Health in Malawi

Malawi ranks 170th out of 174 in the World Health Organization lifespan tables; 88% of the population live on less than £2.40 per day; and 50% are below the poverty line.[1]

Health status

Top 10 causes of death in Malawi

In 2011, the University of Malawi released an article by Cameron Bowie that listed the following as the top ten causes of death in Malawi.[2][3]

  1. HIV/AIDS (25%)
  2. Lower respiratory infections (12%)
  3. Diarrhoeal diseases (8%)
  4. Malaria (8%)
  5. Cerebrovascular disease (4%)
  6. Ischemic Heart Disease (4%)
  7. Perinatal conditions (3%)
  8. Tuberculosis (3%)
  9. Road traffic accidents (2%)
  10. Chronic obstructive pulmonary disease (1%)

Life expectancy

The 2014 CIA estimated average life expectancy in Malawi was 59.99 years.[4]

Fertility rate

In 2014 Malawi had a total fertility rate of 5.26 children born/woman.[5]

Infectious diseases

There is a high degree of risk for major infectious diseases, including bacterial and protozoal diarrhea, hepatitis A, typhoid fever, malaria, plague, schistosomiasis and rabies.[6]

HIV/AIDS

In 2013 Malawi had a HIV/AIDS adult prevalence rate of 11%.[5] In 2013 there were 920,000 people living with HIV/AIDS, and 51,000 AIDS related deaths.[5]

Due to the vast scope of the HIV/AIDS epidemic, many Malawian men believe that HIV contraction and death from AIDS are inevitable.[7] Older men in particular often claim that the HIV/AIDS epidemic is a punishment issued by God or other supernatural forces.[7] Other men refer to their own irresponsible sexual behaviors when explaining why they believe that death from AIDS is inevitable.[7]

AIDS orphans in Malawi

These men sometimes claim that unprotected sex is natural (and therefore necessary and good) when justifying their lack of condom use during sex with extramarital partners.[7] Finally, some men identify as HIV-positive without having undergone testing for HIV, preferring to believe that they have already been infected so they can avoid adopting undesirable preventative measures such as condom use or strict fidelity.[7] Because of these fatalistic beliefs, many men continue engaging in extramarital sexual relations despite the prevalence of HIV/AIDS in Malawi.[8]

However, despite these widespread feelings of fatalism, some men believe that they can avoid HIV contraction by modifying their personal behaviors.[7] Men who decide to change their behaviors to reduce their risk of infection are unlikely to use condoms consistently, particularly during marital intercourse; instead, they usually continue engaging in extramarital sexual relations, but alter the ways in which they choose their sexual partners.[7]

For example, before selecting extramarital sexual partners, men sometimes survey their peers to determine whether their potential partners are likely to have exposed themselves to the virus.[9] Men who choose their sexual partners based on external appearances and peer recommendations often believe that women who violate traditional gender norms by, for example, wearing modern clothing are more likely to carry HIV, while young girls, who are perceived as sexually inexperienced, are considered "pure."[7] Because of this perception, many people are concerned that schoolchildren in Malawi, particularly girls, are becoming exposed to the virus through sexual harassment or abuse by their instructors.[10]

Health indicators

The CIA World Fact Book’s “country comparison to the world” ranking indicates how Malawi’s health indicators compare to other countries in the world. Since the first case of HIV/AIDS in Malawi in 1985, HIV/AIDS has drastically affected Malawi’s health indicators. Malawi’s rankings:[5]

Endemic diseases

Malaria

Malaria affects numerous aspects of social and economic life in Malawi. High malaria prevalence affects fertility, savings and investment rates, crop choices, schooling and migration decisions.[11] There are a wide variety of cost-effective approaches to reduce the burden of malaria. Some current intervention tactics include case management, the use of insecticide-treated bed nets, indoor residual spraying, and environmental vector control measures such as larvaciding (controlling mosquitoes at the larval stage through the use of chemicals) and filling and draining of breeding sites.[12] Each of these interventions has proven to have a high value of health gains achieved per dollar.[11] More specifically, mosquito nets are one of the most effective and widely used approaches. They are most effective in that they require a minimal amount of resource input and result in a large decrease in the prevalence of Malaria.[13]

