 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 supports
Staff 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 package
 Provider Initiated Testing & Counselling (PITC)

 Confidential HIV Testing and Counselling (HTC)

 ARV prophylaxis/ART therapy
 Cotrimoxazole Preventive Treatment (CPT) prophylaxis

 Monitoringand Evaluation
 HRD&T (Pre-service & post basic education for
HIV/AIDS)
 Infant
feeding counselling & support
 Counselling & 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 age
2. Prevention of unintended pregnancies among
women living with HIV
3. Prevention of transmission of HIV from mothers
living with HIV to their infants
4. 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.

 Provideshealth 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 training
staff 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 & mobile
Clinics
Increased 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 for
vulnerable groups increased HIV/AIDS information
access. (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 Traditional
Leader has seen an improvement on PMTCT service
uptake by 16%.
Some communities have even developed bylaws to govern
PMTCT 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
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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 the
provision 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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