election in malawiThe people of Malawi went to the polls in May 2019 eager to make their voices heard.  Due to some electoral static, however, the world only recently received their message. Marred by allegations of impropriety and delayed by legal challenges, a resolution came in June 2020 when the country repeated the election. On June 27, 2020, 13 months following the initial vote, the election in Malawi resulted in Lazarus Chakwera becoming the nation’s next president. Thanks to courageous actions from Malawi’s top court, a nation imperiled by electoral dysfunction has achieved a peaceful transition of power.

The Election in Malawi

Shortly following the initial presidential election in Malawi on May 21, 2019, President Peter Mutharika won by a narrow margin. However, rumors of irregularities in the vote tallies began to cast doubt on the outcome. Of the 5.1 million votes cast, Mutharika won 38.6% of the vote, compared to 35.4% and 20.2% for his closest competitors. The opposition candidates, Lazarus Chakwera of the Malawi Congress Party and Saulos Chilima of the United Transformation Movement, filed a lawsuit. This prompted an investigation of the Malawi Electoral Commission’s (MEC) handling of the election in Malawi. Additionally, the angst from the controversy spilled into the streets, where thousands of citizens engaged in peaceful protests.

Following a protracted investigation, the nation’s constitutional court invalidated the results of the election in Malawi, citing “widespread, systematic and grave” anomalies. In a voluminous report, the five-judge panel cataloged a panoply of suspicious behavior. This ranged from mathematical errors to the use of correction fluid on tallying forms. There were mixed reactions to the court’s surprising decision, as Mutharika retained power while the inquiry took place. In addition, Mutharika decried the decision as “a great miscarriage of justice.” However, others lauded the decision as a powerful demonstration of judicial independence and a hallmark of a functioning democracy.

A Second Chance

The constitutional court’s decision ordered that a new election take place within 150 days of their announcement, which came in February 2020. In June 2020, the Parliament set election day for June 23. Justice Chifundo Kachale oversaw the re-run. Kachale replaced Jane Ansah as chairperson of the MEC following Ansah’s role in the initial vote. Despite the court’s stern ruling, the extent of potential election malfeasance in the initial vote remains unclear.

Leaders of the opposition claimed that correction fluid inflated the vote totals of the incumbent. In their lawsuit, the leaders implicated the MEC. Conversely, the MEC argued the fluid had only been used to alter procedural information, not the vote totals. Luke Tyburski of the Atlantic Council’s Africa Center inspected the actual results sheets, which citizens can access online. Tyburski’s analysis suggests “human error instead of malicious tampering” likely caused the alterations. However, Tyburski suggests that this “does go a long way toward discrediting much of the sensational rhetoric surrounding the vote.” Whether malice or simply human error caused the error, Malawi’s top court felt compelled to clean the slate with a re-run.

Poverty and the Election in Malawi

The judiciary’s choice has broader implications than simply who serves as Malawi’s president. For one, it fortifies the people’s faith in the rule of law. Elections with contested outcomes are not new to Africa. Many leaders hold shambolic votes with impunity, while other electoral disputes cause a descent into chaos or even civil war. What makes the election in Malawi unique is the willingness of its high court to assert itself when warranted. It would have been easy to simply sanctify the initial elections in accordance with the wishes of the president. But the court chose otherwise. Although needing the courts to intervene in the democratic process is far from ideal, it may be necessary to restore the public’s confidence in free and fair elections.

As Malawi relies heavily on foreign assistance, this show of sound governance can only serve as reassurance for Malawi’s benefactors. These include the International Monetary Fund and the World Bank. Additionally, the court’s decision demonstrates to potential trading partners that the nation can be a stable ally. Despite a GDP growth rate of 4% in 2019, the nation’s extreme poverty rate is still around 20%. As such, the international community must see Malawi as deserving of investment and assistance to help lift its people out of poverty. The result of the re-run can do just this.

Looking Forward

When Malawians returned to the polls on June 23, 2020, the international community had a keen eye on the proceedings. This deterred potential bad actors from any hijinks and ensured that the MEC did its due diligence in properly tallying the votes. Chakwera won convincingly, garnering nearly 59% of the vote, and became president. As a result, the people of Malawi won, and democracy was victorious. This is a positive step toward garnering international aid for Malawi and reducing the poverty its citizens face.

