By Laurel White
In a small village in Malawi, a grandmother of five lost her will to live.
Gogo Abiti Juma took over care for her five grandchildren after their parents died of AIDS, and the family struggled to survive. They had little access to food, shelter, health care, or a meaningful social support system. Three of the five children dropped out of school, and Gogo Abiti Juma’s mental health spiraled.
“For three times, I tried to commit suicide,” the grandmother told a team of UW–Madison-funded researchers. “Because of the insults, abuses that community members — particularly the youth — used to throw at me.”
Unfortunately, Abiti Juma’s situation isn’t rare. According to Malawi’s National AIDS Commission, nearly 20 percent of children in the country are orphans because of the AIDS pandemic, and roughly half of those children live in grandmother-headed households where social stigma makes life even more difficult.
That social stigma, experts say, is driven by the lack of working-age adults in the family — typically, these households are seen by their communities as a potential drain on very limited local resources.
“These are the most financially and socially marginalized households in Malawi,” says Nancy Kendall, a professor in the School of Education’s Department of Educational Policy Studies.
Kendall and her longtime colleague, Lori DiPrete Brown, a distinguished teaching faculty member in the School of Human Ecology and the director of the 4W Women and Wellbeing Initiative, have spent decades researching programs that support marginalized populations around the world. Their latest collaboration, Circle of Care, is aimed at identifying sustainable, community-driven ways to change the circumstances of those vulnerable grandmother-headed households in Malawi.
“We started this project as a response to the instability and social isolation that members of these households faced, and the ripple effects on people’s wellbeing and children’s education,” Kendall says.
Circle of Care was first funded in 2019 by a Baldwin Wisconsin Idea grant, a UW–Madison fund dedicated to advancing the Wisconsin Idea — the notion that knowledge and solutions generated at UW-Madison will benefit the people of Wisconsin, the nation, and the world.
Delayed by the pandemic, on-the-ground work for Circle of Care began in Malawi in 2021.
In less than a year and a half, the project has directly touched 200 households that care for roughly 900 orphans — but the indirect results have certainly rippled much further.
Through a many-faceted approach that includes community education, economic development, partnerships with local government, and direct aid to households, Circle of Care’s successes have included triumphs on the individual and community levels.
For individuals, Circle of Care data show grandmothers and orphans have already increased their daily calorie intakes, reported substantial increases in community social support, and improved school attendance. On the community level, the program has helped train “Theater for Development” troupes, facilitated the opening of a new fish farming business, worked with village leaders to strengthen local governance, and opened a non-communicable disease health clinic.
A grandmother interviewed by researchers said the new clinic has offered a friendly place for elderly women to seek care — a challenging endeavor before Circle of Care arrived.
“This clinic, which is very friendly to the elderly, has really helped us to save some money and time, as we no longer have to travel long distances to seek care,” she said.
The project has also helped local government officials to reform a corrupt cash transfer program.
One community leader told Kendall’s colleagues the new system for handling cash transfers from aid organizations brought substantial relief because he was no longer pressured by friends and family for special treatment.
“I was once caught in the practice of giving benefits to my cronies,” he said. “But now I am a champion of participatory approaches when it comes to distribution of relief programs to the needy.”
Kendall credits the project’s community partners for its wide range of successes. The program is co-designed and implemented with the Institute for Participatory Engagement and Quality Improvement (IPEQI), a Malawaiian non-governmental organization with deep ties to UW–Madison. Kendall has worked with IPEQI’s executive director, Zikani Kaunda, for more than 25 years on community-led development approaches and with project officers Isaac Phiri and Abbey Kaliation on girls’ education for more than a decade. DiPrete Brown’s work on quality improvement also informed the organization’s mandate.
DiPrete Brown says quality of care is a “galvanizing idea that helps people to engage community strengths, especially when challenges are being faced.”
“Working with Nancy Kendall and her colleagues has been a great and humbling opportunity to address the needs of grandmothers, children, and their communities,” DiPrete Brown says. “When IPEQI leaders tell us that they hope to serve all of Malawi and beyond some day, I believe that this is possible.”
For Gogo Abiti Juma, life has completely changed since Circle of Care arrived. She and her family have benefited from direct cash payments, and she says community education has drastically changed how young people in her village interact with her and her family.
“I experienced hope that I can still live,” she told researchers. “I was even surprised to see the youths who used to insult me coming to do house maintenance. This project has really helped us, the elderly, to feel respected and we feel like going back to our youthful days.”
Circle of Care is nearing the end of its Baldwin Wisconsin Idea Grant funding and is seeking additional funding in order to continue. Kendall says there is much more to be done.
“Households and communities that are really deeply marginalized and impoverished need resources, and they need partnerships that focus on mobilizing communities for long-term transformation,” she says. “When you do that, you create an environment in which things that have come to be taken for granted can change quite successfully. This program has done remarkable things.”