The Malawi Minister of Health, Dr. Jean Kalilani, recently released a
statement saying that the birth rate in Malawi is too high. The current
fertility rate in Malawi is 5.66 children per woman with an average age
at first birth of 18.9 years of age. (CIA World Factbook) Over
population is tied to a plethora of issues not only limited to medical
care, though that is the current focus of the Minister of
Health. Overpopulation effects deforestation (see last blog post)
and food security, as well as poverty and other issues facing
Malawi. The population of Malawi has faced a huge spike from three
million in 1950 to fifteen million in 2010 and Malawi finds itself
struggling to support so many people. (IRIN)
According to Dr. Kalilani, overpopulation is largely to blame for the
overcrowding of hospitals saying, “We are doing our best to decongest
the hospitals, but what is happening is that we are just making too
many children and the population is growing and there will be more
patients going to the hospital.” (Nyasa Times)
As of 2011, Malawi’s hospital bed density was 1.3/1,000 people, meaning
that for every 1,000 people in Malawi there is 1.3 beds available in a
medical care facility. This can lead to hospitals being unable to
accommodate all patients and sometimes putting more than one person in a
bed or having patients sleep on the floor or in hallways. In some
cases, hospital overcrowding forces hospitals to release patients as
quickly as possible to accommodate those with the greatest need.
Situations like this have an effect on everyone’s health, especially the
health of children and pregnant women. In Malawi the infant mortality
rate is 48.01 deaths/ 1,000 live births and the maternal mortality rate
is 460 deaths/ 100,000 live births. As Dr. Kalilani puts it, if there
were less infants and pregnant mothers, hospitals would be more capable
of providing better care to mothers and children and reduce these
rates.
The current situation in Malawi is, however, better than it has been.
The fertility rate has dropped from 7.62 children per woman in 1980;
the infant and mother mortality rates have dropped respectively and the
life expectancy has risen to 59.99 years of age. This is largely due to
international attention to the issue of overpopulation: countries around
the world are seeing the effects of population increase and
Governments, NGOs and other organizations have begun family planning and
education programs to help reduce the rate. The Malawian Government
even recently increased the minimum age of marriage to 18 in the hopes
of increasing the age at first birth and reducing maternal/infant
mortality rates. (Reuters) A large part of the issue is a lack of understanding of reproductive health and contraceptive choices.
Contraceptive prevalence (the number of sexually active women who
use some form of contraception during intercourse) in Malawi is 46.1%
currently, meaning that about half of all women will admit to using
contraception. As for the other half there are three main barriers:
cultural acceptance; accessibility, and; understanding. In some areas
in Malawi (particularly rural areas) women need their husband’s or
even elders’ permission to use contraception, meaning that on top of
educating women of their reproductive choices there also needs to be
education for men and the village as a whole. This education can help
to relieve the confusion and disapproval for contraception in the eyes
of everyone making it easier for women to seek contraception if they
desire it. Another issue is accessibility. Women need access to reliable
reproductive care that is affordable.
Some people cannot afford condoms or other forms of contraception and
need options for how to protect themselves at little or no cost to them.
Finally, education is key: proper hygiene and understanding of
contraceptive choices/ methods can help everyone to stay healthy. (IRIN)
This blog was written by Zoey Ponder
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