No. 18: The State of Food Insecurity in Blantyre City, Malawi

Chronic food insecurity is considered to be one of the most important challenges facing the people and government of Malawi. Most attention tends to be given to the rural areas where the majority of the population live and where the prevalence of food insecurity is highest. However, Malawi is urbanizing at a rapid rate and those who move to the cities do not automatically become food secure. Urban food insecurity is likely to increase and therefore it is important for policy-makers to begin to think about this issue. AFSUN’s study of food insecurity in the city of Blantyre, Malawi’s industrial hub, formed part of its baseline survey of 11 Southern African cities. The study established that household dietary diversity is very low with most consuming a monotonous diet dominated by grain foods, especially maize. While the dependence on maize and its availability on the market means that absolute levels of food insecurity are lower here than in many other cities surveyed by AFSUN, there is also a clear seasonality to food security that coincides with the rural agricultural cycle. When maize prices rise, households immediately feel the pinch and levels of insecurity rise. Female-centred households, households with large family sizes, households that have lost a breadwinner through death, households with a sick member, and low-income households are more food insecure than the rest

Happiness and Alleviation of Income Poverty : Impacts of an Unconditional Cash Transfer Programme using a Subjective Well-Being Approach

This study analyzes the impact of an exogenous, positive income shock on caregivers’ subjective well-being in Malawi using panel data from 3,365 households targeted to receive Malawi’s Social Cash Transfer Programme that provides unconditional cash to ultra-poor, labour-constrained households. The study consists of a cluster-randomized, longitudinal design. After the baseline survey, half of these village clusters were randomly selected to receive the transfer and a follow-up survey was conducted 17 months later. Utilizing econometric analysis and panel data methods, we find that household income increases from the cash transfer can have substantial subjective well-being gains among caregivers. Households use the cash to improve their families’ livelihoods, ensuring provision of their basic needs including food, shelter, and clothing. Reduction of these daily stresses makes caregivers happier about their current situations and gives them hope that the future will continue to get better

Prevalence and correlates of diabetes mellitus in Malawi: population-based national NCD STEPS survey

BACKGROUND: Previously considered as a disease of the affluent, west or urban people and not of public health importance, diabetes mellitus is increasingly becoming a significant cause of morbidity and mortality in sub-Saharan Africa. However, population-based data to inform prevention, treatment and control are lacking. METHODS: Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based, nationwide cross-sectional survey was conducted between July and September 2009 on participants aged 25–64 years. A multi-stage cluster sample design and weighting were used to produce a national representative data for that age range. Detailed findings on the magnitude of diabetes mellitus and impaired fasting blood glucose are presented in this paper. RESULTS: Fasting blood glucose measurement was conducted on 3056 participants (70.2% females, 87.9% from rural areas). The age- sex standardised population-based mean fasting blood glucose was 4.3 mmol/L (95% CI 4.1-4.4 mmol/L) with no significant differences by age, sex and location (urban/rural). The overall prevalence of impaired fasting blood glucose was 4.2% (95% CI 3.0%-5.4%). Prevalence of impaired blood glucose was higher in men than in women, 5.7% (95% CI 3.9%-7.5%) vs 2.7% (95% CI 1.6%- 3.8%), p < 0.01. In both men and women, prevalence of raised fasting blood glucose or currently on medication for diabetes was 5.6% (95% CI 2.6%- 8.5%). Although the prevalence of diabetes was higher in men than women, 6.5% (95% CI 2.6%-10.3%) vs 4.7% (95% CI 2.4%-7.0%), in rural than urban, 5.4% (95% CI 2.4%-8.4%) vs 4.4% (95% CI 2.8%-5.9%) and in males in rural than males in urban, 6.9% (95% CI 2.8%-11.0%) vs 3.2% (95% CI 0.1%-6.3%), the differences were not statistically significant, p > 0.05. Compared to previous estimates, prevalence of diabetes increased from <1.0% in 1960s to 5.6% in 2009 (this study). CONCLUSION: High prevalence of impaired fasting blood glucose and diabetes mellitus call for the implementation of primary healthcare approaches such as the WHO package for essential non-communicable diseases to promote healthy lifestyles, early detection, treatment and control