Brendan Wade
Photo: Flickr

VillageReach is Improving Healthcare
The history behind VillageReach is very similar to The Borgen Project’s history. Blaise Judja-Sato, a native Cameroonian, founded VillageReach in 2000 after returning to Africa to aid in the relief efforts of a devastating flood in Mozambique. While he was in Mozambique, Judja-Sato saw a problem with the healthcare system. Since many citizens live in rural areas, the government could not provide them with the medical supplies they needed, which led to their frustration. Thus, she coined the phrase “starting at the last mile” and established VillageReach. Here is some information about how VillageReach is improving healthcare in low and middle-income countries.

Healthcare That Reaches Everyone

VillageReach’s mission is simple. It aims to reach “the last mile” in LMICs (low and middle-income countries) where people do not always have access to healthcare or any at all. Even with VillageReach, 1 billion people do not have access to healthcare. However, VR is working to improve the already existing health systems in different areas. It focuses on four pillars including healthcare accessibility, information availability, human resource constraints and lack of infrastructure. VillageReach is improving healthcare in these countries so that the people in and out of rural areas thrive.

Big Partners

Additionally, VR has over 30 partners that keep its organization running strong. From the Bill and Melinda Gates Foundation to UNICEF, VR has quite an array of influential partners. The President of the organization is Emily Bancroft. She stated that VR “could not have made an impact the last 20 years without the collaborative power of partnership.” The team is spread out over 13 countries. It has headquarters in Seattle, Washington and offices in Mozambique, Malawi and the Democratic Republic of the Congo (DRC).

Drones

Furthermore, in 2019, VR collaborated with the Ministry of Health, Swoop Aero and Gavi, the Vaccine Alliance, to launch the Drone Project in the Équateur Province of the DRC. The partners decided to pick this place in the DRC because of its many geographical challenges. More than half of the health systems in place are only accessible by river. The goal of the Drone Project is to increase vaccine availability in areas that are hard to reach. The drones, provided by Swoop Aero, can take off with the push of a button and land without guidance. It can also carry around six pounds. After the Drone Project’s first flights were successful, the partners are already thinking bigger, brainstorming on how to send other medical supplies and equipment.

COVID-19 Response

Also, VR is a supporter of the COVID-19 Action Fund for Africa. The initiative works to supply PPEs (personal protective equipment) to community health workers in Africa. PPEs are practically inaccessible in most African countries and the consequences are horrible. Health workers stay home or work without PPEs. With health workers not working, there is no way that Africa will be able to stop the spread of COVID-19. VR plays a crucial part in the initiative’s seven-approach plan, which focuses on the last mile and working with similar in-country organizations to accomplish its goals.

Recognition

As a 20-year-old organization, VR received recognition numerous times for its fantastic work in Sub-Saharan Africa. Recently, the Washington Global Health Alliance honored VR with the Pioneers Outstanding Organization Award. The WGHA awards winners that work hard to improve health equity all over the world. The judges select winners, and in 2020, WGHA board member Erin McCarthy led it. VR received an award for its innovative approach, collaborations with local governments in the places it works and its international emphasis on equity.

Overall, from COVID-19 response to innovating delivering vaccines by drones, VillageReach has covered it all in its 20 years of service to the world. VR is improving healthcare, one small rural village at a time.

– Bailey Sparks
Photo: Flickr

healthcare worker emigrationThe emigration of skilled healthcare workers from developing countries to higher-income nations has significantly impacted the healthcare systems of the countries these workers leave behind. The quantity and quality of healthcare services have declined as a result of healthcare worker shortages. While there is still incredible room for growth, recent governmental strategies have incentivized healthcare workers to work in their home countries.

Why Is Healthcare Worker Emigration a Problem?

When healthcare workers emigrate, they leave hospitals in developing countries without enough skilled workers. Lower-income countries are likely to carry a greater amount of the global disease burden while having an extremely low healthcare staff to patient ratio. For example, sub-Saharan Africa only has 3% of all healthcare workers worldwide, while it carries 25% of the global disease burden. In many African countries with severe healthcare worker emigration, like Lesotho and Uganda, hospitals become overcrowded. Furthermore, hospitals cannot provide proper treatment for everyone due to the lack of skilled workers.

This directly affects the quality of care patients receive in countries with high healthcare worker emigration. Newborn, child and maternal health outcomes are worse when there are worker shortages. When fewer workers are available, fewer people receive healthcare services and the quality of care worsens for populations in need.

