HIV/AIDS PROGRAM

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• An ecumenical umbrella organization that coordinates provision of health care in church-owned health facilities in Malawi

• Owned by Episcopal Conference of Malawi and Malawi Council of Churches.

• Membership of 172 health facilities of various sizes, located across the country, 80% of which are in hard to reach areas. It has also 10 training Colleges

• Provide about 37-40% of the health care service delivery in Malawi

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HIV prevalence in Malawi for adult population 12% (Sentinel Survey 2007)

Prevalence of HIV in Antenatal mothers 12.6% (Sentinel Survey 2007)

Prevalence among pregnant women had declined from 22.8% in 1999 to 13.5% in 2009 as measured through ANC sentinel surveillance.

52% of pregnant women were tested for HIV in 2009. An estimated 58% of mothers and 41% of HIV-

exposed infants were provided with ARVs for PMTCT in 2009.

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CHAM has an MOU with Govt. that supportsStaff salaries in all CHAM facilities

SLA (currently 38%, 66 of 172 facilities)

Student scholarships- PEPFAR During trainings they are also equipped with HIV

info. To support facilities once they graduate .

40% & 60% of the graduates go to CHAM & GOVT. respectively.

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Strengthen the capacity to prevent HIV/AIDS; provide care, support and treatment and mitigate the impact of the epidemic

Strengthen the delivery, coordination, scale up and monitoring of HIV/AIDS services in the faith-based health sector in Malawi.

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1. Strengthen quality of PMTCT services in all health facilities. currently working on EMTC

2. Improve quality of care and treatment for HIV and AIDS, STI, TB & OIs

3. Strengthen the capacity of CHAM in planning, M&E & use of data for management of HIV/STI/TB programmes.

4. Ensure quality diagnostic services for surveillance, diagnosis, treatment, CD4, HIV screening and blood safety.

5. Improve the HR capacity to effectively provide HIV services.

6. Strengthen HIV prevention by providing voluntary medical male circumcision (VMMC)

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Full packageProvider Initiated Testing & Counselling (PITC)Confidential HIV Testing and Counselling (HTC)ARV prophylaxis/ART therapy Cotrimoxazole Preventive Treatment (CPT) prophylaxis Monitoring and EvaluationHRD&T (Pre-service & post basic education for

HIV/AIDS) Infant feeding counselling & supportCounselling & follow up

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Reduce paediatric HIV infection in children and ensure an HIV-free generation, all pregnant women should have access to comprehensive quality PMTCT services

Provide a continuum of entry points to expand coverage and strengthen follow up of PMTCT and paediatric HIV/AIDS services

ANC, Labour/Delivery, Postpartum Care

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There are 4 Prong Areas;1. Prevention of HIV Infection among women of

childbearing age2. Prevention of unintended pregnancies among women

living with HIV3. Prevention of transmission of HIV from mothers

living with HIV to their infants4. Treatment, Care and Support of mothers living with

HIV and their infants

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Use of new cadre of HSAs & CHCWs to provide PMTCT services at community and household levels

Adopted PMTCT & HIV counselling & training materials for health care providers to create a learning resource package for HSAs

Utilization of HSAs & VCHW to improve community awareness and demand creation for ART/PMTCT services while strengthening referral linkages for HIV women and their infants

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Development of HIV/AIDS Integration Framework Serves as a “Roadmap” throughout

implementation; it enables CHAM facilities to reposition services to achieve maximum impact

Development of Operational Integrated Framework Enables our health facilities to develop joint work plan

and coordinate a single agreed approach rather than haphazard, parallel systems.

Provides health facilities with single understanding of accomplishments and gaps remaining to be addressed

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Improved HR in HIV/AIDS management

CHAM managed to train and is still trainingstaff in areas of;

Couple Counseling , PITC, ART, PMTCT, HTC for Site supervision , CD4 testing,

DBS/PCR collection and management, Motor Cycle Riding (for follow up), M&E/HMIS and Early Infant Diagnosis

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Establishment of integrated HIV/AIDS static & mobileClinicsIncreased number of clients accessing HIV/AIDS services:

HTC (Jun 2011-May 2012)• 124 Facilities providing HTC• 475,494 Clients reached• 51,828 Positive• 104,507 on ART PMTCT 120 Facilities providing PMTCT services 5,696 Pregnant Women reached About 30% of the facilities trained for Option B+

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Establishment of HIV/AIDS interventions forvulnerable groups increased HIV/AIDS

informationaccess. (e.g.) Sex workers intervention/support groups

reached up to 57% of the targeted numbers of sex workers in some of our facilities

Increased number of sex workers now accessing HIV/PMTCT services due to the awareness provided to them through these interventions/support groups

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Promotion of male involvement through TraditionalLeader has seen an improvement on PMTCT serviceuptake by 16%.Some communities have even developed bylaws to governPMTCT issues within their communities; Every pregnant woman to attend ANC Every visit to ANC a woman to be escorted by her

husbands WASH intervention (where when a women comes with her

husband she is given some incentives)

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High quality strategic information

management A strengthened surveillance system which shows a pattern of

changing behaviour and decreasing HIV prevalence, (CHAM CDC interventions highlight the needs of vulnerable hidden populations)-

Significant number of HSAs & VCHWs trained in comprehensive ART/PMTCT and use of HIV rapid test kits resulting into increased HIV service delivery, improved referral system and also increased PMTCT service uptake

Renovations of key buildings PMTCT/ART clinics and Laboratories 17

Our facilities have formed support groups for vulnerable population help increase HIV/AIDS service uptake (e.g.)

Sex workers support groups has enabled sex workers to open up and start accessing HIV/AIDS and PMTCT services. Stigma and Discrimination has been reduced

and this encourages other vulnerable populations to access HIV/AIDS services

 

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low participation of CHAM facilities in preparation of the district implementation plan despite that CHAM facilities’ budgets are included in the DHO’s budget.

EHP, Some facilities (38%) signed SLAs but for govt to pay the bills takes time which sometimes results into

conflicts Too high expectations from govt. on what CHAM can do

within its limited mandate and resources Distrust & misinformation between MOH & CHAM. This is

due to poor communication system within our institutions and sometimes due to lack of transparency in the way the two bodies conduct their business

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HIV initiatives are effective when they are situated within Govt structures and follow govt. SP & priorities

Active involvement of beneficiaries and marginalized groups ensures the effectiveness and sustainability of interventions

Working at a variety of levels-from national to local-allows for more comprehensive response

Partnerships create synergies, better meet beneficiaries’ needs and maximize available resources

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CHAM & MOH are the 2 most important partners in theprovision of health care in Malawi....Need to improve relations in areas of communication

and cooperation at district level There need for increased district based collaboration

between CHAM facilities and DHOs in health planning and health policy issues

Involvement of church structures to reach out to larger population is key

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CHAM is optimistic that through ACHAP forum FBOs shall assist in scaling-up and strengthening the HIV/AIDS/NCD service delivery in Africa (Some FBOs across Africa fail to provide HIV/AIDS/NCD services to the maximum due to lack of ideas , innovativeness and financial support)

This forum will result into meaningful contribution towards the Continent’s HIV/AIDS and NCD response

Malawi will be on track to achieve its national targets for PMTCT by 2013 since efforts to scale-up and reduce loss-to-follow up will have been redoubled

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