Malawi’s population growth, 3.31% (2015 estimate) poses problems at the national level in the following areas:
At a family unit level the fertility rate of 5.60 (2015 estimate) children born to each woman has consequences to both mother and children, especially to those who are economically disadvantaged. The more children in a family the more likely the family have insufficient resources to support their economic and nutritional needs. Many infant deaths are associated with mothers living in poverty or undernourished. Those that do survive through their first five years are more likely to suffer from chronic diseases or other restrictions (stunting, wasting etc).The risk of maternal mortality has been shown to be significantly higher as the number of previous births increases.
Of course equally important as the number of children is the spacing between their deliveries. Timing a child’s arrival appropriately leads to:
The fertility rate tends to track with the educational and health elements of the Human Development Index. Reductions in fertility rate correlate with reduction in child mortality, increasing mean years of education of women of a reproductive age and increasing contraceptive prevelance.
While Malawi has made significant steps in reducing child mortality, the rate of 45-46 per 1000 live births exceeds the mean (24) and median (13.3) of 224 countries tracked worldwide. Opportunities for improvement exist particularly in rural and lower income families and communities.
Education of girls has many benefits in addition to reducing the fertility rate. While the Gender Parity Index for Secondary School enrolment is 0.91, only ~33% of eligible Malawian boys and girls enrol in secondary education. Of these ~33% do not complete lower secondary schooling. Clearly much can be done here. Note: Secondary education is not free in Malawi.
Contraceptive prevalence rate is the percentage of women who are practicing, or whose sexual partners are practicing, any form of contraception. The 2010 DHS (Demographic & Health Survey) showed this rate at ~46% while the more recent 2013 MICS (Multi Indicator Cluster Survey) documented a 57% rate. The former survey indicated an unmet need for contraception (the % of sexually active women who expressed a desire to avoid or delay more children but were not practicing any method of contraception). With ~67% of the population 24 years old or younger increasingly the challenge is reaching the youth with information and sexual and reproductive health solutions appropriate to them.
The 2014 Governance and Corruption Survey reveals that up to 96% of ordinary Malawians believe that a corruption is a serious problem.
Evidence of recent years suggest they are not wrong. Systematic looting of public finances, facilitated by politicians and civil servants is believed to have cost the country 35% of its government income over the previous 10 to 15 years. The 'Cashgate' affair involved exploitation of flaws in the financial management system by several government departments. The Health service suffers from theft of drugs and donor provided funds. The problem extends to the private sector as described by Escom. Traditional leaders are not exempt from these practices and even the CHAM (Christian Health Association of Malawi) education sector has had incidences of abuses in the recruitment of student nurses.
Historically the “aid business” has some responsibility for this situation. The arrival of many well-funded aid organizations challenged the capability of government to support their activities. Faced with the risk of projects not meeting their goals a system of allowances was initiated to incent officials and civil servants to work on the development projects. These allowances became more generous as competition between organizations grew.
In terms of public perception Malawi Police Service is viewed as the most corrupt of the public services (95% of correspondents). Following on the next two groups of workers perceived by high percentage of correspondents were public officials / civil servants and the judiciary. Little wonder then that corruption reporting mechanisms are often seen as too dangerous, ineffective or unclear.
The abuse of power for the benefit of the already privileged few comes at the expense of the many, and causes serious and widespread harm to individuals and society. The problems that Malawi faces require the engagement of all its people and if it is the general perception that the country's leadership are venal and / or incompetant then that widespread engagement is unlikely to happen. Corruption is particularly harmful with respect to aid. Not only does the money not all reach the intended recipients but the taxpayers who provide the monies to donating organizations or governments become less willing to support the activities and are likely to walk away. Therefore it is important that corruption needs to be confronted and not accepted. Transparency International's Local Office can help. Increased independence for the Anti-Corruption Bureau would also be recommended.