The Government of Malawi has over the years provided sexual and reproductive health services including maternal and newborn health care to its people. The country is undertaking concerted efforts in achieving improved maternal health. This dedication is manifested through the MDGs formally adopted at the UN General Assembly meeting in September 2002. They represent a renewed, refined and consolida
ted and targeted set of development commitments made by governments to be achieved by 2015
Malawi is one of the countries with the highest maternal mortality ratios globally, currently estimated at 675 per 100, 000 live births down from 984 per 100, 000 live births in 2004. About 56% of the maternal deaths occur in the Southern Region, 26% in the Central and 17% in the Northern Region. A separate analysis of 81 maternal death audit reports (2005) from various districts in the country showed that 85% of the deaths took place in rural areas, compared to 15% in urban areas (2004 routine reports). Some of the underlying causes of high maternal death include early childbearing and the high fertility rate. Concerned with the worsening poverty situation and its relationship with health, especially for the most vulnerable groups, the United Nations (2000) adopted the Millennium Declaration which led to the establishment of the Millennium Development Goals (MDGs). The Millennium Summit identified maternal health as an urgent priority in the fight against poverty. Four of the MDGs (MDG 3, 4, 5, & 6) have direct bearing on maternal and neonatal health. MDG 3 calls fro promotion of gender equality and empowerment of women; MDG 4 calls for reduction in child mortality, MDG 5 calls for reduction of maternal deaths, and MDG 6 urges nations to halt the spread of HIV/AIDS, control and prevent malaria and other infectious conditions. The MDGs set targets and indicators for monitoring the situation. As one way of commitment to achieve and improve MDG 5 on maternal health, the Presidential Initiative on Maternal Health and Safe Motherhood was launched by the country’s leadership Her Excellency, Mrs. Joyce Banda at a consultative meeting held with the traditional leaders on 25th April 2012. The enabling environment for making progress and eventually achieving the MDGs include among others, peace and stability, a genuine democratic evolution, good governance, economic growth and increasing equitable distribution of the benefits of growth, social inclusion and delivering on promises made by national and international partners. Notwithstanding these, there is a consensus that the MDGs cannot be achieved without effectively addressing the population dynamics and Reproductive Health Issues. Recent global evidence indicates that availability of Emergency Obstetric and Neonatal Care (EmONC), Family Planning and skilled attendance are key to the reduction of maternal and neonatal morbidity and mortality. In recognition of that, Malawi undertook a national assessment of availability, quality and utilization of EmONC services in 2005 that showed poor access and utilization of EmONC services, poor quality of health services as evidenced by high cases of fatality rates. A follow EmONC in 2010 shows still slow progress on the indicators. Some of the barriers to the utilization of maternal health care services include social and cultural/ traditional beliefs and practices. Concerned with the high maternal mortality ratios, the government of Malawi has renewed its commitment to address and accelerate the attainment of MDGs related to maternal and neonatal health issue in a more comprehensive manner by accelerating the reduction of maternal and neonatal morbidity and mortality.
