The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to saving lives and reducing the burden of disease in low-and middle-income countries, while strengthening the capabilities of governments and the private sector in those countries to create and sustain high-quality health systems that can succeed without our assistance. For more information, please visit: http://www.clintonhealthaccess.org.
In 2006, CHAI signed a Memorandum of Understanding (MoU) with the Government of Malawi (GoM) to strengthen health systems in the most challenged districts, provide national support to HIV/AIDS drug pricing and programmatic work, support the pilot and scale-up of prevention of mother-to-child transmission of HIV (PMTCT) initiatives, expand access to ART for children, strengthen Malawi’s lab system, and scale-up an integrated nutrition program for children. CHAI’s support to Malawi has expanded to include Human Resources for Health (HRH), Vaccines (pneumococcal and rotavirus), Health Financing, and Pediatric HIV and TB among other areas.
Malawi’s pediatric treatment coverage at 54% lags behind adult coverage (71%). Malawi has been a pioneer in the PMTCT space as the first country to implement Option B+ and these efforts have been largely successful with the country experiencing a significant decline in new pediatric HIV infections. However, universal pediatric treatment coverage is not possible unless all HIV+ children are identified and linked to treatment.
Meanwhile, tuberculosis (TB) remains a major source of morbidity and mortality in Malawi. It is estimated that less than 60% of cases are diagnosed each year, with over a quarter of cases resulting in death. Innovative approaches to identifying TB cases are necessary to both improve case identification and decrease mortality from TB.
In 2014, CHAI Malawi initiated a comprehensive pediatric HIV and TB program with funding from the ELMA Philanthropies. CHAI supported the Ministry of Health to achieve its pediatric HIV coverage targets through operationalizing effective strategies for identifying HIV-exposed and HIV-positive children, initiating them on treatment, and retaining them in care. Additionally, the program aimed at improving case finding and identification of children exposed to and infected with active TB.
Beginning in 2018, the Pediatric HIV program entered the second Phase. During this time, CHAI will build on lessons learned and evidence generated in the first Phase to support the national scale up of proven testing, linkage, and retention strategies for children and adolescents. The project combines technical and analytical support with hands-on implementation. Strategies include development of tools and job aides to operationalize existing guidelines, review meetings at a district level, coordination of partner resources towards government ownership, and others. CHAI will coordinate all activities planned for the project, working closely with the Ministry of Health (MoH) and other stakeholders.
Additionally, with support from TB Reach, CHAI Malawi will be implementing an innovative and ambitious TB case finding model to engage informal, private sector providers to improve identification and referral of TB presumptives.
The Pediatric HIV and TB Technical Advisor will provide policy and technical leadership to the team implementing the ELMA Pediatric HIV and TB Reach grant, as well as supporting conceptualization of future program phases around Pediatric HIV and TB. This will include support in generating evidence through direct district-level implementation and oversight of field staff. The Technical Advisor will support the Ministry of Health in developing national policies and implementation plans, and utilizing evidence and best practices to make Pediatric HIV and TB policy decisions to ensure optimal use of limited resources to achieve high-impact change. The Technical Advisor will manage a range of partnerships with Ministry of Health and Pediatric HIV and TB stakeholders, provide guidance and oversight on policy development, and support translation of policy into actionable implementation plans.
The Technical Advisor will be based in Lilongwe, Malawi and expected to travel 30% of their time within the country. This person will report to the Program Manager, Pediatric HIV and TB.
Working in close collaboration with MoHP, the Technical Advisor, Pediatric HIV and TB will: