Hiv and Aids Management

Programme background

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Malawi is one of the countries in sub-Sahara area that is greatly impacted with the pandemic. According to Malawi Growth and Development Strategy (MGDS 111), in 2014, Malawi had 1.1 million people living with HIV (PLHIV), out of which 51% were on treatment. Over the last ten years, Malawi has witnessed significant progress in the delivery of effective HIV and AIDS prevention, care, and support and treatment interventions. However, the disease burden related to HIV/AIDS remains high and has adversely affected all sectors of the economy and population. To encounter the effects of the pandemic, there is a need for more concerted efforts from all stakeholders in the implementation, treatment, care and support and impact mitigation.

Therefore protecting community in getting new HIV infections especially children, adolescent girls and women as future free generation is vital for achieving and reducing prevalence rate of HIV/AIDS.

In Livingstonia- Rumphi district where Mtende Homecraft Foundation operates, there is high prevalence rate of HIV combined with malnutrition which have contributed to the suffering of women, children and adolescent girls including people living with HIV resulting into increased morbidity and mortality rate and under-nutrition. Life expectancy has dropped to 39 years and infant and under five mortality rates at 104 and 189 deaths per 1000 live births. This has greatly affected rural productivity as the community spends an average of 2 days per week attending funerals. Women are the grossly affected as they have almost 45% of the productive time spent on caring the sick in particular those living with HIV/AIDS. Nearly 13% of children have lost one or both parents, half of them to HIV-related illness, while a further 6% live in households with a sick parent or other sick adult. Many of Malawi’s 1 million orphaned children live in poor communities that struggle to provide optimal care and protection, leaving the children vulnerable to neglect, abuse and exploitation. This situation has heavily affected community’s participation in the management of their families and the little resources raised are therefore spent on survival strategies as opposed to their children’s health and education.

Nutrition

Adequate nutrition throughout the life cycle is the centrepiece for physical and intellectual development. Nutrition is a major determinant of one’s intellectual’s performance, academic and professional achievements, and overall work productivity at later stages.

Malawi has one of the highest rates of stunting in Africa, but significant progress has been achieved since 2010. The percentage of children under five years of age who are stunted has decreased from 47.1% in 2010 to 37.1% in 2015-16. The prevalence of under-nutrition is high among adolescent girls at 15.6%. The DHS 2015-16 showed relatively stagnant rates of anaemia in children since 2010, reported at 62.5% and 62.6% respectively. Similarly, the infant Young Child Feeding practices needs to be improved as only 7.8% of children aged 6-23 months consume foods that meet the minimum acceptable diet. Even with the noted decline in under-nutrition, continued efforts are needed to address micronutrients deficiencies and the high rates of stunting. The causes of under-nutrition are manifold; repeated infections, diarrhoea, malaria, suboptimal breastfeeding and infant feeding practices resulting inadequate dietary intake are the immediate causes of malnutrition. The underlying causes include food insecurity, gender inequality, poor hygiene practices and lack of safe water and sanitation (Malawi Growth Development Strategy 111) MDGS.

Under-nutrition is categorised by wasting a low weight-for-height ration, stunting-a low height-for-aged and underweight-a low weight-for-age. In early childhood, under-nutrition has negative life-long and intergenerational consequences; undernourished children are more likely to require medical care. Without proper care, underweight and wasting in children results in higher risk of mortality.

During schooling years, stunted children are more likely to repeat grades and drop out of school, thus reducing their income earning capability later in life. Furthermore adults who were stunted as children are less likely to achieve their expected physical and cognitive development, thereby impacting on their productivity.

A healthy population is a key to increased productivity and sustainable economic growth. There is a strong correlation between health status and level of development. In general poor health is costly to households and the economy. In particular, access to health care is low among the rural poor and the cost of maintaining better health is high