Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 7874
Country/Region: Malawi
Year: 2008
Main Partner: Management Sciences for Health
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $500,000

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $125,000

Summary

Management Sciences for Health (MSH) recently won the TASC III award. This activity will support the

Government of Malawi's (GoM) goal of promoting reproductive health through informed choice and

integration with HIV/AIDS. The program has three main components: behaviour change and

communication; outreach; and health provider capacity building. The overall purpose of this task order is to

promote through informed choice, safer reproductive health practices by men, women and young people,

and increased use of high quality, accessible Family Planning/Reproductive Health (FP/RH) and HIV/AIDS

services.

Background

Integration of HIV and FP has proven to be an effective approach to stimulate new activities and meet

active demand for HIV Counseling and Testing (HCT) by overcoming constraints to accessing services. The

overall purpose of this task order is to promote integration of family planning and HIV/AIDS through

increased use of high quality, accessible FP/RH services, and HIV/AIDS services. The activities to be

implemented in FY 2008 are part of an initiative to be undertaken starting in October 2007 through TASC-III

in eight districts with Child Survival and Health Population funds (POP) and 2007 Emergency Plan (EP)

funding. In achieving the purpose, the program will undertake various activities in three programmatic areas

of other prevention, HCT, and systems strengthening to accomplish the following results: increased

community knowledge and interest in FP and HIV/AIDS services; improved social norms for

SRH/FP/HIV/AIDS; increased access and utilization of FP/HIV/AIDS services in communities; increased

integration of HIV issues into FP services and vice versa; improved linkages between point of service and

the community and household levels; and a strengthened enabling social environment for FP/RH and

HIV/AIDS services and behaviors. Achievement of these results shall be carried out principally through

partnerships with the district health offices in Malawi.

Cross cutting among health issues is the high fertility rate, which undermines the poverty reduction efforts,

contributes to high maternal and infant mortality levels, and exacerbates the AIDS-related orphan problem.

Considerable progress has been made over the last decade in reducing total fertility from 6.7 in 1992 to 6.0

in 2005. At the same time the contraceptive prevalence rate (CPR) for modern methods has raised from

7% in 1992 to 28% in 2004. FY 2008 HIV/AIDS funds will wrap around larger programs in Family

Planning/Reproductive Health which are funded with POP Child Survival and Health funds.

Activity 1: Dual Protection

TASC-III will integrate HIV/AIDS, family planning and sexually transmitted infections (STI's) prevention

through promotion of dual protection, encompassing condom promotion and other behavioral change efforts

to reduce pregnancy and STI/HIV risk. Integration of family planning counseling and services (or referral for

services) into HCT centers for women and men who wish to avoid future childbearing will include programs

focused on mother to child transmission.

Activity 2: Gender

TASC-III will incorporate a gender approach into family planning and HIV/AIDS services by training

providers to address gender-related barriers/issues, including identifying signs of gender-based violence

that should be addressed as part of family planning and HIV/AIDS counseling. Steps will be taken to ensure

that protocols address legal and support services in the community to mitigate impact (e.g. partner testing

and notification to support disclosure).

Activity 3: Behavior Change Communication

Behavior change communication (BCC) will be incorporated into TASC III activities and shall portray

adequately family planning and HIV testing and treatment as mainstream health interventions. BCC

messages should include those targeted at men as clients, allies/supportive partners, and agency of change

toward more positive norms.

Funding for Prevention: HIV Testing and Counseling (HVCT): $125,000

Summary

Management Sciences for Health (MSH) recently won the TASC III award. This activity will support the

Government of Malawi's goal of promoting reproductive health through informed choice and integration with

HIV/AIDS. The program has three main components: behavior change and communication, outreach, and

health provider capacity building. The overall purpose of this task order is to promote through informed

choice, safer reproductive health practices by men, women, and young people, including increased use of

high quality, accessible family Planning/Reproductive health (FP/RH) and HIV/AIDS services.

Background

Integration of HIV/AIDS and FP has proven to be an effective approach to stimulate new demand as well as

meet active demand for HIV counseling and testing (HCT) by overcoming constraints to accessing services.

