UNICEF has worked with the World Health Organization and other partners to advocate for a renewed commitment to Acceleration of Child Survival and Development (ACSD) in Malawi. A national policy for ACSD using the IMCI approach was adopted in 2006 and a costed national strategic plan finalized in 2007 and will run until 2011. The Plan calls for a rapid scale-up of high impact interventions, in particular at community level using dialogue as the preferred medium of communication.
UNICEF, in collaboration with the World Health Organization, supported the Government in achieving routine immunization coverage of over 86 percent, leading to a significant reduction of vaccine preventable diseases. Polio, measles and neonatal tetanus have been virtually eliminated. No confirmed case of polio has been reported since 1992. More than 5.5 million insecticide-treated nets (ITN) have been distributed resulting in more than 51 per cent of households owning at least one net. Malawi has maintained over 90 percent coverage for vitamin A supplementation in children under the age of one but coverage for children over one year and for postpartum mothers has been low, at around 50 percent and 30 percent, respectively.
The mortality rate among children with acute severe malnutrition admitted in nutrition rehabilitation units (NRU) was reduced from 30-40 percent to 16-17 percent between 2002 and 2003. More than 76,000 children have been treated for severe and acute malnutrition with UNICEF’s support since 2002 through 95 Nutrition Rehabilitation Units (NRUs). A new approach - Community Therapeutic Care (CTC) - is being rolled out to 27 districts and is expected to reach 50,000 severely malnourished children. The approach uses a ready-to-use therapeutic food called Plumpynut for the treatment of severe malnutrition. This strategy could be a cost-effective way of tackling acute malnutrition at community level.
The national policy on newborn care, guidelines and a training package have been revised in line with ACSD. Health workers have been trained in newborn care and a 10-bed Kangaroo Mother Care unit has been built at Queen Elizabeth Central Hospital. Coverage of emergency obstetric care increased from two sites in 2006 to 22 in 2007, representing 23 per cent of the 109 sites earmarked for development by 2009.
UNICEF has supported the expansion of youth-friendly health services to 15 districts. To date, 45 per cent of health centres in those districts offer reproductive healthcare and in many instances voluntary counselling and testing for HIV. In 2007, more than 100,000 young people, half of them girls, tested for HIV.
The coverage of prevention of mother-to-child transmission (PMTCT) services increased from 7 in 2002 to 454 in 2008. The number of pregnant women testing for HIV has increased from 320 in 2001 to more than 280,000 in 2007. UNICEF-supported HIV voluntary counselling and testing sites increased from 41 to 75 in 14 districts. 111 out of 317 (35 percent) health facilities in the target districts provide youth-friendly health services. In addition, UNICEF is procuring antiretroviral drugs and other health products for the Government with funding from the Global Fund and providing in-country logistics for the distribution of the drugs and supplies.