This report is part of a larger, five-year study of adolescent sexual and reproductive health issues called Protecting the Next Generation: Understanding HIV Risk Among Youth (PNG). The project, which is being carried out in Burkina Faso, Ghana, Malawi and Uganda, seeks to contribute to the global fight against the HIV/AIDS epidemic among adolescents by raising
awareness of young people’s sexual and reproductive health needs with regard to HIV/AIDS, other sexually transmitted infections (STIs) and unwanted pregnancy; communicating new knowledge to a broader audience, including policymakers, healthcare providers and the media, in each country, regionally and internationally; and stimulating the development of improved
policies and programs that serve young people. The research involves focus group discussions and qualitative interviews with adolescents, teachers and health workers, as well as national surveys of adolescents. This synthesis is the first publication of the PNG project in Malawi. It identifies important knowledge gaps and informs the project’s communication and advocacy initiatives by providing an overview of current policies and interventions for youth. The primary goal of this report is to summarize what is known about adolescent sexual and reproductive health in Malawi and to identify knowledge and program gaps requiring further research and program action. Drawing from a wide range of studies carried out in the
country since 1990, the synthesis reviews the social, cultural and economic context in which adolescents live; their sexual and reproductive health experiences; sources of information and services related to sexual and reproductive health; knowledge and attitudes about HIV/ AIDS and personal risk assessment; and policies and programs on adolescent sexual and reproductive health in the country. The studies reviewed include the Demographic and Health Surveys (DHS) conducted in Malawi in 1992, 1996 and 2000, and other small-scale studies
carried out in different parts of Malawi to inform the development of specific programs.
Past studies highlight various cultural practices that influence young people’s behaviors, attitudes and motivations related to sexual and reproductive health issues. The socialization process, which involves various forms of initiation ceremonies, has a strong influence on how adolescents understand their sexual and reproductive health. Although Malawian culture values virginity and condemns premarital childbearing, there is a general understanding that initiation ceremonies, which are meant to groom young people to be responsible sexual beings, sometimes achieve the undesired outcome of encouraging young boys and girls to initiate sexual relationships prematurely because they feel that the initiation ceremonies mark their transition to maturity. The socialization process also reinforces the dominance of men and boys and the subordination of women in sexual relationships. This social orientation
is likely to weaken women’s autonomy and latitude to negotiate for safer sex. It is also evident that the traditional socialization system’s role in adolescent sexuality and reproductive health has been waning as a result of the increasing influence of religion, schooling, exposure to media and other sources of information on these issues. While sexual abuse appears to be a major problem in Malawi, the actual magnitude of this problem is not known.