In Malawi, PSI works with consumers to design interventions that bring care right to their front door and accelerate the market. PSI Malawi’s interventions allow Malawians to access their choice of products on-demand, including products for HIV prevention, sexual and reproductive healthcare and malaria prevention.
Since 1994, PSI Malawi, with support from the American, British and German governments, implements programs with a multidisciplinary approach to social and behavior change that draw upon the tenets of public health, marketing, behavioral economics and human-centered design. Priority health areas for the platform include HIV prevention, sexual and reproductive health and rights and malaria prevention.
In 2018, PSI Malawi provided 1,026,981 lives years of healthy life for its clients, including:
years of protection against unintended pregnancy for Malawian couples
users reached with sexual and reproductive health services
More than 30 years into the HIV/AIDS epidemic, Malawi, like other countries in sub-Saharan Africa, still faces many challenges when it comes to HIV prevention. Its 9.2% HIV prevalence rate includes a very high incidence of HIV among groups that are most at-risk of infection, and there are also increasingly substantial levels of HIV transmission among Malawi’s general population. As a result, nearly one million Malawians aged 15 years and older are living with HIV. PSI Malawi works to prevent infections using interventions like condom distribution, HIV testing (especially self-testing) and counseling.
PSI Malawi plays two roles in Malawi’s condom market: it facilitates supply chain management for the government’s free condom distribution program and distributes socially marketed male and female condoms. PSI Malawi’s Chishango brand of male condoms targets young men who are sexually active. Since its introduction, over 200 million Chishango condoms have been sold and the brand continues to enjoy nationwide coverage: 74% of condoms that Malawians pay for and 25% of the condoms distributed or sold across the market are Chishango condoms. PSI Malawi also offers a female condom brand, called Care, that offers a female-initiated option for condom use.
Since 2012, PSI Malawi has provided voluntary medical male circumcision services using both mobile service delivery and static sites and currently covers four districts in southern Malawi. To date, the program has carried out 248,639 male circumcisions through the USAID-funded Support for International Family Planning Organizations 2 (SIFPO2) project and the TASC4 Voluntary Medical Male Circumcision Scale-Up project. PSI Malawi’s current interventions are built on local capacity to deliver voluntary medical male circumcision services, and they serve as a model to inform scale-up for voluntary medical male circumcision programming in Malawi as a whole.
PSI Malawi provides HIV testing and counseling services in hard-to-reach areas through both stand alone and outreach services that are integrated with sexual and reproductive health provision. Mobile teams target areas at high-risk for HIV and refer all patients that test positive to the nearest health facility for follow-up and care.
Half of the 100,000 new HIV infections in Malawi occur among young people ages 15 to 24 years old. Through the DREAMS initiative, funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), PSI Malawi offers integrated health services, including for gender-based violence, for adolescent girls and young women in Malawi’s Machinga district. Outreach includes screening for sexually transmitted infections, HIV testing and first-line support to survivors of gender-based violence.
In 2015, PSI Malawi launched Unitaid’s HIV Self-Testing Africa (STAR) project to contribute to the global effort to achieve the UN’s 95-95-95 targets to fight HIV. In Malawi, the project is designed to reach those in rural and peri-urban areas. STAR aims to increase access to and promote self-testing among those who currently have limited access to HIV testing services due to privacy issues or lack of convenience and encourages re-testing among those at high risk.
With support from KFW (the German Development Bank) and USAID, PSI Malawi partners with the Malawian government, the Family Planning Association of Malawi, Action by Churches Together Alliance and Pact Malawi to implement Project N’zatonse. The project is a multifaceted intervention and focuses on increasing access to and demand for contraception; equipping young people with the knowledge and power to make responsible choices for their sexual and reproductive health (including HIV and prevention of sexually transmitted infections); and transforming societal attitudes and practices for access to sexual and reproductive health services and rights. The project uses rights-based and gender equality approaches to increase the ability of girls, men and boys and to access these services and activates political, traditional, community and religious leaders at the local and national level to advocate for them. Project N’zatonse ultimately aims to contribute to stronger health systems and communities that can better meet the needs of rural and poor populations in Malawi.
PSI Malawi is partnering with Banja La Mtsogolo and University of Strathclyde to implement the five-year, DFID-funded Tsogolo Langa project for sexual and reproductive health and rights in Malawi. The program aims to contribute to the Government of Malawi’s commitments to the Family Planning 2020 goals, with a special focus on women, youth and people with disabilities. The Tsogolo Langa project aims to expand the access, choice and reach of quality integrated sexual and reproductive health services for all women, particularly in underserved areas, as well as among youth and people with disabilities. To achieve this, it fosters an enabling environment for adolescents, including people with disabilities, to access youth-friendly health services, teaches economic and life skills, and leads the development and sharing of evidence-based approaches that improve the uptake of sexual and reproductive health services, especially for adolescents, and informs supportive policies and programming.
For over 10 years, PSI Malawi has partnered with the Government of Malawi to implement its National Malaria Strategic Plan, which aims to scale-up interventions for a malaria-free Malawi. PSI Malawi’s main contribution to this program is the distribution of insecticide-treated nets. With additional support from the US President’s Malaria Initiative, PSI Malawi has also supported the Government of Malawi with the free and routine distribution of insecticide-treated nets for pregnant women and caregivers with children under 5 years old through public health facilities. PSI Malawi also markets Super Chitetezo nets in both urban and peri-urban areas.
In addition to the distribution and management of insecticide-treated nets in public health facilities, PSI Malawi has provided technical assistance to the National Malaria Control Program on the procurement and nationwide distribution of nets. Its areas of assistance include quantification and planning for net distribution and refining of the national program’s policy for nets. PSI Malawi assisted by identifying target groups, setting criteria for those who would receive insecticide-treated nets, creating distribution strategies, monitoring net distribution and use and overall behavior change communication for malaria prevention.
As Malawi’s economy dwindles and its population soars, the public health sector has been over-stretched and struggles to effectively meet the country’s demand for healthcare, ultimately leading to compromised and poorer quality health service delivery. To bridge this gap, PSI Malawi established the Tunza family health network to provide quality, equitable and affordable healthcare through the private sector. Launched in 2012, Tunza has grown into a network of 69 franchisees based in central and northern regions. PSI Malawi provides training and ongoing mentorship in business and finance, quality assurance and youth friendly health services, which has greatly improved service delivery in private clinics. In 2016, more than 20 Tunza clinics integrated HIV testing and counseling services into their health offerings to provide comprehensive sexual and reproductive health services to the population. Tunza continues to grow as a financially sustainable social enterprise.