The Need For Nutrition and HIV Therapy in Malawi

2.1          Poverty, rapid urbanization and inadequate employment opportunities have resulted in high poverty rates in the urban areas, which currently stand at 25 percent of the city population, with 9 percent being ultra-poor.  Poverty is exacerbated by a steady growth in the prices of basic goods and lack of access to the basic urban services.   Acquiring loans for economic development is hard for the poor due to the high interest rates, and their participation in city development is minimal.  About 43 percent of household income is spent on food (Malawi Urban Profiling – Lilongwe 2010).

2.2         Good nutrition is a basic building block of human capital and, as such, contributes to economic development. In turn, sustainable and equitable economic growth in developing countries will convert these countries to “developed” states' (WB, 2006). There is abundant evidence on the two-way relationship between nutrition and economic development. Malnutrition undermines economic growth and consequently brings about poverty. It is also evident that the poor progress of the world towards attaining the Millennium Development Goals (MDG) especially poverty reduction was due to the failure to tackle malnutrition by the international community and most governments in developing countries over the years. Persistent malnutrition contributed immensely to the failure to meet the MDGs of eradicating extreme poverty and hunger, achieving universal primary education, promoting gender equity, reducing child mortality, improving maternal health, combating HIV/AIDS, malaria and other diseases.

2.3         In the informal settlements, like the area where this pilot project is going to operate from, residents access water through communal water points (kiosks). However, this water is not enough to service all the informal settlement residents and some residents rely on unprotected water sources, such as rivers and boreholes, to supplement the water provided by Lilongwe Water Board.   Water demand in Lilongwe is increasing with the rising population.

2.4         Sanitation and refuse collection is a major challenge in Lilongwe.  Over 75 percent of the population relies on pit latrines and the sewerage infrastructure covers only about 9 percent of the city.  In this area the city does not collect refuse.  Most households, especially in the informal settlements, dispose their waste in open spaces, on riverbanks and along roadsides.  Uncollected refuse is a common site in Lilongwe’s markets and a major cause of environmental degradation.    Habitat have come forward to assist in improving sanitation in the city through the promotion of ecological sanitation (eco-san) toilets that encourage use of human excreta and urine as organic manure.  The participation in this scheme has been patchy because most people could not afford to make the contribution that they were asked to make towards the construction of the toilets.

2.5         NNHSR wants to develop community based health and nutrition care models and programmes with communities. The programmes will focus on seeking solutions to priority public health challenges, such as maternal and reproductive health and rights, child health, HIV and AIDS, safe water, basic sanitation and personal hygiene, and non-communicable diseases.  Poor Communities are at the heart of NNHSR’s approach.  We will reach, respect and become part of them, supporting them to create change from within by building on their own resources and strengths.

2.6         Our role will be to catalyse the hidden but real energies within communities, to help participants find innovative solutions and to share their stories with others. We will champion women, who are at the heart of their families’ and communities’ health.

2.7         However, women in Malawi have relatively fewer resources or negotiation power with which to address their needs.  Acknowledging these defined gender roles, we will engage men while continuing to empower women, and while also ensuring that gender is mainstreamed in all of NNHSR’s health programmes. NNHSR acknowledges that men have got to be a major entry point and point of contact if programmes targeting women and children are to be successful.   As men are partners in reproductive health, they need to be informed and engaged in reproductive health programmes for women to ensure their success.

2.8         As authority figures in some of the households, they make the important decisions in matters that affect the welfare of their children, and are therefore a critical factor in determining the outcome of child health initiatives.  NNHSR will strive to close the gap between the communities and formal health systems. This will be achieved by partnering with the very poor, malnourished, most vulnerable and the chronically ill affected by HIV/AIDS.

Lilongwe Demonstration Garden at Kauma