Emergency Health Service Linkages for Street Children Following Sexual Abuse in Lilongwe, Blantyre and Zomba Cities in Malawi. Health Linkages for Street Children.

Abstract

The “Health Linkages for Street Children” project addresses the long-neglected and proliferating public health problems of human immuno-deficiency virus (HIV) infection and pregnancies among street children in Malawi. The problems largely stem from childhood sexual abuse and marginalized intersectional identities of the street children that make it difficult to access emergency public health services following sexual abuse. The purpose of this project is to improve equitable, inclusive and gender-sensitive access to emergency health services, such as the HIV Post-Exposure Prophylaxis (PEP) and Emergency Contraceptive Pills (ECPs) for street children aged 7 to 17 years, residing in Lilongwe, Blantyre and Zomba cities in Malawi.

By using three interlinked pathways, this project will first aim to understand the experiences and health needs of the street children. Second, it will use this evidence to create survivor-centred and gender-sensitive space and staff for service delivery. Lastly, empower street children, particularly girls, with peer-led influencing to encourage them to make their own decisions on their health. Activities will be implemented over three years with an additional six months of evaluation. The first activity will be baseline assessment, which will guide gender mainstreaming, service providers' capacity building, and integrating emergency health services in three street-based rehabilitation centres in Lilongwe, Blantyre and Zomba. Next, the project will link these services to the street girls who are significantly marginalized by creating segregated girls-only safe spaces within the rehabilitation centres. Additionally, a demand for services will be created through mass community awareness campaigns and peer-led influencing.

Using intersectionality and gender mainstreaming at all levels, the project will offer inclusive, value-based, and equitable health care for street girls and boys. Moreover, activities shift beyond biomedical services to address social factors, essentially reducing vulnerability to sexual abuse and associated health problems. Overall, implementation will cost € 287.280 and led by a consortium of two organizations working on street children and adolescent health. Through the consortium and partnership with government ministries, there will be sustained capacity, a staff with a mix of skills, and strengthened collaboration to outsource resources for sustainability of the services.