Malawi Emergency Appeal (May - October 2020)


Emergency Appeal at a Glance





Overview of the Crisis

Coronavirus Disease-19 (COVID-19) was declared a global pandemic on 11 March 2020, and Malawi declared its first case on 2 April. As of 30 April, there were 36 confirmed positive cases of COVID-19 and 3 deaths. A State of Disaster was declared by President Arthur Peter Mutharika on 20 March and a 21-day lockdown was implemented from 18 April to 9 May. The lockdown measures include: bans on public gatherings; closure of schools; and bans on international flights and cross-border passenger buses.

The COVID-19 pandemic is expected to negatively impact the economic outlook for Malawi, while measures implemented to control the spread of the disease are expected to affect the most vulnerable. Around 70 per cent of the population in Malawi live below the international poverty line of US$1.90 per day,1 and 89 per cent of Malawi’s workforce are employed in the informal economy. Malawi has one of the lowest per capita Gross National Incomes (GNI) in the world, at just $320, and its economy -which is heavily reliant on rain-fed agriculture- is vulnerable to shocks. Real GDP is forecasted to shrink by 3.2 per cent in 2020, while slow economic activity and labor mobility are expected to disproportionately affect urban residents who depend on daily incomes. Markets will experience substantial disruptions to supply chain over the coming months, and international trade links are already affecting imports for small industry. While suppliers have relatively good volumes of most products in stock locally, disruption in international supply chains are likely to lead to future shortages or increased cost of basic goods. Tourism, one of the priority growth sectors in Malawi, will be greatly impacted in the period ahead. Malawi also depends on imported petroleum products which have price transmission effects on goods and services. Sudden supply shock will have negative consequences, while the potential reduction in global demand may result in logistical challenges in the neighboring countries, affecting the availability of fuel.

Malawi’s health system has limited capacity to deal with the additional burden of COVID-19. There are just 20 ventilators nationwide, for a population of over 18 million, and approximately 25 intensive care unit (ICU) beds. Malawi also has one of the highest health worker shortages in Africa, with only 28 nurses and 2 physicians per 100,000 people.2 Owing to the limited critical care infrastructure, there is a risk of health centres quickly becoming overwhelmed, should severe COVID-19 cases rise. This may disrupt routine medical services, reducing existing treatment for HIV, TB, malaria, and maternal, newborn and child healthcare (MNCH). The need to redirect supplies to the treatment of COVID-19, compounded by general supply chain disruptions, could lead to stockouts of resources needed for COVID-19 management (e.g. personal protective equipment to protect hospital frontline workers) and to maintain essential services.

Sustaining access to sexual and reproductive healthcare during COVID-19 is a specific concern. Malawi registers some of the highest annual birth rates in the world, with approximately 520,000 births recorded per year, according to 2019 trends. Its maternal mortality rate, although declining, remains high, at 349 deaths per 100,000 births3. Approximately 30 per cent of babies in Malawi are born to mothers under 19 years of age, leading to an increase in preterm and underweight babies and contributing to the high maternal and neonatal mortality rate.4 Health facilities have limited stock of relevant equipment and supplies for the care of pregnant woman and there are frequent stock outs of essential medicine for managing obstetric complications, as well as shortage of trained personnel to provide emergency obstetric care. In any crisis-affected population, approximately 4 per cent of the total population will be pregnant at any given time, of whom 15 per cent will experience an obstetric complication, while 9 per cent to 15 per cent of newborns will require lifesaving emergency care.

Over 1.9 million people who were estimated to be facing severe food insecurity in Malawi prior to COVID-19 will struggle to cope with the economic strain, escalating an already fragile situation. Despite average harvests, prices of maize and alternative commodities rose by 60 to 100 per cent above average in 2019, even in areas producing a surplus, as private traders withheld stocks for better prices. At the same time, low tobacco prices -a key cash crop in Malawi- led to reduced income and low access to food for many households.5 Within this context, the global economic downturn and local economic impact of COVID-19-related measures are expected to further deteriorate household food security, particularly for the urban poor. Malnutrition is also expected to rise as access to healthy and nutritious food become more difficult for vulnerable groups. Over 37 per cent of children under 5 in Malawi are stunted. Limited health outreach services, including community-based nutrition screening for children, will impact the ability to detect moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) cases early, potentially resulting in children having to be admitted to SAM treatment facilities in deteriorated condition, adding to the burden of stretched health facilities. Over 2.9 million children in Malawi are currently out of school and lack access to school feeding programmes which serve as a vital source of nutritious food.

Children and youth are at increased protection risks as they are no longer able to access the protective environment education provides and as households come under increased economic strain. Children in already vulnerable situations -such as those in street conditions, living in institutions, or in detention- are at higher risk of infection. Abrupt closure of schools and community services for children have increased children’s vulnerability to violence, neglect, and exploitation. As households’ ability to cope is exhausted, they may resort to negative coping mechanisms such as child labour and early child marriage. Only 51 percent of children in Malawi complete of primary school, and there is a risk that girls (especially for vulnerable households) may not return to education once schools reopen. Just 29 per cent of Malawian girls (compared to 36 per cent of boys) complete secondary school.6 For youth, entering the job market will become more difficult; many engage in the informal sector which will significantly impacted by movement restrictions.

Gender based violence and intimate partner violence is high across Malawi and expected to increase with the restrictions and the economic strain from COVID- 19. An estimated 14.5 per cent of women have experienced physically abuse and 25.3 per cent of those have experienced sexual violence.7 The most common perpetrator of violence is usually a partner or family member and, as family strain increases due to COVID-19 lockdowns and curfews, intimate partner violence is expected to increase. Malawi’s child marriage and adolescent birth rates are among the highest in the world,8 and COVID-19 will compound the challenges faced by young women and adolescent girls, including: increased gender-based violence; unplanned pregnancies and high violence incidents; increased burden of care; and lack of access to safe spaces. Approximately 47 per cent of girls in Malawi marry before the age of 18 years912 per cent marrying before the age of 15. Without legitimate support structures to investigate and resolve these issues, women and girls are unlikely to come forward and seek assistance.

Malawi hosts 46,296 refugees, more than half of whom fled the Democratic Republic of Congo. Dzaleka refugee camp was originally built to host 10,000 refugees but has far exceeded capacity. There are, on average, 450 new asylum-seekers every month exacerbating conditions at the camp. In 2019, the Government of Malawi adopted a prima facie determination for Congolese asylum-seekers from North and South Kivu and it is expected that those seeking asylum from DRC will increase in 2020. The government has allocated additional land for expansion, but refugee populations living in crowded conditions are at risk during an outbreak.


UN Office for the Coordination of Humanitarian Affairs
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