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Malawi is one of the most densely populated countries in sub-Saharan Africa. Sixteen million people live in Malawi, approximately 80 percent of whom live in rural areas. The economy relies heavily on agriculture and over half of the country’s population lives below the poverty line.

Health Care Challenges

With 11 percent HIV seroprevalence, there are an estimated 920,000 people living with HIV in Malawi. Only one-third of pregnant women with HIV receive antiretroviral prophylaxis to prevent mother-to-child transmission and nearly 600,000 children have been orphaned by HIV. In recent years, however, progress has been made to increase access to antiretroviral therapy and the government has made a commitment to strengthening the capacity of the health system at all levels.

Health Care System

Malawi faces a severe shortage of human resources for health at every level of service delivery. This shortage compromises the population’s access to quality health care services. The vacancy rate for nursing and midwifery positions in the public sector is 65 percent and, to adequately address this gap, an additional 23,000 health workers are needed. In addition, the geographical distribution of health workers is severely imbalanced—although urban areas are home to only 20 percent of the population, these areas are served by 74 percent of the total number of practicing health workers. Nearly one-third of the nursing workforce is non-practicing due to poor salaries, inadequate living and working conditions in rural areas, and limited opportunities for career advancement.

ICAP in Malawi

ICAP is the prime implementing partner for the Nursing Education Partnership Initiative (NEPI) in Malawi. The project aims to address the shortage of human resource for health in the country and to improve the quality of nursing and midwifery education. It operates in partnership with USAID, the PEPFAR in-country team, the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and in-country stakeholders.

Through NEPI, effective working relationships have been established with the Ministry of Health, three public nursing education institutions (Kamuzu College of Nursing, Mzuzu University, and Malawi College of Health Sciences) and other stakeholders (including the Nurses and Midwife Council of Malawi, Nursing and Midwifery Associations in Malawi, and the Christian Health Association of Malawi).

Examples of ICAP’s activities in Malawi include: