Malawi
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About Malawi
Malawi is one of the poorest countries in the world, where nearly 3 out of 4 people live on less than $2 a day.
As the climate changes, Malawi’s rainy seasons have become more irregular — and everyone suffers the consequences in a country where more than 80% of the population relies on agriculture. Harvests that farmers have depended on for generations are no longer guaranteed. And when harvests fall short, families struggle to find enough to eat. When the rains do return, the risk of already rampant water-borne diseases like malaria increases.
The health of the nation hangs in the balance. Malawi has made great strides in addressing challenges in the past decades, but there is still work to be done. More than one-third of all children under 5 are stunted by malnutrition, and high rates of tuberculosis and HIV put the population — particularly women — at great risk.
The Challenges
High incidence of HIV and TB
HIV/AIDS is the top cause of death in Malawi. Although AIDS-related deaths have been cut in half since 2010, the country still has one of the highest rates of HIV in the world, with 1 million people living with HIV. More than half of them are women, and young people are at highest risk.
In 2018, new HIV infections among young women ages 15–24 were more than double those among young men. Only around 40% of young people have been reached with information on how to avoid HIV, and nearly 1 million children in the country have lost one or both parents to AIDS. Orphans and those caring for them are less likely to access health care, less likely to remain in school, and are more vulnerable to abuse and neglect.
HIV is the most serious risk factor for developing TB: About half of people in Malawi with TB are also infected with HIV. In 2017, 1 in 10 people in Malawi had TB.
High maternal, infant, and child mortality rates
Malawi has made tremendous progress in reducing maternal, child, and infant mortality rates in the past two decades, but the numbers are still too high — particularly for mothers, at 349 deaths per 100,000 live births.
The combination of HIV/AIDs, infectious diseases, malnutrition, and limited access to health care puts all Malawians at extreme risk — but especially its youngest. Nearly 40% of children are stunted by malnutrition — a challenge felt across the country, but most intensely in rural areas where poverty is more extreme and food supplies more limited. Almost one-quarter of all preventable child deaths are related to undernutrition.
Bringing HOPE to Malawi
Our history in Malawi
Project HOPE has worked to improve the health and survival of mothers and children in Malawi for more than 30 years. In 1996, we joined the fight to curb HIV/AIDS with workplace and cross-border interventions, along with programs that address TB and HIV co-infection. Our work has also included efforts to control malaria and increase access to cervical cancer screenings.
Reducing the risk of HIV
Through the USAID-funded One Community program, HOPE takes a multi-faceted approach to effectively address and prevent HIV among some of the country’s most vulnerable populations: orphans and vulnerable children, their caregivers, adolescent girls and young women, fishing communities, and people living with HIV.
We train community leaders to increase access to high-quality HIV prevention, care, and support services. Leaders also encourage best health practices within their communities, while HOPE works to strengthen the capacity of Malawian organizations to implement prevention, care, and mitigation efforts.
In addition to helping people get tested and access health services, we engage communities through mother care groups, village savings groups, and business training. Many Malawians are only unable to access health services because they can’t afford them. That’s why we connect them to the business skills and loan support needed to earn a better living.
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We also teach parenting skills and facilitate safe spaces, bringing people together to learn how to better care for their families and break down stigmas about the illness. By offering 360-degree care, HOPE strengthens entire communities around the collective fight against HIV.
Addressing the incidence of TB
Since 2006, HOPE has supported the National TB Program to increase access to TB diagnosis services. We train health and lab workers, improve diagnostics, and increase access to case detection and treatment.
In 2011, Project HOPE implemented the TB REACH project to increase the detection of TB and drug-resistant TB among people living with HIV, utilizing the new diagnostic technology, GeneXpert. Traditional methods of TB diagnosis can be unreliable and take weeks to get results, particularly among people living with HIV and people with drug-resistant TB. GeneXpert conducts rapid molecular testing, providing diagnosis of TB and drug-resistant TB in a matter of hours.
Our Impact
HOPE is empowering Malawi’s most vulnerable communities around the collective fight against HIV.
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Since 2016, we have trained more than 2,000 community leaders and reached more than 159,000 people with HIV testing and counseling services to accelerate progress toward the UN’s 90-90-90 targets.
We have also reached more than 113,000 orphans and vulnerable children and their caregivers through the One Community program, supporting families in building resilience, breaking out of poverty, and better managing and protecting their health for the long term.
Our efforts to improve access to TB diagnosis services using GeneXpert machines increased the detection of TB cases in intervention districts by 21%.
