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Malawi

Malawi is a nation of about 9.3 million people. In addition, up to 1.3 million refugees from Mozambique have been temporarily settled in the country. The population growth rate during the period 1985-92 was estimated to be 3.4% per annum. Population growth is a critical problem here, as most of the suitable land is now under cultivation. Malawi is one of the most densely populated countries in Africa with more than 170 persons per square kilometer of arable land.

Recent Trends in Nutrition

The prevalence of underweight children in Malawi was estimated in 1992 as 27% (<-2 s.d. weight-for-age NCHS) of 0-59 month old children based on a national nutrition survey carried out by the Malawi National Statistical Office in 1992 in collaboration with the Demographic and Health Surveys. A comparable national survey in 1981 gave the extent of underweight in children as 24%. Thus the prevalence is estimated to have increased by about 0.3 percentage points per year through the 1980s.

The malnutrition figures for 1992 were affected by drought, which occurred in the 1991/92 crop year. The survey was carried out late in 1992, and the harvest 4-6 months earlier was the worst in many years. Thus the estimated increase in prevalence includes effects of the drought.

An increase in acute malnutrition (measured by wasting - <-2 s.d. weight-for-height NCHS) was likewise observed comparing the two periods and this showed an increase from 1.6% to 5.4%. Stunting in 1992 was estimated at 48% - a high figure for Sub-Saharan Africa. The estimated number of underweight children has risen from 290,000 in 1981, to a level of 590,000 in 1993. This doubling of the size of the malnutrition problem is the product of the prevalence and the high population growth rates in the country.

The 1992 nutrition survey indicates that the Central and Southern regions are worse off than the North. The rural areas had considerably higher rates of underweight prevalence compared to the urban areas -nearly double in some cases. The prevalence of underweight appears to peak with the 12-23 month age group, and during the pre-harvest period. This was observed in all the 24 districts of the country.

The infant mortality rate (IMR) in Malawi is extremely high, estimated at 141 per 1000 live births in 1993 - more than double that estimated in Kenya for instance. The IMR figures have not been improving in the last decade or so.

Factors Affecting Trends in Nutrition

Economic Growth. In 1993 the per capita GNP was estimated at U.S.$220. GDP per capita remained virtually unchanged between 1986 and 1993, except for a significant drop in 1992 due to a drought. Strong growth came to a halt in the early 1980s with the onset of a series of economic problems and external shocks including weather-related problems. The year 1992 was perhaps the worst year in terms of economic development in the country for many years. Macroeconomic difficulties were compounded by the most severe drought in the last several decades. In 1993 the rate of inflation was estimated at 23.5%, reflecting, in part, the impact of two substantial devaluations of the kwacha (local currency).

Food Security. The drought of 1992 caused marked increases in the price of maize. A 90 kg. bag of maize cost more than an equivalent of a months's wage in many regions (see Figure 1). In fact, the number of days' work required to purchase a 90 kg. bag rose from about 25 days in September 1992 to about 43 days by January 1993, falling again by mid-1993. The food price index in Malawi in that period rose considerably faster than the general CPI. Further deterioration of nutrition is thus likely to have occurred in 1993 (after the 1992 survey).

Data based on food balance sheets indicate that the per capita kcal intake fell during the 1980s, to around 2000 kcals in 1990, and further during the 1991/92 drought. The drought of the 1991/92 crop season brought production of maize to its lowest level in the last decade (see Food Production Index). Food crop production, however, experienced a turnaround in the 1992/93 crop season with national surpluses in maize, rice, and millet, allowing the government to replenish its Strategic Grain Reserve.

Figure 1. Malawi: Number of Days' Work Required to Purchase 90kg. bag of Maize. September 1991-May 1993.

Source: Malawi Department of Planning and Development (1993).
Malawi has widespread poverty and food insecurity problems. More than half of the population lives below poverty line, including about 60% of small holders and estate workers. The country is still recovering from 60% crop losses during the 1992 drought. Refugees stress food supplies, and the division between estate productivity and smallholder agriculture continues to worsen skewed income distribution in the rural sector.

Agriculture in normal years contributes one-third of GDP and over 90% of export earnings. It employs almost half of those in paid employment, and supports at least 85% of the population. The main subsistence crop is maize, grown by most smallholders, and other crops are sorghum, millet, pulses, root crops, and fruit, whilst fish is also important in the subsistence diet. The food production index has been showing an erratic trend since 1986. It declined to 70 in 1993 (base, 1979-81=100). The food supply situation in 1993/4 was generally favorable due to a record harvest in 1993.

The government monitors the nutrition and food security situation through its food security and nutrition unit in the Department of Economic Planning and Development, under the office of the President.

Health, Education. Although the government has been committed to a policy of primary health care, the quality of services had been very low due to inadequate funding. In 1990, fiscal data indicate that the government spent about $4 per capita on health, roughly 7% of the total budgetary expenditures for that year. Estimates in 1991 indicate that about 80% of the population had access to primary health care, and maternal and child health services had been more widely available compared to the 1980s. More recently the country has been beset by problems of malaria and AIDS, which put increasing strains on health services. Recent estimates show that 11% of the total health budget has been directed towards problems related to AIDS. Malawi now has one of the highest rates of AIDS cases in Southern Africa, with 22,300 cases reported in June 1993.

Literacy in Malawi has been reported at 41% in 1991. School enrollment rates are about 43% in the primary level, but only 7% at the secondary level. Trends in education expenditure show a stagnant picture. The latest data from 1989 show that the government spent less than $5 per capita for education, a figure considerably lower than its neighbors in Southern Africa.

MALAWI

(Estimates in 1993)

Population

: 9.3 million

Population Density

: 74 per sq. km.

Population Growth Rate

: 2.9% per annum

Urban Population

: 12%

IMR

: 141

GNP US$ (Per Capita)
(WB Atlas Methodology)

: 220

PPP estimates of GDP
($ Per Capita, in 1991)

: 800


CHILD GROWTH AND SURVIVAL

Underweight preschool children (Percent below -2 s.d. weight for age)

Infant mortality rate (Per 1,000 live births)

ECONOMICS

GDP per capita (1987 Mkt. prices, Kwacha / capita)

Debt service ratio (Debt service/exports)

FOOD

Food production index (Per caput, 1979-81=100)

Dietary energy supply (Kcals/caput/day)

Consumer price index (1980=100)

FPI/CPI ratio (1980=100)

HEALTH

Immunization coverage (Percent)

Access to local health care (Percent)

PUBLIC EXPENDITURES

Education and health expenditures (US $ per capita)

Education and health expenditures (Percent of government expenditures)


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