Let us not forget men, they are the priority too

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“If there was a really interesting time for Malawi EMPOWER Project, I can say it was the time when we were working with priority men in Mangochi, Machinga, Zomba and Chikwawa districts,” Kumbukani Chawinga, the Senior HIV Testing Advisor for Malawi EMPOWER, recalls the FY20 period as he prepares the Team for outreach activities to another hard to reach area in Zomba district.

Malawi EMPOWER Project is supporting Malawi government’s drive to epidemic control through stopping transmission and preventing new HIV infections among the priority men and Adolescent Girls and Young Women (AGYW) aged in the range of 10 to 24 years old to achieve the 95:95:95 goal. It is a five-year USAID and PEPFAR funded project.

Chawinga says it was Interesting as it required coming up with creative strategies to find them (men) to access the services which is different with AGYWs, while at the same time government had restricted public gatherings in line with Covid-19 prevention.

As he looks back on ensuring that more men were reached with the services, he says the Team focused on being creative with “demand creation prior to and during service provision as a result more men came to access the services.” 

In FY20, the clinics provided an opportunity to men, from rural and remote communities to get tested for HIV, who had hitherto not tested for HIV.

“We conducted mentorship and capacity building activities targeting Ministry of Health (MoH) providers in case finding for men through training of HIV self-testing (HIVST) distributors in all the four districts, involving MoH staff during outreach clinics and sharing notes on strategies used,” says Chawinga adding that the implementation of case finding acceleration  in four districts  proved successful in FY20.

There were 1026 individuals that were tested through routine outreach clinics and more were reached during acceleration plan with 94 testing HIV positive representing 9% yield.

For the smooth implementation of the project, maintaining a health work relationship with implementation partners was very critical in FY20.

“In project implementation we collaborated with the other partners who were already on the ground with similar activities proved helpful. We had good collaboration with stakeholders in the 4 districts. Each time we had, and we have outreach clinics, we conduct(ed) them together with DHO staff while also providing commodity support,” chips in Chawinga.

Despite the journey registering some highlights, all was not smooth. There were hurdles, too.  

Covid-19 the pandemic posed as the greatest threat.

“Malawi Covid-19 guidelines banned community testing amidst Case Finding rollout which led to low reach. Due to Covid-19 guidelines that were restricting public gatherings, there was general resistance to support Malawi EMPOWER Project activities in some districts by other district implementing partners,” Chawinga says as he takes stock of the first year of Malawi EMPOWER Project, adding that in course of navigating around Covid-19 there were stock outs of essential drugs such as sexually transmitted infection drugs and oral self-testing (OST) kits in some districts with Covid-19 pandemic.    

However, the project was able to devise ways in dealing with the challenges that were experienced.

“As a way of dealing with some of the challenges, the project came up with strategies which were adhering to the Malawi government Covid-19 guidelines though the reach was still lower than the targets. For example, we were able to do index testing through antenatal care clinics,” says Chawinga.

He says that the project intensified advocacy on the need to also conduct index testing during outreach clinics and be done at district level.  Further, Malawi EMPOWER project supported the districts with transport to collect OST kits from other districts with reasonable stocks and engaged Diagnostic Health Assistants on the need and OST kits were provided to clients.

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