Analyzing Health Promotion: HIV Prevention Strategies in Malawi

This essay critically examines the health promotion needs in Malawi, focusing on the prevalence of HIV and the factors contributing to its spread. It explores the current influences on the problem, including unprotected sex, poverty, and lack of awareness, particularly among young people. The essay analyzes existing policies and interventions, such as HIV education, condom distribution, prevention of mother-to-child transmission, and voluntary medical male circumcision, while also addressing the barriers hindering their effectiveness, like limited resources, poor education, and community resistance. The study concludes by suggesting potential health promotion interventions to improve HIV prevention and control in Malawi, emphasizing the need for increased awareness, better access to healthcare, and addressing socio-economic factors.

Promoting Health

TABLE OF CONTENT
INTRODUCTION...........................................................................................................................3
Health promotion need in Malawi...............................................................................................3
Current influences on this problem..............................................................................................4
Current policies for preventing people from this health issue (612)...........................................6
Current barriers to addressing this health issue in policy............................................................8
Potential health promotion interventions to address this issue....................................................9
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................12

INTRODUCTION
Health promotion is a process of making people able to control over and improving their
health (Jennings and Bamkole, 2019). This present study is based on Malawi, a landlocked
country in South-eastern Africa. Today, this part of South Africa has multi party republic and
democratic and it is among the world’s least developed country and health issues in this country
is increasing mortality rate. This study is going to discuss prevalence of HIV in this country and
reasons of increasing HIV rates. It will further discuss some current HIV prevention policies
such as: availability and usage of condoms, sex education to adults and others. Along with this, it
will show some barriers by which all these current policies of Malawi become fail such as:
poverty, lack of availability of resources and others. It will then suggest some better strategies by
which Malawi can decrease HIV rate and can prevent people from this health issue.
Health promotion need in Malawi
Health promotion refers to the procedure that has been taken in account in order to add
effectiveness in the health. In has been found from various research that, in Malawian, the public
is highly getting affected by the HIV (Yarchoan and Uldrick, 2018). It has been considered as the
sexually transmitted diseases that leads to pass the infection from one person to another after
having sexual contact. As the healthcare specialist suggest that, the proper health treatment in
needed in order to treat HIV. As it leads to create AIDS in the individual. In Malawian, young
people are at high risk due to the increasing rate of HIV. The 60% of the population in Malawian
is not even aware about the prevention of the HIV. Therefore, the rate of this diseases increasing
on a high note. Thus, it is mandatory to have the health promotion in the Malawian.

The country is highly close in touching the highest rate of having HIV positive patient in
the world. The youngsters of the country are getting concerned with the HIV diseases on a high
not. Major issue in the country is that, there is no major step has been taken in relation on
creating the awareness regarding the diseases (Alonso and et.al., 2019). The HIV has been
considered as one of the deadliest and highly infected diseases from all the infectious diseases.
Hence, the health promotion is needed in the nation in order to make aware about the causes of
the HIV to the people and along with this for determining the precautions to them.
Current influences on this problem
As from the above discussion, it is found that Malawi is suffering from both communicable and
non-communicable diseases and it is evidence by high level of child mortality rates. It is found
that 18.17% of deaths happen in this state because of HIV/AIDS. Malawi’s HIV prevalence is
one of the highest in the world as around 9.2-9.5% of adult population live with HIV.
Whom it is impacting: In regard to this health issue, it is found from secondary data that
HIV epidemic is affecting the general population and certain high risk group. As with the name
of disease itself, it can be said that unprotected heterosexual sex between married as well as co-
habiting partners is one of the main reason as it accounts for the majority of all new HIV

infection (Sasse, 2020). Other than this adolescent girls and young women, sex workers and men
who have sex with men are more exposed and vulnerable to HIV.
In addition, it is also found that HIV epidemic in Malawi varies geographically as 4.9% of adults
are living with HIV in the Central East region to 17.7% of adults with HIV in Blantyre city. In
urban districts of Lilongwe and Zomba as well as Southern region of this country has also high
prevalence of HIV. Cyclone Idai and Kenneth in the month of April and May of 2019 caused
huge damage in Malawi as it has lead widespread flooding. It has increased the rate of HIV
because people were finding difficulties in accessing healthcare services or treating HIV.
Women and girls were exposed to gender based violence the great extent at this time (Umar and
et.al., 2019).
Overall, it can be said that HIV disproportionately is affecting women in Malawi. On the
basis of survey report, done by the Malawian ministry of health in the year of 2015-16, it is
found that adult women or women with the age group of 15-64 are more likely to be affected.
This age group of women are to be 12.8% affected as compared 8.2% men. This disease is
prominent among 25-29 years of people. New HIV cases have been seen among 15-24 age group
of people in the year of 2019.
Why it is an important issue: HIV infection is caused by human immunodeficiency virus
and people can get this disease when they come in contact with infected blood, vaginal fluids and
semen. Most of the people get affected with this disease and virus by having unprotected sex
with someone who has HIV. As it is known that around 38000 people newly diagnosed with HIV
in the year of 2018 (Thiabaud and et.al., 2020). As it is also known that around 60% of young
people of this country do not have sufficient knowledge about this disease and ways of
preventing this.
In regard to this disease as an important issue, it can be said that this disease takes a toll on
the body over time and put people who are affected with HIV at greater risk for health conditions
such as: kidney disease, cardiovascular, bone disease, liver disease and diabetes. Along with this,
it is also found that South Africa is the poor country as about half of the world’s people, living in
extreme poverty live in sub-Saharan Africa. So, on the basis of this data and reason it can be said
that HIV is an important issue that needs to be considered and decreased otherwise, it may
increase death rate, mobility rate and lower life expectancy (HIV and AIDS in MALAWI, 2020).

