This paper is concerned with the gap in educational provision for vulnerable learners in Malawi who are at risk of falling behind and dropping out of school due to irregular attendance. It draws on a study in high HIV-prevalence areas that explores the patterns of inequality and disadvantage that disrupt learning and uses this knowledge to design a school-based intervention to complement conventional schooling with more open and flexible delivery of the curriculum and increased school and community support. The intervention was implemented over one school year and evaluated using a randomized controlled design. The findings show that the intervention reduced dropout overall by 42% in intervention compared to non-intervention group. These findings suggest that there is a role for more open and flexible models of schooling and support in reducing educational inequalities. However, transforming established practice would require an integrated strategy supported by national policies that recognize the need for schools to change. (Contains 2 figures, 3 tables, and 1 note.)