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Malawi

HIV remains the leading cause of death in Malawi. Médecins Sans Frontières (MSF) teams work there to improve detection and treatment, particularly for women, adolescents and other vulnerable groups.

Malawi is making great strides after decades of underdevelopment and the impact of HIV/AIDS.

 

Since 2007 the landlocked southeast African country made real progress in achieving economic growth due to programmes instituted by the government of President Bingu wa Mutharika in 2005.

But, a major limitation to healthcare provision is the shortage of skilled healthcare workers – the vacancy rate for clinical staff is around 60 percent in a country of nearly 18 million people.

Médecins Sans Frontières/Doctors Without Borders (MSF) has worked in the country since 1986 and provides a wide range of medical care, from HIV and tuberculosis (TB) treatment to maternal health and natural disaster response.

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MSF’s work in Malawi: 2019 

Of the 300,000 people living in the rural district of Nsanje, in southern Malawi, around 25,000 are HIV positive. Many patients admitted to the MSF-supported hospital arrive at an advanced stage of the disease, despite having been on antiretroviral (ARV) treatment before.

Esther, a patient who was diagnosed with advanced HIV, is discharged from Nsanje District hospital. Malawi, October 2019.

To tackle this issue, we focus on early detection of sick patients, treatment delivery at community level, improved care at the district hospital, postdischarge follow-up and a strong referral system. Since we initiated this model, the number of deaths due to advanced HIV at the hospital has decreased by half, to below 15 per cent.  

Nsanje and mwanza

In Nsanje, and also in Mwanza, Dedza and Neno districts, we provided peer-led outreach activities and a ‘one-stop’ clinic integrating HIV, tuberculosis (TB) and sexual and reproductive health services for almost 6,000 female sex workers. Around half of the enrolled patients are HIV positive and of those, 82 per cent are virally suppressed, thanks to the treatment they receive.

In 2019, we specifically targeted girls under 18, who face even bigger challenges in accessing healthcare due to fear of legal consequences and stigma. 

 Read more  

Malawi: Detained for a dream >

Umberto PellecchiaHealth Promoter / Anthropologist

 

prevention and early treatment of Cervical cancer 

Cervical cancer is the most common cancer among women in Malawi, accounting for 45.4 per cent of all cancers and killing over 2,300 women every year. A major reason for this is the high prevalence of human papillomavirus, which causes cervical cancer, and inadequate screening and treatment services. Recently, MSF has been developing a comprehensive cervical cancer programme through primary, secondary and tertiary prevention.

In 2019, we scaled up screening activities and opened a specialised operating theatre and inpatient ward at Queen Elizabeth Central Hospital in Blantyre. Our teams offer vaccinations, screening and diagnosis, treatment of various stages of cancer and palliative care for non-curable patients, as well as staff training and mentoring.

 

Healthcare for prisoners  

Prisoners experience higher rates of TB and HIV than the general population due to factors such as overcrowding and delays in diagnosis. Through a partnership with the prison authorities, we provided systematic screening at entry, stay and exit for HIV and TB and access to treatment for prisoners at Chichiri prison in Lilongwe. 

Focusing HIV care on adolescents and AIDS patients

In Chiradzulu, we continue to implement two different models of HIV care: comprehensive ‘teen clubs’ and ‘intensive clinic days’. In the clubs, teenagers with HIV are offered clinical consultations, individual counselling, health education, sexual and reproductive health services and group support sessions in a friendly environment, where peer presence and recreational activities encourage attendance and adherence to the treatment plan.

Intensive clinic days’ are held in 11 MSF-supported health facilities within the district, for patients whose treatment is failing or who have developed advanced HIV (AIDS). We provide them with consultations, counselling sessions, laboratory tests and hospital referrals.

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