Health & Nutrition

Facilitators of Community Transformation (FACT), with support from O’Neil Institute is pleased to invite applications for The TB/HIV Advocacy Knowledge Seminar. We are looking for prospective advocates who;

• Wish to make a difference in the lives of key populations and people living with TB/HIV
• Are committed to advance their knowledge and adopt tools for effective, evidence based advocacy work on TB and HIV at a local and national level

The knowledge seminar will be held on an annual basis for participants from Malawi with a view to developing a pool of advocates with expertise on TB and HIV in the country. The seminar is for a period of 5 weeks, consisting of 2 hour online weekly sessions.

The knowledge seminar will equip participants with:

• A better understanding of the national, international and regional treaties, declarations and guidelines that can be utilized to shape national responses to HIV and TB
• Guidance on how to use law, policy and research to promote an evidence based response to HIV and TB i.e. policy advocacy, development of policy documents etc.
• A better understanding on social mobilization for TB diagnostics (uptake of new tools)
• Examples of good practice in advocacy for an evidence-based response to HIV and TB in Southern Africa.
• Latest science and advancement in HIV and TB prevention and treatment and
• Project planning and management skills
• A certificate of completion

Please note that after completion of the knowledge seminars FACT will roll out advocacy initiatives with the successful participants, inline with their advocacy plans, and may provide small grants for advocacy and communication on TB/HIV. In addition, internet data will be given to the participants to attend the online sessions and to enable participants to access the weekly tutorial sessions.

Modules

The seminar comprises of the following modules:

• A 2 hour workshop on TB and HIV fundamentals: April 2022
• A 2 hour workshop on project management:
• A 2 hour workshop on HIV and TB prevention and treatment literacy:
• A 2 hour workshop on TB and HIV policies and guidelines in Malawi:
• A 2 hour workshop on TB/HIV advocacy and development of advocacy strategies:

Eligibility Criteria

Individuals must be affiliated with an NGO or CBO and demonstrate active engagement in TB/HIV interventions. Members of the National TB CSO Network are strongly encouraged to apply.

How to Apply

The application template must be downloaded  Here, filled in and submitted to hello@factmw.org no later than 18^th March, 2022.

Facilitators for Community Transformation (FACT) received funding from TAG to implement a project called: “Strengthening CSO Engagement on TB Preventive Therapy (TPT) Supply Chain Management in Malawi”. The project aims to reduce incidences of TB in Malawi by 2021 through increased political will and meaningful engagement of communities on the roll-out of TPT. The project, further, specifically focuses to influence the allocation of sufficient TB funding and implementation of effective TPT Supply Chain policies and processes for effective rollout to ensure 94, 000 people are on TPT by 2021 as stipulated in Malawi’s United Nations High Level Meeting (UNHLM) TPT targets.

It is envisaged that by the end of the project, access to TPT (INH, 3HP and 3HR) drugs for PLHIV and the general population with TB in Malawi will have increased; and that there will be increased implementation of TB policies and guidelines, national budgetary allocation on TPT, including PEPFAR COP21.

This report is presented out of an assignment that was aimed to conduct a desk review of the existing evidence regarding the sufficiency of TPT funding i.e., INH, 3HP and 3HR in Malawi. The consultant pooled together available literature/documentation and conducted a budget assessment to analyse the sufficiency of TPT funding with the aim of comparing funding for TPT against the number of people that need TPT. An assessment was also made to ascertain if the funding can support the procurement of TPT drugs for its effective rollout in Malawi.

VIEW REPORT

Community-based approaches have been recognized as critical to preventing and treating TB. Communities are important to the TB response, globally, regionally, nationally and locally. For example, the Stop TB Partnership recommended that ending TB by 2030 should incorporate strong coalitions with civil society and community organizations and Human Rights and Gender-Based Approaches.  A TB response with the full integrated involvement of communities will achieve a TB free status. Community-based Monitoring (CBM) is a data-driven process of drawing in, activating, motivating, capacity building and allowing the community and its representatives to directly give feedback about the functioning of public health services. In this assessment we aimed to assess the current community-based monitoring for TB in Malawi. We specifically aimed to;  (a) Map and assess the community-based interventions in Malawi, (b) describe the gender and human rights barriers and enablers in accessing the Tuberculosis services in Malawi, and (c) assess the current community monitoring and evaluation tools and processes that are in place for monitoring community-based TB interventions.