In their article titled "The Economic and Social Burden of Malaria," Pia Malaney and Jeffrey Sachs present an argument for the prominent social theory regarding the intimate relationship between disease prevalence and poverty. They state that where malaria prospers most, human societies have prospered least.[11] In Poor Economics authors Banerjee and Duflo explain how poor healthcare contributes to the poverty trap.[14] That is, inadequacies of Malawi’s healthcare lead to an increased prevalence of disease and other health issues, which, in turn, results in increased poverty incidence.[13]

A comparison of income in malarious and non-malarious countries indicates that average GDP (adjusted to give purchasing power parity (PPP)) in malarious countries in 1995 was US$1,526, compared with US$8,268 in countries without intensive malaria - more than a fivefold difference.[15] According to Jaimeson, effective intervention at the level of healthcare provision will have the greatest rate of return in the form of improved health.[16]

Maternal and child healthcare

In 2013, Malawi had an infant mortality rate of 76.98 deaths/1,000 live births.[5]

See also Healthcare in Malawi

References

  1. ↑ Scott, David (4 July 2017). "Developing pharmacy in Malawi". Pharmaceutical Journal. Retrieved 17 July 2017.
  2. ↑ Bowie, Cameron (2011). "Burden of Disease Estimates for 2011 and the potential effects of the Essential Health Package on Malawi’s health burden.". University of Malawi.
  3. ↑ "CDC in Malawi". Center for Disease Control. Retrieved 10/18/2013. Check date values in: |access-date= (help)
  4. ↑ "CIA - The World Factbook Life Expectancy". Cia.gov. Retrieved 2014-06-25.
  5. 1 2 3 4 5 "The World Fact Book". Africa:: Malawi. Central Intelligence Agency. Retrieved 2013-10-17.
  6. ↑ "Malawi". The World Factbook. CIA. Retrieved 2010-02-06.
  7. 1 2 3 4 5 6 7 8 Kaler, Amy (2004). "AIDS-talk in Everyday Life: The Presence of HIV/AIDS in Men's Informal Conversation in Southern Malawi". Social Science & Medicine. 59 (2): 285–97. doi:10.1016/j.socscimed.2003.10.023.
  8. ↑ Kalipeni, Ezekiel; Jayati Ghosh (2007). "Concern and practice among men about HIV/AIDS in low socioeconomic income areas of Lilongwe, Malawi". Social Science & Medicine. 64 (5): 1116–1127. doi:10.1016/j.socscimed.2006.10.013.
  9. ↑ Smith, Kirsten; Susan Watkins (2005). "Perceptions of Risk and Strategies for Prevention: Responses to HIV/AIDS in Rural Malawi". Social Science & Medicine. 60: 649–660. doi:10.1016/j.socscimed.2004.06.009.
  10. ↑ Mitchell, Claudia (2004). "The Impact of the HIV/AIDS Epidemic on the Education Sector in Sub-Saharan Africa: A Synthesis of the Findings and Recommendations of Three Country Studies (review)". Transformation: Critical Perspectives on Southern Africa. 54 (1): 160–63. doi:10.1353/trn.2004.0024.
  11. 1 2 3 Malaney, Pia; Jeffrey Sachs (7 February 2002). "The economic and social burden of Malaria". Nature. 415: 680–5. PMID 11832956. doi:10.1038/415680a.
  12. ↑ Goodman, C.A.; P.G. Coleman; A.J. Mills (1999). "Cost-effectiveness of malaria control in sub-Saharan Africa". Lancet. 354: 378–385. doi:10.1016/s0140-6736(99)02141-8.
  13. 1 2 Berthélemy, Jean-Claude; Josselin Tuillez; Ogobara Doumbo (13 June 2013). "Malaria and Protective Behaviours: Is There a Malaria Trap?". Malaria Journal. 12 (1): 200. doi:10.1186/1475-2875-12-200.
  14. ↑ Banjeree, Abhijit; Esther Duflo (2011). Poor economics: a radical rethinking of the way to fight global poverty. New York: PublicAffairs.
  15. ↑ Gallup, J; J. Sachs (2001). "The Economic Burden of Malaria" (PDF). American Journal of Tropical Medicine and Hygiene. 64: 85–96.
  16. ↑ Jamison, Dean (2006). Disease control priorities in developing countries. New York: Oxford University Press World Bank.
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