Service Use and Resilience among Adolescents Living with HIV in Blantyre, Malawi

Blessings N Kaunda-Khangamwa; Innocent Maposa; Moffo Phiri; Kennedy Malisita; Emmanuel Mtagalume; Lalio Chigaru; Alister Munthali; Effie Chipeta; Sam Phiri; Lenore Manderson

doi:10.5334/ijic.5538

Service Use and Resilience among Adolescents Living with HIV in Blantyre, Malawi

Int J Integr Care. 2021 Nov 1;21(4):11. doi: 10.5334/ijic.5538. eCollection 2021 Oct-Dec.

Authors

Blessings N Kaunda-Khangamwa^{1

2

3}, Innocent Maposa¹, Moffo Phiri⁴, Kennedy Malisita⁴, Emmanuel Mtagalume⁴, Lalio Chigaru⁴, Alister Munthali⁵, Effie Chipeta⁶, Sam Phiri^{2

7}, Lenore Manderson^{1

8

9}

Affiliations

¹ School of Public Health, The University of the Witwatersrand, Johannesburg, South Africa.
² The School of Public Health and Family Medicine, University of Malawi, College of Medicine, Blantyre, Malawi.
³ The Malaria Alert Centre, University of Malawi, College of Medicine, Blantyre, Malawi.
⁴ Umodzi Family Centre, Blantyre, Malawi.
⁵ Centre for Social Research, University of Malawi, Chancellor College, Zomba, Malawi.
⁶ Centre for Reproductive Health, University of Malawi, College of Medicine, Blantyre, Malawi.
⁷ Lighthouse Trust, Lilongwe, Malawi.
⁸ School of Social Sciences, Monash University, Australia.
⁹ Institute at Brown for Environment and Society, Brown University, Providence RI, USA.

Abstract

Introduction: Adolescents living with HIV (ALHIV) experience social and health challenges that warrant the provision of services and relational support to build resilience. Little is known about how social, community and health services help. We examine formal and alternative service use by and resilience of ALHIV participating in an enhanced teen-club clinic (TCC) programme.

Description: TCC is an adolescent-centred differentiated care model offering a 'one-stop-shop' for HIV/Sexual and Reproductive Health (SRH) services to ALHIV. A survey was conducted with 406 ALHIV to determine frequency of use and satisfaction with services. In addition, we conducted 26 in-depth interviews with ALHIV, 12 group discussions with 144 caregivers, and observations of workshops held for 35 health workers to capture multiple perspectives on service use and relational support systems for adolescent's wellbeing.

Discussion: About 70% of ALHIV were concurrently clients of three or more services. The multi-method analysis showed variations on risks, range of services, frequency of use and satisfaction. Interview data reflected complex factors influencing access to formal services, and caregivers and adolescents also sought alternative care from spiritual and traditional healers.

Conclusion: Adolescent centred-approaches have the potential to enhance resilience promoting resources and outcomes. A multi-sectoral approach to service use and provision is critical to inform adolescent intervention programs and wellbeing.

Keywords: Malawi; adolescent-centred approaches; adolescents living with HIV; resilience; service use; teen-club clinic.

Publication types

Case Reports

Grants and funding

This paper was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand, South Africa and is funded by Sida (Grant No: 54100113), Carnegie Corporation of New York (Grant No. G-19-57145), the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the Fellow.