Despite a falling AIDS-related mortality rate, changes need to be made to Malawi’s health care system to make better use of the aid it receives to treat AIDS and lower HIV transmission rates, experts say.
Some crucial problems Malawi faces in its fight against HIV include a poor health care infrastructure and inefficient health insurance schemes. Such inadequacies result in limited access to crucial ARV drugs as well as other health care services.
While Malawi has been successful in reducing the stigma associated with HIV through increased advocacy campaigns and review meetings on national policies, the country is still crippled by the epidemic. Although deaths caused by HIV/AIDS have decreased from 240 per day in 2004 to 48 per day in 2009, an estimated 1 million (out of the country’s 13 million) people are living with HIV/AIDS and approximately 80,000 of those are children. About 104,000 HIV-positive women give birth every year with an infection rate of more than 30% of the newborns.
Health experts attribute the high mother-to-child trasmission rate to the limited access most mothers have to PMTCT (prevent mother-to-child transmission) services during birth. Accoding to Leopold Buhendwa, the Doctors Without Borders PMTCT coordinator, the current coverage of PMTCT services are still too low to impact the epidemic among children. He also noted that approximately 50% of Malawian women do not give birth in healthcare facilities, but rather deliver in remote villages with the assistance of a traditional midwife whose skills can vary hugely. Anthony Costello, a London pediatrician who worked in Malawi, said that traditional birth attendants and community volunteers must be equipped with antibiotics to treat infection, as well as misoprotosol to treat postpartum hemorrhaging, the two biggest risks to women in childbirth.
Since African countries are particularly reliant on foreign aid for their health care needs, one important priority for aid reform is the decentralization of the health care system to give the population better access to health care.
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