BLANTYRE PREVENTION STRATEGY:
A NEW SUB-NATIONAL HIV PREVENTION SYSTEMS MODEL IN MALAWI
The Malawi Ministry of Health, National AIDS Commission, Blantyre District Council, and Blantyre City Council came together with partners to create the Blantyre Prevention Strategy (BPS) — strengthening local leadership to utilize data-driven decision making for improved coordination, service delivery, and patient outcomes. BPS is closing gaps in Malawi’s HIV prevention efforts by building capacities for data use, surveillance, quality improvement, demand generation, health promotion, and addressing structural risks. It's an adaptable model for country-led, decentralized, and sustainable HIV prevention that can be utilized in other localities.
WATCH: The story of BPS — told by all those who made it happen.
TRANSFORMING BLANTYRE’S HIV RESPONSE
The Blantyre Prevention Strategy arose from a shared understanding that Malawi needed a new approach to address its HIV epidemic, particularly in its Southern Region. While Malawi was working toward the 2020 global 90-90-90 targets, and new infections had been dropping steadily over several years, more than 20,000 people were newly infected in 2019. The epicenter of Malawi’s HIV epidemic was its Southern Region for which Blantyre is its hub. Blantyre is a rapidly urbanizing district of more than 1.5 million people. In 2015-16, the HIV prevalence rate in Blantyre was 17.7% — highest in Malawi and nearly double the national average at the time —according to the Malawi Population-based HIV Impact Assessment (MPHIA) 2015-16.
“The greatest challenge that we faced was an uncoordinated response among stakeholders in the HIV response.”
Dr. Gift Kawalazira, Director of Health and Social Services, Blantyre District
"[BPS] brought everyone together on the table to start looking at the vision we wanted to see for Blantyre as a district…I would say that we are collaborating a little bit more, we are working better, we are coordinating, and we are networking better than we used to do before."
Grace Kumwenda, Former Chief of Party for Pakachere Institute for Health Development Communication
Prior to BPS, HIV prevention efforts in Blantyre were fragmented and uncoordinated, complicated by the complexity of HIV prevention service delivery, which includes multiple interventions that need to be targeted and delivered to different risk groups, ages, and demographics. Blantyre struggled with these and other issues — including weak data systems for HIV prevention and insufficient local data use, poor risk assessments and targeting, and inconsistent community demand. In the absence of a systemic approach, there was fragmentation across donor-funded partners and lack of communication between organizations working on HIV prevention in the district. Communities also were rarely engaged in program planning and implementation.
BPS represented the first time partners came together to co-design a solution that unified numerous disparate efforts and elevated district leadership. BPS was designed to leverage the trend towards health systems decentralization and reflect the best thinking from public health leaders in Malawi and around the world. BPS’s innovative approach has improved HIV service delivery in Blantyre by creating a more unified health system that links political and community leaders, public and private health clinics, community-level entities, and others, under city and district leadership.
BPS MODEL PROGRAM ELEMENTS
By building essential technical capabilities and systems capacities — including governance and technical leadership, digital health, quality improvement, and community and corporate engagement — BPS is enabling Blantyre’s HIV system to:
Detect and target risk factors within, and services to, individual communities using timely and high-quality data.
Generate demand for HIV prevention by collecting community insights and raising local awareness.
Effectively deliver quality and accessible prevention products and interventions.
Support sustained use of prevention products through periods of risk.
BLANTYRE PREVENTION STRATEGY IN ACTION
Click below to explore case studies that demonstrate how BPS’s systems strengthening approach has brought together a fragmented HIV prevention landscape to establish a nimble, locally led HIV prevention system capable of detecting and targeting disease risks, generating demand for HIV prevention services, engaging communities, delivering prevention products and interventions, and supporting sustained use of prevention tools and products.