A study of child-related policies, services and the needs of orphans in Malawi

Introduction: Due to HIV/AIDS epidemic, Malawi experienced a proliferation of orphans. These orphans are experiencing difficulties in meeting the basic necessities of daily life. Hence, donors have increased funding, Government has developed new policies for children and orphans and many civil society organisations are providing services to orphans. However, there is a paucity of research to establish the responsiveness of these initiatives to the needs of orphans. Purpose: The aim of this thesis was to assess how child-related policies and service delivery were responding to the needs of orphans. The research was designed to identify weaknesses and strengths in service delivery and policy design with the intention of proposing strategies and making recommendations to better address the needs of orphans. Methods: In 2010, 72 in-depth interviews were conducted in Blantyre and Lilongwe districts in Malawi. These comprised of 16 orphans aged 13-16 years, 12 caregivers, 12 national service providers and 13 policy makers. In addition, 12 interviews were conducted with participants playing both policy and service provision roles. Seven focus group discussions were conducted with district and community service providers. Government policies were also reviewed. Data were analysed using framework analysis. Findings: Food was found to be the most critical need among orphans, followed by financial security for meeting needs autonomously. Child-related polices did not fully guide service implementation due to weak policy coordination, lack of alignment between structures stipulated in policy and structures used in for policy implementation, poor policy design and limited participation of service users and stakeholders in policy development and implementation. Non-comprehensive services, poor service integration, inequitable service delivery, inaccessible services and insufficient resources were found to undermine service responsiveness to orphans’ needs. Recommendations: To improve orphan related policies and service delivery, policies and services should focus on improving service coordination, resource mobilisation and policy design. Donors and non-governmental organisations should operate within Government plans, priorities and implementation structures. Services should prioritise food and household income generation strategies.