Why Do Healthcare Workers Emigrate?

The emigration of doctors, nurses, and other skilled healthcare workers from developing countries occurs for a number of reasons. The opportunity for higher wages elsewhere is often the most important factor in the decision to emigrate. Additionally, healthcare workers may migrate to higher-income nations to find political stability and achieve a better quality of life. The rate of highly skilled worker emigration, which has been on the rise since it was declared a major public health issue in the 1940s, has left fragile healthcare systems with a diminished workforce.

Moreover, the United States and the United Kingdom, two of the countries receiving the greatest numbers of healthcare worker immigrants, actively recruit healthcare workers from developing countries. These recruitment programs aim to combat the U.S. and U.K.’s own shortages of healthcare workers. Whether or not these programs factor into workers’ migration, both the U.S. and the U.K. are among the top five countries to which 90% of migrating physicians relocate.

Mitigating Healthcare Worker Emigration

The World Health Organization suggests that offering financial incentives, training and team-based opportunities can contribute to job satisfaction. This may motivate healthcare workers to remain in the healthcare system of their home country. Some developing countries have implemented these strategies to incentivize healthcare professionals to remain in their home countries.

For example, Malawi faced an extreme shortage of healthcare workers in the early 2000s. Following policy implementation addressing healthcare worker emigration, the nation has seen a decrease in the emigration rate. Malawi’s government launched the Emergency Human Resources Program (EHRP) in 2004. This program promoted worker retention through a 52% salary increase, additional training and the recruitment of volunteer nursing tutors and doctors. 

In only five years after the EHRP began, the proportion of healthcare workers to patients grew by 66% while emigration declined. Malawi expanded upon this program in 2011 with the Health Sector Strategic Plan. Following this plan, the number of nurses in Malawi grew from 4,500 in 2010 to 10,000 in 2015. Though the nation still faces some worker shortages, it hopes to continue to address this with further policy changes.

Trinidad is another a country that has mitigated the challenges faced by the emigration of healthcare workers. Trinidadian doctors who train in another country now get government scholarships to pay for their training. However, these scholarships rest on the condition that they return home to practice medicine for at least five years. Such a financial incentive creates a stronger foundation for healthcare professionals to practice in their home country.

A Turn Toward Collaboration

A recent study determined that the collaboration of nurses, doctors and midwives significantly decreased mortality for mothers and children in low-income countries. As developing countries work toward generating strategies to manage the emigration of healthcare workers, a team-based approach can improve the quality of healthcare. When there are shortages of certain kinds of health professionals in remote areas, family health teams composed of workers in varying health disciplines can collaborate to provide care. 

Improving working conditions and providing both financial and non-financial incentives to healthcare professionals in developing countries not only benefits workers and the patients, but the nation’s healthcare infrastructure as a whole. An increase in the number of skilled healthcare workers in developing countries gives people there the opportunity for a better life.

– Ilana Issula
Photo: Flickr

Sanitation in MalawiMalawi is an impoverished, landlocked country in southeastern Africa. As is common among impoverished nations, Malawi critically struggles with health and sanitation. Here are the top 10 facts about sanitation in Malawi.