The assessment was done in Karonga, Mulanje, Zomba and Nkhotakota. The assessment used a mixed methods approach (quantitative and qualitative methods of data collection). Quantitative data was collected through a Patient survey, Provider survey and review of documents while qualitative data was collected through Key Informant Interviews (KII), Focus Group Discussions (FDGs) and case studies with relevant stakeholders and beneficiaries. Structured questionnaires were used during the Patient survey, provider survey and review of documents while Checklists were used during Key Informant Interviews (KII), Focus Group Discussions (FDGs) and case studies.

VIEW REPORT

Delegates at the Seminar

Dr. Azariah Mosiwa, Director of Programs & Strategy, FACT

On 7th April 2021, FACT, with support from OSISA, organized a health financing reforms policy analysis dissemination seminar at Golden Peacock Hotel in Lilongwe. The event was graced by various stakeholders from the donor community, Civil Society Organizations (CSOs), and members of parliament such as the UHC champion Hon. Enock Phale. The seminar was organized to disseminate findings from a health policy analysis conducted by Impala Insights, a consultant contracted by FACT. Impala Insights was represented by Arthur Chibwana who was making the presentation. Gaps in the country’s health policy and recommendations on addressing the problems in order to attain UHC were presented to all stakeholders.

By: Wanangwa Sichinga

Public Relations & Communications Officer

Date: 1^st September 2020

Venue: Malawi Parliament

Facilitators of Community Transformation (FACT), together with Malawi Network of AIDS Service Organizations (MANASO), Journalists Association Against AIDS (JournAIDS) and Christian Aid are jointly advocating for a project called sustainable health financing for universal health coverage. MANASO in its role as coordinators of CSOs in Malawi held an engagement meeting with Parliamentarian Committee For Health On Universal Health Coverage and Sustainable Financing on the 1^st of September, 2020 in collaboration with FACT, Journal AIDS and Christian Aid. The meeting was held at parliamentarian building from 9:30 pm to 11:00pm and the core objective of the meeting was to engage with the Parliamentary committee on Health regarding access to health care services in Malawi towards achieving Universal Health Coverage (UHC).  The project is being implemented in the context of the proposed health financing reforms as outlined in the 2017-2022 Health Sector Strategic Plan. The project has been designed to build multi-stakeholder engagement to enhance citizen engagement and dialogue on health financing policies and reforms. For instance, the proposed creation of the National Health Fund and the National Health Insurance Scheme which are all vital towards moving to UHC.

At present, Malawi’s sustainable health financing reforms are taking shape slowly, while many CSOs are not effectively participating due to lack of capacity, while there is a general lack of awareness on health financing reforms such those being carried out by Government. For instance, turning all central hospitals into autonomous bodies (trusts), creation of a national health fund and the NHIS. The project is very critical taking into account that Malawi’s health sector faces a lot of challenges due to wastage of financial resources due to corruption, inefficiency.  The particular project is very unique as it seeks to bring the UHC/health financing reforms closer to the general public and the civil society.

Even the smallest fee for healthcare can have a catastrophic impact on people living in poverty. For some, user fees necessitate the selling of household assets to pay for vital care, jeopardizing their livelihoods. The Ministry of Health has argued that Malawi’s healthcare fees will remain optional and that the poorest patients will therefore be protected from their impacts. Yet situations where user fees are in effect compulsory are already widespread. Lilongwe city has small number of primary healthcare centres serving an estimated total population of one million people. Each centre shuts in the afternoon, leaving patients with no choice but to pay fees for hospital-based care outside of clinic opening hours, or go without treatment altogether. For patients living close to fee-charging facilities only, bypass fees are seen simply as ‘a punishment or abandonment’

It is against the given background that a consortium of CSO’s led by Mr Maziko Matemba held a briefing with the parliamentary health committee on  the following topics/subject

• Malawi Health Financing
• Accountability on UHC
• Access to Health Services and Inclusion
• UHC Youth Involvement

1.3 Achieved Outputs and Deliverables

• Support was pledged to influence policy reform that would increase domestic financing on health inorder to achieve UHC
• There would be in increased accountability on the national budget as the parliamentary committee on health pledged to lobby for the government to make the national budget statements easily accessible online in a timely manner. This would in turn enhance budget accountability for UHC.
• Support was pledged by the parliamentary committee on health to set a motion in parliament to increase the national response to non-communicable diseases (NCD’s) through increasing budget allocation to NCD response mechanisms
• The parliamentary committee on health also pledged to lobby for the government to increase the availability of youth friendly services at health facilities such as youth corners, mental health facilities etc. and employ more youthful health personnel so that the youth are not excluded from UHC.
• There should be a review of the health act.