The scarce money is usually not enough to be protected by condoms from infection as it let alone
for an HIV test. Overall, it can be said that this health issue is increasing mortality rate.
Current policies for preventing people from this health issue
As it is known that one of the main causes of this problem or health issue is lack of
awareness and poverty. So, by considering this factors, government has made poverty reduction
policies. By establishing poverty alleviation programme and developing poverty reduction
strategies, it has supported people in preventing with this issue. It has provided fund to
associated institutions of highly poor state and districts. People have found easier in getting
healthcare service or access and getting proper treatment (Wong and et.al., 2017). It is found that
Malawi’s population is diverse in ethnic group, religion and language as there are around 9
indigenous grouping and smaller number of Asians as well as Caucasians. Some objectives of
this governmental initiative and policies, developed for preventing people against HIV include:
 Improving delivery of prevention, care and treatment.
 Preventing HIV infection.
 Decreasing impact of HIV on family, communities and individuals.\
 Decreasing societies vulnerability to HIV and improving life expectancy.
 Strengthen multi-disciplinary institutional framework for successful implementation of
HIV programme.
Some other HIV prevention programmes that have been developed in Malawi include:
HIV education and approach to sex education: Raising awareness about ways to
prevent HIV is one of the main important part of Malawi’s prevention strategy. This is an
important subject covered in life skills education for those young students who are in school and
out of school. Life skills education (LSE) subjects include promotion of mutual faithfulness and
using both male as well as female condoms. On the basis of data, it is found that still, there are
number of adults who have not participated and attained this subject. As target of 150,000, only
53,600 young out of school had received this education or attained this subject. There are some
factors that has affected success of this program such as: poor teaching conditions, lack of
community support for sex education and hesitation as teachers feel inappropriate to teach sexual
education to 9-10 year olds (Chirwa, 2020). For this purpose, people and media started using
radio for increasing awareness. Health policy plus is helping out young people in producing local

weekly radio programs on family planning and HIV. Still, it can be said that this program has not
increased awareness among people to the great extent.
Condom availability and use: Provision of free condom is also one of the main
elements of Malawi’ national HIV prevention strategy. As per the survey and data, it is found
that around 77 million male condoms were required to meet needs in this country and due to
poverty, 55 million among this estimated number, needed to be supplied by the public sector. It
is believed that by increasing usage of condom by Malawian women can lower high risk sex and
HIV at 50%.
Prevention of mother to child transmission: Transmission of HIV virus from affected
HIV mothers to infants can also increase HIV rate. So, for this purpose and preventing this rate,
mothers have been provided with prevention of mother to child transmission services. This
strategy has become successful as this country has implemented Option B+ approach. As per this
approach, all pregnant women, living with HIV have been offered antiretroviral treatment as it
can prevent transmission of HIV virus from mothers to infants. This program and strategy has
great positive impacts (Hassan and et.al., 2021). As of 2018, around 95% of pregnant women,
who tested HIV positive were on treatment. So, on the basis of this data, it can clearly be said
that this current policy has decreased HIV rate to the great extent.
Voluntary medical male circumcision: It is other main effective and current HIV
prevention strategy that has become National prevention strategy. Availability of this VMMC
has been increased in the year of 2012. In the year of 2018, around 199,405 circumcisions were
done. But there are number of factors that have created barriers in achieving targeted number of
circumcision such as: doubts and misconceptions about efficacy of this, lack of knowledge and
others. But it has been stated by associated institutions that this VMMC is one of the guaranteed
protection against HIV. so, in this context, it can be said that people needs to be made aware
about this by which HIV rate can be decreased in this country and life expectancy can be
increased.
Overall, it can be said that Malawi and government of this country wants to prevent HIV
infection and to decrease HIV vulnerability. In addition, it has invested in provision of treatment,
care and support for people who are living with HIV and AIDS (Geter, Herron and Sutton,
2018).

