In Malawi since 1983, Save the Children works directly or through partners in over a dozen districts.  We seek to ensure that children in need are protected, healthy and nourished, educated and live in economically secure households, while helping communities mitigate the impact of HIV/AIDS.  In 2007, Save the Children’s programs reached over two million people in Malawi.

Challenges for Children

Poor children and caregivers in Malawi have limited access to services that can improve children’s health and nutrition.  One child in eight dies before reaching age 5.  Malnutrition is widespread and nearly half of all children under 5 have stunted development.  While Malawi is one of only a few African countries on track to reach the reduction in under-5 mortality set out in Millennium Development Goal 4, neonatal, infant and child mortality rates are still unacceptably high.  Seven out of 10 child deaths in Malawi are due to preventable causes such as malaria, diarrhea, pneumonia, anemia, malnutrition and neonatal causes. Malaria and pneumonia alone account for nearly half of those deaths.

Malawi is thought to have nearly 500,000 children who have lost one or both parents to HIV/AIDS, and approximately 25,000 new pediatric HIV/AIDS infections are registered every year.  Extended family members have been overwhelmed with new demands for support to these orphaned and vulnerable children, both economically and psychosocially. 

Just over 80 percent of all children between ages 6 and 13 are enrolled in primary school.  Young people’s literacy has increased to 76 percent and women’s literacy is making gains.  However, the quality of education remains poor.  There is an acute shortage of teachers and physical infrastructure, and many children either do not graduate primary school or repeat many classes.  Causes of drop-out include the inability to purchase materials to attend school, the need for labor at home, and, particularly for girls, early pregnancy and marriage as well as fears about safety and security while at school. 

Numbers at a Glance

• Malawi ranks 166 out of 177 on the human development index.
• 6.7 million people, more than half the country’s population, live below the poverty line.
• 14% of reproductive age adults are infected with HIV/AIDS.
• 1 in 8 children die before the age of 5.
• Almost half of children under the age of 5 have stunted development.
• Maternal mortality is 984 deaths per 100,000.

Our Response

From 2008−2012, our four focus areas are maternal and newborn health, child health and nutrition, early childhood development and primary education.  Ensuring food security for vulnerable households and protecting children from abuse will underlie all of these efforts.

Specifically, our programs in Malawi include the following areas:

Health
Save the Children promotes the use of low-cost and effective, proven interventions at the health facility, community and household level.  We seek to increase the number of skilled health service providers (the supply side) as well as improve knowledge, attitudes and practices at the community and household level (the demand side).  We have been working with the Ministry of Health and others to demonstrate a community-based maternal and newborn care package in six districts.  Community-based health surveillance assistants provide counseling and encourage women to seek prenatal, delivery and postnatal services from skilled providers at the facility level.  We also train and support health education volunteers, who provide neighbors with maternal, newborn and child health messages and counseling.

Early Childhood Development
For the past 11 years, Save the Children has helped communities care for orphans and young children.  Community-based childcare centers run by volunteer caregivers provide an ideal entry point for reaching young children.  We support the government’s efforts to improve the quality of early childhood development by training caregivers and by strengthening management committees.  We also work to help communities recognize and address the psychosocial needs of particularly vulnerable children, especially orphans.  We are also testing new approaches to strengthen services for children under age 2 and continue to replicate enrichment activities for children ages 3-6.  Currently, we are assisting more than 200 community-based childcare centers, each with an average enrollment of 50-70 children.

Basic Education
We increase children’s access to basic education, help children stay in school and enhance the quality of education.  Save the Children supports the construction and renovation of schools to reduce overcrowded classrooms and increase children’s access.  We also improve the quality of education by enhancing teachers’ professional skills and knowledge through a mentoring program.  In addition, we promote children’s literacy – a key foundation for learning – by mobilizing schools and communities.  There is special emphasis on reaching girls and other vulnerable groups in the school setting.  In 2007, our education programs reached more than 550,000 children.

Livelihoods
We seek to ensure that households have the incomes to meet the needs of children.  Given that nearly 90 percent of the population is engaged in agriculture, our goal is to improve household income by helping families produce and market more crops.  This includes technical assistance, seeds and the establishment of village savings and loan groups.  Save the Children also plays a crucial role in providing technical support to the Malawi Vulnerability Assessment Committee, a government-led structure that conducts national analyses on vulnerability to food insecurity, poverty and malnutrition.  In 2007, our livelihoods programs benefited more than 8,000 households in five districts.

HIV/AIDS
Our programs help children and families affected by HIV/AIDS obtain community-based care that prolongs and improves their quality of life.  We minimize the impact of HIV/AIDS on orphans and other vulnerable children by bringing together communities to address food, livelihoods and other needs of AIDS-affected households and preventing new infections through behavior changes.  In 2007, our behavior change programs alone reached more than 250,000 people in the country.

Plans for the Future

Save the Children will continue to focus on maternal, newborn and child health, early childhood development, basic education and agricultural production.  Protective environments (particularly for girls) and support and inclusion of vulnerable children (particularly HIV/AIDS-affected children) are integral to all of our programs, with a special focus within early childhood development and basic education programs. 

A Success Story:  Agogos Spread Messages and Save Lives

In 2008, five agogos (grandparents) from every village in Khuyukuyu area in northern Mzimba District attended training sponsored by Save the Children through Ekwendeni Mission Hospital.  Upon completion, they decided to meet at a central spot every Wednesday to discuss matters related to essential newborn healthcare in their area and to monitor the pregnant mothers they were advising.  They encouraged any pregnant mothers in their area to join the meetings.  Elliness, a young mother from a nearby village, was expecting her first baby.  She heard about the sessions from her aunt and started attending.  When Elliness suffered from convulsions (preclampsia) later in her pregnancy, the agogo arranged transport to the hospital and discouraged local villagers from banging pots and pans around her ears as a local belief would have them do.  Elliness’ baby was delivered at the hospital and survived, thanks to the specialized care he received there and the  agogo’s quick action and careful monitoring.