Strengthening Civil Society and Parliamentary TB Caucus response towards effective national TB Policy development, Implementation and oversight, necessary for the reduction of TB among Children in Malawi

TB is the world’s deadliest communicable disease. In 2017 alone, 1.7 million people died from TB (compared to 1.2 million from HIV, and 450,000 from Malaria). 10.4 million People fell ill including 1 million children globally. TB is in the top ten causes of death worldwide. It also predominantly affects people of working age, so has a serious impact on families and communities and is the largest killer of people living with HIV.

TB is a major challenge in child health in Malawi, Over half (55%) of the estimated 1 million children with TB of age 0-14 years were reported in 2017.  In 2016, Malawi registered 16,959 TB cases and childhood TB made up 8.6% of these cases. Childhood TB policy is available and the world health organization oversees the implementation of the policy, however affected communities and CSOs were not fully engaged in the policy development process which has created a gap in the implementation. The policy stipulates that the need to diagnose TB in children earlier enough for early treatment initiation using child friendly formulations. The NTP rolled out GeneXpert machines, recommended by WHO as the initial test for pediatric TB diagnosis, which will significantly improve diagnosis of TB in children compared to the old and less sensitive method based on microscopy, however this is failing to reach optimum utilization and scale up due to domestic financing challenges and weak policy implementation mechanisms, compounded by the lack of demand for accountability by the affected communities.

In addition, there exist plans by the Ministry of Health of progressing the current first-line formulation of pediatric TB drugs to a new, child-friendly formulation. However, additional support is needed to rollout these innovations, including ensuring new pediatric formulations both for active and latent TB infection are ordered, available in clinics and used. It is common knowledge that if the community affected by TB had adequate information they would be able to lobby for strong TB policies, adequate resources and development of effective community oriented programs, sufficient to addressing the needs of people affected by TB particularly children.  Annually Malawi is estimated to be missing 12000 cases of TB and only diagnosis 49% of all active TB cases (national Tuberculosis annual program report 2017). This means that there still exists a lot of infections happening within the community. The recent MDR-TB outbreak in prison is evidence enough to validate the existence of MDR-TB and TB infections within the community. Health equity in TB programming will not only contribute to the achievement of Universal Health Coverage but also improve the social economic status of communities. Communities affected by TB in Malawi often lack information regarding TB – its prevention, treatment and diagnosis. This is because Civil Society coordination platforms have not been well capacitated to take up social mobilization, awareness, education and advocacy around TB.

Therefore FACT intends to implement a project with support from EGPAF to strengthen Civil Society Organizations and Parliamentarians in response to effective TB management. Moving forward FACT is planning to convene CSOs and affected communities to develop Pediatric TB and TPT policy advocacy and monitoring strategy in 7 districts.

PROJECT ACTIVITY

• Convening CSOs and affected communities to develop Pediatric TB and TPT policy advocacy and monitoring strategy in 7 districts.

Overall Project Goal:

FACT proposes to carry out a demand creation and advocacy project to address the gaps that have been highlighted above with the goal to:

• Strengthening development and implementation of effective TB policies on management of Childhood TB, TPT implementation and scale up through implementation of tailored demand creation strategies among parliamentary committees, TB CSOs and affected groups by end of the project.

PROJECT OBJECTIVE

• Building an effective team of 70 CSO and community advocates that will roll out robust pediatric TB, TPT and TB policy advocacy strategy development and identification of key priorities.

PROJECT OUTCOME

• 70 CSOs oriented on existing pediatric TB policies and TPT
• A community mobilization and advocacy strategy on TPT and childhood TB developed

Under The Theme;

Enhancing Media Engagement for Sustainable Health Financing for Universal Health Coverage in Malawi

19^th August, 2020, The Venue at Face Forward, Lilongwe, Salima Road

Journalists Association Against AIDS (JournAIDS) and Facilitators for Community Transformation (FACT) are jointly implementing a project called sustainable health financing for universal health coverage. The project is being implemented in the context of the proposed health financing reforms as outlined in the 2017-2022 Health Sector Strategic Plan. The project has been designed to build multi-stakeholder engagement to enhance citizen engagement and dialogue on health financing policies and reforms. For instance, the proposed creation of the National Health Fund and the National Health Insurance Scheme which are all vital towards moving to UHC.

