In the battle against the HIV epidemic, Malawi’s situation is characterized by prevalence rates of between 9 – 18%, limited care and treatment adherence and retention for children and adolescents living with HIV, and high rates of new infection among adolescent girls and young women. Widespread poverty, harmful cultural norms, and gender inequity are co-drivers of HIV infection, as communities struggle with growing climate, food, and economic insecurities that fuel child marriage, child labor, substance use, and violence. These challenges have been amplified by the COVID-19 pandemic – creating conditions for HIV transmission that could seriously threaten Malawi’s progress toward 95:95:95 goals.
The goal of the Ana Patsogolo (“Children First”) Activity or APA, is to prevent new HIV infections and reduce vulnerability among orphans and vulnerable children (OVC) and adolescent girls and young women (AGYW) in high HIV burden districts in Malawi’s southern region. To achieve this goal, APA will ensure at risk children and adolescents are tested for HIV, facilitate linkage to care and treatment through case management, and deliver evidence-based HIV and GBV prevention programming. APA will also scale up DREAMS programming in Blantyre, Zomba, and Machinga districts with expanded social asset building, gender-based violence prevention, economic strengthening, and employment opportunities for adolescent girls and young women.
Led by WEI/Bantwana, the APA consortium is comprised of five local non-governmental /faith-based organizations:
- The Catholic Diocese of Chikwawa
- Global Hope Mobilization (GLOHOMO)
- The Global AIDS Interfaith Alliance Malawi (GAIA/M)
- Malawi AIDS Counselling and Resource Organization (MACRO)
- Youth Net and Counselling (YONECO)
Each partner will receive organizational and technical capacity building support as they deliver OVC and DREAMS services in their geographic areas and to help them transition into direct USAID grant recipients within the first three years of the project.
Key Result Areas
Enhanced capacity of families and communities to support OVC and AGYW
APA will deliver age-specific, evidence-based parenting interventions that equip caregivers, children, and adolescents with socio-emotional and life skills that help them thrive, while supporting treatment adherence and retention among those living with HIV. APA will layer a suite of household and youth economic strengthening services onto parenting groups, adherence support groups, and youth clubs. These include VSLA+ (voluntary savings and loan associations), financial inclusion, integrated vocational training and employment support for AGYW, and market linkages for enterprises. APA will reach high-risk OVC — children living on the street, children of female sex workers, survivors of sexual abuse — with trauma-informed case management and a broad referral network of specialized services. Case Care Workers, teachers, Mothers Groups and other community resource persons will learn to recognize sexual violence and link young victims to comprehensive care through health clinics, community victim support units, and trauma counseling.
Increased uptake of health and HIV prevention, care, and treatment services among OVC and AGYW
APA will use integrated case management, Youth Health Days, and youth-friendly mobile outreach to offer sexual and reproductive health services alongside HIV testing services, condom promotion, and counseling for family planning and PrEP to increase service demand and access. APA will train clinic-based Community Linkage Facilitators to identify and link children living with HIV to case management, Youth Peer Navigators to link youth to adolescent-friendly health services (AFHS), and expert clients or “near peers” close to their age to lead community-based teen clubs.
Reduced sexual violence and GBV among OVC and AGYW
APA will engage a broad range of district, local government and community stakeholders to build sustainable capacity for a gender-sensitive, multi-sectoral response to GBV. This will include school-response mechanisms that are linked to the case management system. APA will deliver evidence-based HIV- and sexual violence-prevention interventions to OVC ages 9-14 and to AGYW and adolescent boys and young men. Alongside efforts that empower AGYW, APA will mobilize faith communities and traditional structures to respond to GBV; engage male sexual partners of AGYW in conversations around gender equity, positive masculinity, GBV, and HIV; and connect men to convenient male-friendly health services.
Enhanced child protection systems
APA will support the Government of Malawi to strengthen the national Child Protection Case Management System (CPCMS) and operationalize multi-sector coordination from national to village level. This involves supporting the roll out of enhanced standard operating procedures, vulnerability assessment tools, and training for HIV and GBV sensitive case management. It will also include capacity development for District Child Protection Committees, Area and Village Development Committees, District AIDS Councils, the Police, Gender and Youth Officers.