MDG Goal 6: Combat HIV/AIDS, TB, malaria and other diseases
Target 7: Halt and begin to Reverse the Spread of HIV and AIDS
Indicator 1: HIV prevalence among 15 to 24 year old pregnant women
The national HIV prevalence rate among pregnant women aged 15 to 24 years has been declining from 24.1 percent in 1998 to 12 percent in 2009. The decline is attributed to the success of the increased awareness programmes on HIV prevention and behavioral change such as abstinence and practicing safe sex. It is projected that by 2015, HIV prevalence rate is likely to be at 6 percent. Although the projected rate of 6 percent shows that MDG target of 0 percent may not be achieved by 2015, nevertheless the country will have made good progress towards reducing the HIV prevalence.
Indicator 2: Ratio of School Attendance of Orphans to School Attendance of Nonorphans aged 10-14
Figure 20 shows that the ratio of orphans to non-orphans attending school had increased from 0.12 in 2003 to 0.18 in 2006 and dropped to about 0.14 in 2007. There has been a slight increase in the ratio of orphans to non orphans attending school from about 0.14 in 2007 to about 0.15 in 2009. The projection shows that the ratio may increase to about 0.18 in 2015. Hence, there is need for government intervention to ensure that more orphans of school going age are being enrolled in schools.
Target 8: Halt and begin to Reverse the Incidence of Malaria and other Major Diseases.
Malaria remains the most common cause of illness and death among under five children and pregnant women in Malawi. Malaria alone accounts for 40 percent of Out Patient Department (OPD) onsultations in most health facilities in the country.
Indicator 1: Death Rates associated with Malaria
Figure 21 shows that deaths associated with malaria increased from 3.6 percent in 2000 to 5 percent in 2006. This rise was attributed to development of high resistant strains to Fansidar SP which was a recommended drug for malaria. Nevertheless, the malaria related deaths has decreased to about 3 percent in 2009. This drop has been as a result of the introduction of a new anti malaria drug known as Artemether Lumefantrine (LA) and also increased distribution and use of ITNs.
Indicator 2: Access to Malaria Treatment
Government is committed to control malaria through a number programmes such as the Roll Back Malaria (RBM) initiative. The objective of the initiative is to ensure that those at risk of malaria, particularly pregnant women and under five children have access to the most suitable and affordable combination of personal and community preventive measures such as insecticide-treated mosquito nets (ITNs) and prompt effective treatment for malaria within 24 hours of onset of illness.
Figure 22 shows that proportion of population with access to malaria treatment has increased from 17 percent in 2004 to 22 percent in 2010. This increase is attributed to intensive sensitization campaigns on the dangers of malaria. The projection shows that, if this trend is sustained, the proportion of the population accessing malaria treatment is expected to rise to about 30 percent by 2015.
Indicator 3: Proportion of Households with at least One ITN
The use of Insecticides Treated Nets (ITNs) has been adopted in Malawi as one of the key strategies to control malaria especially among under-five children and expectant women. Figure 23 shows that households with at least one ITN decreased from 42 percent in 2004 to about 38 percent in 2008. However, between 2008 and 2010 the proportion of households with at least one ITN has risen significantly from about 38 percent to 60 percent. This increase emanated from cumulative number of ITNs distributed throughout the country and campaigns on the use of ITNs. It is projected that by 2015, the proportion of households with at least one ITN will rise to about 74 percent.
Indicator 4: Death Rates Associated with Tuberculosis
Tuberculosis is the biggest single cause of adult illnesses and death from a communicable diseases in Malawi. Its greatest impact is on the poor, with crowding and poor nutrition favouring transmission and development of active disease from latent infection. This situation has been worsened with the advent of HIV infection. This accelerates the progression from infection with the bacterium to TB disease thereby resulting in an increase in the number of TB cases. Unless HIV infection in the community is reduced, TB cases will remain high.
Death rates associated with TB cases has been declined from 19 percent in 2005 to 8 percent in 2009 as shown in Figure 24 above. Previously, co-infection with HIV and AIDS led to the sharp increase in TB cases between 1990 and 1998 as can be observed from the figure. This drop is attributed to the success of the direct observed treatment short-course (DOTS). The projection shows that Malawi will likely reduce TB related deaths to 6 percent by 2015.
Indicator 5: Proportion of Tuberculosis cases cured under Directly Observed Treatment Short-course (DOTS)
Proportion of TB cases cured under DOTS has increased from 57 percent in 2001 to almost 100 percent in 2009 as indicated in the Figure 25 above. This is mainly attributed to clear policy on TB control, improved case detection, standardized TB treatment, adequate effective drugs, and universal access to treatment even in the most remote areas. If this trend continues, the country will be in a position to maintain its cure rate of TB cases by 2015.
- ↑ Ratio used is on total number of orphans to non orphans of school going age at primary school level.