Malawi women empower themselves and others to expand access to HIV treatment

In Malawi, where an estimated 1 million people are living with HIV/AIDS, women living with HIV launched a campaign to build women’s leadership and organising capacity to advocate for access to safe and effective medicines and tackle stigma and discrimination, among other issues. The Our Bodies, Our Lives (OBOL) campaign – an 8,000 women-strong initiative – has mobilised to demand accountability and improve healthcare for HIV+ people. 

In Malawi, as in much of the rest of Africa, women are disproportionately affected by HIV/AIDS, often due to sexual violence. Progress that has been made on increasing access to HIV treatment is in danger of being reversed, as people discontinue their anti-retroviral medication when they see their viral loads reduced to undetectable levels, due to the medication, and mistakenly believe that they are cured. In other cases, women are discouraged from seeking the services they deserve, because they experience neglect or mistreatment in health clinics.

MANERELA+ (Malawi Network of Religious Leaders Living with or Affected by HIV and AIDS), and COWLHA (Coalition of Women Living with HIV/AIDS) – together with CMI! member JASS (Just Associates) – launched the OBOL campaign to raise awareness in affected communities, so that individuals are not misinformed and continue their life- saving treatment. At the same time, OBOL organised to engage local authorities, to work with religious leaders, and to educate healthcare workers. 

Recognising that access to medicines alone is not sufficient for maintaining health, in 2018 the OBOL campaign focused on expanding feminist literacy treatment (FTL) workshops and dialogues in 24 of Malawi’s 28 districts. With a feminist approach, these workshops apply a power analysis and centre women’s bodies – critical components missing in many treatment literacy efforts. Through the FTL trainings, women increase their understanding of their bodies and become experts in and drivers of their own healthcare. They also bring that knowledge to their communities and organisations. For example, in February, OBOL conducted a Trainings of Trainers (TOT) for 15 members, who then rolled out six more feminist FTL trainings to reach 150 women in 12 districts. 

JASS’s capacity building and advocacy interventions supported women’s leadership strengthening by enabling women to build collective power, to speak out, build constituencies, challenge power holders including traditional and religious leaders and cultivate alliances to ensure an enabling environment to further the agenda of HIV+ women and their organisations. 

Through these activities, OBOL members discovered and exposed widespread abuse of HIV+ women by health care workers. The initiative provided women with tools to report cases of patient neglect or mistreatment. The resulting exposure lead to improvements in patient care. The impact has been impressive; in Malawi there is now greater access to a variety of health services, such as cervical cancer screenings, and people living with HIV have benefited from equitable treatment access, greater social acceptance, and reduced levels of stigma and discrimination. 

In the words of one FTL participant: 

This training has given me the platform to speak out, share my story and experiences. Now I know that I am in control of my sexuality and body.

– Emily, OBOL member 

And a health provider speaks to its effectiveness: 

By the end of the training, I witnessed a room full of informed and empowered women, who were determined to make good choices for their health and collectively to challenge systems that made it difficult for them to choose healthy options.

– Dr Di Lavies, a clinical doctor, specialising in HIV. 

The role of CMI! 

With its partners, CMI! has sustained the process of strengthening the capacity and leadership of women activist leaders across Malawi. CMI! has supported the treatment literacy component by supporting the organising efforts of more than 8,000 women in developing workshops and creating dialogues in 30 district hubs. This in turn has contributed to shifting attitudes and norms toward women living with HIV and to increasing their access to improved health information and services. 

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