Policy Briefs
Although malaria is a largely preventable and treatable disease, it is a significant cause of mortality, morbidity, and productivity loss in Malawi. This study estimates that in 2019, malaria generated health and productivity losses equivalent to MWK 94,770 million – or 1.7 per cent of GDP. Increasing insecticide resistance and less than optimal (60%) care-seeking behaviour represent two of the most pressing issues facing the country when it comes to reducing the burden of malaria. The main policy recommendation from this cost-benefit analysis is that the National Malaria Control Program (NMCP) should fully adopt piperonyl butoxide (PBO) insecticide-treated bednets (ITNs) and rollout community-informed mass media to increase the rate at which people seek formal care when they, or their children, have fever. PBO ITNs have been shown to have a greater effectiveness against mosquitos compared to the ITNs that Malawi has used in the past.
Malawi enacted land reform policy in 2016. Implementation has been initiated but there is much work left to do with 4.7 million hectares of land in the country still untitled. Secure land tenure has substantial benefits for Malawians with 15 percent of households having a dispute over land and one out of five households fearing that their land would either be encroached upon or taken away from them. Implementing the land reform policy would require MWK 64,920 million in upfront costs for land titling, adjudication, and demarcation of 4.7 million hectares.
Quality early childhood education (ECE) increases literacy levels, improves school enrolment and achievement, and enhances developmental outcomes. While Malawi has been successful in its ability to expand early childhood education to 47% of the 3-5 year olds through Community Based Child Care Centers (CBCCs), there is still room for improvement. Over half of young children remain unenrolled in pre-school, and the quality of the roughly 12,400 CBCCs varies considerably with many centers lacking key infrastructure and materials. Furthermore, only 50% of caregivers have received training in providing pre-primary education.
In Malawi, 6 out 7 girls are not enrolled in secondary school, while 3 out of 7 girls are married before the age of 18. Common factors drive these two startling statistics: insufficient number of secondary schools, limited labor market opportunities for girls and cultural norms and practices that normalize early marriage. Missing out on secondary school and getting married early has a number of negative effects, including earlier pregnancy, poorer health outcomes for mothers and children, increased domestic violence and higher national fertility rates. Estimating the social and economic costs of child marriage, this report finds that each case of child marriage costs Malawian society around MWK 9 million.
Blackouts, shortages, and unreliable access to electricity are a challenge for Malawi’s businesses. Malawian firms experience approximately 7.4 outages per month, with each outage lasting 3.6 hours. An independent evaluation of ESCOM revealed its showed an insufficient (and in some areas, deficient) corporate governance and management practices as principal causes of its weakened financial position and frequent power outages. We recommend that the ESCOM board consider providing a 10-year long-term technical assistance program to improve corporate governance and management practices at ESCOM. This is expected to address some, but not all, the challenges of electricity provision, effectively preventing 5% of Malawi’s generated electricity from being lost before it reaches the consumer.
Many key AMR bacteria are present throughout humans, animals and the environment, and are in a constant state of flux between all three “compartments”. This cycle of transmission between humans, animals and the environment is exacerbated if there is inadequate access to effective WASH infrastructure, as is frequently the case in LMICs. In order to effectively address AMR, a One Health approach is essential including incorporating WASH. Interrupting bacterial and AMR transmission through promoting appropriate WASH practices and developing adequate infrastructure will reduce the incidence of AMR infection and spread.
Food Insecurity remains a significant concern, with 63% of Malawian households deemed severely food insecure. Focusing on sustainable farming models, this cost-benefit analysis identifies two interventions which demonstrate significant promise in improving food security: Purdue Improved Crop Storage (PICS) Bags Promotion; and Specific Crop Diversification Strategies.
Agriculture is the backbone of Malawi’s economy; it accounts for almost 80 per cent of employment, and 80 per cent of the country’s total exports (World Bank, 2020). However, Malawi remains highly reliant on tobacco and has been slow to diversify into other crops. Two barriers preventing the export of regionally demanded crops are the long-standing export ban on maize and poor quality-control standards and regulations for groundnuts.
The following policy solutions for maize and groundnuts demonstrate the greatest potential for export growth and alignment with national priorities.
Malawi has made great strides since primary education was made free to all students in 1994. This has encouraged many children to attend school. In spite of 88% enrollment rates in primary schools (pre-pandemic) learning outcomes are poor with low passing rate for fundamental (English and Mathematics) subjects. The most cost-effective method identified to improve learning outcomes is Technology Assisted Learning (TAL).
Agricultural commercialization in Malawi is broadly constrained by poor market systems and unorganized farmers. Further still, there are a multitude of other challenges constraining the development of formal agricultural markets in Malawi. The COVID-19 pandemic has also introduced additional challenges to the agriculture sector in Malawi.
The proposed intervention for this analysis is the reform of the two commodity exchanges. This was selected because it has the potential to improve policy and market coordination at a national level, as well as provide a practical avenue for farmer training, storage, and credit systems.
Creating wealth through agriculture has been a long-running development goal in Malawi. Within the country, irrigation is viewed as a valuable opportunity and has increased substantially for smallholder farmers, quadrupling from 15,988 ha in 2011 to 61,977 ha by 2019.. It has the potential to open up the dry season for cultivation on a grand scale, comparable to rainy season harvests, while also stabilizing wet season cultivation, insuring yields against variable rainfall patterns. The main takeaway from this cost-benefit analysis is that policymakers need to pay very close attention to costs of irrigation technologies and the choice of commodities promoted. Tomato, paprika and to a lesser extent cassava appear to fare well under irrigation, with gross margins large enough to cover the cost of irrigation investments studied in this report.
The population of Malawi is expected to double from 2020 to 2050. Reducing population growth is imperative for Malawi to unlock the benefits of a demographic benefit. Access to and use of contraception in Malawi has increased substantially over the past two decades. In this report, we have assessed the costs and benefits of providing women with postpartum counselling services and free access to contraceptives and transportation.