Malawi’s lakeside districts are accustomed to the age-old practice of fish vendors and fishers exchanging sexual activity for fish, which is then sold in markets. Sexual transactions such as this give rise to sexual exploitation and abuse, often in a context of circular and fluid migration between communities of origin, transit and work. Recent reports indicate a high prevalence of HIV, particularly among fish-dependent communities in Nkhatabay, Salima and Mangochi districts, with suspected related high cases of sexual gender-based violence (SGBV) in these regions. These same districts have also seen high case rates due to the current cholera outbreak, demonstrating the need for institutional and community-centered support to district health systems. The objective of this project is to contribute to improved health outcomes among highly mobile fisherfolk and fish-dependent communities on Lake Malawi, with a specific focus on SRHR, HIV and emerging public health threats. To achieve this the project will have two complementary outcomes: 1) District and community health systems around Lake Malawi effectively plan for and respond to the gender-sensitive health needs of highly mobile fisherfolk and fish-dependent communities; and 2) Mobile fisherfolk and fish-dependent communities actively take steps to exercise their rights to health. Specifically, the project will contribute to the evidence base regarding the mobility patterns of fisherfolk alongside Lake Malawi, including seasonal patterns, duration of stay and the extent to which they are using health services. Additionally, the project will focus on community structures to develop their capacities to effectively plan for the health needs of fisherfolk and fish-dependent communities. Lastly, it will pilot a community-led approach to providing health services to the fishing communities around Lake Malawi. It will identify and develop the capacities of community change agents who will support the community through targeted outreach mobile health clinics on docking days. The lessons learned from this pilot will feed into the overall planning processes within each district.