Enhancing the HIV Response through Social Protection

Lessons learned from the Malawi Social Cash Transfer Programme

Ms. Hyacinth KulemekaDirector, Child Development Affairs

Ministry of Gender, Children and Community Development

International AIDS Conference 2010Vienna, Austria20 July, 2010

MALAWI SOCIAL CASH TRANSFER PROGRAMME

• Began in 2006 as an HIV impact mitigation programme for OVC

• Targets households who are ultra poor and, at the same time, labour constrained– Inclusive targeting enables the programme to

reach more vulnerable groups – Typical beneficiary households include:

• Child headed • Gap generation elderly caring for OVC• Headed by chronically ill persons• Households with high dependency ratio

DIRECT IMPACT• HIV infected persons

– Self-reported improved access to ART and medicine for other HIV related illness

– Improved nutrition through diet diversification and better food security

– Self-reported longer survival times

VOICES OF PLWHA• “We are able to eat good food. I buy meat at least once

and fish twice every month. I am advised at the hospital to eat good food, which helps body building as I am on ARV treatment.” – PLWHA

• “Before the cash transfer I often get sick; every week in bed with different types of disease like headache, malaria, stomach ache but since the cash transfer, life status has changed. I am on ARV treatment now.” – PLWHA

DIRECT IMPACT• HIV affected persons OVC

– Better reported health and nutrition outcomes– Increased education enrolment and retention– Decreased child labour– Grandparents and caretakers enabled to provide

alternative care for OVC

• “With … money I can now buy bathing soap for the children, the children have stopped doing casual work, I can buy school uniforms and I can now pay school fees. I now have enough food to last for a year. The children have mats to sleep on and blankets.”

– 38 year old female caring for 6 orphans

CHILD HEALTH

HOUSEHOLD DIET DIVERSITY

HOUSEHOLD FOOD INTAKE

HIV SENSITIVE TARGETING• Inclusive household targeting, not HIV

exclusive– Ultra poor households who are labour

constrained i.e. chronically ill • HIV positive and affected households avoid

stigmatisation and discrimination• Multiple vulnerable groups are reached

through one intervention• OVC (~ 50% of beneficiaries are orphans)• Gap generation households (~ 60% of households

are elderly headed)• Persons living with HIV and AIDS

EXTENDING THE HIV RESPONSE BEYOND MINISTRY OF HEALTH

• Managed by the Ministry of Gender, Children and Community Development – Decentralised implementation through District

Social Welfare Office• Helps Government of Malawi to achieve

multiple multi-sectoral commitments– National HIV/AIDS Policy– National AIDS Framework– National Social Support Policy (draft)

RECOMMENDATIONS• Social Protection initiatives, like cash

transfers, need to take higher priority in Malawi’s HIV response and resources leveraged accordingly

• Family support works but not without a protective environment built in the community

• HIV response must move past treatment and care into improving the quality of life for both HIV infected and affected persons

Thank you!for additional information:email: hyacinth_kulemeka@yahoo.commobile: +265 888 386 906