positive children on ART.

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Technical Assistance to Community-Based Organizations 

(2011 - 2017) Through funding from ViiV’s Positive Action for Children Fund, EGPAF-Malawi provides technical assistance and capacity building to six CBOs in Malawi focusing on organizational development, financial management, building partnerships and networks, monitoring and evaluation, and technical capacity. 

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HIV Service Delivery, Quality Improvement and Health Systems Strengthening

(2012 - 2018) EGPAF is one of the major PEPFAR HIV service delivery implementing partners in Malawi. Through this project, EGPAF-Malawi increases access to high-quality HIV prevention, care and treatment services, TB and HIV co-management services and treatment of sexually transmitted infections. EGPAF provides both financial and programmatic support to health facilities in activities such as clinic renovations, purchasing medical supplies, clinical mentorship, and quality improvement initiatives. Through this program, which serves a population of almost three million people in the seven EGPAF-supported districts, there were 72,620 adults and 7,189 children on ART as of September 2016.

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Optimizing HIV Treatment Access for Pregnant and Breastfeeding Women

(2013 - 2016) Through this multi-country effort, EGPAF-Malawi focuses on improving the quality of health service delivery through capacity building approaches (training and mentorship of health workers and managers); improvements in monitoring and evaluation systems in collaboration with community stakeholders; community sensitization and mobilization to create greater involvement and demand for HIV services among women; and strengthened systems for mother-baby pair tracing, to improve retention in treatment. The project was implemented in three districts (Mzimba North, Mzimba South, and Dedza) and coordinated through the United Nations Children’s Fund with funding from the Swedish International Development Cooperation Agency and the Norwegian Agency for Development Cooperation, and is implemented in Côte d’Ivoire, Democratic Republic of Congo, Uganda, and Malawi.

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Publications

Haba Na Haba: Spotlight on Pediatric Care and Treatment (2015)

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Journal Article: Lessons learned from early implementation of B+: The Elizabeth Glaser Pediatric AIDS Foundation experience (2014)

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ViiV Healthcare's Positive Action For Children Fund in Malawi (2015)

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HIV-Positive Pregnant and Postpartum Women’s Perspectives about Option B (2016)

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Barriers, facilitators and recommendations for the early infant diagnosis and treatment (EIDT) cascade: A qualitative study in Malawi

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EGPAF Country Fact Sheet: Malawi

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Accelerating Children’s HIV/AIDS Treatment: Promising Practices and Lessons Learned from the ACT Initiative 

 

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Haba Na Haba: Maximizing the Impact of Programs to Prevent and Treat HIV and AIDS Through Quality Improvement

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