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.
The Government of Malawi (GoM) has made agricultural development and nutrition top priorities. Under President Banda’s Presidential Initiative on Hunger and Poverty Reduction as well as the Agriculture Sector Wide Approach, the GoM is unlocking latent private sector investment and opening export markets for smallholders. USAID is collaborating with the GoM to seize these opportunities while addressing challenges in agriculture-led economic growth.
Malawi faces several major health challenges that undermine its growth and development. Its population of 15 million is expected to triple by 2040 if there is no reduction in its total fertility rate of 5.7. Over half of its population lives below the poverty line, and more than a third consumes less than the required daily calories, leading to a 47% stunting rate for children under five. Leading causes of death include HIV/AIDS, lower respiratory infections, malaria, diarrheal diseases, and pregnancy-related complications. Malawi’s health indicators are among the worst in the world, with maternal mortality at 675 maternal deaths per 100,000 live births, under-five mortality at 112 deaths per 1,000 live births, and infant mortality at 66 deaths per 1,000 live births.
Last updated: November 27, 2014