Engaging city councilors to address social and structural drivers of HIV in Blantyre City: A formative study

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Date
2021-11-04
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Kamuzu University of Health Sciences
Abstract
Introduction: The 2020 National AIDS Commission’s HIV epidemiological estimate in Malawi, has shown that Blantyre City is leading in terms of proportion of People living with HIV (PLHIV) (10%), despite its contribution to only 4.5% of the national population in Malawi. In addition, Blantyre is also among the top Districts with the highest numbers of new HIV infections. Although the Government of Malawi, in partnership with external partners and stakeholders have made efforts to address HIV epidemic in Blantyre and Malawi in general, interventions are largely biomedical. Little emphasis is placed on addressing the social and structural drivers of HIV infections in Blantyre and identifying strategies to address such factors. Problem: More investments are directed towards addressing the biomedical risks of HIV infections compared to the social and structural drivers of HIV infections in Blantyre. In addition, there are gaps in coordination of HIV programmes in Blantyre City. Although City councilors have the potential to provide oversight and support coordination of HIVprogrammes in their Wards, they are not optimally engaged and utilized and are largely excluded from HIV coordinating. Objectives: The broad objective of this study is to identify gaps and opportunities for engaging councilors to address social and structural drivers of HIV in Blantyre City. The specific objectives are as follows: (1) To describe councillors’ and other stakeholders’ awareness and understanding of social and structural drivers of HIV infections in Blantyre; (2) To describe councillors awareness of their current and potential roles and responsibilities in addressing the social and structural drivers of HIV; (3) To describe the councilors’ awareness of the types of data or information needed for effective mobilization of resources to support the implementation of interventions that address the social and structural drivers of HIV; (4) To describe councilors’ and other stakeholders’ perspectives on the existing opportunities and challenges in addressing the social and structural drivers of HIV in Blantyre City; and (5) To describe the councillors’ and other stakeholders’ views regarding the establishment of a councillor’s working group aimed at addressing the social and structural barriers of HIV in the City. Methodology: A descriptive qualitative study will be conducted involving in-depth interviews with City councilors and representatives from District HIV and AIDS coordinating committee (DACC), City AIDS coordinating committee (CACC), developmental partners working on HIV programmes in Blantyre, and community leaders. We will purposively sample 50 participants as follows: 20 City councilors, 8 representatives from DACC, 8 representatives from CACC, 4 developmental partners working on HIV programmes in Blantyre, and 10 community leaders. Data collection will be conducted between November and December 2021. In-depth interviews will be conducted in Chichewa language, with flexibility of using English and using an open-ended interview guide. Interviews will take about 45-60 minutes to completion. Audio files will be transcribed verbatim, while translating directly from Chichewa to English, and data will be analyzed thematically using framework analysis method, and with the aid of MAXQDA software. Expected findings: Findings from this formative study will inform the design of a structural risk reduction working group, comprised of City councillors, that can effectively address the social and structural drivers of HIV in Blantyre City.
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formative research HIV
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