Alisha Kramer
Research Assistant, Global Health Policy Center
Any new President has a vast array of items on his or her agenda, but newly inaugurated Malawian President Joyce Hilda Banda has elevated a praise-worthy agenda for maternal health at the very outset of her time in office.
After former President Bingu wa Mutharika died unexpectedly from a heart attack, President Banda took office on April 7th, 2012 after a brief succession struggle. Domestic and international observers of Banda are optimistic that Banda’s vision for improved governance can reverse the downward course of her predecessor.
During the week of June 11th, President Banda traveled to Washington, D.C. to take part in a series of global health events. At USAID’s Frontiers in Development conference she gave a keynote address and sat on a panel with other current and former heads of state to discuss “Development, Democracy, and Global Security in the 21st Century.” She also participated in a roundtable discussion at the Aspen Institute where she spoke on women’s leadership for maternal and reproductive health. At this roundtable discussion I heard President Banda detail her plans to focus special attention on maternal and child health, and to make governance in Malawi smarter, more transparent, and more efficient.
At the outset of her new administration, President Banda sold or leased her Presidential jet and her fleet of 60 Mercedes government cars, underscoring her commitment to ensure resources are directed to the needs of the country, rather than personal luxury.
A priority area that the President intends to devote considerable time and resources to is maternal health. Maternal mortality in Malawi is dire -- for every 100,000 live births, 460 mothers die as a result of pregnancy and childbirth related causes. Malawi lags far behind the 2015 MDG 5 target of 155 maternal deaths per 100,000 live births.
At the Aspen roundtable discussion, President Banda explained how she could have been one of those 460 women, had she not received a blood transfusion for postpartum hemorrhaging in time to save her life. Many women and their children in Malawi are not so lucky. President Banda recounted one clinic visit where a woman described how she lost her child delivering at night because there was no electricity, and it was too dark to see that the umbilical cord was wrapped around her newborn’s neck.
To address these challenges, Banda launched a Presidential Initiative for Maternal Health and Safe Motherhood, which focused on increasing salaries and improving working conditions for nurses and midwives among other priorities. She has also recruited ten village Chiefs as champions of this cause, who will work with her through a Chiefs committee on Maternal Health and Safe Motherhood.
The President will also increase trained nurses, build additional waiting shelters for expectant women, and expand electricity to hospitals and clinics across the country.
Although many are hopeful that her leadership will help produce real improvements in Malawi, the challenges are numerous. Malawi is one of the poorest countries (almost ¾ of the population lives below the poverty line), 50% of women are married by age 18, only 66% of women are literate, and HIV among adults is estimated at 12%. Banda will also have to mend donor relations, which deteriorated in the face of the previous president’s corruption, poor governance, and human rights abuses.
President Banda has set herself an ambitious agenda on maternal health, and while optimism is high, so is the wall of challenges Banda is determined to scale. It will be interesting to track Malawi’s progress in the months and years to come.
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