Analysis of policy for protection of HIV positive adolescent girls against vulnerabilities faced in using contraception in Malawi.
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Date
2022
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Abstract
There are challenges faced in accessing and using contraception by adolescent girls, but the
reality is worse for adolescent girls living with HIV. Thus, it is important to investigate the
extent to which current policies in Malawi put into account the vulnerabilities faced by this
sub-population.
This study therefore sought to answer the following research questions:
1. What are the structural and socio-cultural issues affecting the use of contraception
among AGLHIV in Malawi?
2. What policy provisions are in place in Malawi to address the issues/risks faced by
AGLHIV during reach and use of contraception?
3. What implementation challenges affect the effectiveness of the available policy
provisions?
This study was guided by the healthy policy triangle (HPT) framework and it was qualitative
in nature, using both secondary and primary data collection methods. The findings include;
• Access to contraception by adolescent girls living with HIV is hampered by several
structural and socio-cultural issues, mainly; the mode of service provision, supply chain
and infrastructural challenges, age restrictions, conditioned access, as well as
integration challenges. The socio-cultural issues include; the high momentum for
children, male dominance, social labelling, non-disclosure of HIV serostatus to sexual
partners, social sensitivity, perpetuation of harmful content, and a general lack of social
support, and poor risk perception.
• The available provisions include those addressing gender-based violence,
discrimination and stigma, community engagement, confidentiality, and emphasis on
adolescent girls and young women. However, most of the provisions are broadly stated
and gaps exist too.
• Effective implementation is affected largely by cascading challenges, lack of sufficient
funding, limited political will, low comprehension of policy directives, limited
participation of target population, coordination challenges, social resistance, effects of
decentralization, low capacity of implementing partners and the slow pace of behaviour
change among the targeted population and communities.
While the policy environment in Malawi is seemingly favourable, undertones exist around
harmonization, and representation of interest groups, mainly PLHIV groups. Policy makers
ought not to continue ignoring the importance of formulating HIV-sensitive policies which can
give way to social protection programs for the most vulnerable within the society, given the
benefits of a healthy youthful population.
Description
Doctoral Degree. University of KwaZulu-Natal, Durban.