MARKING 50 YEARS OF WORKING FOR DEVELOPMENT IN MALAWI

Building strong social services and protecting the most vulnerable

In a remote village of Sawali in Traditional Authority (T/A) Msamala
in Balaka district lives 13-year old Elube James, a Standard 8 pupil
at Sawali Primary School.
I dream of becoming a nurse after completing my education. I
like the profession, she says, adding, My aim is to save lives.
Elubes dreams of becoming a nurse are admirable, but the road
she will need to travel to realise her dreams is not smooth. Lack of
access to quality health care, adequate nutrition, safe water and
risks of being a victim of violence all stand in the way of many
young boys and girls in Malawi.
It is against this background that the United Nations has for the
past 50 years been working with the Government of Malawi and
other partners to alleviate the problems such as those Elube faces.
Specifically, the UN has been supporting government to provide
equitable and quality basic social and protection services to all
Malawians, especially vulnerable populations, and tremendous
progress has been achieved in this regard.
Malawis social development, then and now
When Malawi became independent in 1964, some of the
challenges that hindered access to education, health care and
other social services included limited infrastructure, inadequate
personnel and insufficient interventions to deal with socio-cultural
and economic obstacles.
With the population growing from less than four million people in
1964 to over 15 million people at present, the pressure on the
available structures for social services has also been increasing
exponentially. This is why for the past 50 years, the UN has been
supporting government to strengthen national systems to ensure
improved access to better quality health care, education,
protection and other services.
According to the 2013 Afrobarometer report, out of 16 African
countries where comparable data exists, Malawi has the second
highest improvement in providing health services between 2002
and 2012, and third largest improvement in providing education.
Also, the 2010 Economic and Social Rights Fulfilment Index
(ESRFI)which measures the fulfilment of the populations social
and economic rights in relation to the capacity of the
countrygives Malawi scores of 78.6 percent and 67.49 percent
in guaranteeing the right to health and the right to education to
its citizens, respectively.
Despite several interventions and achievements, some of the
challenges that hindered access to social services in Malawi 50
years ago, such as limited infrastructure and inadequate
personnel, still exist today. Going forward, the challenges require
more collective action to find innovative solutions to address
them.
Decent Healthcare for All
The UN has been a key partner in the health sector. As a result of
this partnership and governments strong support to the
community based primary health system, several gains have
been recorded including reduction of under-five mortality rate of
over 70% since 1990.
As a result, Malawi is likely to achieve Millennium Development
Goal (MDG) 4 target on reducing the number of children dying
before their fifth birthday. This makes Malawi one of the seven
African countries that are likely to achieve the MDG for child
mortality.
Other gains in the health sector include, reduction of maternal
deaths from 1,120 deaths per 100,000 births in 2000 to 574 deaths
per 100,000 births in 2014 and an increase in the percentage of
health facilities capable of providing the essential health
package from nine to 74 between 2004 and 2009.
However, there are still challenges which Malawi needs to
overcome in the next 50 years. Chronic malnutrition rates have
reduced only slightly and still stand at 42 percent of children.
Neonatal mortality currently 29 babies dying during the first
month of life for every 1000 live births - is still high; health workers
shortages still limit access to quality health care services; and
malaria is still the leading cause of morbidity, accounting for 40
percent of hospital admissions for children under five as well as
40 percent of hospital deaths throughout the country.
Going forward, efforts such as improving health infrastructure,
strengthening drug supply systems, dealing with human resource
issues, and improving community participation in delivery of
health care services will remain critical for Malawis health sector
to achieve the desired results in the next 50 years.
Good nutrition is key to good health and wellbeing
Malnutrition remains a serious challenge nationally and the
major contributor to child mortality. According to the 2010
Demographic Health Survey, 47 percent of children were too
short for their age (stunted), a condition caused by chronic
malnutrition.
Stunting affects a childs brain and physical development,
leaving them disadvantaged for life. Progress has been made in
this area, with the prevalence of moderate and severe stunting
down from 47 percent to 42 percent over the past years,
according to the 2014 MDG End Line Survey.
Among other nutrition efforts, the UN has also been supporting
nutrient supplementation interventions and provision of
treatment to ensure those suffering from malnutrition get the
care they need.
In the next 50 years, Malawi needs to continue addressing
challenges of poor quality and undiversified diet; limited access
to food; inadequate care and poor feeding practices for
vulnerable groups; and institutional and capacity constraints for
effective nutrition programmes in order to reduce the prevailing
high levels of malnutrition at 42 percentone of the highest in
the SADC region and above WHOs critical threshold of 30
percent.