Current barriers to addressing this health issue in policy
On the basis of above discussion, it can be said that Malawi put great efforts in preventing
HIV and improving life expectancy. But there are number of factors that have created barriers in
successful implementation of current HIV prevention policies in this country. Some common and
main factors include; poverty, lack of resources availability, poor education, poor support of
community service providers and violence behaviour of male partners in abusive relationship.
Limitations
There are number of factors that have created barriers in successful implementation of HIV
policies in Malawi. Some factors that have created barriers include: fewer financial resources and
South Africa is the poor country and economic condition of this country is not good. There is no
doubt as government provided funds but still there is requirement of heavy investment in
providing care and support to people living with HIV. Other main barrier is: Poor availability of
healthcare resources in some of its area, violent reaction from partners towards women in
abusive relationship, less access to transportation and low literacy (Topp and et.al., 2020).
Along with these, it is also found that people in this country or state have poor physical and
emotional support to women. As due to lack of education, male partners do not support their
female partners if they are diagnosed with this disease and lack of support increase mental and
emotional problem. Due to hesitation, women are less likely to go for treatment. Overall, it can
be said that lack of education and poverty are main reasons of unsuccessful implementation of
policy.
Along with these, there are number of barriers to successful implementation of current HIV
prevention policies and practices in Malawi such as:
Fewer financial resources: As it is already discussed that Malawi is one of the poorest and
the least developed country. So, on this basis, it can be said that poor economic condition of this
country is making difficult for public institutions and government to successful implementation
of HIV prevention. Having proper financial resources and funds is vital. Health care providers do
not have proper resources by which they can provide treatment and services to people, living
with HIV. Due to poverty, people find difficulties in using condoms and due to this, prevalence
of HIV is increasing but due to poor economic condition, government also finding difficulties in
providing condoms at free of cost. So, it is one of the main barrier to successful HIV prevention
policies.

Violent reaction from partners: It is found that due to violent behaviour of male partners,
it becomes difficulty for female partner to resist their sexual behaviour. females are being taught
that they need to abide everything, stated by their partners otherwise, it may affect their marriage
life (Kutcher and et.al., 2019). As number of females of Malawi are not educated so, they find
difficulties in identifying the different between the wrong conduct and right conduct. Due to this,
they become unable to resists their partners and this aggressive violent sexual behaviour become
the main reason of HIV and barrier to successful implementation of current policies.
Lack of emotional support: Poor support by community service providers to such
responsible institutes and female population is one of the main other barrier. Along with this,
female population find difficulties and has fear of telling their family about HIV because of
negative and wrong perception of people towards this health issue. This hesitation and lack of
support makes it difficult for government and associated authorities to implement effective HIV
prevention policies in a successful manner.
Overall, it can be said that there are number of additional factors along with poverty and
lack of education that are creating barriers to successful current HIV prevention.
Potential health promotion interventions to address this issue
On the basis of above discussed barriers, it is found that lack of education, financial
resources availability and poor emotional support are affecting successful implementation of
HIV prevention. So, by considering these factors, it can be suggested to Malawi that they should
implement 2 main interventions such as:
Behavioural: Behavioural interventions address cultural context in which risk behaviours
regarding HIV occur such as: violent and aggressive behaviour of people, fear among women
regarding telling about this health issue. Some appropriate behavioural interventions that can
decrease HIV rate in Malawi include: information provision such as: educational programs by
which adults and women can be made aware about this and making them feel comfortable with
this (Mwale and Muula, 2018). It can decrease fear and hesitation that they have about HIV. Safe
infant feeding guidelines as it can also prevent mother to child transmission of HIV virus.
counselling and other psycho social programs by which partners with violent behaviour can be

made aware about consequences of this behaviour. By changing behaviour of people of this
country towards this health issue, prevalence can be decreased and it can also help out in
increasing life expectancy.
Biomedical: Biomedical interventions use a mix of medical and clinical approaches to
decrease HIV transmission. One of the best and guaranteed example of biomedical intervention
is male circumcision. This simple medical process can decrease the risk of HIV transmission by
up to around 50-60% at the time of unprotected heterosexual sex. It is believed that for
preventing HIV in an effective manner, biomedical interventions should be implemented along
with behavioural interventions. For example: If someone or male is circumcised then he should
be tested with HIV often and should be given counselling as well as education about using
condoms and safe sex. It can prevent people or adult women from HIV and can decrease
mortality rate (Rutstein and et.al., 2019). some common and effective examples biomedical
interventions include:
 Sex as well as reproductive health services.
 Using male and female condoms
 Antiretroviral drugs by which transmission of HIV virus from mother to infants can be
decreased.
 Continuous HIV testing and counselling to people who are not educated.
 Opioid substitution therapy
 Blood screening
On the basis of above discussed interventions, it can clearly be said that Malawi can decrease
prevalence of HIV and can improve living standard of people.
CONCLUSION
It has been summarised from the above study that educational and health awareness
programs play a vital role in improving health of people and decreasing health issues. It has
discussed number of factors that are increasing HIV cases in Malawi. Lack of education and
poverty are main factors that have been discussed in the study in a detailed manner. It has further
discussed effectiveness of HIV education and approach to sex education and ways in which this
program can help out young people in understanding ways of preventing themselves against
AIDS and HIV. Availability of condoms and prevention of mother to child transmission are

some other effective HIV prevention strategies that can also decrease prevalence of HIV in
Malawi. Along with current HIV prevention strategies, it has shown some barriers or factors that
have become reasons of failure of implementation of current policies. It has further suggested
some effective ways and policies that can decrease this HIV rate and can increase life expectancy
of people.

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ONLINE

HIV and AIDS in MALAWI. 2020. [Online]. Available Through <
https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/malawi>