MULTI-SECTORAL COLLABORATION IMPROVES COMMUNITY ENGAGEMENT, SERVICE DELIVERY, AND DATA-INFORMED DECISION MAKING

Ernest Takomana

Assistant Environmental Health Officer Bangwe Health Centre,

Blantyre DHO

Leveraging baseline data collected early in the project implementation and initial programmatic learning, the BPS Consortium introduced the “Network Model” in July 2023. In 15 initial district sub-geographies, BPS has supported the establishment of multi-sectoral networks that link and strengthen multiple, fragmented channels across sectors, bring community groups into program planning and implementation, leverage network resources, and ensure data-driven, coordinated HIV prevention activities are targeted. It has been a key approach in building a unified, local management system.

Grace Kumwenda

Former Chief of Party for Pakachere

For each network, committees were formed in each cluster around the public health facility with multi-sectoral representatives, including political and community leaders, local governance and public health structures, public health clinics, private (for-profit and not-for-profit) clinics and other service delivery, community-based and civil society organizations, under the coordination of the district and city health offices. Each committee developed an action plan for the year specific to their cluster with indicators to track progress.

A central objective of the approach was to ensure that local entities are equipped to coordinate with other entities within their catchment area to ensure coordinated resource allocation and referrals. Each cluster has reported an increase in coordination between the public facility and local stakeholders operating in the facility catchment area, particularly with private facilities. The increased connectivity and linkages between all levels across the Blantyre HIV prevention system was validated by the results of the second round of the community organization mapping data collection completed in late 2023. The mapping provides a comprehensive landscape of HIV prevention services delivered by non-governmental service providers (including community and faith-based) and facilities and how these services are offered in Blantyre. The first round, conducted in 2021, showed very little in the way of linkages between community organizations and between organizations and health facilities.

Coupled with other data, the initial community organization mapping informed the launch of the network model.

Of the 154 organizations included in the second round, 92 (60%) organizations had at least one connection with another organization, while 146 (95%) had at least one connection with a health facility. Though many CSOs operate independently, some organizations work together to provide HIV prevention services in Blantyre. Of the 35 repeat organizations from both data collections, 12 increased their connections to other organizations, and 14 increased their connections to other health facilities over two years.

Figure: Network maps between CSOs and CSOs and Health Facilities in Blantyre (late 2023)

Committees also use PALMS data and their own programmatic observations to trigger actions in their communities often in partnership with the Konda Blantyre, Konda Moyo health communications campaign. Examples of collaboration include:

The Mpemba committee and “Konda Blantyre, Konda Moyo” (Love Blantyre, Love Life health promotion campaign) committee identified a hot spot within the catchment area, and the committee planned a coordinated outreach to conduct HIV testing and provision of other HIV prevention services at the hot spot in collaboration with staff from Mpemba Health Facility.
In Bangwe, Pakachere stepped in to provide 7,200 condoms to the public health center, which had run out of condoms.
In Chirimba, the Network Model committee collaborated with the Konda Moyo Konda BT committee to conduct road shows that provided health education and distributed 6,000 condoms to 15 bars.

The approach successfully demonstrated that the local management system envisioned by the project is not only possible but can thrive. It has demonstrated how multi-sectoral stakeholders can come together – under the leadership of the DHO – to use data, link service delivery, and address challenges in their communities for a more effective HIV response. The networks are the optimized system in action – capacitated with the prevention cascade capabilities and health system enabler capacities. The approach forms a framework for articulating Blantyre’s future unified HIV response in the sustainability plans and district-level toolkit.