IIn Nsanje, a more rural district in the south and one of the country’s poorest where men travel for seasonal jobs in sugar plantations, many women operate more secretly through informal networks and who often live with husbands and families.
In Nsanje, MSF works hand-in-hand with the Ministry of Health to reach a variety of women who transact with or sell sexual services from their homes, or around seasonal trade or hotspot sites in Nsanje district. These women often live with their husbands and families or in close-knit communities. MSF Community health workers – themselves sex workers who have been recruited from their local communities and trained - discretely identify and approach women engaging in sex work in their communities, and arrange home visits with trained community health workers to provide health education and preventive materials (condoms, lubricant, PEP and ECM).
‘One-stop’ clinics are either held on regular afternoons in rented rooms for adult sex workers or further adapted for sexually exploited adolescents and girls, or at Ministry of Health centers, where health ministry and MSF staff provide a comprehensive package of sexual and reproductive healthcare plus HIV care and follow up. MSF has reached approximately 1320 sex workers across these five sites in Nsanje.