AEGiS-15IAC: Modification of high risk cultural practices within a traditional framework and its integration into national planning and implementation in Malawi.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Modification of high risk cultural practices within a traditional framework and its integration into national planning and implementation in Malawi.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrD1163)

Kamkwamba H, Malekezo M, Deutsch B
Salvation Army, Blantyre, Malawi

ISSUES: In Malawi, cultural practices which increase risk of transmission of STIs including HIV/AIDS, unwanted pregnancy, and delay women's access to emergency maternal health care services have been well documented. The National Behaviour Change Interventions Strategy for HIV/AIDS/SRH (2002) also highlights the elimination of high risk cultural practices as a critical area to be addressed in behaviour change interventions with traditional leaders and initiation counsellors. Nevertheless, there are few documented examples of how governments and NGOs have effectively worked with traditional leaders to modify damaging social norms and cultural practices which place men and women at risk.

DESCRIPTION: The Ministry of Health and the Salvation Army worked in collaboration with a traditional advisory group in Phalombe District to develop training materials which facilitate cultural change with culture bearers based on Salvation Army's successful work in the district. The development of picture codes and materials based on analysis and guided by the advisory group were pilot tested with traditional initiators and communities in five districts.

LESSONS LEARNED: Critical analysis of cultural practices indicated that sex/semen was perceived to prevent illness, provide strength and solve community problems. The use of traditional medicine which had the same properties of sex could be used as a culturally accepted alternative to the cultural practice of sex. Despite traditional secrecy within communities around specific cultural practices, the provision of picture code materials and messages facilitated open discussion and problem solving among pilot communities around their own high risk cultural practices.

RECOMMENDATIONS: Our experience shows that any work to identify and modify cultural practices must be conducted with utmost respect for community belief systems, values and seek to strengthen partnerships with traditional culture bearers to develop culturally appropriate behaviour change strategies.

Keywords: AEGIS, Malawi, Health Planning, Acquired Immunodeficiency Syndrome, Federal Government, HIV Infections, Medicine, Traditional, Culture, Health, Behavior, Emotions, Research, Health Services, Counseling, HIV Seropositivity, Humans, Female, Male, Pregnancy, ethnology, education

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