Matt Hackworth, Director of External Relations at IMA World Health discusses how IMA engages faith leaders and community-based leaders to educate people about HIV in Malawi at the CCIH 2018 Conference.

1. The Power of Partnerships:
Leveraging Community-Based Groups
to Increase the Prevention of Mother-to-
Child Transmission of HIV
in Rural Malawi

2. RELIGIOUS LEADERS TRAINING
ON
PREVENTION OF MOTHER-TO-CHILD
TRANSMISSION (PMTCT)
COMMUNITY MOBILIZATION
Hosted By
MANERELA+, IMA World Health, EGPAF
April 11 – 12, 2017

3. AIDSFree Project
Strengthening High Impact
Interventions for an AIDS-free
Generation (AIDSFree)
PMTCT Activity
Dedza District, Malawi
May-November 2017

4. About AIDSFree
• The Strengthening High Impact Interventions for an AIDS-free
Generation (AIDSFree) Project aims to improve the quality and effectiveness
of high-impact, evidence-based HIV and AIDS interventions in order to meet
country-specific goals and objectives
• Funded by USAID and implemented by a consortium of 8 partners (JSI, Abt
Associates Inc., Elizabeth Glaser Pediatric AIDS Foundation, EnCompass
LLC, IMA World Health, the International HIV/AIDS Alliance, Jhpiego
Corporation, and PATH)
• Works globally, mostly in Sub Saharan Africa
• IMA World Health’s role on the project is faith based health systems
strengthening, community engagement and CSO capacity building
• Period of performance: July 22, 2014 – July 21, 2019

5. Purpose : WHAT
Technical Assistance to build the technical competence and organizational capacity
of Civil Society Organizations’ (MANERELA+) in community mobilization in PMTCT
through faith engagement
Objectives : WHY
• Strengthen the capacity of MANERELA+ and its network in community
mobilization for PMTCT
• Increase community knowledge of PMTCT services
• Increase demand, uptake and retention of mothers/baby pairs to PMTCT
services
Approach : HOW
Partnership Religious leaders

6. Our FBO Partners
MANERELA+ (Malawi chapter of INERELA+)
CHAM (Christian Health Association of Malawi)
Community Linkages
Interfaith AIDS Alliance (Dedza)
Mentor Moms and Peer Educators (participants in a
Global Fund project also underway in Dedza)

7. Context
FRAMEWORK: UNAIDS 90-90-90 Goals
FIRST: 90% of HIV+ people know their status
NEXT: 90% of these receive ART
THEN : 90% of these achieve viral suppression
NEED: 90% of HIV+ pregnant women in Malawi go on ART …
BUT… gaps in identifying and in retaining mother-baby pairs
(50% retention, compared to 85% national target).
OPPORTUNITY: Malawi is 90% Christian. Religious leaders
have considerable social capital.

8. 4-Pronged Strategy
• 1. Engage local health facilities to receive
referrals and share PMTCT service delivery data
• 2. Train religious leaders as PMTCT advocates
and mobilizers
• 3. Facilitate coordination with other community-
based actors
• 4. Provide monthly supervision & group process
for RL cadre

9. 1. Engage Health Facilities
• Two faith-based HFs in the CHAM network
(Mua, Mtendere) were directly engaged
• Two government facilities (Lobi,
Mtakataka) also provided data

10. 2. Train religious leaders as PMTCT
champions
• Local interfaith AIDS group identified 20
religious leaders to participate:
– 10 Christian, 10 Muslim
– 10 male, 10 female
– Range of ages

11. • 3-day workshop conducted in April :
– Charging religious leaders as PMTCT advocates &
mobilizers (MANERELA+)
– PMTCT technical sessions (EGPAF, with Assistant PMTCT
Coordinator, Dedza District)
– Community coordination visit
– “Framework for Dialogue between Religious Leaders and
People living with HIV” (MANERELA+)
– “10 Key PMTCT Messages for Religious Leaders”
(facilitated by IMA)
– M&E for RL participants and health facilities (CHAM)

12. TOPICS included:
Why data matter
What the
project will track
What the
“PMTCT
Champions” will
record
What we hope
to learn
M&E Session for
RLs and HFs

13. Community Meeting, Mtendere
• Religious leader cadre
• Health facility
management and staff
• Health Advisory
Committee
• “Mentor moms”
• “Peer educators”

14. “10 Key Messages”
• S = Safer Practices
1. With PMTCT, an HIV-positive woman can give birth to an HIV-free baby.
2. HIV-positive pregnant women need the support of their male partners and
family members to encourage them in PMTCT.
3. Good nutrition is important for all pregnant mothers, even more so if HIV-
positive.
4. Exclusive breastfeeding for 6 months is the best plan for all babies,
including babies of HIV-positive mothers who stay on ARVs.
5. Importance of family planning.

15. “10 Key Messages”
• A = Access and Availability
6. All HIV-positive individuals should begin treatment as advised - and STAY
on treatment faithfully. This is a very important intervention for prevention of
mother-to-child transmission of HIV.
• V = (Voluntary) HIV Testing and Counseling/Self-
Testing
7. All pregnant women should go to ANC and get tested for HIV. Their male
partners should be tested as well.
8. Exposed infants should be tested for HIV.

16. “10 Key Messages”
• E = Empowerment
9. HIV is a disease, not a curse. Stigma and discrimination must
end.
10. An AIDS-free generation is possible if we work together with
other community actors. RELIGIOUS LEADERS HAVE A VERY
IMPORTANT ROLE TO PLAY!

17. Achievements
• Mobilization of diverse group of RLs who utilized
a range of activities for outreach
• Male involvement
• Coordination with health facilities and
community groups
• Draft PMTCT Addendum to SAVE Toolkit
• Sustainability plans

18. Data, May-Nov 2017
• Community level data collected through
RL activity reports and referral tracking
>11,000 people reached with HIV messages
• Facility level data collected in registers and
analyzed with facility staff monthly
> 2,700 women tested during antenatal care (ANC) with
42 (1.52%) positives

19. 1282
1515
546
366
534 504
1999
1914
850
479
677 667
0
500
1000
1500
2000
2500
June July August September October November
#ofPeopleReached
Month
COMMUNITY DATA: OVERALL SUMMARY; # of
People Reached
Jun - Nov 2017, n = 11,333
Male
Female
Linear (Male)
Linear (Female)

20. Challenges!
• Brief implementation period
• Participant recruitment process
• Small budget
• Tracking referrals

21. Some Project Take-Aways …
• Religious leaders are effective educators and mobilizers
for HIV/AIDS activities
• Relating to congregations and to couples, RLs can
encourage male engagement in PMTCT
• The RL who takes on such a role also benefits, gaining
skills, knowledge, community recognition
• Mechanisms for ongoing support and monitoring are
important to address issues and sustain momentum

22. Some Project Take-Aways …
• Linkages are can provide benefits at many levels.
– Community actors may not know what others are doing and thus
miss opportunities to coordinate, reinforce, learn from each
other, reduce duplication of effort.
• Even small-scale, short-term efforts can build enough
interest and momentum to present opportunities for
sustainability.

23. Thank You!