This investigative report documents the impact of U.S. global health assistance policies, funding decisions, and programmatic shifts on the sexual and reproductive health and rights of people in Malawi, with a particular focus on women and girls. Based on CHANGE’s interviews, focus groups, and desk research, this report provides an in-depth analysis of SRHR in U.S. global health assistance.

The Malawi case study captures first-hand accounts of the repercussions of historic and current U.S. global health assistance policies, programs, and funding decisions on SRHR in Malawi. It also highlights the successes and challenges associated with implementing U.S. global health assistance programs in Malawi and documents the local political and cultural factors that shape program implementation.