Malawi Introduction Population & Development Progress through Family Planning By Dr. Chisale Mhango Director, Reproductive Health Services Ministry of Health Photo by Gunnar Salvarsson 2
Malawi National Vision Introduction Photo by Scott Gregory 2020 Vision Malawi will be secure, democratically mature, environmentally sustainable, self-reliant with equal opportunities for and active participation by all, having social services, vibrant cultural and religious values and a technologically driven middle-income economy Growth and Development Strategy Poverty reduction through sustainable economic growth and infrastructure development 3
Population Population Economie et and Society Introduction How does population affect Malawi s economic growth and social development in the coming decades? Photo by Gunnar Salvarsson 4
Population Current Situation Population Statistics 13 million people in 2008 52% population under 18 6 births per woman 35% teens 15-19 bear children 12% HIV prevalence Sources: Malawi DHS 2004-05, 2008 Census, and UNAIDS Photos by Angeli Kirk, Gunnar Salvarsson, Karl Mueller 5
40 Million People Population Population Triples by 2040 Current Fertility Rate People Millions of 45 36 27 18 13.1 40.6 13 to 40 million people 9 0 2008 2020 2030 2040 Sources: 2008 Malawi Census, Spectrum 6
Population Photo by Gunnar Salvarsson 2 in 5 births are unintended or arrive too soon Contraceptive Use Malawi Primary factor to lower growth Well-established in the culture Many women want to delay or limit births, but are not using contraceptives Potential exists to increase contraceptive use 7
Family Planning Population Unmet Need for Contraception Women 40% 38% 1 in 4 women need contraception 30% 28% 27% 25% 20% 10% 22% 13% 0% Rwanda Malawi Zambia Kenya Tanzania Zimbabwe Source: Various Demographic and Health Surveys Photo by Gunnar Salvarsson 8
Growing Demand Demand for Family Planning by Married Women Population Married Wom men (%) 75 50 25 36 30 28 Unmet Need Using FP Services 31 33 0 13 1992 2000 2004 Source: Malawi DHS 2004-05 9
Slower Population Growth By Meeting Existing Demand for Family Planning Population Populatio on (Millions) 50 40 30 20 13 41 31 High Fertility Low Fertility 10 0 2008 2016 2024 2032 2040 Source: Spectrum 10
Outline Development Sectors 1 2 3 4 Education Health Agriculture Economy and the Labor Force 11
Education Education 12
Primary Students Fewer Students, More Resources Available per Child Education Number of Students (Million) 10 8 6 4 3.0 8.7 5.5 High Fertility Low Fertility 2 0 2008 2020 2030 2040 Sources: Malawi Ministry of Education and Spectrum 13
Primary Schools Education Fewer Schools Needed Scho ools Needed 15,000 10,000 5,000 4,854 13,950 8,824 High Fertility Low Fertility 0 2008 2020 2030 2040 Source: Malawi Ministry of Education and Spectrum 14
Education Better Education With Less Population Pressure More resources for training and incentives to keep teachers in rural areas More resources for classrooms and educational material Smaller classrooms and better learning environments Progress on MDGs 2: Achieve universal primary education Photo by Gunnar Salvarsson 15
Health Critical shortage of human resources Inadequate infrastructure for IFAD Photo by Robert Grossman universal access to health care Malawi RAPID16 16
2038 2040 Annual Health Expenditure 900 800 700 600 500 400 300 Declining Fertility Constant Fertility The cumulative savings is $1.8 Billion. Malawi RAPID17 US $ millions 200 100 0 2008 2010 2012 2014 2016 2018 2020 2022 2024 2026 2028 2030 2032 2034 2036
Agriculture Agriculture Land Availability 18
Issue #1 Agriculture Land Fragmentation Higher Population, Less Land per Holder Land holdings divided among more family members Lower productivity from small farms less food security Less food per person Photo by Gunnar Salvarsson 19
Issue #2 Environmental Degradation Higher Population Leads to Overuse Lower Productivity Overexploitation Deforestation Erosion Less soil fertility Photo by John Duffell 20
