Malawi is one of the world’s poorest countries; landlocked, with few natural resources and limited exports.

Reliance on farming makes the country particularly vulnerable to climate change: Malawi made news headlines in March 2019 when Cyclone Idai caused catastrophic flooding.

Child well-being has a huge impact on the population: almost half of the 18 million people who live in Malawi are under the age of 15.

Despite the challenging environment, great progress has been made to improve child health over recent years.

Malawi was one of the few countries in sub-Saharan Africa to achieve Millennium Development Goal 4, reducing under-5 mortality from 232 to 55 per 1000 live births between 1990 and 2016.


However, there are still an estimated 40,000 children under the age of 5 that die every year due to preventable and treatable illnesses including pneumonia, diarrhoea and malaria.

Two thirds of these deaths occur in infancy. Improving neonatal care is a priority. Malawi has the highest rate of premature birth worldwide – overall 18% of babies are born early and complications of low-birth weight and prematurity are common, as are neonatal infections and birth asphyxia.

Other emerging priorities include non-infectious diseases (asthma, epilepsy, diabetes, heart and kidney disease), trauma and mental health.

Adolescent health is an overlooked area. Teenage girls often drop out of school and are at high risk of violence, HIV and early pregnancy: 30% of all babies in Malawi are born to teenage mothers.

Members of the International Child Health Department at Alder Hey are involved with clinical and research projects directly addressing several of these important areas;

Current projects in Malawi
  • Dr Sarah Rylance is finding ways to improve asthma care for children
  • Dr Stephen Ray is investigating causes of febrile coma in children
  • Dr Maryke Nielsen is exploring how best to fight neonatal infections
  • Dr Joe Langton is improving emergency care of children in A&E
  • Dr Melissa Gladstone is trying to improve outcomes for children with neurodisability
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