1. L EVERAGING THE COMMUNITY WORKFORCE TO SUPPORT OPTION B + AND ENSURING COMMUNITY ENGAGEMENT AND ACCOUNTABILITY IN M ALAWI Michael Eliya National PMTCT Coordinator Malawi 29.11.15

3. O PTIMIZED C OMMUNITY HEALTH WORKERS (HSA) HIV Testing Services (HTS) for pregnant women and exposed children Identification, referral, linking of mothers and their exposed children Supporting mother infant pair clinics (MIP) Follow up of mothers and children who miss appointment/defaulters Bridge between health facility and community Supervision of community groups Maintaining village health register HSA planning Meeting Tasks in Option B+

4. M ALE MOTIVATORS IN OPTION B + Health education to fellow men Couple testing ANC attendance Hospital delivery Family planning Linking facility and community Compiling community activity reports Reporting to health facility Male study circlesRoles

5. C OMMUNITY ENGAGEMENT Role of community leaders Community auditing Community mobilization Feedback to health facility Proportion of pregnant women reporting in the 1 st trimester Proportion of pregnant women attending four antenatal visits Proportion of pregnant women who deliver in the health facility Community advisory groups Community tracking indicators

6. HIV STATUS DETERMINED Q1 2013- Q2 2015 IN 8 DISTRICTS

7. P ROPORTION OF P REGNANT WOMEN ON ART 2013-2015 IN 8 DISTRICTS

8. R ETENTION RATES AT 24 MONTHS BY QUARTER IN 8 DISTRICTS 2013-2015

9. O PTION B+ R ETENTION RATES NATIONALLY AT VARIOUS TIME POINTS, J UNE 2015

10. Multiple roles of Community Health Workers (CHW) Regulation with regulatory body Lack of transport for follow up activities Monitoring and evaluation community initiatives Definition indicators for tracking community interventions Management and supervision of community structures Human resource plan Global fund, Development partners Deploying special cadre for HTS Diagnostic Assistance (HDA) Partners supporting deployment of community workers (Tingathe Project by Baylor) ChallengesMitigation factors

11. W AY FORWARD Packaging and scaling up of community models Defining community indicators to better monitoring community models Steps to improve retention in care: - To develop national system that links mother and child - Set up mechanism of identifying clients who miss appointment/loss to follow up - Scaling up community initiatives

12. Thank you Zikomo Kwambiri