Malawi: Parliamentarians advocate for care work policies

Ephraim Abel Kayembe, Member of Parliament for Malawi’s Dowa West Constituency, is a policymaker working with civil society organisations such as VSO RAISA, to bring attention to the concerns of care workers in his area. The current policy in Malawi is confined to addressing professional care givers and excludes the work of children and women. As with other SADC states there are no incentives, remuneration or psychosocial support programmes for those who fall in this grouping. (1)

Through his work Kayembe is setting new standards for multi stakeholder collaborations and partnerships to respond to the country’s care work needs. He has been involved in a proposed motion that urges the government of Malawi to develop a standalone national policy to support the work of care givers. This motion was due to be moved in the June 2011 budget seating of parliament. In addition, Kayembe is part of a group of MPs working with the Ministry of Health and the SADC Parliamentary Forum to finalise Malawi’s draft care work policy.

Malawi is a signatory to the SADC Protocol on Gender and Development signed in 2008. In response to the disappointing progress of his country on reaching the Protocol targets around HIV and AIDS, Kayembe used the commitments to develop and move a motion on urging Government to review and develop a specific national policy on HIV and AIDS to address care work. The Government of Malawi could not reject the proposed motion because it was a reflection of commitments the state had made by signing the Protocol. This allowed the creation of space within which several initiatives are now being undertaken to address issues of women and children carers.

The initiative benefits 40 000 in the constituency. The projects have a particular focus on 1000 carers and 2000 orphans and other vulnerable children in the area. However, there is now a national drive supported by various NGOs and private companies to reach more carers through providing resources for conducting trainings in quality home-based care through similar processes.

Article 27 (3) c of the SADC Protocol states that States Parties shall, by 2015: develop and implement policies and programmes to ensure appropriate recognition of work carried out by caregivers, the majority of whom are women, allocation of resources and psycho-social support for caregivers as well as involvement of men in the care and support of people living with HIV and Aids.”

As such initiatives undertaken by Kayembe have been at the national, constituency and regional levels.

National progress towards Article 27

• Collaboration with civil society organisations such as VSO RAISA and GEMSA to bring to the attention of Government the concerns and needs of the workers in Malawi. Particular emphasis is on the challenges caregivers face in his constituency.
• Through the Parliamentary Committee on HIV and AIDS, spearheading review of proposed Bill on HIV and AIDS Management to ensure inclusion of incentives, remuneration, standardised trainings for carers, psycho-social support and male involvement in care work. The Bill has been reviewed and it will be brought into the chamber in September, 2011.
• Participation in the National Conference on review of the policy for professional carers so that it includes issues of informal carers. It was unanimously agreed that a stand-alone policy on informal carers be developed and that Ministry of Health should take a leading role in developing the policy with maximum support and participation of other relevant government departments and stakeholders. The consultation process is ongoing and it is expected that the draft proposal will be scrutinised by participants to the conference on policy formulation and development in August, 2011.
• Proposal of a motion to urge Government to develop the policy on caregivers developed and referred to Business Committee of Parliament for rigorous review. The motion was supposed to be moved during the June 2011 budget seating of parliament, unfortunately there was insufficient time to accommodate private member’s motions. There are strong indications that the motion will be moved during the September parliamentary seating and that it will be agreed upon and adopted. Once adopted, the Ministry of Health will be tasked by this legislation to translate the undertaking of parliament into development of the policy. Currently, the Parliamentary Committees on HIV and Aids, Health and Gender and Community Development are working with Ministry of Health and civil society to finalise the development of the policy in line with the SADC PF policy framework.

Progress at Constituency Level
At constituency level, there has been significant focus on issues of male involvement in care work as a strategy to reduce the burden of care on girls and women caregivers. The following initiatives were taken to get the understanding, commitment and support of men and boys in care work:

• Awareness and sensitisation campaign meetings were conducted in the constituency on the importance of reducing the burden of care on women and girls. These targeted traditional leadership, households and communities so that they participate in advocating for male and boy’s involvement.
• During World AIDS Day, Kayembe was at the forefront of initiatives to raise awareness on the role that youth carers play in communities. He challenged communities on the extent to which these young people could be supported by families, communities and Government.
• Mobilising men and youths to engage in care work and encouraging those already engaged to remain so.
• Youths sometimes use theatre for development strategy for disseminating information on care work, HIV and AIDS prevention and treatment.
• With funding from VSO Malawi, training in home-based care was conducted for Mayesero community-based organisation in provision of quality care to those in need.
• Income generating activities such as bakery, poultry and piggery have been initiated for the OVCs and other vulnerable households.
• Orphans and other vulnerable children have been supported with writing materials and uniforms. This form of support has been main area of focus for Kayembe in Dowa West.

