Results from the final year of pilot project Thandizo shows increased adherence to HIV treatment and decreased stigma among young people living with HIV in Malawi. Contributing to these results are the refresher trainings for support group leaders and community health volunteers, and young people engaging in small-scale businesses enabling them to make a living and better look after their health.
The Thandizo approach supports young people to better adhere to their HIV treatment by strengthens support group systems and the use of a digital app. A young person says: “Through the app, especially the videos and animations, we also learn that we can even be in love and get married.”
Refresher trainings
40 community health volunteers and 174 support group leaders have received a refresher training and team building exercise. This has given them a better understanding of their role and equipped them with more tools and knowledge to better support young people living with HIV.
In addition, 20 support group leaders of 7 existing support groups were newly trained. This expansion has led to support group leaders being able to better support more young people living with HIV.
Business development
In multiple support groups, young people have decided to engage in income generating activities. They’ve started vegetable gardening, juice making, tailoring and livestock farming, among others. To raise skill level for their own small-scale businesses, 28 young people were trained, enabling their support groups to run a business, increase income and, with their own yield from gardening, to improve their nutrition. Healthy food is important for maintaining HIV treatment.
Steep growth in support group members
At the start of the Thandizo pilot project, in 2019, the support groups had 247 members. Now, close to 3000 young people attend these groups and new groups had been established. This means many more young people living with HIV are supported. They know more about living with HIV and the importance of treatment, they have more confidence and self-worth, they feel less of a stigma surrounding HIV and see a future of living a healthy life.
Testimonials show what positive impact the Thandizo approach has had on young people. “The mental health support is so helpful that we no longer commit suicide…in fact we do not have cases of suicide among youth since the coming of Thandizo App,” said a focus group participant in Mangochi. A young person in Chikwawa tells us their outlook on a bright future: “Through the app, especially the videos and animations, we also learn that we can even be in love and get married. This excites us because before we started learning through the Thandizo App, each one of us thought being on ART, we would never be able to fall in love again.”
2022 was the last year for the pilot programme of Thandizo. Because of successes managed in this pilot, for 2023 to 2025, Aidsfonds and the Coalition of women Living with HIV and AIDS plan to expand best practices beyond Chikwawa and Mangochi, with the cities Blantyre, Nsanje and Mulanje. Peer educators will be trained and young people living with HIV in these areas can join local groups for support. Local and regional governments will be involved to increase the approach’s effectiveness and to ensure sustainability.
A response to lack of adherence to HIV treatment
The Thandizo approach was set up in response to a lack of adherence to HIV treatment among young people living with HIV in Malawi and rolled out in the districts of Chikwawa and Mangochi. They experience a lot of stigma, which discourages them, and they feel they don’t have enough of a support system in their communities. A 24-year-old in Chikwawa tells us: “Previously, we did not know how good it is to belong to a group of like-minded people and share ideas and experiences. We did not think that disclosure would bring peace and help one to live happily despite being on ART.”
Thandizo in practice
To resolve this lack of adherence the community support groups system was strengthened and an app was developed. In the support groups, led by peer educators, with support of community health workers, young people receive necessary health information and they can lean on each other and get support from their peers. .
During these group sessions as well as during individual talks with a community health volunteer the Thandizo app is used. The app contains animated video’s, tips, advice and topics that are great jumping off points for both group and individual discussions. Italso refers young people with concerns or issues to the appropriate health services. The app was designed in co-creation with young people themselves, so the content is directed at young people, to make them feel understood.
As of December 2022, Malawi has a population of 18,352,000. Of the total population, 984,572 people in Malawi are living with HIV. Of this number, 51,764 are young people. 920,226 of these people are on treatment, making this 93% treatment coverage. Malawi aims to end AIDS as a public health threat by 2030. To reach this goal, treatment coverage must be raised to 95%.
The Thandizo approach was developed and implemented by Aidsfonds and the Coalition of women Living with HIV and AIDS in Malawi. Are you interested in partnering with us on the Thandizo Approach project or do you want to know more about the approach? Feel free to contact Leon Essink, project manager Thandizo at Aidsfonds, or download the pilot evaluation 4-pager.
The Thandizo approach supports young people living with HIV to adhere to treatment. It is a combination of support groups and a mobile app. This online application is used by Community Health Care Workers and peer educators. At the same time, the app collects data of responses, which supports health facilities to adapt services based on the needs of young people with HIV.
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