Improving the Quality of Services for Vulnerable Children and Families in Malawi: An Evaluation

HIV/AIDS has placed many children and families in a vulnerable situation due to death and chronic illness. Supporting households to be self-reliant and resilient is essential for improving the wellbeing of children and their families. In Malawi, children and their families face challenges with economic wellbeing and accessing health and education services. Many projects funded by government and non-governmental agencies are working to address these challenges.

In 2009, the USAID Health Care Improvement Project, with support from the USAID Mission in Malawi and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), supported the Ministry of Gender, Children, Disability, and Social Welfare (MOGCDSW) to develop minimum quality service standards aimed at guiding the delivery of quality services provided to vulnerable children. The MOGCDSW endorsed the standards and recommended their scale-up. In FY13, the follow-on project, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project, was requested to improve the quality of services for vulnerable children in two districts using quality improvement (QI) methods.

Beginning in 2013, ASSIST supported the MOGCDSW to mobilize 151 villages through 10 community QI teams to carry out improvement work in Balaka and Mangochi districts with support from the District Social Welfare Officers. ASSIST built the capacity of community QI teams by training and mentoring community-based organizations (CBOs) and other community government extension workers with skills to identify the needs of vulnerable children, brainstorm root causes of challenges faced by vulnerable children, propose and test potential solutions to the identified problems, and adopt interventions that yielded improvements among vulnerable children. Periodically, the 10 teams were brought together at district level to share lessons learned and challenges faced in improving the lives of vulnerable families in the targeted communities. In communities where social services were not provided, ASSIST worked with the CBOs to identify potential sources of support for vulnerable families.

In FY16, ASSIST Malawi partnered with the One Community Project led by John Hopkins Center for Communication Programs in seven districts (ASSIST had previously worked in Mangochi, one of the seven districts) to comprehensively support vulnerable communities targeted by One Community.  In FY17, ASSIST continued collaborating with the One Community Project to scale up the use of OVC standards using QI methods to improve health and social services among vulnerable populations and promote their resilience.

Through the efforts described above, the USAID ASSIST Project contributed to improved household economic strengthening and food security, improved primary school education performance among vulnerable children, increased access to and utilization of health services, and increased awareness, identification of and action on abuse toward vulnerable children in Balaka and Mangochi districts. This evaluation examined household respondents’ perceptions of and participation in these services.


USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project/URC
ASSIST publication: 
ASSIST publication
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