Malawi EMPOWER’s use of demand-creation strategies for sexual and reproductive health services for adolescent girls and young women during COVID-19 in Zomba and Machinga Districts​

Authors: Patrick Gwaza¹, Yona Nyondo¹, Nennie Lungu¹, Boniface Maket¹, Maria Mkandawire¹, Linda Muyumbu¹, Matthew Kankhulungo¹, Patrick Gwaza¹, Pius Mtike¹, Fatsani Gadama¹, Leo Magombo¹, Jennifer Arney², Elled Mwenyekonde³, Patricia Magombo³

¹ FHI360, Malawi EMPOWER Activity
² FHI360, Washington DC
³ CHAM, Malawi EMPOWER Activity

Background

Adolescent girls and young women (AGYW) in Malawi bear a disproportionate burden of HIV compared to male peers; HIV prevalence is 2.3 times higher among young women ages 15–24 compared to young men the same age, according to the 2018 Malawi Population-Based HIV Impact Assessment. High access to and utilization of sexual and reproductive health (SRH) services among AGYW ages 10–24 requires increased use of demand-creation strategies in communities. This abstract highlights the USAID-funded Malawi EMPOWER Activity’s use of digital platforms in demand-creation strategies to increase SRH service uptake among AGYW in Zomba and Machinga Districts during the COVID-19 pandemic.

Description:

Social and behavior change communication interventions were adapted to fit Malawi’s COVID-19 restrictions, which suspended direct community mobilization. To eliminate barriers to service access by increasing awareness of the services being provided in targeted districts, demand-creation messages on the benefits of services and service delivery schedules were shared with AGYW, community mobilizers, and health care workers through social media (Facebook, WhatsApp groups) and other digital platforms such as radio.

Lesson Learned:

Malawi EMPOWER began implementation in March 2020, just when the Malawi government established restrictive measures against COVID-19. These restrictions suspended demand-creation activities such as dialogue sessions with AGYW, Go! Girls Clubs sessions, community special events, advocacy meetings, and campaigns. From March to April, EMPOWER experienced a 40% drop in AGYW accessing SRH, HIV, and gender-based violence (GBV) services due to the ban on these activities. Following implementation of adapted strategies from the end of April to August 2020, 28,971 AGYW were reached with SRH services (family planning methods, counseling), including HIV testing services, representing a 73% achievement of the annual target of 39,643. Of these, 64% (n=17,090) were ages 10–14, 27% (n=7,051) were ages 15–19, and 9% (n=2,421) were ages 20–24.

Conclusions:

Although COVID-19 has presented barriers to full implementation of mobilization activities affecting the uptake of SRH/HIV/GBV services among AGYW, an adapted package of demand-creation strategies implemented through social media and other digital platforms was successful in reaching this population with messages and services.