Malawi

The Malawian healthcare system is marked by a number of weaknesses, which are reflected, among other things, in the still high rates of maternal and child mortality. Malaria, tuberculosis, HIV/AIDS and respiratory diseases are widespread. The healthcare sector lacks money, personnel and medical equipment in clinics, hospitals and health stations. The management of health services is inadequate at central and district level. Together with international donors, the Malawian Ministry of Health has coordinated a joint work programme with the involvement of the German Federal Government.

Germany is also active through KfW in a number of bilateral projects. This involves building, renovating and better equipping health stations and financing vaccines. Medical supplies needed at short notice, e.g. in the context of the COVID-19 pandemic, can also be procured. In view of significant population growth with high population density, access to modern family planning methods is promoted.

Initial improvements in core health indicators are already visible. For example, maternal and infant mortality rates are steadily decreasing. Access to vaccines and contraceptives is also relatively assured throughout the country.

Project Information- German-Norwegian Mother-Child Health Initiative  (PDF, 75 KB, non-accessible)

Malawi is one of the poorest countries in the world. Almost half the population lives below the national poverty line. To ensure that these people, too, can meet their basic daily needs such as food, clothing and medicine or pay for their children’s schooling, they now receive financial aid from the government. The amount of the benefits depends on how many people are in the family and how many school-age children there are. On average, the families receive just over 5 EUR per month – not much by European standards, but it helps the poor there to alleviate their most extreme hardship. The Social Cash Transfer Programme (SCTP) in Malawi is financed by different donors. In addition to the Federal Ministry for Economic Cooperation and Development (BMZ) and the EU, the World Bank and Irish Aid are also involved. In the meantime, the programme now covers the entire country.

KfW is implementing the programme in Malawi on behalf of the BMZ and the EU in 14 of Malawi’s 28 districts, covering around 130,000 households occupied by more than 580,000 individuals. As well as financing the transfers, KfW also supports the continual monitoring and improvement of the SCTP’s design, administration and implementation. This includes technical equipment, consulting services, capacity building, and the introduction of software and a comprehensive management information system.

External evaluations have demonstrated that the programme has made an effective contribution to alleviating poverty in Malawi. The recipient families eat more regularly, while more children go to school and stay in school longer overall. The improved living conditions also have a knock-on effect on their social lives. Young girls in recipient households are under less pressure to go into sex work to increase the household income or help to sustain themselves. In addition, there are fewer early pregnancies and health in general has improved, with the under-five mortality rate falling. The number of households with assets such as livestock or land has grown, and their overall financial situation has improved.

In Malawi two thirds of the population live in poverty and there is a shortage of job opportunities. The population’s food supply is not assured and people go hungry if it does not rain and there is a drought.

The country’s potential lies above all in the economic development of rural areas and improved links to urban areas. This is because Malawi is an agricultural country; most people live on the land and from subsistence farming. However, the low productivity of subsistence farming is at the heart of the problem. As a result, increased efficiency, diversification and commercialisation of locally manufactured products have high priority. This is where the priority area of German development cooperation comes in – with the aim of improving income and employment in rural areas, especially for the poorer population.

The Malawi Innovation Challenge Fund (MICF), which is managed by the United Nations Development Programme (UNDP), promotes innovative business models for private enterprises that have positive social impacts – e.g. by involving smallholders in value chains – or positive environmental impacts. In addition, the Malawi National Local Government Finance Committee (NLGFC) finances the construction or expansion of markets, which is intended to make it easier for the small towns receiving support to generate income and stimulate the local economy. In addition, the operators – usually the local administrations – are given a stronger role in the management of these facilities so that these services can be sustainably supplied to the population.

Malawi is one of the countries with the highest rates of malnutrition in Africa. As many as 13% of newborns are underweight at birth. This results in negative health risks and chronic consequences. The main causes are poor nutrition and illnesses of the mother before and during pregnancy as well as a diet that is not suitable for small children. To prevent malnutrition and undernourishment, the availability, access, use and stability of the food supply must be ensured. In Malawi, however, none of these basic conditions is consistently met.

The Malawian government’s food security programme, which is supported by KfW with BMZ funds, aims to improve child nutrition in the first 1,000 days. During this period, stunted growth in children can be most successfully addressed and reduced. At the same time, this phase is crucial for the general development of children and especially for the development of the brain. Beyond this age, numerous negative impacts of malnutrition can lead to chronic consequences. To this end, information and instruction on healthy nutrition, hygiene, preventive health care and early childhood development is provided to the mothers on site in small groups. Women and children are also supplied with trace elements and vitamins.

The project therefore contributes to improving the health of women and children in particular, with positive impacts on the development of small children, on school performance and thus in the medium term also on the country’s economic development.

In Malawi, parents have not had to pay school fees for several years. As a result, school enrolment rates and the percentage of children completing primary school have doubled in the last ten years – but at the cost of larger classes and declining levels. On average, there is one teacher for every 65 children and after finishing the sixth grade the learning outcomes of Malawian pupils are far below the regional average. German-Malawian development cooperation therefore supports the government in the basic education sector, which is so important for the country.

KfW mainly implements projects in the infrastructure sector. This included the construction of classrooms, sanitary facilities, administrative buildings and teachers’ houses at the primary schools as well as rehabilitation measures at teacher training colleges where primary school teachers are trained. In addition, textbooks and tablet computers with tailor-made learning apps are provided. The main aim of the programmes is to improve the quality of training. This includes training of qualified teachers and more efficiency in the Ministry of Education.

Around three million Malawian primary school pupils benefit directly from the projects: fewer lessons are cancelled, the classes are smaller, new and better teaching materials ensure a higher performance level and, last but not least, the education system is becoming more sustainable.