At present, Malawi’s sustainable health financing reforms are taking shape slowly, while many CSOs are not effectively participating due to lack of capacity, while there is a general lack of awareness on health financing reforms such those being carried out by Government. For instance, turning all central hospitals into autonomous bodies (trusts), creation of a national health fund and the NHIS. The project is very critical taking into account that Malawi’s health sector faces a lot of challenges due to wastage of financial resources due to corruption, inefficiency.  The particular project is very unique as it seeks to bring the UHC/health financing reforms closer to the general public and the civil society.

As part of the project’s interventions to enhance media engagement and raise awareness on the health financing reforms and the work on championing Universal Health Coverage in line with the 2017-2022 Health Sector Strategic Plan (HSSP II). The two organizations, FACT and JournAIDS conducted a media training workshop engage and drill local journalists on reporting UHC and issues around health financing reforms.

Malawi’s journalists are greatly challenged to scale up media coverage on health-related issues based on the fact, most media houses lack financial resources to help build better in depth and high-quality stories that can help shape policies related to sustainable health financing and universal health coverage and the current health financing reforms. The media are an integral part of the project and will greatly help to bridge the policy research and awareness gap on UHC issues in Malawi.

• Achieved Outputs and Deliverables

• At least a total of 15 journalists engaged and trained in the UHC processes and sustainable health financing issues in Malawi, both radio and print media represented in the workshop and made a commitment to help increase media coverage
• A follow up media monitoring visit to generate a media monitoring report based on the workshop’s output agreed and JournAIDS to lead the process

Making Our Dream Choices; Creating Sustainable Health Financing for Universal Health Coverage in Malawi

10^th July, 2020, Golden Peacock Hotel

 Journalists Association Against AIDS (JournAIDS) and Facilitators for Community Transformation (FACT) are jointly implementing a project called sustainable health financing for universal health coverage. The project is being implemented in the context of the proposed health financing reforms as outlined in the 2017-2022 Health Sector Strategic Plan. The project has been designed to build multi-stakeholder engagement to enhance citizen engagement and dialogue on health financing policies and reforms. For instance, the proposed creation of the National Health Fund and the National Health Insurance Scheme which are all vital towards moving to UHC.

At present, Malawi’s sustainable health financing reforms are taking shape slowly, while many CSOs are not effectively participating due to lack of capacity, while there is a general lack of awareness on health financing reforms such those being carried out by Government. For instance, turning all central hospitals into autonomous bodies (trusts), creation of a national health fund and the NHIS. The project is very critical taking into account that Malawi’s health sector faces a lot of challenges due to wastage of financial resources due to corruption, inefficiency.  The particular project is very unique as it seeks to bring the UHC/health financing reforms closer to the general public and the civil society.

Even the smallest fee for healthcare can have a catastrophic impact on people living in poverty. For some, user fees necessitate the selling of household assets to pay for vital care, jeopardizing their livelihoods. The Ministry of Health has argued that Malawi’s healthcare fees will remain optional and that the poorest patients will therefore be protected from their impacts.[1] Yet situations where user fees are in effect compulsory are already widespread. Lilongwe city has small number of primary healthcare centres serving an estimated total population of one million people. Each centre shuts in the afternoon, leaving patients with no choice but to pay fees for hospital-based care outside of clinic opening hours, or go without treatment altogether.[2] For patients living close to fee-charging facilities only, bypass fees are seen simply as ‘a punishment or abandonment’

Recently a project inception meeting for the project was conducted in Lilongwe which was vital as a strategic intervention to formally introduce the project to all stakeholders. The inception meeting was graced by the presence of two key legislators from the Parliamentary Committee on health and HIV represented by Hon. Darlington Harawa and Hon. Enock Phale who all stressed on the importance of the project.

Another key point was the legislators affirmed their full support to the project and called on other development partners other than OSISA to co-finance the project so that it is widely scaled up in the country for a longer duration than the 2-year time-frame. Most importantly was the fact that key stakeholders in the meeting also lauded the project as coming at the most critical time, when the Covid19 pandemic is raging which could have a negative impact towards achieving UHC progress in Malawi.

• Achieved Outputs and Deliverables

• An inception meeting conducted with at least 30 stakeholders participating and others joining virtually using the Blue Jeans virtual platform. At this inception meeting, key UHC activists and international organizations such as AIDS Health Care Foundation (AHF) also joined including the Members of Parliament from the parliamentary committee on health and HIV
• Media coverage at the inception balanced up with both Times Radio, Times Newspaper and the Zodiak Radio and TV producing stories on the event.
• Better branding and acknowledgement of OSISA as a funder at the project inception meeting reflecting good standards of branding and communication of the project, in which materials produced will be utilized to positively communicate about the project throughout its lifecycle