C ommo nwe a l t h memb e r c o u n t r i e s 10.3 per cent in 2012. The prevalence of HIV peaked at around 16 per cent in the period 1996–2000, following which it has shown a consistent rate of decline. In 2012 there were 1,564,984 reported cases of malaria. Estimated levels of mortality from malaria have seen a small overall decrease in the period 2006–12. Both the estimated incidence of and the estimated mortality (when mortality data excludes cases comorbid with HIV) from tuberculosis (TB) reduced by around half in the period 2000–13. Non-communicable diseases (NCDs) accounted for an estimated 28 per cent of all mortality in 2012. The most prevalent NCDs in Malawi are cardiovascular diseases, which accounted for 12 per cent of total deaths across all age groups in 2012. Cancer, non-communicable variants of respiratory diseases and diabetes contributed five per cent, two per cent and one per cent to total mortality, respectively (2012). Injuries accounted for seven per cent of deaths in 2012. The most commonly diagnosed mental illnesses in Malawi include depression and anxiety. Health systems: In 2012 government expenditure on health was seven per cent of GDP, equivalent to US$19 per capita. In the most recent survey, conducted between 1997 and 2010, there were two doctors, and 28 nurses and midwives per 100,000 people. Additionally, in 2010, 71 per cent of births were attended by qualified health staff and in 2013, 88 per cent of one-year-olds were immunised with one dose of measles. In 2012, 85 per cent of people were using an improved drinking water source and ten per cent had access to adequate sanitation facilities. The most recent survey, conducted in the period 2000–11, reports that Malawi has two pharmaceutical personnel per 100,000 people. Malawi has a three-tier health care system, based on a patient referral system. Primary care is mainly made up of communitybased outreach, health posts, dispensaries, urban health centres and primary health centres. Primary level hospitals, with postnatal beds, outpatient services, maternity care and antenatal services, make up the remainder of the primary care level. Patients needing more sophisticated treatment are referred to secondary care, which is provided by the district hospitals in each of Malawi’s districts. These hospitals can provide the same basic services as the primary care facilities, but also have x-ray machines, ambulances, operating theatres and laboratories. The top tier of care comes from central referral hospitals located in the major urban areas. There are two at Blantyre and Zomba (Southern region), one in Lilongwe (Central) and one in Mzimba (Northern). Under-five mortality 250 200 150 100 1990 1995 2000 2005 2010 2015 Under-five mortality per 1,000 live births 2015 MDG 4 target 60 50 200 Commonwealth Health Partnerships 2015 50 Life expectancy and HIV/AIDS 20 15 1980 1990 2000 2013 Prevalence of HIV/AIDS among those aged 15–49 Life expectancy Prevalence of HIV, total (% of population aged 15-49) Life expectancy in years 40 10 Mortality by cause of death (% of all deaths), 2012 Communicable diseases, Injuries maternal, perinatal and nutritional conditions Non-communicable diseases Tuberculosis: Incidence and mortality 1990 2000 2010 Mortality excluding cases comorbid with HIV (per100,000 people) Incidence of tuberculosis (per 100,000 people) – including cases comorbid with HIV 500 400 300 200 100 0
Commonwealth Health Partnerships 2015
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