Malawi

For a summary of MCHIP work that has ended in Malawi, click here.

The SANKHANI Moyonela Program

  • Start and end dates: July 2013 – July 2017
  • MCHIP Partner Involved: Jhpiego

Key Partners in Country: Ministry of Health (MOH), Christian Health Association of Malawi (CHAM), village leadership and communities, the National AIDS Commission, HIV Unit and District Health Management Teams, and other donors.

Description of Work

The SANKHANI Moyonela program—also known as “Smart Choice”—aims to scale up voluntary medical male circumcision (VMMC) services for men aged 15- 49 by providing 150,000 circumcisions by 2017. The program uses a multi-pronged approach that targets VMMC program strengthening, quality service delivery, and demand generation at the district and community levels to ensure rapid scale-up.

Technical Scope

  • VMMC
  • HIV/AIDS

Scale/Coverage

Three districts: Zomba, Chikwawa and Thyolo

Key Results to Date

  • Circumcised 47,225 men in the first program year. Fewer than 2% of these clients experienced moderate or severe adverse events, and nearly 60% returned to sites for follow-up visits within 14 days of the procedure.
  • 99% of these clients also underwent HIV counseling and testing prior to the circumcision procedure.
  • Supported the capacity building of the MOH, CHAM and Jhpiego staff in key areas of VMMC implementation, including clinical training.
  • Created and harmonized key VMMC monitoring and evaluation tools, leading the process to eventual national tool harmonization.
  • Developed innovative demand creation strategies to sensitize communities on VMMC.
Select Health and Demographic Data for Malawi
GDP per capita (USD) 309.73
Total Population 15,263,417
Maternal Health
Maternal Mortality Ratio (deaths/100,000 live births) 510
Percent of maternal deaths due to HIV 31.8
Skilled birth attendant coverage 73.0*
Antenatal care, 4+ visits 57.1
Newborn Health
Neonatal mortality rate (deaths/1,000 live births) 31*
Infant mortality rate (deaths/1,000 live births) 66*
Child Health
Under-five mortality (deaths/1,000 live births) 112*
Treatment for acute respiratory infection 65.7*
Oral rehydration therapy for treatment of diarrhea 70.1
Immunizations
Diphtheria-pertussis-tetanus vaccine coverage (3 doses) 93
Percent of districts with >80% DPT3 coverage 100
DPT3 coverage equity ratio (wealthiest:poorest quintile) 1.22
Family Planning
Modern contraceptive prevalence rate 42.2*
Total fertility rate 5.7*
Malaria
Vulnerable populations who slept under an insecticide-treated net (ITN) the previous night** 39.1*
Pregnant women receiving 2 doses intermittent preventive treatment for malaria 42.9
Children with fever treated with antimalarials within 24 hours 28*
HIV
HIV Prevalence, adult 11
ART coverage, adult 46
Health Systems
Density of physicians (per 1,000 population) 0.019
Density of nurses & midwives (per 1,000 population) 0.28
Total Health Expenditure per capita (USD) 19.07
Sources: Demographic information and health systems, World Bank; Newborn health, child health, DPT3 equity ratio, family planning, SBA, malaria and ANC4, Malawi Demographic and Health Survey; DPT3 coverage and percent districts >80%, MMR, ART coverage and maternal deaths due to HIV, WHO; HIV prevalence, UNAIDS 2010 Global Report
*Indicators taken from the Malawi 2010 Demographic and Health Survey Preliminary Report. All other DHS data is from the Malawi 2004 DHS. **Calculated from DHS data as number of pregnant women and number of children under five who slept under an ITN the previous night divided by the total number of pregnant women and children under five.