The overall purpose of this task order is to promote integration of family planning and HIV/AIDS through

increased use of high quality, accessible FP/RH and HIV/AIDS services. The activities to be implemented in

FY 2008 are part of an initiative to be undertaken starting in October 2007 through TASC III in eight districts

with USAID Child Survival Health Population funds (POP) and 2007 Emergency Plan (EP) funding. The

program will implement various activities in three program areas: Condoms and Other Prevention,

Counseling and Testing, and Other Policy and Systems Strengthening, to accomplish the following results:

•Community knowledge and interest in FP and HIV/AIDS services increased

•Social norms for SRH/FP/HIV/AIDS improved

•Access and utilization of FP/HIV/AIDS services in communities increased

•Increased integration of HIV issues into FP services and vice versa

•Linkages between point of service and the community and household levels improved

•An enabling social environment for FP/RH and HIV/AIDS services and behaviors strengthened.

Achievement of these results shall be carried out principally through partnerships with the district health

offices in Malawi.

Expansion of HCT is a critical step towards achieving Malawi's ambitious universal access targets of having

at least 250,000 patients with advanced HIV disease alive and on ART by 2010. Malawi's Universal Access

target for HCT is to attain a testing rate of 993,000 people per year by 2010. Although the country has

recorded a large increase of testing sites from 39 in 2001 to 351 in 2006, and a correspondingly sharp

increase in number of people tested annually from about 52,000 to 661,400; knowledge of HIV sero-status

among adults over 15 years is only 15%. The expansion of HCT services in Malawi still faces many

challenges including inadequate human resource capacity for program coordination at a national level,

shortage of trained counselors, and weak coordination of testing activities in medical settings. Other

challenges include low testing rate for couples and children.

Activity 1: Community Based Counseling and Testing

TASC III will initiate community-based family planning and CT services in eight districts and scale up

operations by expanding coverage, access, and consistent use of FP/RH and HIV services. The focus of

the expansion should be in rural and underserved areas and among high risk populations defined by high

unmet demand for services or marginalized groups. Consideration will be given to cost effectiveness and

potential health impact in identifying areas and population for expansion. TASC III will focus on consistent

family planning use and look for windows of opportunity to leverage increased access to HIV/AIDS services,

particularly in HIV counseling and testing and positive living as well as addressing gender related reasons

for lack of access such as women's limited financial resources and lack of partner support for contraceptive

use.

Activity 2: Post Test Clubs

TASC III will support post test clubs that are designed to decrease stigma and discrimination experienced

by PLWHA. Innovative approaches to expand use of HIV and other RH services available to women

through community-based distributors (CBDs) thereby increasing women's access to services in rural areas

shall be strengthened. CBDAs will include HIV/AIDS prevention messages, support testing, treatment

seeking, and adherence behaviors.

Funding for Health Systems Strengthening (OHSS): $250,000

Summary

Management Sciences for Health (MSH) recently won the TASC III award. This activity will support the

Government of Malawi (GoM) goal of promoting reproductive health through informed choice and

integration with HIV/AIDS. The program has three main components: behaviour change and

communication, outreach, and health provider capacity building. It is a wrap-around activity which will

promote linkages between HIV/AIDS and Reproductive Health (RH).

Background

Integration of HIV and Family Planning (FP) has proven to be an effective approach to stimulate new, and

meet active, demand for HIV Testing and Counseling (HCT) by overcoming constraints to accessing

services. The overall purpose of this task order is to promote integration of family planning and HIV/AIDS

through increased use of high quality, accessible Family Planning/Reproductive health (FP/RH) and

HIV/AIDS services.

The activities to be implemented in FY 2008 are part of an initiative to be undertaken starting in October

2007 through TASC-III in eight districts with POP (CSH population funds) and 2007 Emergency Plan (EP)

funding. In achieving the purpose, the program shall undertake various activities in three programmatic

areas of other prevention, counseling and testing and systems strengthening to accomplish the following

results: Increased community knowledge and interest in FP and HIV/AIDS services; improved social norms

for SRH/FP/HIV/AIDS; increased access and utilization of FP/HIV/AIDS services in communities; increased

integration of HIV issues into FP services and vice versa; improved linkages between point of service and

the community and household levels; and strengthened social environment for FP/RH and HIV/AIDS

services and behaviors. Achievement of these results shall be carried out principally through partnerships

with the district health offices in Malawi.

Activity 1: District Health Management Team (DHMT) Support

TASC-III will strengthen District and Community Provision and management of FP/RH and HIV and AIDS

services by supporting the district health management team (DHMT) so that they provide their mandated

supervisory and support functions to the health centers. By directing efforts towards the district level, the

program can create sustainable supervision and management capacity.

The TASC-III order activities will also focus on strengthening the capacity of the DHMT members to support

community based providers, as well as DHMT's capacity in performance monitoring and improvement as

related to HIV.