Top 10 Facts About Sanitation in Malawi

  1. Menstrual hygiene – In Malawi, there are imbedded cultural beliefs surrounding menstruation that lead to communal ignorance. This stigma surrounding menstruation extends to schools, where girls similarly do not receive education about menstruation. Furthermore, most school bathrooms provide little to no privacy. This lack of privacy, combined with the societal shame of menstruation, results in girls leaving school once they get their period.
  2. Hygiene in schools – For children without access to clean water, toilets or soap at home, school can be their only hope of sanitation. Unfortunately, hygiene in schools often falls short in Malawi. As of 2018, only 4.2% of Malawian schools had handwashing facilities with soap and 9% did not have a secured water source.
  3. Education about hygiene and sanitation – Schools are a key tool for educating youth on basic hygiene and sanitation, especially due to the fact that children are effective agents of behavior change. They capable of sharing lessons they learn at school with their local community. However, similar to their lack of sanitation infrastructure, schools also lack education surrounding sanitation in Malawi. Even if schools did offer education surrounding hygiene and sanitation, high rates of enrollment would be required to create a large scale change in behavior. In many rural communities, girls are tasked with traveling long distances to collect water. This responsibility combined with the obstacle of menstruation reduces female enrollment in school.
  4. Toilets – As of 2015, 9.6 million Malawians – almost half of the population – did not have access to an adequate toilet. There are two types of toilets in Malawi. The first is the Western-style with a toilet bowl and a seat; the second is a hole in the ground. The Western-style is common in urban towns and cities while the hole in the ground is common in rural areas.
  5. Open defecation – In 2008, Malawi adopted the Community Lead Total Sanitation and Hygiene program (CLTS) in an effort to make the country Open Defecation Free (OPF). Malawi has made great strides, but 6% of rural communities continue to openly defecate. Open defecation results from inadequate health infrastructure such as toilets and is a key health concern in Malawi. Open defecation is linked to sanitation-related diseases, high child mortality and the spread of cholera.
  6. Access to water – As of 2015, only 67% of households in Malawi had access to basic drinking water. Similarly, 5.6 million do not have access to a safe water source. In fact, pproximately 30% of water points in rural areas were non-functional at any given time. Water is deeply intertwined with sanitation. Without access to clean water people catch water-borne diseases, are unable to stay clean through bathing and risk their safety by traveling long distances to receive water.
  7. Access to local sanitation facilities – As of 2015, only 42% of Malawian rural households had access to basic sanitation services. Consequently, in 2018 there were 9.9 million people in Malawi who did not use basic sanitation. Combined with poor transportation infrastructure, this lack of local sanitation facilities places strain on rural communities. Communities that do not have secure access to water, predominantly rural communities, are reliant on local sanitation facilities to stay clean and healthy. Thus, without such facilities, the risks of experiences the consequences of poor sanitation increase dramatically.
  8. Role of drought – In the past 36 years, Malawi has experienced eight major droughts. Droughts directly cause a reduction in water availability and thus, indirectly impact sanitation. The most recent drought in Malawi occurred in 2016 and disrupted household economic activities by increasing the time needed to search for water. It also increased the degradation of water catchment areas and increased the risk of water-washing diseases due to a prioritization of water for drinking rather than personal hygiene. Drought places another obstacle in the way of achieving universal sanitation in Malawi.
  9. Higher risk of diseases – Poor sanitation and unhygienic practice result in approximately 3,000 under-five child deaths per year in Malawi. Diarrhea is often a tragic consequence of poor sanitation with 11.4% of infant and child mortality resulting from diarrhea. Similarly, even if diarrhea does not result in death, frequent episodes can yield a negative effect on child development, stunting and acute respiratory infections. Furthermore, poor sanitation not only leads to diarrhea but also waterborne illnesses such as cholera. Thus high rates of communicable diseases are intimately tied to poor sanitation in Malawi.
  10. Improvements to WASH services – USAID is an active participant in increasing WASH services in Malawi and has made great progress. In 2015 alone USAID had constructed 60 shallow wells and three boreholes. It built 360,080 toilets with handwashing facilities as well as installed 2600 chlorine dispensers in 25 villages. This progress provides hope for the achievement of universal sanitation in Malawi.

Malawi is an impoverished African nation currently suffering from inadequate sanitation. This lack of sanitation in Malawi not only impacts health but household income and child attainment of education. While progress has been made through organizations such as USAID, more still needs to be done. Please consider visiting the Borgen Project website on information on how to call or email your representatives to put international aid as a priority on the U.S. agenda.

Lily Jones
Photo: Flickr

gender gap in malawiFemale education has been an ongoing challenge for the East African country of Malawi. With 50.7% of the population living below the poverty line, the nation is one of the poorest in the world, and a large percentage of the poor are women. A significant reason why is that girls often fall behind early in their education especially in areas like math and reading and end up dropping out. Also, the average elementary classroom in Malawi has 76 students meaning faculty are frequently overburdened and unable to address the delicate situation many young women find themselves in.  The London based nonprofit organization Onebillion has developed the Onecourse technology that is closing the education gender gap in Malawi.

A Girl’s Challenge

While both boys and girls face high dropout rates in Malawian schools, girls are less likely to return due to factors such as labor demands at home, being discriminated against as the perceived weaker gender, absence of female role models and harassment by male teachers and fellow students. With typical teaching practices concerning math and reading in Malawi early grade schools, boys usually pull ahead of girls in math by second grade while girls pull ahead of boys in reading, but this advantage in reading disappears by sixth grade and girls are behind in both subjects.

