:: Health in Malawi

PSI interventions focus on the biggest public health challenges facing Malawi : the HIV/AIDS pandemic that continues to rend the country's social and economic fabric, with the eighth highest infection rate in the world; malaria , the biggest single killer of Malawian children under five years of age; and diarrhoeal disease often related to the consumption of contaminated drinking water.

HIV/AIDS

The HIV/AIDS epidemic continues to have a catastrophic impact on Malawian society and economic development.

The human immunodeficiency virus (HIV), the virus that causes AIDS, is spread primarily through heterosexual contact in Malawi .

Facts:

• Malawi has the eighth highest HIV prevalence in the world and it is estimated that 16.4% of people aged 15-49 years are infected.
• Life expectancy has declined due to HIV/AIDS from a projected 57 years (in the absence of the disease) to 39.
• It is estimated that over 1 million of a total of 10 million Malawians are currently HIV positive, and that 720 new infections occur every day.
• There is a significant amount of cross-generation infection, with HIV prevalence among females 15-19 years of age estimated to be seven times greater than their male counterparts.
• By 2005, if the epidemic continues unchecked, AIDS will be the cause of 80-85% of deaths among urban adults, and that 25-50% of skilled professionals in the development sectors (education, health care, military etc.) will have died of AIDS.
• By 2010, it is projected that over 2 million Malawians will be infected with the HIV virus, one million will have full-blown AIDS, and there will be between 350,000 and 700,000 AIDS orphans.
• Economically, real GDP is calculated to be 10% less than it would be in the absence of AIDS.

Malaria

Malaria is a major public health concern in Malawi , especially among pregnant women and children under the age of five.

The type of malaria most common in Malawi ( plasmodium falciparum ) can lead to death. People at highest risk are pregnant women and children aged three-months to five years and. malaria is a leading cause of pregnancy loss, low birth weight, and newborn mortality.

The human and economic costs are enormous. In addition to the expenses of consultation, treatment, hospitalisation, and travel, malaria often leads to low productivity and lost income from days of work missed.

Facts:

• Malaria is the most frequent cause of morbidity and mortality in Malawian children under five years of age, and is the cause of over 40% of deaths in children under two.
• Children under-five suffer on average 9.7 malaria episodes per year, while adults suffer 6.1 such episodes.
• The cost of malaria to the average Malawian household has been estimated at 7.2% of average household income. This rises to 32% in very low-income households (earning less that US$167 per annum) - which comprise 52% of the population.
• Malaria accounts for one-third of all outpatient visits - and more than one-third for children under age five.
• Treating malaria costs Malawi 's government US$2.7 million per annum.
• There is compelling evidence that malaria infection during pregnancy increases the chances of mother-to-child transmission of HIV . This is due to the high malaria parasite density in placenta, facilitating the transmission of the virus.

Diarrhoeal Disease

Dehydration caused by severe diarrhoea is a leading cause of illness and mortality among young children in Malawi . When children do not receive adequate fluids or essential salts following an episode of diarrhoea, their chances of experiencing serious complications or dying are significantly increased.

Exposure to the diarrhoea is often related to the unhygienic food preparation, or the consumption of contaminated water. Mothers have inadequate knowledge of how to deal with episodes of diarrhoea, and of the nutritional requirements of their children.

Facts :

• 18% of Malawian children had experienced diarrhoea in the two weeks that preceded the Demographic and Health Survey in 2000.
• Susceptibility to diarrhoea reaches its peak between 6-11 months of age.
• More than one third of children suffering from diarrhoea do not receive adequate rehydration; 24% are provided no treatment at all.
• Only 28% of mothers take their children to a health facility when faced with a diarrhoeal episode.

Only 35% of children suffering from diarrhoea are given more fluids - 33% are actually given less.