Supporting Health Access for Key Populations through Participatory and Theatre Based Techniques
Supporting equitable and quality health access for key populations is essential in the global HIV/AIDS response.
While the rate of AIDS related deaths has slowed, several regions globally continue to see a rise in new HIV infections every year (UNAIDS, 2022). Additionally, the number of people on treatment has grown more slowly since 2021 than it has over the last decade (ibid).
Globally, most new HIV infections are amongst key populations including men who have sex with men, sex workers, people who inject drugs, and the sexual partners of these groups (UNAIDS, 2022). However, projects supporting these groups receive only 2% of all HIV/AIDS funding (Aidsfonds, 2020).
To ensure healthy lives and promote well-being for all at all ages by 2030 (SDG3), we need to arrest the rate of new infections by expanding prevention and treatment. This not only means expanding the provision of services, but also ensuring services are accessible to all, by addressing the many and multi-faceted social determinants of health.
One South is committed to supporting organizations to address these needs and believes that a robust HIV/AIDS response should be guided by credible evidence on what works.
This World AIDS day, we are pleased to spotlight the work of an organization we support, the Arts and Global Health Center Africa (ArtGlo), which is making strides in promoting access to quality care for key populations in Malawi.
ArtGlo’s Umunthu Programme works to improve health access by reducing healthcare discrimination against LGBTI people and by building the capacity of civil society and health service providers to support and implement inclusive policies and practices.
Umunthu is a pan-African concept of humanity that celebrates interconnectedness and interdependence . In Malawi, Umunthu can be understood to mean: “I am because we are” ; “To be in someone else’s shoes” ; and “The feeling I have towards others.”
The project was implemented in eight districts across Malawi: Mulanje, Zomba, Nsanje, Nkhotakota, Dedza, Thyolo, Phalombe, and Mchinji and trained 930 health workers, 310 community leaders, 60 partner organization members and 420 health worker students across 32 health clusters.
The evaluation of the Umunthu programme found that:
The participatory and theatre based methodology was a useful tool set ground rules, breakdown barriers and support mutual understanding and connection. Health workers' attitudes towards LGBTI people improved after attending the workshop. Health workers reported an increased understanding of the perspectives of LGBTI people and the barriers affecting their health access.
Some barriers remain in implementing changes in facilities as project trainings need to be replicated to reach a critical mass of health workers.
Health workers valued the opportunity to hear from LGBTI people, legal and civil society representatives in their communities in a safe setting and ask questions about how they can work together to improve health access.
Improving attitudes and strengthening engagement between health workers and LGBTI community members supported adaptations to improve patient confidentiality and established feedback mechanisms, which will be sustained beyond the project’s life cycle.
Healthcare staff shared several most significant change stories as part of the evaluation. One healthcare worker summarized, “I have managed to increase the turnout of LGBTI community members at my facility. I am so proud of the changes that have come because of Umunthu.”
ArtGlo will continue to implement projects that reduce barriers to quality health care for key populations. One South has supported sexual and reproductive health projects around the world since 2014. This has included projects supporting sexual health outcomes for adolescent and marginalized girls, women in sex work, LGBTI populations, and older people across Africa, Asia, and Latin America.