The Onecourse Experiment

Onecourse is unique in its approach in that it is an all-digital platform where students are guided by a virtual teacher through a strategically crafted set of activities. Students are given a Onetab tablet loaded with Onecourse apps in their native language. For Malawian students this was Chichewa. One of the biggest challenges for developer Onebillion is to prove in trials that significant learning can happen in the absence of a teacher. “For the Onebillion trial, children were taken out of their huge classes, put in groups of 25 and given tablets loaded with math software; similar-sized groups were given tablets without the math software, to control for the possibility that children might benefit from any instruction given in smaller groups.”

Promising Results

Onebillion’s software has helped Malawian girls make significant advances. Evaluations by the University of Nottingham and the University of Malawi demonstrate that digital intervention can not only educate students but prevent girls from falling behind in their learning. Specifically, eighteen 30 minutes sessions with Onecourse early grade math apps prevent girls from falling behind early in mathematics. Early mathematics intervention may also promote girls more likely going to Science, Technology, Engineering and Mathematics courses in the future.

Final Thoughts

Overall, Onecourse technology is closing the gender gap in Malawian early education. Digital learning platforms like Onebillion’s Onecourse have helped aid undertrained and over burned faculty in many developing countries like Malawi, Uganda and Tanzania and is also being used to help marginalized children in the United States. The Onebillion organization, in a tie with the Kitkit school (a similar digital program developer), was awarded the Global Learning Xprize that promotes organizations that create programs allowing children to educate themselves in reading, writing, and math. This program, and others like it, will be essential in ending the educational gender gap in Malawi.

– Joseph Maria
Photo: Flickr

Severe Land Degradation in Malawi: Its Cause and Solution

Malawi, a small country located in southern Africa, is heavily experiencing the negative effects of deforestation: severe land degradation. If the country cannot find a successful way to fix its watersheds, it could become water scarce.

Malawi has a population of over 18 million people. Poverty affects a large percentage of Malawi’s population. Agriculture is the main source of income for most households in Malawi, making up more than one-third of the country’s $7 billion GDP and 90% of its exports. Over 80% of the population in Malawi lives in more rural areas, while around 11 million of those people partake in smallholder farming.

While agriculture is the main contributor to Malawi’s GDP, the majority of the land in Malawi is not suitable for farming. Because of this viability issue, the country is experiencing mass deforestation. Smallholder communities, therefore, push into the marginal land to survive. Other than expanding agriculture, Malawi forests are suffering from high demand for charcoal. In March 2017, the Malawi army went to major forests in the country to stop people from cutting down the trees for charcoal production, which was contributing to the land degradation that was contaminating the Shire River, the country’s main water source.

Due to these actions and others, cities in Malawi are experiencing deforestation at alarming rates. For example, between 2001 and 2019, a mere two regions were responsible for over 50% of Malawi’s deforestation. Nhata Bay lost 64.3-kilo hectares of forest, equivalent to about 158,889 acres; Mzimba lost 25.8-kilo hectares of forest, equivalent to about 63,753 acres. Over the last 40 years, over half of Malawi’s forests have been cut down, and because of that, nearly 80% of the total land area in Malawi has experienced degradation.

How is Land Degradation Hurting Malawi?

Here are some ways that severe land degradation and watershed degradation affect the communities in Malawi:

  • The lack of vegetation covering the soil results in erosion, surface runoff, flooding, contaminated water, droughts and reduced energy security.
  • In the last decade, chemical land degradation has led to a 15% loss in arable land.
  • In 2014, the average annual national soil loss rates were 29 tons per hectare.
  • The Shire River Basin is a hotspot for land degradation. As fallen sediment mixes into the water at a higher rate, it is more expensive for the country to filter the water to keep it safe.
  • Sediment in river beds and reservoirs impedes irrigation canals and hydropower generation.
  • About 95% of Malawi’s power generation comes from hydropower produced through the Shire River and Lake Malawi. However, because of low water levels, the electricity generation has reduced by 40%.

Efforts to Help

The Malawi Watershed Services Improvement Project (MWASIP), which the Ministry of Agriculture Irrigation and Water Development (MoAIWD) implemented, aims to fix the watershed crisis and the severe land degradation issue through three different components:

  1. Scaling up landscape restoration ($53 million): Some of the things this component is focused on is scaling up restoration interventions in areas in the middle and upper Shire River Basin and helping the livelihoods of smallholder communities.
  2. Improving watershed services ($82 million): Some things this component focuses on are providing grants to watershed management institutions, enabling infrastructure investments and improving climate information services.
  3. Technical and Project Management Support ($25 million): This component is mainly focused on strengthening MoAIWD’s ability to implement the project.

