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PSI MALAWI STAKEHOLDER MAPPING - Coggle Diagram
PSI MALAWI STAKEHOLDER MAPPING
Primary HIV prevention lead
Are your beneficiaries involved in making decisions on your preventive strategy?
Not involved - Policy excludes patients
No feedback on services offered - strongly believes that they should get involved to improve and align resources
Quality of medicine committee...going through many committees ie health centre advisory committee (very powerful)- church, etc - bring these 2 together
If you identify a challenge in your space, are you in a position to solve it on your own? If not, who would you have to involve?
Deficit of personnel
Many trained workers but not employed
Normal work days are very busy
In your view what is the biggest barrier to prevention? What are your reasons for having this view?
Stigma and discrimination
Lack of knowledge of HIV prevention measures
Accessibility of facilities
• Would you be willing to be assigned a role?
Yes
Also give other people roles - have a deliverable as well. Let ppl participate
• Would you be willing to be part of an innovative group that works with patients to articulate their issues (in prevention) and develop different solutions?
They have time - some work flexibility (incentives)
• Would you have the time if it meant spending 1 day every month to workshop with clients?
Previously they would get 5 days/3wks etc
In a month they work 20 days...If activity is in district then no problem (commit fully) in 6 months. Outside district, 15 working days
How do you bring different stakeholders together - bring them together in a physical place. Online meetings are not preferred
How do you normally get customer feedback?
No way of getting customer feedback
Are there tools that you use?
No
If yes, what is your perception about these tools? Do they work? How can they be improved?
• Are you part of an innovative group that works with patients to articulate their issues (in prevention) and develop different solutions?
Not at all
Zoom not good
Money is a big incentive. Workshops should be in a good place
Prevention
Done at hospitals. Community sensitisation by calling meetings and heavy education. More interactive questions
Condom distributions. Roll out PrEP - only in 5 facilities one. Main challenge around PrEP is access to reagents. PrEP is accepted but ppl are still stopping coz they are afraid that this might be confused with ARVs
There is training to health providers on PrEP by NGOs
There are peer educators following up on PrEP uptake
Youths are at high risk of contracting HIV and don't have knowledge and are shy. Female sex workers. Price of having sex with a condom is higher
No much support from district council on HIV prevention
Issues of PrEP
PrEP looks like HIV
It's a daily drug
Side effects
What is your experience in getting serving patients in sensitive groups such as sex workers and MSMs?
Stakeholders should work together from scratch (step by step)
Education is now more on acceptability of MCMs
Ensure you are clear on who you're involving and make it clear on your objective
She belongs to a professional association
Many social groups ie a group of all nurses in Blantyre. Leadership is not clear. Managed by a number of people. They make contributions
Biggest challenge in preventive HIV space
Stigma
Lack of knowledge
Accessibility
Don't involve patients
Don't get feedback
They should get involved
Who we would need to talk to - protocal approval
Health center advisory committee
Health center c
Would have time to be involved in the innovation
Works 20 days in a month. would be allowed to committ 6 months. 5 days in month
Venue
MSM and Sex workers value their time with money. So venue should be in a nice place such as a high end hotel
Should be outside their base location
Sensitive populations can now be involved in public forums without fear of being arrested
Are you part of any association for professionals like you?
• Nurses council of organisations
• Nurses in Blantyre district (do they have leadership? - organic and managed by district nursing officer, nurses make contributions)
Other Stakeholders
Village headmen
Peer educators
Patients stop taking Prep because
• Stigma from resemblance of prep bottle to ARV
• Afraid of having drug resistance as prep is an ARV (not true)
•
Preventive interventions currently in use in Blantyre
PrEP
Lab testing is slow because there are no re agents
Accepted but with some problems
Sex workers started taking Prep but stopped b
Training provided by NGOs
Condoms
Youth at more risk of contracting HIV
No support from government and district health council to reach sex workers. i.e. no transport to reach them at night etc This could be an opportunity for design that can be addressed by the comm labs
HIV Testing Services Coordinator - Rural
Tamanda
How do you address change in customer preferences?
Are your customers involved in formulating the plan for testing?
Not involved in planning
How do you identify challenges in your job. Is there a system of dealing with the challenges you identify?
• Seems there is a good system to collect info but unclear on how good it is
What in your view is the biggest barrier to testing?
Decision making is a whole process
Most patients default even on ARVs
Who or what different entity do you work with often?
How do you normally get customer feedback? Are there tools that you use? If yes, what is your perception about these tools? Do they work? How can they be improved?
What is your experience in getting serving patients in sensitive groups such as sex workers and MSMs?
Good experience working with this group. Goes there with a good attitude. (Empathy). Talk with them in vernacular
Refer HIV positive ppl to facilities. For prevention it is condoms, lubes etc
Nurse by profession also coordinator at Blantyre DHO
A nurse by profession - Coordinator (added roles)
Work with various coordinators to supervise, report verification etc
Moonlight activities for sex workers
Mentorship
Moonlight activities
There is no involvement of patients in the HIV sector - she thinks it is a good idea.
Activities in place - use of suggestion boxes
Feedback process is there but not solid.
Office of Ombudsman who take complaints of patients. There is a hierarchy on how the feedback process works
Reaching out to sex workers and MSMs
Non judgemental attitude
Sex worker peer educators
Involvement of patients/community is not there
Once in a while trainings
There are programs already in place to prevent HIV
Barriers to testing &
Long time making decision to go in for testing
defaulting after testing positive
Open to designing with clients
Focal person for QI
Mentor
Suggestion boxes
They collect feedback and acts upon it by presenting to facilitiy leadership
Office of the
ombudsman
in facilities - takes compaints from patients
She would be very happy re Quality improvement. Test these idea. She is passionate
Time
Time is possible - this is from a place of passion and duty
Happy to be involved especially on quality improvement and management
Support - she is. HR supports
She feels there are enough
Resources are own. She has no laptop
Lack resources
Random testing. No processes in place
No follow ups until someone tests HIV
Donor reliant
Motorbike bodas in Malawi
Testing methods
Oral
Sex workers are willing to show up. Willingly