C.10.Experiences in the delivery of integrated HBC/OVC services in Malawi
M. Kaseje; M. Gondwe; E. Chatipwa
Providing HBC care and support for chronically ill clients and OVC is a challenge in Malawi. Constraints include: stigma, isolated care for patients and OVC at household levels, food shortages, drug shortages in health facilities, inadequate educational support among other basic needs. Volunteers are important community resources but often have limited skills and lack adequate transport to provide quality care and supervision. There is limited involvement of PLWHAs in care and support and limited transfer of skills from care providers to care givers. Weak referral systems and inadequate collaboration between HBC/OVC care providers, other service providers and communities compound the problems.
Through USAID/Malawi funding, FHI works in partnership with local community organisations in five districts (Nsanje, Chikwawa, Blantrye, Mangochi, and Dowa) to support an integrated HBC/OVC program to mitigate the impact of HIV/AIDS. FHI provides technical assistance through training in service delivery and monitoring of activities using monthly and quarterly reports, review meetings, field supervisory visits and discussions with collaborating partners. Volunteers have been trained to provide support and continuity of care at the community level. Partners are providing incentives to volunteers including bicycles, umbrellas and bags. Partner organisations are also facilitating formation of PLWHA support groups and participation in care and support activities. A total of 2,552 chronically ill clients and 21,000 children have been reached and supported in the five districts.
Integration is not a one time event but is a process entailing participation from different stakeholders. Dynamic and strong community support are prerequisites for a successful integrated HBC/OVC program.
Linkage with other service providers helps clients and OVC to meet their diverse needs. Provision of incentives enhances volunteer retention. Involvement of PLWAs promotes disclosure.