The proposed project costs $160 million. On June 19, 2020, The World Bank Board of Executive Directors approved $157 million for the MWASIP. The World Bank press release noted a few specific things that the $157 million will go towards. It will use the available $45 million dedicated to increasing water infrastructure to create 10 small multipurpose dams; 20 rainwater harvesting structures; 10 small irrigation schemes to increase access to water for productive use; create over 2,500 construction jobs; provide $40 million in livelihood support through community grant programs.

Sophie Dan
Photo: Flickr

Child Marriage in MalawiChild marriage rates in Sub-Saharan Africa are the highest in the world, with an average of 35% of girls married before the age of 18. In the sub-Saharan nation of Malawi, the rate of child marriage in 2015 was the ninth highest worldwide. The widespread issue of child marriage in Malawi has impacted many young girls and their futures. One of the major contributors is widespread poverty. Over half of the Malawi population lives below the poverty line, causing girls to be married off in hopes of economic advancement. However, these marriages perpetuate the cycle of poverty in the nation as girls are unable to continue their education: 55% of girls in Malawi do not return to school after eighth grade. However, recent successes are working to end child marriage in Malawi.

Changes to Malawi’s Constitution

The Malawi government has been making strides against child marriages within the nation. In 2015, the Marriage, Divorce and Family Relations Act raised the minimum marriage age from 15 to 18. Nevertheless, a loophole limited this law from fully eradicating child marriage by allowing children between the ages of 15 and 18 to get married as long as their parents gave consent.

Luckily, in February of 2017, the country’s government addressed this loophole. A vote ensued in the nation’s Parliament to pass a constitutional amendment banning child marriage in Malawi for those under the age of 18. The amendment passed unanimously, making child marriage officially illegal in the nation.

The Road to Change

In recent years, organizations around the world have shown increasing interest in eliminating child marriage in Malawi. For example, Plan International, an organization dedicated to advancing equality for children with a focus on girls, joined the movement by supporting Malawian youth groups that spoke up against child marriage.

The United Nations has also spoken out against this issue. U.N. Women Malawi engaged through lobbying efforts, holding consultations with different Malawian agencies about banning child marriage. The organization is continuing to support the ban by aiding in the law’s implementation.

Government Efforts

Local leadership and government have also proven a fighting force against child marriage. Many chiefs within the nation have created specific rules regarding child marriages for their communities. For example, Chief Kapolona of Machinga, Malawi has seen success as the number of child marriages in his community decreased from 10-15 a year to just two cases in 2017.

On the national level, the Malawian government has made commitments to ensure a complete ban on child marriages. For instance, the government has pledged to a United Nations Sustainable goal to “achieve gender equality and empower all women and girls.” Through this goal, the nation plans to eradicate all child marriage in Malawi by 2030. Malawi’s government also created the National Plan of Action to Combat Gender-Based Violence in Malawi. This document includes many smaller goals, all of which are designed to end child marriages.

Although Malawi has a robust history of child marriage, the nation has made drastic progress in eradicating the issue. Hope now exists for young girls across the country to escape poverty, finish their education and gain financial independence.

– Erica Burns
Photo: Flickr

Healthcare in Malawi
Malawi is a landlocked country in Southern Africa with a population of over 18 million people. It also has one of the worst healthcare systems in the world, ranking at 185 out of 190 countries and having a life expectancy of about 64 years old. While Malawi is gradually improving its system, lowering death rates and increasing its life expectancy, healthcare in Malawi still faces serious issues.

Healthcare Structure

Malawi’s healthcare system has three sectors:

  • Public: The public sector comprises of three different parts that link together by a system of referrals. The three parts are primary, secondary and tertiary care. This sector includes the Ministry of Health (MOH) and government facilities. The government provides the largest amount of free health facilities with more than 8,000 facilities – 86% of the total amount.
  • Private for-profit: The PFP sector includes private hospitals, clinics, laboratories and pharmacies. Malawi’s private health facilities only make up about 1% of the total free health facilities with 120 health facilities.
  • Private not-for-profit: The PNFP sector consists of religious and non-governmental organizations (NGOs), religious institutions, statutory corporations and companies. The Christian Health Association of Malawi (CHAM) is the most notable religious organization, providing approximately 37% of Malawi health services and 73% of the healthcare services in rural areas.

