MARKING 50 YEARS OF WORKING FOR DEVELOPMENT IN MALAWI
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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.” Elube’s 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. Malawi’s 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 population’s social and economic rights in relation to the capacity of the country—gives 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 government’s 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 Malawi’s 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 child’s 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 percent—one of the highest in the SADC region and above WHO’s 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 child’s 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 Malawi’s 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 children”— Desmond 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.
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Building strong social services and protecting the most vulnerable
Transcript of MARKING 50 YEARS OF WORKING FOR DEVELOPMENT IN MALAWI
MARKING 50 YEARS OF WORKING FOR DEVELOPMENT IN MALAWIBuilding 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.”
Elube’s 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.
Malawi’s 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 population’s social and economic rights in relation to the capacity of the country—gives 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 government’s 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 Malawi’s 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 child’s 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 percent—one of the highest in the SADC region and above WHO’s 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 child’s 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 Malawi’s 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 m o 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.
