Abstract
Background: Equity and social inclusion for vulnerable groups in policy development processes and resulting documents
remain a challenge globally. Most often, the marginalization of vulnerable groups is overlooked in both the planning and
practice of health service delivery. Such marginalization may occur because authorities deem the targeting of those who
already have better access to healthcare a cheaper and easier way to achieve short-term health gains. The Government of
Malawi wishes to achieve an equitable and inclusive HIV and AIDS Policy. The aim of this study is to assess the extent
to which the Malawi Policy review process addressed regional and international health priorities of equity and social
inclusion for vulnerable groups in the policy content and policy revision process.
Methods: This research design comprised two phases. First, the content of the Malawi HIV and AIDS Policy was assessed
using EquiFrame regarding its coverage of 21 Core Concepts of human rights and inclusion of 12 Vulnerable Groups.
Second, the engagement of vulnerable groups in the policy process was assessed using the EquIPP matrix. For the latter,
10 interviews were conducted with a purposive sample of representatives of public sector, civil society organizations
and development partners who participated in the policy revision process. Data was also collected from documented
information of the policy processes.
Results: Our analyses indicated that the Malawi HIV and AIDS Policy had a relatively high coverage of Core Concepts
of human rights and Vulnerable Groups; although with some notable omissions. The analyses also found that reasonable
steps were taken to engage and promote participation of vulnerable groups in the planning, development, implementation,
monitoring and evaluation processes of the HIV and AIDS Policy, although again, with some notable exceptions. This
is the first study to use both EquiFrame and EquIPP as complimentary tools to assess the content and process of policy.
Conclusion: While the findings indicate inclusive processes, commitment to Core Concepts of human rights and
inclusion of Vulnerable Groups in relation to the Malawi HIV and AIDS Policy, the results also point to areas in which
social inclusion and equity could be further strengthened.