Major Contributions to a Struggling Healthcare System

Several factors contribute to a struggling healthcare system, but there are two major healthcare issues in Malawi to be aware of:

  • Poverty/Funding: Malawi is one of the poorest countries in the world which directly affects how much the country can spend on healthcare. The country’s GDP is $7.6 billion, and it spends only 9.6% of it on healthcare goods and services. This comes out to be approximately $32 towards health per capita, which is relatively low. In comparison, the U.S. spends about $10,000 per capita. Due to the scarce amount of money, the healthcare facilities in Malawi cannot receive suitable funding, causing a lack of proper maintenance, health-worker training, infrastructure, transportation, communication and efficient equipment which are necessary for successful healthcare.
  • Distance: In 2019, approximately 82% of the population in Malawi lived in rural areas. This large rural population makes easy access to health facilities more complicated. In 2016, around 90% of the population in Malawi lived within 8 km of a health center or hospital, which means that over a million people still lacked easy access to healthcare services. Also, 56% of Malawian women noted that the distance to health facilities was one of the biggest complications when they needed health services.

Solutions

While healthcare in Malawi is slowly progressing, poverty is still an issue that makes good healthcare a challenge to attain. Programs to educate future and current healthcare workers, proper resources and suitable facilities all require adequate funding. Fortunately, there are organizations like CHAM that are working towards providing Malawi with better healthcare with health-workers and accessible facilities.

CHAM is the largest NGO and healthcare practitioner trainer in Malawi. It emerged with the hope of bringing affordable and quality healthcare to hard-to-reach and rural areas. CHAM is a network of church-owned health facilities, hospitals and training colleges. It has over 175 healthcare facilities and 12 training hospitals where it has educated 80% of Malawi’s healthcare workforce, provided care for 37% of the Malawi health services and 73% of the health services in rural communities. CHAM’s health facilities also administered projects like family planning, HIV prevention programs and empowerment programs. In the future, the organization hopes to find ways to bring in more income so that it can continue to affordably help Malawi citizens, as well as expand its colleges to accept more healthcare trainees.

Although Malawi is receiving help and steadily improving, more can and needs to occur to help fund and implement effective healthcare in the country.

Sophie Dan
Photo: Flickr

Gender Inequality in MalawiWhile the idea of women being denied property may seem antiquated, it is a modern norm furthering gender inequality in Malawi. In the central and southern regions of Malawi, land is intended to be passed down to women through generations; however, Bridget Matinga-Katunda, a researcher at Stellenbosch University in South Africa, explained that this matrilineal system is not as good as it may sound. She stated, “Even under matrilineal systems, decision-making power on land ownership usually lies with male clan leaders who decide who gets a piece of land.”

Excluded from Ownership

Ministry of Hope Malawi, a nonprofit helping orphans and other at-risk communities, spoke to The Borgen Project on this issue. The Program Director for this organization, Daniel Moyo, recalls his personal experience with gendered land laws in Malawi. He describes a “patrilineal culture” where “men own the land and women have no access to land.” According to U.N. Women, around 70% of women work in agriculture. Therefore, despite taking care of the land, they are still not entitled to its ownership.

Additionally, the United Nations states that Malawian legal codes do “not provide for the division of matrimonial property upon dissolution of the marriage. This matter has been left entirely to the courts to decide.” Even if modern legal codes attempt to address the gender inequality in Malawi regarding land ownership, societal trends – often discriminatory – determine who inherits the land. This is especially true if the woman in question is not in a position of power in the community.

Moyo commented, “Personally, after the death of my Dad, all the land we had was confiscated by people we did not even know, leaving us and mum with no land.” His situation is not unusual. Reuters News uncovered that only around 17% of Malawian females are landowners. This parallels the lack of power and representation, as the World Bank reports that in 2019, only 23% of parliamentary seats in Malawai were held by women.

Advocating for a Cultural Shift

While there are legal protections in place for women, the land delegation and nuptial divisions are vague. Groups within the culture are open to interpret them and often adhere to sexist traditions and thought processes. Furthermore, less than one percent of land in Malawi is purchased. Almost all of it is inherited or acquired through marriage. Women report deep insecurity on their land ownership especially if something were to happen to their husbands. Malawian society’s cultural attitude toward women as more inferior to men is often used to justify the sexist land laws.

