A Network Analysis of HIV Civil Society Organizations to Enhance HIV Prevention Service Delivery in Blantyre, Malawi

BackgroundCivil Society Organizations (CSOs) play a critical role in HIV prevention and service delivery in Blantyre, Malawi. Yet district-based public health leaders often lack a nuanced understanding of CSO connections, service offerings, and linkages to health facilities; information needed for effective district-level coordination and facility level uptake of HIV prevention resources. MethodsWe conducted an organizational network analysis (ONA) of CSOs providing HIV prevention support in Blantyre to identify connections between CSOs, the strength of those connections, and the services these organizations offer. We sampled organizations in September 2021 and November 2023. We used Kumu Software to interactively display the relationships among CSOs. We assessed CSO connections to health facilities to gain a comprehensive understanding of linkages that impact how HIV prevention services are delivered. ResultsWe had a sampling frame of 227 organizations with a final sample size of 154 organizations. Ninety-two (60%) organizations had at least one connection with another organization and 146 (95%) had at least one connection with a facility. There is a hub of connected organizations that work together to provide HIV prevention services in Blantyre. Of the 35 repeat organizations from both data collections, 12 increased their connections to other organizations and 14 increased their connections to other health facilities over two years. ConclusionKnowledge of the highly connected organizational hub allows the government and partners to leverage these organizations to support and enhance HIV prevention service delivery. Tracking network changes networks over time can enhance collaboration among organizations to maximize resources based on the greatest need.