Malawi, like the rest of southern Africa, has a high adult HIV prevalence (estimated at about 12% in 2004) yet the country’s health sector is crumbling under severe pressure, largely due to limited investment. In 2004, the government of Malawi mobilised further local and international resources to commit itself to providing free antiretroviral therapy (ART) free to all patients, based on clinical need, in a large public sector-led programme.
This study was implemented under the fair financing theme in the Regional Network for Equity on Health in East and Southern Africa (EQUINET) and co-ordinated by the Health Economics Unit of the University of Cape Town. It aimed to assess equity in uptake of antiretroviral therapy in Malawi in 2005, especially according to age (children vs. adults), gender (men vs. women) and income. Particular reference is made to the scaling up of ART and the removal of fees for ART in 2004.
Informal interviews were conducted with health sector antiretroviral programme implementers and key policy makers in the Ministry of Health. The purpose of these interviews was to obtain their perceptions and experiences on a selected list of key issues affecting antiretroviral treatment rollout in the country. An interview guide was used. We also searched both published and grey literature to collect information on the history and operations of the Malawi public sector-led ART programme.