In order to correct these injustices, a policy shift is necessary to help widows survive and take care of children. Updating the territorial legislation in Malawi could vastly improve its gender equality and the overall economy. Moyo explains that “decision making in the homes is often left to the men. This is one key issue [and at] Ministry of Hope we have been championing women leadership and helping the women to have a voice and not just take everything that the man says…how to use money, how many children to have…they say women in Malawi produce seventy percent of the food but they consume only thirty percent of the same.”

Similarly, organizations such as the Malawi Law Society are fighting for a legal system that is more modern and just. However, an all-encompassing solution must go beyond legality and address the nuances of Malawian agriculture and its connection to gender. Providing social, economic and ownership protections for these laborers is crucial for correcting sexist land laws in Malawi.

Moving Forward

Organizations such as the Ministry of Hope are fighting the discriminatory land laws and working toward ending gender inequality in Malawi by shifting cultural perception. Individuals can help by funding nonprofits based in southern Africa that provide guidance along with financial assistance. Moving forward, continued work by these groups will hopefully help end discriminatory practices.

– Annie Bennett
Photo: Flickr

Girls' Education in Malawi
Malawi, a small country in Southern Africa, is known for its rich culture. Unfortunately, their economy is still very poor. There are many factors that lead to poverty, but education, specifically girls’ education in Malawi, is a major source of financial turmoil that is often overlooked.

Girls’ Education and Poverty

World Bank has found that girls around the world are consistently enrolled in school at lower rates than boys. Malawi is no exception. While around 67% of boys in the country complete primary school, that number is 8% lower for girls. This gap stays consistent throughout different stages of schooling. Low-income households have a larger divide between male and female education. When analyzing upper-class families in Malawi, researchers found little difference in the percentage of girls and boys attending school.

The Malala Fund discovered that improving girls’ education has the potential to unlock trillions of dollars in revenue, while also increasing human rights. Therefore, the barriers to female literacy must not be overlooked. Data analysis proves that nations that discourage education for girls also have higher rates of financial struggle and a larger wage gap. As proven by the aforementioned connections between class and school enrollment, economic barriers are a factor to illiteracy. However, attempting to combat poverty without working toward equal access to education for girls will not yield results.

Barriers to Girls’ Education in Malawi

Daniel Moyo spoke to The Borgen Project on the relationship between education inequality and economic strain in Malawi. As the program director for Ministry of Hope Malawi, he witnesses these issues firsthand. The entrenched cultural norms that Moyo says “look at girls as sexual objects and not as equal human beings” are much more difficult to overcome than the financial burdens. Moyo explains that sexism in schooling directly impacts the economy by “creating a situation where most women are not only housewives, but also left to suffer in acute poverty.”

When charities provide economic funding for girls’ education in Malawi without understanding cultural barriers as well, their efforts are futile. Moyo cites an example of aid that went wrong due to this oversight. An NGO sponsored a secondary school in Phalombe and provided every girl with economic support. However, this backfired because it neglected to tackle the surrounding issues. Moyo discusses how the money gave the students freedom without guidance, resulting in their newfound status being used to “compete for boyfriends and men and not necessarily for financial or material gain.” Thus, “at the end of one year, almost half of the girls at this one high school became pregnant.”

Holistic Approach to Improving the Economy

The efforts by organizations such as Ministry of Hope are helping to improve poverty by recognizing its connection to girls’ education in Malawi. This nonprofit, dedicated to helping vulnerable communities, takes a holistic approach to aiding Malawians that has assisted in making tangible change. Between 2000 and 2018, almost 9% more girls were enrolled in secondary school.

Ministry of Hope encourages organizations to not blindly give money to improve the economy. Rather, “it calls for a lot of factors including policy shifts, cultural beliefs, behavior changes, and a lot of investment in girls’ education.” This is why supporting bills such as the Keeping Girls in School Act (S.1071) is so crucial for tackling poverty in the Global South.

There tends to be a narrative that poverty causes illiteracy. However, if that approach is flipped, there comes a new solution with additional potential for forging change. By advancing education, poverty can also be lowered. Those fighting for change must help organizations on the ground who are providing guidance along with their scholarships. By addressing the cultural and economic barriers of educational inequality, poverty can begin to decrease in Malawi.

– Annie Bennett
Photo: Flickr