Thandizo: Towards Increased ART Adherence by Young People Living With HIV

Published on: 24/04/2025 by Admin

Thandizo: A Youth-Led Approach to ART Adherence

Thandizo means “support” in Chichewa language.  Developed by the Coalition of Women Living With HIV and AIDS (COWLHA) and Aidsfonds, the Program supports young people living with HIV (YPLHIV) in Malawi to remain in care and on treatment. It combines a peer-led support group model with a digital adherence tool – the Thandizo mobile application – to address the root causes of HIV treatment interruption, including stigma, mental health, lack of treatment literacy, and socio-economic vulnerability.

The project is implemented in collaboration with local health systems and is supported by Aidsfonds under the “From Idea to Scale” innovation fund.

Context

Despite progress in the national HIV response, adolescents and young people aged 10–24 in Malawi remain disproportionately affected by HIV. According to national data, this group continues to experience high levels of treatment interruption, mainly due to:

  • Stigma and discrimination

  • Hunger and poverty

  • Lack of understanding about lifelong ART adherence

  • Limited psychosocial support

In many cases, these challenges result in defaulting from care and deteriorating health outcomes. Thandizo was created in response to this reality, aiming to restore confidence, connection, and continuity of care for youth.

The Approach

Thandizo is built on two complementary pillars:

1. Peer-Led Support Groups

COWLHA mobilizes adolescents and young people living with HIV into safe, youth-led support groups. These groups:

  • Provide psychosocial support and treatment literacy

  • Create safe spaces for youth to share experiences and build confidence

  • Are led by trained Community Health Volunteers (CHVs) and youth champions

  • Encourage group-based referral and follow-up systems

2. The Thandizo App

The Thandizo mobile app is a digital counselling tool designed to:

  • Help Community Health Volunteers (CHV) assess adherence risks through guided questions

  • Provide tailored counselling using interactive tools such as quizzes, animations, and treatment tips

  • Track follow-ups and referrals for clinical and psychosocial care

  • Promote treatment adherence through personalized support

The app is used during one-on-one (individual) consultations and group sessions to improve treatment literacy and facilitate structured peer-led engagement.

Achievements

The Thandizo approach has proven effective in re-engaging young people in HIV care and treatment. Key achievements include:

  • ART defaulters reduced significantly:

    • From 384 to 87 in Mangochi

    • From 94 to 9 in Chikwawa
      (2019–2021)

  • Support group participation increased:

    • From 169 to 451 in Mangochi

    • From 226 to 979 in Chikwawa

  • Improved treatment literacy, confidence, and mental health among youth

“I used to be gloomy, but now I’ve let go of fear. The app helps me understand everything better.”
– Kalenga, 12

“We even lend each other money when one of us is stuck. This group changed everything.”
– Wilson, 16

“ Before we started learning  through the Thandizo App, each one of us thought being on ART, we would never be able to fall in love again… Through the interactions that we have with the mentors and amongst ourselves, such mindset is a thing of the past. Everyone is becoming more and more open, a thing that has also helped us to attract more fellow youths to join the support group.”  – Chimwemwe, 24. 

Scale-Up

Since its initial pilot, Thandizo has successfully scaled up to four Traditional Authorities across Mangochi and Chikwawa:

  • TA Ngabu and TA Kasisi in Chikwawa

  • TA Jalasi and TA Nankumba in Mangochi

This expansion has included:

  • Training youth champions to independently administer the app

  • Integrating socio-economic support, including savings groups and linkages to nutrition services

  • Deepening coordination with district health systems

  • Promoting youth-led advocacy and participation in planning and decision-making

Where We Work

As of 2025, Thandizo is actively implemented in:

  • Mangochi District: TA Jalasi, TA Nankumba

  • Chikwawa District: TA Ngabu, TA Kasisi

With continued support, the programme is reaching hundreds of young people through a combination of tech-driven counselling and community-led support.

Real Stories of Change

Visit our Articles page to meet young people like Agnes, Wilson, Chimwemwe, Kalenga, Noel, and Mercy  (names changed for privacy) — who are finding hope, strength, and support through Thandizo.

Want to Support Thandizo?

Thandizo is a simple, scalable solution that works. Your support helps us reach even more youth, strengthen communities, and build a future where no young person stops taking medication because of lack of knowledge on treatment adherence, stigma or discrimination.

Partner with us. Share our stories. Join the movement!

Looking for a quick overview of the Thandizo project?
📄 Click here to download the Thandizo 4-pager summary (PDF)

This document outlines the program’s background, approach, impact, and key results — ideal for partners, stakeholders, and anyone interested in learning more about how Thandizo is changing lives across Malawi.

Get Involved

Are you passionate about supporting young people living with HIV in Malawi?  Join us in expanding the reach and impact of the Thandizo program. Whether you’re a donor, partner, advocate, or just someone who cares — there’s a role for you.

📬 Contact Us
📧 Email: info@cowlha.org
📞 Phone: +265 993686878
🌍 Website: www.cowlha.org

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