Tutulane AIDS Organization Chitipa District, Northern Region, Malawi



Kennedy Odhiambo Oulu, Technical Adviser

Faculty Supervisor:

Mbithe Anzaya


MDI-Kenya Class of September 2007

History of the Agency:

TAO was initiated in 1998 by local community leaders as a response to escalating HIV prevalence among Malawian youth who lacked information about sex and reproductive health. TAO now runs programs in home-based care, orphan support and vocational training, HIV counseling and testing, advocacy on access to treatment and cultural drivers of HIV, youth behavior change programs, a community child care program and a community library and resource center. TAO’s mission is to effectively provide quality and comprehensive HIV and AIDS prevention, capacity building, treatment and impact management services to those infected, affected and vulnerable in 
the community.

CHIP Project:

“ART and Nutrition Access Improvement for PLWHIV in Underserved Traditional Authorities (TAs) of Chitipa District, Malawi.”


  • To increase the number of PLWHIV on ART by 40% in 4 traditional authorities by October 2008
  • To train 100 caregivers in home gardening and nutritional counselling by December 2008

Changes Made:

  • Conducted a management training workshop for Tutulane and committees in the 5 TAs
  • Carried out ART literacy campaigns in the whole district and reaching 364 people in 6 months by the end of December 2008
  • Developed and submitted a grant proposal
  • Sourced 1 CD4 count machine
  • Trained 22 PLWHIV as community health workers on ART adherence and follow-up
  • Increased number of PLWHIV on ART to 476 people (193 males, 283 females) as of Dec 2008
  • Trained 57 (14 male, 43 female) caregivers in 2008 and have plans to train 60 more in 2009 in home gardening and nutritional counselling. The program encourages male involvement in home-based care to reduce burden of care on females.
  • 7 service outlets under Tutulane are providing HIV-related palliative care (including HIV and TB)

Lessons Learned:

  • Planning the CHIP: The CHIP must reflect a comprehensive and strategic awareness of the program. Cross-sector consultations are necessary, since the program affects other sectors differently. The person planning the CHIP should have a clear understanding of current donors’ priorities and interests, and appreciation of the existing national policy framework on HIV/AIDS and possible changes.
  • Gaining buy-in from stakeholders: Skepticism exists when the concept and the partnership role is not well explained. Stakeholders will support such initiatives only when they gain from it, either image, funds or appeal. The buy-ins’ objectives must be espoused within the wider goal of the initiative for it to be accepted. Radical initiatives will likely face a challenge with buy-in due to the risks anticipated. “Nobody wants to lose in a partnership,” Oulu explains.
  • Implementing the CHIP: Wide stakeholder involvement is key to success, especially when issues require sustained advocacy. Access to baseline data is necessary; measurement of progress becomes difficult when such data do not exist. Commitment from partners goes beyond funds and includes technical and logistical support. The process is likely to include unforeseen problems (e.g., TAO’s CD4 count machine broke down and must be replaced) and therefore needs to be versatile.

Oulu reflects, “I am honored to have participated in the last MDI. It has really enhanced my effectiveness in program management, leadership, and monitoring and evaluation. The mix of strategy, operations management, leadership and finance allows me to develop effective indicators for program monitoring and design.”