Malawi

The landlocked country of Malawi in southern Africa was formerly the British colony of Nyasaland, and a part of the Federation of Rhodesia and Nyasaland, until independence in 1964. With a population of 13.9 million (2008 estimate), it has a birth rate of 43.1 per 1,000 and an infant mortality rate of 94.4 per 1,000 live births.

Malawi shares borders with Zambia, Mozambique, and Tanzania; Lake Nyasa forms much of the eastern border. In 2009, the legal age for marriage was increased from 15 to 16 years of age. A 2003 study found that the probability of divorce was 40 to 60 percent, among the highest in Africa.

Under the British, there were few health care provisions outside Zomba, the capital, and Blantyre, the economic capital. This has continued after independence with Blantyre becoming the country's capital, with only minor attempts to improve the medical services throughout the country. The first leader of the country from 1963 until 1994, Dr. Hastings Kamuzu Banda, was himself a former [Page 678]general practitioner, as was the major anti-British activist Daniel Sharpe Malekebu; Banda worked in Britain and Malekebu in Philadelphia. However, with 297 people per square mile, Malawi is one of the most densely populated countries in southern Africa, and this has put much pressure on the food supply of the predominantly agricultural nation.

The country's fertility rate is 5.7 births per woman (2008), the 17th highest in the world, with families in Malawi being, on average, some of the largest in the world. There are now four central hospitals: 24 on the district level, 35 rural on the rural level, and nearly 350 clinics, but these remain heavily understaffed with only 266 doctors and 7,264 nurses and midwives. In recent years, the nature of family life in Malawi has been transformed by the spread of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), which now affects as many as 16 percent of the country's population, and is the cause of 70 percent of the deaths in the country. The result has been that at least half a million children have lost one or both of their parents either through HIV/AIDS, or from mothers dying during childbirth. The maternal mortality rate at 18 per 1,000 births in 2005 is the third highest in the world, having risen dramatically from 5.8 per 1,000 only 10 years earlier.

Save the Children ranked Malawi 4th on its Mothers' Index, 5th on its Women's Index, and 6th on its Children's Index among 33 Tier III or least developed countries.