The Government of Malawi has established a goal to provide access to basic health services for all—a daunting task given widespread poverty and a predominantly rural and hard-to-reach population.
High rates of HIV/AIDS (10.6 percent), fertility (5.7 children per woman), infant mortality (66 per 1,000 live births), child mortality (112 per 1,000 live births) and maternal mortality (675 per 100,000 live births) are exacerbated by a severe shortage of health workers, unhealthy behaviors, chronic malnutrition, frequent outbreaks of communicable diseases and limited access to quality health services, especially for the most vulnerable groups.
USAID is improving the health and well-being of Malawians by investing in strategic, high-impact health initiatives that support Malawi’s development goals, such as increasing access to and use of quality health care and encouraging development of strong health policies. We strengthen the overall health care system by supporting better planning and management, human resource development, supply chain management and distribution of essential drugs down to facilities and communities.
Through the Presidential Malaria Initiative (PMI), USAID expands efforts to expand proven preventive and treatment interventions toward achievement of 85 percent coverage among vulnerable groups to support the PMI goal of reducing malaria-related morbidity by 50 percent.
The United States is supporting Malawi as it takes the leadership role in its fight against HIV/AIDS. In May 2009, the Governments of Malawi (GOM) and the United States signed a Partnership Framework on HIV/AIDS, which outlines a five-year joint strategic plan to build a country-led, sustainable response. The PEPFAR Malawi program focuses on strengthening and growing the national HIV treatment program, a new approach to prevention of mother-to-child transmission, and voluntary medical male circumcision. Underlying all these activities is PEPFAR Malawi’s ongoing commitment to country ownership of the HIV response. All of PEPFAR Malawi’s programs are fully aligned with the GOM’s National Action Framework for HIV and developed in consultation with the GOM.
Maternal and Child Health
Our assistance focuses on quality of care in the provision of maternal health activities, increasing access and utilization of services by testing and scaling-up innovative and sustainable delivery approaches. We are also working closely with the Government of Malawi to improve national capacity to train skilled providers in basic emergency obstetric and neonatal care. A major focus of our work is increasing the capacity of village clinics and community health volunteers to deliver a package of high impact child health interventions aimed at prevention and management of childhood diarrhea, pneumonia, malaria, and malnutrition. Other activities increase point-of-use water treatment products and safe water supply points, increase immunization for vaccine-preventable childhood diseases, and support polio eradication.
USAID continues to support Malawi’s five-year TB strategic plan to strengthen directly observed treatment short-course (DOTS) programs by increasing case detection and the treatment of multi-drug resistance TB and TB/HIV co-infected individuals to reduce morbidity, mortality, and transmission. Enhancing TB/HIV programmatic integration at all levels and leveraging TB control interventions to strengthen overall health systems are also important elements of this strategy.
Family Planning and Reproductive Health
The population of Malawi is projected to more than triple in 30 years. If unchecked, this rapid growth would overwhelm the already struggling health care system, resulting in many inefficiencies and failures. The most recent Demographic and Health Survey shows modern contraceptive use among married women rose from 7 in 1992 to 42 percent in 2010, and the fertility rate dropped from 6.7 to 5.7 during the same period.
U.S. assistance promotes awareness of the importance of family planning and impact of rapid population growth on development through advocacy and social behavior change and communication. Other efforts expand voluntary, quality family planning services within health facilities and through outreach and community-based distribution.
Our assistance supports community-based interventions focused on identification, treatment, referral and support, as well as food security and livelihoods initiatives. We are also piloting interventions to introduce nutrition surveillance and treatment into existing pediatric HIV and TB sites. We are working with the Government of Malawi to increase their ability to manage and monitor nutrition programs, including how to develop indicators and collect high-quality data.
Last updated: May 10, 2013