Arable Land More Land per Person with Lower Population Agriculture Population per km 2 High Fertility Low Fertility Sources: FAOSTAT, World Bank and Author Calculations 21
Better Agriculture Agriculture Photo by Molly Stevenson Less Pressure on Resources Used to Modernize Fertilize for higher yields Improve family nutrition Reduce environmental degradation Progress on MDGs 1: Eradicate extreme poverty and hunger 7: Ensure environmental sustainability 22
Employment Economy More Youth Requires More Jobs Million Youth 4 Million More Youth Need Jobs Scenario Cumulative difference in the number of youth at a high versus low fertility rate High Fertility Low Fertility Source: Spectrum, Youth: 18-24 years old 23
Economy Better Economy With Less Population Pressure More funding for social sector Greater disposable family income for education and health Lower youth unemployment Greater stability Progress on MDGs 1: Eradicate extreme poverty and hunger Photo (top down) by Molly Stevenson and Angeli Kirk (2) 24
Why Act Now? Cost of Inaction Increases with Time Conclusion ISSUE OPPORTUNITY High population growth Unbalanced age distribution (half below age 18) 41% of births are unintended or ill-timed 28% of married women want to avoid or delay pregnancy but don t use contraception Contraceptive use is established in the culture 33% of married women already use contraceptives Potential for increased use is large READINESS Political will is present Service networks are established and developing Development partners very sympathetic to Malawi s population development agenda. 25
FP Facilitates Achievement of MDG Targets 1. Eradicate extreme poverty and hunger (MDG1): ❿ Targets: (a) Halve, the proportion of people whose income is less than $1 a day, and (b) who suffer from hunger between 1990 and 2015 FP improves maternal health, thereby increasing women s productivity, and reduces dependency level at both family & national levels 2. Achieve universal primary education (MDG2): Target: Ensure that, by 2015, children, boys and girls alike, will be able to complete primary schooling ❿ FP reduces the number of children that have to be provided with education & makes the target manageable 3. Promote gender equality and empower women (MDG3): ❿ Target: Eliminate gender disparity in primary and secondary education preferably by 2005 and in all levels of education no later than 2015 When a family has too many children parents tend to educate sons only promoting gender inequality 4. Reduce child mortality (MDG4) ❿ Targets: (a) Reduce by two thirds, the under-five mortality rate 1990 by2015, (b) 100 % measles immunization of 1 year old children The fewer the number of children the better the care, the more the food, the lower child mortality. There will be savings on vaccines Malawi RAPID26
FP Facilitates Achievement of MDG Targets cont. 5. Improve maternal health (MDG5) ❿ ❿ Targets: (a) Reduce by three quarters the maternal mortality ratio 1990 by 2015 Family planning reduces exposure to risk of pregnancy related death The fewer the births, the more likely we can cope with provision of skilled attendance at births 6. Combat HIV/AIDS, malaria, and other diseases (MDG6) ❿ ❿ Targets: (a) By 2015 halt and begin to reverse the spread of HIV/AIDS, malaria and other major diseases Condom use in family planning protects against HIV infection The fewer the children the more likely the target to provide U5C with ITNs can be achieved 7. Ensure environmental sustainability (MDG7) ❿ Targets (a) Reduce by half the proportion of people without sustainable access to safe drinking water and sanitation Family planning reduces the number of people that have to be provided with safe water and good sanitation 8. Develop Global Development Partnership (MDG8) [Goal calls for increasing access to essential drugs on a sustainable basis ++] ❿ The savings realised from family planning will assist to increase availability of essential drugs on a sustainable basis. Malawi RAPID27
Progress through Family Planning Malawi Support for this study was provided by the USAID Health Policy Initiative, Task Order 1 Thank You Photo by Sarah Depper 28