A health systems approach to more effective decentralised HIV prevention
Development of Malawi’s Blantyre Prevention Strategy
Bibliographic Data
| ID | 21879103 |
|---|---|
| Authors | Gift Kawalazira (Malawi Government), Yohane Kamgwira (Georgetown University), Sara M Allinder (Georgetown University), Chimwemwe Mablekisi (National AIDS Commission), Rose Nyirenda (Malawi Government), Deborah Hoege (Georgetown University), Alinafe Mbewe (Malawi Government), Suzike Likumbo (Malawi Government), Tyler Smith (0000-0002-3119-259X, Cooper/Smith, Washington, District of Columbia, USA), Tyler R Smith (Cooper Standard (United States)), Grace Kumwenda (AIDS Vaccine Advocacy Coalition), Betha O Igbinosun (0009-0005-0468-8820, Georgetown University), Charles B Holmes (0000-0002-7924-6761, Georgetown University) |
| Year | 2025 |
| Volume | 10 |
| Issue | 2 |
| Pages | e016880 |
| Publication date | 2025-02-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2024-016880 |
| PMID | 40010778 |
| OpenAlex | W4407984610 |
| Language | EN |
| Citations received | 1 |
| References cited | 11 |
Achieving global targets to end the HIV/AIDS epidemic as a public health threat by 2030 and beyond requires enhanced health system capacity for HIV prevention at national and subnational levels. Specifically, this system’s capacity must enable countries to reach high-risk populations effectively, systematically engage communities to generate demand for HIV prevention services, build diverse delivery channels to meet this demand and address structural barriers that undermine prevention programmes. Integrating these capacities at the local level is especially critical to creating sustainable uptake and impact of emerging highly efficacious prevention options, such as long-acting injectable pre-exposure prophylaxis. Decentralised, locally led approaches that reflect the local context—yet are linked to national systems and policies—are needed to embed these capacities and strengthen the ability of local governments to coordinate and implement HIV prevention. Within this framework, the Government of Malawi is developing a district-based approach to enhance local institutional capacity for more effective and sustainable HIV prevention, starting in Blantyre—a large urban district noted for its high HIV incidence. This article provides the conceptual basis for, and early implementation experience of, the Blantyre Prevention Strategy (BPS), a health systems-based approach to HIV prevention that directs investments towards embedding essential functions within Blantyre City and District. The approach includes developing district-led systems and capabilities in effective disease surveillance and data-driven targeting, demand generation, quality service delivery and promoting the sustained use of HIV prevention interventions. Early learnings from BPS offer lessons for other low- and middle-income countries seeking to implement HIV prevention strategies that bolster their health system capacity and integrate with broader health responses
Business · Capacity building · Economic growth · Economics · Geography · Political science · Psychological intervention · Public health · Service delivery framework · Sustainable development · Adolescent Sexual and Reproductive Health · HIV/AIDS Impact and Responses · HIV/AIDS Research and Interventions · Medicine · Nursing · Marketing
| Unique citing works | 1 |
|---|---|
| Citations per year | 1 |
| Citation span | 2026 - 2026 (1) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 1 |