Not much larger than Pennsylvania in total land area, Malawi is one of the most densely populated countries in the world with 14 million people. Nearly 1 million Malawians age 15 and older are living with HIV.
PSI/Malawi has responded to this crisis with social marketing strategies that promote condoms, including Chishango (“shield”) condoms, which are targeted to sexually active young males and CARE female condoms that offer an alternative, female-initiated option in a country where men have usually been the decision-makers regarding condom use. PSI/Malawi is involved in some of the largest health communication programs in the country:
Evidence-based, Targeted HIV Prevention Project
This highly targeted, 5-year program launched in 2009 with USAID funding is designed to reduce HIV incidence among populations with high risk behaviors, EBT-Prev will achieve this goal through a set of comprehensive prevention interventions designed to increase the adoption of safer sexual behaviors among high risk populations (partner reduction and increased condom use.) Based on evidence generated through an extensive research agenda, interventions will include:
- Delivery of integrated Behavior Change Communications targeted to high risk populations in priority prevention areas thereby ‘surrounding’ the target audience with consistent messages that rotate on a quarterly basis.
- Distribution and promotion of male and female condoms for use by high risk groups and the general population
- Enhance the network of existing health service providers for greater accessibility and service to high risk populations
- Pakachere Health and Development Communications: Meaning “under the fig tree” (fig trees have rich cultural associations for Malawians), Pakachere is a TV, radio and print campaign that targets at-risk groups as well as legislators and others in influential positions that can positively affect public health policy. In 2008, the Pakachere Institute for Health and Development Communications became an independent Malawian NGO and now collaborates closely with PSI/Malawi and the Soul City Institute for Health and Development communications (PSI’s key partner in the creation of Pakachere).
The January-to-April rainy season also brings great risk of infection beyond the lakeshore. More than 110 people die of malaria every day – nearly half of them under age 18.
PSI/Malawi distributes both long-lasting insecticide-treated mosquito nets (LLINs) and conventional insecticide-treated nets (ITNs) to protect Malawians as they sleep. On behalf of the Government of Malawi’s malaria prevention program and with additional support form the US Presidents Malaria Initiative (PMI), PSI/Malawi distributes green-colored Chitetezo LLINsfree to pregnant women and caregivers with children under 5. PSI/Malawi also socially markets blue conventional mosquito nets with insecticide kits, as well as separate insecticide retreatment kits (M’bwezera Chitetezo brand, which means “restore protection”) to urban residents.
Women in Malawi are often disempowered from making positive reproductive health choices. PSI/Malawi is working with UNFPA and the Reproductive Health Unit of the Malawi Ministry of Health to empower women by promoting CARE female condoms. With PSI discretionary funding, PSI/Malawi also launched a program in 2008 for the injectable and oral contraceptive products: SafePlan Injectolette and SafePlan Microlette.
PSI/Malawi socially markets Thanzi (“health/vitality”) oral rehydration salts to treat dehydration from diarrheal disease, a leading cause of childhood morbidity under its USAID-funded Child Survival Health Grant project Under this same project, PSI/Malawi also promotes WaterGuard liquid, the first household point-of-use water treatment product marketed in Malawi, for the safe and effective treatment of household drinking water. As a complement, PSI/Malawi also markets and promotes with funding from Procter and Gamble’ (P&G) Children’s Safe Drinking Water Program PUR, another point-of-use water treatment product under the local brand name WaterGuard Wa Ufa (“WaterGuard powder”). A national survey found that more than 50% of Malawian mothers who had heard of WaterGuard had tried it. However, current use was only 12%, compared to survey results in nearby Zambia of 42%. A 2007 study in Emerging Infectious Diseases journal concluded that Malawi's use rate would rise to the Zambia level if Malawi's programs received more stable funding.