Nzotheka: Inclusive access to non-judgmental comprehensive healthcare for women in sex work

About the project

Despite the presence of governmental policies in Malawi, women and gender diverse people in sex work struggle to access non-judgmental inclusive healthcare support. HIV prevalence amongst women in sex work in Malawi is estimated at 55%, which is in stark contrast to the national HIV prevalence rate of 5.7% (Malawi National Strategic Plan for HIV and AIDS 2020–2025). Sex workers also experience high rates of unintended pregnancy and 78,000 women across the country undergo unsafe abortions each year (MSI Reproductive Choices 2022). Covid-19 has exacerbated the issue as increasing numbers of women and girls are entering sex work, many of whom have moved from rural locations and are unaware of, or afraid to access, healthcare services.

This is an advocacy project aimed at increasing access to non-judgemental comprehensive health care for women and gender diverse people in sex work. This will be achieved by identifying and supporting the urgent needs of these women and girls who have been marginalised by the health care system, and then building their agency and advocacy skills to call to account those who have power to meet their needs. The project aims to support Malawi’s Ministry of Health to achieve its goal of providing inclusive healthcare in line with its national and international health targets.

Theatre for a Change will also work with a partner (Malawi Sexual Reproductive Health & Rights Alliance) to build bridges and solidarity with the sexual and reproductive health and rights movement in Malawi. This will provide opportunities for inclusion of sex worker rights within the movement to advocate for universal healthcare long-term.

This will be achieved by:

• training sex workers to advocate for their right to access sexual and reproductive health services using interactive theatre
• organising capacity building workshops for local Health Surveillance Assistants to transform negative attitudes and help them deliver more inclusive and comprehensive services, provide psychosocial first aid and ensure adequate safeguarding
• developing a policy brief and a booklet with guidelines on providing non-judgemental and comprehensive sexual and reproductive health services to women engaged in sex work, potentially modelling an ideal service package for adoption by the Ministry of Health
• convening advocacy forums and a national dialogue with policy-makers
• raising public awareness through a radio panel discussion on the need for inclusive and comprehensive sexual and reproductive health service delivery

As a result of this project, it is hoped that women in sex work will be more able to advocate for their health rights, local healthcare workers will be trained to deliver more inclusive services, and dialogue with policy-makers on the provision of non-judgmental comprehensive healthcare will be strengthened.