Tuberculosis (TB) is a major public health problem in Malawi. In 2013, 20,335 new and relapse cases and 1,400 deaths were reported in Malawi. The World Health Organization estimates that only 78% of TB cases are diagnosed in Malawi. Six in ten people with TB are also infected with HIV. The number of TB cases in Malawi increased steadily from 1995 until 2003, when it reached its peak (28,000 cases). Since 2003, there has been a downward trend to just over 20,000 cases recorded in 2013. This promising news is largely due to the efforts of the National TB Control Program (NTP) and its partners.
USAID partners with the Government of Malawi (GOM) to increase the country’s capacity to undertake and sustain uninterrupted supply of life-saving health commodities at the facility and community levels. This includes direct procurement of commodities for voluntary medical male circumcision, malaria, and reproductive health; and secured storage and monthly distribution of anti-malaria and family planning commodities to 600 public health facilities in Malawi. USAID also builds the institutional capacity of the Ministry of Health (MOH) for procurement and supply chain management through seconded advisors at the MOH and training of district health facility staff.
Malaria is the leading cause of morbidity and mortality in children under five in Malawi. There are approximately five million episodes of malaria per year. It is endemic in 95% of the country, with 98% of infections due to Plasmodium falciparum, the most severe form of the four human malarial species. The Ministry of Health (MOH) estimates that malaria accounts for 34% of all outpatient visits and 40% of all hospital admissions among children under five. Four out of ten hospital deaths are reported to be due to malaria.
Nutrition remains a serious health and development problem in Malawi. While stunting and underweight rates decreased markedly from 2004 to 2010 (from 53% to 47% and 17% to 14% respectively), the rates remain high and are a reflection of chronic shortages in food quantity and quality. USAID’s programs therefore focus on preventing chronic under-nutrition. As a lynchpin across various U.S. Government initiatives, nutrition programs are funded through multiple sources.
USAID’s global Maternal, Neonatal and Child Health (MNCH) goal is ending preventable child and maternal deaths in a generation. USAID integrates evidence-based MNCH practices into activities in households, communities, and health facilities, and works with the Ministry of Health (MOH) to incorporate an MNCH focus into district and central level health activities.
The Integrating Nutrition in Value Chains (INVC) project is designed to implement USAID’s Feed the Future (FTF) and Global Health Initiative (GHI) strategies with the aim to sustainably reduce rural poverty and improve nutritional outcomes. INVC, which is USAID/Malawi’s flagship FTF project, runs from April 2012-April 2015.
Securing more sustainable financing, and increasing the efficiency and effectiveness of current spending through improved health sector governance, is critical for Malawi in the coming years.
Malawi faces a range of challenges to sustainably finance and efficiently manage the delivery of high-quality health services. There is a severe shortage of adequately trained health personnel across all professional cadres, and it is difficult to train, retain, supervise, and manage existing workers within the health system. There are also critical gaps in supply chain management, infrastructure and equipment. Donors provide over 60% of all health financing in Malawi and as much as 85% of funding for public sector health care services that serve the majority of Malawians.
USAID works with the Ministry of Health (MOH) to strengthen its Family Planning and Sexual and Reproductive Health Program (FP/SRH). Building on a historic partnership, USAID and the MOH are implementing the National Sexual Reproductive Health Strategy to increase contraceptive coverage rates from 42% to 60% by 2020. USAID also collaborates with development partners and civil society to address rapid population growth, which remains a significant development challenge in Malawi.
Climate change is already evident in Malawi. Projections for the coming decades suggest more erratic and less predictable rains, more frequent and extended dry periods, and more extreme heat events. The vulnerability of Malawians and their ecosystems to the adverse impacts of climate change is increasing with high population growth, increasing rates of deforestation and land degradation, severe erosion, and poor land management practices.
The United States Agency for International Development (USAID) has embarked on an ambitious reform effort, USAID FORWARD, to change the way the Agency does business. The seven key reform areas fall under three mutually reinforcing principles.
Last updated: August 21, 2014