Overview (Lilongwe City)

The goals of this analysis are:

For given travel times (60, 90, 120 minutes) or geographical distances (5, 8, 10 km), estimate the proportion and number of PLHIV that can reach their closest ART facility. This is done on a district and traditional authority (TA) level.
Produce a gridded PLHIV prevalence map of Malawi using the WorldPop population density map and Naomi PLHIV estimates that supports the identification of locations that may be underserved.
Incorporate travel time maps that indicate the time and distance needed to reach the closest ART facilities, based on a combination of digital elevation and land cover maps as well as road layouts in Malawi.
Identify and propose new candidate facilities and locations for ART treatment scaling-up activities.

For the detailed methodology on how these maps were created, please refer to the supplementary material provided.

Download the full district report here.

Lilongwe City Maps

Population, PLHIV and Travel Times

Malawi Overview Map

Each pixel on the map corresponds to an area of 1km x 1km. Below we display a map of Malawi with some general information:

Population: population density using the WorldPop population density map, adjusted to the 2018 census numbers.
PLHIV: gridded prevalence estimates of the number of people living with HIV (“PLHIV density estimates”).
HIV Prevalence: estimated gridded HIV prevalence.
Geographical distance: direct distance (in km) to the closest ART facility.
Walking time: estimated travel time (in minutes) to the closest ART facility at a given pixel.

Additionally, it is possible to add markers with facility locations to the map:

ART Facilities: health facilities that provide ART services and had at least one patient on ART in 2020 (based on the DHA-MIS database).
- “Private for profit” facilities are excluded from the analysis.
- The number of ART patients in Q3/2020 is provided in the brackets.
Non-ART Facilities (Static): other (nonprofit) health facilities that do not currently provide ART facilities. (These include facilities that have indicated that they have capacity to provide ART services).

Time Thresholds

By comining the travel time maps with the gridded PLHIV prevalence, the number of PLHIV that is not reached within a certain time limit or distance (km) is computed. This is visualised in the below two maps, stratified by geographical distance and walking time.

Example interpretations:

Walking 15 minutes: this gives a map of the regions with PLHIV for which the closest facility is more than 15 mintues (walking time) away.
5km distance: this gives a map of the regions with PLHIV for which the closest facility is more than 5km (geographical distance) away.

TA analysis

To support the analysis, we have computed the proportion and number of PLHIV that are not reached within a given time or distance. Higher percentages correspond to a larger proportion of PLHIV that is not reached within the relevant area.

Candidate Facilities (60 Minutes)

Below we provide proposed facilities for scaling-up activities, illustrated on the maps. Green areas indicate additional PLHIV that can be reached through the proposed facilities within 60 minutes. Note: facility labels were aligned to district reports that were disseminated.

Summary Information

Summary estimates for Lilongwe City, September 2020.
Total PLHIV (all ages)	87,905 (77,544–98,717)
HIV prevalence, age 15-49 years	11.4% (10.1%–12.8%)
Total patients receiving ART	65,074
Average walking time to nearest ART (minutes)	18 (17–18)
Number PLHIV > 60 minutes walking time	240 (173–333)
Percentage PLHIV > 60 minutes walking time	0.3% (0.2%–0.4%)

