- Malawi has experienced significant macroeconomic growth in recent years. The annual growth rate for the period 2008-2010 was over 7 percent. However there is an unequal distribution of economic gains and available resources. About 39 per cent of the population lives below the poverty line, poverty being particularly severe among female-headed households and in rural areas.
- The 2008 census indicated a population of 13.1 million, with an annual growth rate of 2.8 per cent. The total fertility rate declined slightly from 6.5 to 5.7 children per woman between 1998 and 2010. Fifty per cent of the population is aged 17 years and below which indicates a youthful population. One third of women aged 15-19 have begun childbearing
- The maternal mortality ratio has declined from 984 in 2004, 807 deaths in 2006 to 675 per 100,000 live birthsin 2010 but remains high. AlthoughSkilledbirthattendanceincreased from 54% in 2004 to 73% in 2010, thereispooraccess to essential emergency obstetric care services, withonly 2% healthfacilitiesproviding basic emergency obstetric care. Inadequateequipmentdrigs and supplies has compromisedquality of maternal and neonatalhealth care The contraceptive prevalence rate is 46 per cent among marriedwomenusinganymethod of contraception, with 42 per cent using a modern method of contraception and 4 per cent traditionalmethods.
- Infant mortality rate declined from76 to 66 deaths per 1,000 live births between 2004 and 2010 and under 5 mortality from 133 to 112 deaths per 1,000 live births during the same period. Life expectancy at birth has increased significantly from 39 years for male and 45 years for female in 1998 to 48.3 years and 51.3 years respectively in 2008.
- The national HIV prevalence rate among the general population stands at 12 percent since 2007. Women and girls have higher infection rates than men, and are more often affected at younger ages. The higher prevalence rate among women can be attributed to among others, early age of marriage, harmful cultural practices, lack of skills to negotiate safer sex, and limited access to HIV prevention services. The HIV epidemic is predominantly occurring in stable relationships and discordant couples fuelled by multiple and concurrent partnerships, low, in-correct and in-consistent condom use.
- The UNDP gender equality index for Malawi was 0.374 in 2009, one of the lowest in the world. The difficulty with achieving gender equality is due to weak legal, policy and coordination frameworks, inadequate financing for gender activities and poor planning and implementation of development programmes that are not gender responsive. Women and adolescent girls continue to meet unsurpassed challenges and limited opportunities which increase their vulnerability to reproductive health challenges and gender based violence. Only 22 per cent of parliamentarians are women, well below the Southern African Development Community target of 50 per cent of women in decision-making structures by 2015.
Past cooperation and lessons learned
- The end of the sixth country programme evaluation found that the programme achieved most of its targets in all its outcome areas and had contributed to the improvement of lives for the people of Malawi.
- In Reproductive Health, the programme supported:
- the review and formulation of national sexual reproductive health and rights policies and strategies;
- the Reproductive Health Commodity Security and the Condom Strategies;
- a follow-up Emergency obstetric and neonatal care assessment;
- the youth-friendly health services standards and implementation framework and
- the HIV prevention Strategy.
- At service delivery level, the programme supported
- the capacity building of health service providers on the implementation of the roadmap for the reduction of maternal and neonatal morbidity and mortality although human resource challenges remain especially in hard to reach areas;
- mass media campaign to address key drivers of HIV/AIDS epidemic .
- In the area of population and development, the programme supported:
- the 2008 Population and Housing Census which resulted in the production of thematic reports that informed the development of the Malawi Growth and Development Strategy and the United Nations Development Assistance Framework;
- the 2010 Demographic and Health Survey whose results provided baseline data for key CP indicators. ‘While significant effort has been made to generate and analyze population-related data, deficiencies in dissemination and utilization of this data still remain.
- The Gender Equality component supported the review and implementation of:
- the National
- Key Lessons from the sixth Country Program include:
- Strategic partnerships with government, parliamentarians, NGOs, FBOs, other UN organisations and the media are very important when advocating for population and development issues;
- Community mobilisation is key in reaching out to the most vulnerable, underserved and hard to reach communities including young people;
- mpowering young people to stay in school, delay age of marriage, reduce adolescent fertility and HIV incidence contribute significantly to the reduction of maternal mortality and morbidity;
- continuous capacity building of Implementing Partners on financial management and National Execution audits is crucial for NEX implementation.
Program management, monitoring and evaluation
The Program will be implemented in accordance with UNFPA policies andprocedures and through government, and civil society partners with the Ministry of Development Planning and Cooperation coordinating the programme. UNFPA and the Government of Malawi will develop joint programs with the United Nations and other development partners in the areas of HIV prevention, response to gender-based violence and data management and utilization and the implementation of the road map on maternal and neonatal mortality reduction. UNFPA will participate in the Sector Wide Approaches (SWAps) on Health and Gender and Youth.
The 7th country program will be implemented using a results-based planning, monitoring and evaluation approach. A monitoring and evaluation framework will be developed and implemented for timely performance assessment and an end of program evaluation will be carried out to assess the achievements of the program and to inform the development of the next country program.
The Country Office in Malawi consists of a Representative, a Deputy Representative, an Assistant Representative, an Operations Manager, 7 National Program Officers and support staff. Program funds will be earmarked for additional international and national Program staff posts to facilitate effective programme delivery, especially where additional resources for specific projects have been mobilised. Technical support will be sought from national experts and institutions wherever possible, UNFPA Regional and Sub-regional Offices and other international experts. The country office will encourage and support South-South cooperation