Malawi also needs to improve coordination within and across
programmes dealing with nutrition to avoid duplication of efforts
and ensure effective implementation of the programmes. If not
addressed, malnutrition will continue hindering economic
growth, reducing learning and school completion rates,
disempowering women, increasing child and maternal
mortality, increasing infection and diseases, reducing
adaption to environmental stress, and increasing pressure on
global partnerships for development.
Safe water, improved sanitation and healthy habits
The UN has contributed to the country's achievements in water
supply, having already surpassed the MDG 7 target of halving
the proportion of the population without sustainable access to
safe drinking water.
Overall, the 2014 Malawi MDG Endline Survey shows that 86.2
percent of Malawians now have access to improved water
sources (piped water, protected wells or boreholes), which
represents a substantial increase since 2000 when only 47
percent had access to water from such sources.
Also, the 2013 Afrobarometer report shows that 64 percent of
Malawians did not experience water shortages in the past
year, as compared to an average of 51 percent among 34
African countries. Malawi is also ranked number five out of the
34 countries in providing water and sanitation services.
Despite this positive overall score on water and sanitation
services, access to improved sanitation in Malawi is still low at
53 percent, according to the 2013 Joint Monitoring
Programme (JMP) report. This does not only call for more
behavior change interventions but also increased provision of
sanitation facilities to improve sanitation habits among
Malawians, especially those in rural areas.
Only 53 percent of the national population uses improved
sanitation and at least 10 percent regularly uses the bush for
defecation. For the sake of our children, we need to reduce
these numbers, said UNICEF Country Representative
Mahimbo Mdoe at the recent Open Defecation Free (ODF)
celebration in Kasungu district in central Malawi.
Education - every childs right
Human capital development is vital to sustaining socio
economic development. The government of Malawi removed
primary school tuition fees in all public schools in 1994, a policy
which led to over 50 percent increase in enrollment. The net
enrollment in primary schools has since further increased from
78 percent in 2000 to 85 percent in 2014 (with urban net
enrollment being higher at 92.7 percent compared to the rural
84.6 percent).
Further the proportion of pupils starting grade 1 who reach grade
5 without repeating a grade increased from 69 percent in 2000 to
77 percent in 2012 and the literacy rate increased from 68.1 in
2000 to 75.2 percent in 2013.
The UN has played a major role in Malawis education sector,
providing critical support to help improve the quality of
education by training teachers, constructing schools and
improving water and sanitation facilities. In 2012 alone, a total of
10,000 trainee teachers were recruited and the average
classroom size went down, improving the quality of teaching in
classrooms.
While access to education has improved in the past years,
drop-out rates remain high and transition to secondary school
remains a challenge especially for girls. Shortage of qualified
primary school teachers; inadequate infrastructure, limited
teaching and learning materials; and equity issues affecting
pupils with special needs; are some of the challenges still needing
more efforts in the education sector.
Protecting women and children from violence
Protecting children, young people and women from violence,
abuse, exploitation and neglect and ensuring that they have
access to an expanded range of protection services is another
area where the UN in collaboration with partners has been
supporting to enable Malawi achieve significant progress.
Over the past 50 years, Malawi has developed strong structures
such as victim support units for the protection of women and
children across the country. However, the country still needs to
redouble efforts against gender based violence by ensuring that
relevant legislations are fully enforced. Two out of three children
in the country still experience some form of violence during their
childhoods, and too few of them receive the help they need. The
country also needs to continue expanding protection services
and behaviour change interventions to reduce these
unacceptably high levels of violence.
Going forward, the UN will continue working as a key partner in
supporting the Government of Malawi to accelerate progress
towards the achievement of lagging targets in the area of basic
social and protection services so that adequate social safety nets
are in place to ensure girls such as Elube survive, thrive and realise
their full potential.
The establishment of the
Coalition on Child Rights has
been as a result of strong
technical and financial
support from UNICEF with
the shared interest that civil
society organisations
coordinate their national
efforts for the protection of
c h i l d r e n D e s mo n d
Mhango - Chair NGO CCR
UNICEF Country Representative Mahimbo Mdoe addressing a community gathering in Kasungu at an
open defecation free (ODF) event.
Working to ensure that all young people understand their
rights, reaching out to malnourished children and protecting
children from malaria through distribution of bed nets have
been some of the amazing efforts the UN has supported in
several districts in Malawi. Apart from that, there has been
great improvement and transformation among youth
because of support towards promotion of information
communication and technology, vocational skills, life skills,
sexual reproductive health rights, leadership skills, girls
empowerment and different sporting activities.Youth
worker and Active Youth Initiative for Social Enhancement
(AYISE) Bangwe Youth Centre coordinator Monica Dzonzi.