Regional Progress towards Article 27
In response to the regional impact and needs of HIV and Aids care work, Kayembe carried out a study tour to Mozambique in April 2011. There he participated in discussions with staff of VSO Mozambique and OVCs on the challenges they face when providing care to people infected and affected by HIV and AIDS.

The discussions revealed that even in Mozambique there was no detailed policy to address the issues of caregivers. It underlined the similarity of issues facing care givers in Malawi: women dispproportonately carry the burden of care for adults and children living with and affected by HIV at home and in communities; the elderly are not spared from being carers and are forced into these positions by circumstances; lack of resources, energy, skills and knowledge to provide quality care; and children, especially young girls, are often forced to drop out of school.

There are many challenges and risks to the work in Dowa District. Stigmatisation and discrimination of carers on the basis of their status continues. More sensitisation meetings are being conducted to raise awareness on the disadvantages of discriminating against t providing care work. A second challenge is that youth carers lose critical educational opportunities as a result of caring for sick people and parents.

Kayembe is working hand in hand with CBOs to begin designing daily work schedules that will allow children to attend classes in the first part of the day and revert to caring when they are out of school. The success of these initiatives is constrained by financial resources. In addition, increased political understanding, commitment and willingness are required to speed up the process of developing relevant policy and legislative frameworks on informal carers. Lobbying efforts have been intensified and there is some commitment to introduce the motion on care work in parliament very soon.

These challenges notwithstanding, approximately 4000 people, including traditional leaders and communities, have been sensitised on the importance of reducing the burden of care on girls and women through advocating for more involvement of men and youths in care work. Two hundred men and 160 boys have been mobilised to raise the profile of women and girl carers. They are now currently engaging themselves in provision of care work to those infected and affected with HIV and AIDS. A draft national policy on care work for informal carers has been developed in close collaboration and partnership with the Ministry of Health and other relevant stakeholders. The consultation processes on the policy are in progress around the country and it is anticipated that it could be approved this year.

There is a commitment on the part of parliamentary leadership to bring the proposed motion on care work policy into the chamber for thorough scrutiny and approval in September 2011. More men and boys are now joining women and girls in providing care and support with traditional leaders paving the way as advocates for this much desired and needed result. Larger civil society organisations have also expanded their programmes to work more closely with smaller CBOs and legislators. Finally, a noteworthy outcome is increased understanding within the executive arm of government of the significance of putting necessary legislative and policy frameworks to address issues of carers.

Although funding can hamper progress in Dowa West, many of the initiatives are relatively easy to sustain. Kayembe notes that the funds required to conduct sensitisation meetings on care work raise the profile of women and children carers are not too prohibitive.

The fact that this work has been carried out in Dowa West means it is possible for other MPs to do the same in their own constituencies. It is also possible to carry out this work in other countries within SADC. This and cases such as the successful development of a care work policy in Namibia are excellent best practice examples.

Platforms such as the regional partnership of parliamentarians (SADC PF) have proven useful to encourage heads of states to prioritise development of various policies in the past; national care work policies are not exempt from this. Replication must be strengthened through state-supported study tours within the region. Most parliamentarians have access to constituency development funds provided through state budgetary support structures. This would therefore be an opportunity for parliamentarians to allocate adequate resources for implementation of these activities as it is customary to develop and approve government budgets every year.

Ultimately MPs are able to provide the necessary leadership on issues of care work and Kayembe’s case demonstrates that MPs are well placed to raise the profile of children and women care givers at all levels of government and decision-making. They occupy a strategic position that enables them to continuously and effectively engage civil society, media institutions, community organisations and legislative processes around care work in the region. MPs are able to provide the necessary leadership on issues of care work and illustrate the need of involving care workers in processes related to policy making.    

(1) Honourable Ephraim Kayembe, MP Dowa West, (2011). Presentation: Parliamentarians Experience in Advocating for Development of National Policy to Support Caregivers in Malawi. Global Partners Conference, UNICEF, New York.