Facility List

ART Facilities

List of active ART facilities that had at least 1 registered ART patient in September 2020. The column “ART” indicates how many ART patients are registered at the ART facility. Facilities outside the district boundaries that may be accessible to residents within the district are marked with “*“.
ID	District	TA	Name	Type	Authority	Long.	Lat.	ART
A1	Lilongwe City	Area 2	Bwaila Hosp.	District hospital	Government	33.77	-13.99	24846
A2	Lilongwe City	Area 25	Area 25 HC	Health centre	Government	33.77	-13.89	5883
A3	Lilongwe City	Area 36	Partners In Hope Clinic	Special	NGO	33.79	-14.02	5417
A4	Lilongwe City	Area 18	Area 18 HC	Health centre	Government	33.78	-13.94	4461
A5	Lilongwe City	Area 58	Likuni Mission Hosp.	District hospital	CHAM	33.71	-14.03	4385
A6	Lilongwe City	Area 33	Baylor Childrens Centre Of Excellence In Malawi	Central hospital	NGO	33.79	-13.98	2623
A7	Lilongwe City	Area 37	MACRO Lilongwe	Special	NGO	33.78	-14.00	2611
A8	Lilongwe City	Area 27	Daeyang Luke Hosp.	Other hospital	CHAM	33.81	-13.87	2148
A9	Lilongwe City	Area 36	Partners In Hope Clinic	Special	NGO	33.79	-14.02	1922
A10	Lilongwe City	Area 35	Kamuzu Barracks	Special	Other	33.82	-13.98	1509
A11	Lilongwe City	Area 53	Lumbadzi HC	Health centre	Government	33.81	-13.77	1392
A12	Lilongwe City	Area 47	African Bible College Clinic	Special	CHAM	33.74	-13.97	1268
A13	Lilongwe City	Area 30	Area 30 Police Clinic	Special	Other	33.78	-13.93	1099
A14	Lilongwe City	Area 33	Kamuzu Central Hosp.	Central hospital	Government	33.79	-13.98	1042
A15	Lilongwe City	Area 25	Dzenza HC	Health centre	CHAM	33.75	-13.88	936
A16	Lilongwe City	Area 57	Lilongwe City Assembly Chinsapo	Special	Government	33.73	-14.01	801
A17	Lilongwe City	Area 6	Maula Prison HC	Health centre	Other	33.77	-13.97	599
A18	Lilongwe City	Area 53	Blessings Hosp.	Other hospital	Private	33.82	-13.79	408
A19	Lilongwe City	Area 7	FPAM Clinic Kawale	Health centre	NGO	33.80	-13.99	383
A20	Lilongwe City	Area 14	Adventist HC Lilongwe	Other hospital	CHAM	33.78	-13.95	281
A21	Lilongwe City	Area 29	Alliance One Clinic	Special	Private	33.80	-13.90	98
A22	Lilongwe City	Area 44	New State House Disp.	Dispensary	Government	33.85	-13.96	80
A23*	Lilongwe	TA Tsabango	Kang’oma HC	Health centre	Government	33.88	-13.98	483
A24*	Lilongwe	TA Njewa	Airwing Clinic	Health centre	Other	33.70	-13.96	399

Non-ART Facilities

List of non-ART facilities considered in the analysis. The column “PLHIV” indicates the number of PLHIV that currently need more than 60 minutes to walk to the closest ART facility but less than 60 minutes to the listed health facility in the table. Facilities outside the district boundaries that may be accessible to residents within the district are marked with “*“.
ID	District	TA	Name	Type	Authority	Long.	Lat.	PLHIV	95% CI
F1	Lilongwe City	Area 38	Chimwala HC	Health Centre	Government	33.80	-14.05	792	(579-1024)
F2	Lilongwe City	Area 23	Mlodza SDA Disp.	Dispensary	CHAM	33.82	-14.01	142	(105-183)
F3	Lilongwe City	Area 29	Africa Leaf Clinic Kanengo	Clinic	Company	33.80	-13.89	1	(0-1)
F4	Lilongwe City	Area 36	SOS Clinic	Special	NGO	33.79	-14.02	0	(0-0)
F5	Lilongwe City	Area 1	BLM Falls	Special	NGO	33.78	-14.00	0	(0-0)
F6	Lilongwe City	Area 25	BLM Area 25	Special	NGO	33.76	-13.89	0	(0-0)
F7	Lilongwe City	Area 7	BLM Kawale	Special	NGO	33.80	-13.99	0	(0-0)
F8	Lilongwe City	Area 3	City Assembly Health	Clinic	Government	33.77	-13.99	0	(0-0)
F9	Lilongwe City	Area 3	Lilongwe City Assembly Staff C	Clinic	Government	33.77	-13.99	0	(0-0)
F10	Lilongwe City	Area 29	Auction Holdings Clinic	Clinic	Company	33.80	-13.89	0	(0-0)
F11	Lilongwe City	Area 29	Carlsberg / Sobo Clinic Lilong	Clinic	Company	33.80	-13.90	0	(0-0)
F12	Lilongwe City	Area 3	Escom Clinic Lilongwe	Clinic	Company	33.77	-13.99	0	(0-0)
F13	Lilongwe City	Area 39	Kanengo Tobacco Processors Cli	Clinic	Company	33.81	-13.90	1	(0-1)
F14	Lilongwe City	Area 29	Limbe Leaf Tobacco Co. Ltd. Cl	Clinic	Company	33.80	-13.89	0	(0-0)
F15	Lilongwe City	Area 20	MoH Hq	Clinic	Government	33.79	-13.95	0	(0-0)
F16	Lilongwe City	Area 16	Reserve Bank of Malawi Clinic	Clinic	Company	33.79	-13.96	0	(0-0)
F17*	Lilongwe	TA Mtema	MNGWANGWA	Health Post	Government	33.68	-13.84	442	(315-590)
F18*	Lilongwe	TA Njewa	BULI	Health Post	Government	33.71	-13.92	0	(0-0)

Distances and travel times to ART facilities for PLHIV

March 2022