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Determinants of Health

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Most people think that a person's health status is detrmined by the availability of doctors. Nothing could be further from the truth. The availability of doctors or health care workers is only one aspect of the determinants of health. Doctors and health care workers can be compared to car mechanics. They repair ill health - they do not create health. Many factors interact  to create a person's health (see figure on the left).

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It has been estimated that health care contributes only about 10% to a person's health.


In September, 2000, the UN Millennium Summit adopted the 8 Millennium Development Goals (on the right) which have synergy, albeit incomplete, with the determinants of health. This offers opportunities to re-double international collaborative efforts to influence the determinants of health in the developing world for the better .

Our work is guided by the Determinants of Health as cited by the World Health Organisation (WHO):

  • the social and economic environment,

  • the physical environment, and

  • the person’s individual characteristics and behaviours


We believe that the focus for our programmes has potential to make positive and sustainable impact on health and lives of the individuals and their communities.

Healthcare Services

The 3rd Sustainable Development Goal seeks to ‘ensure healthy lives and promote wellbeing for all at all ages’. It’s 4th target states that ‘By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being’.

The aim of Umoyo is to work with the people of Malawi and Southern Africa towards achieving the Global Goals and turning the dream of “Health for All” into reality. We dream of the people of Malawi achieving a level of health comparable to the best in the world by the middle of the 21st century and extending that achievement to the rest of Southern Africa thereafter.


We collaborate with our counterparts in Malawi to understand the health challenges affecting the communities. We focus on addressing the plight caused by Non Communicable Diseases.

Doctor's Appointment


Educational attainment plays a central part in being able to learn and understand the world around us, including the determinants and influences on our health. The better one's educational attainment, the better one is able to better look after one's health. Low education levels are linked with poor health, more stress and lower self-confidence.


Malawi is ranked as one of the lowest-performing nations for literacy in sub-Saharan Africa. Only 35% of children in Malawi complete primary school. 

Challenges include inadequate supply of infrastructure, teachers, and teaching and learning materials. Extremely large class sizes translated to extremely poor student performance, particularly in terms of literacy.

We collaborate with state and non-state actors to support attainment of Malawi Ministry of Education goals.

Agriculture, Food & Nutrition

Food supplies and access to affordable food play a huge part in nutrition and good health. Malnutrition contributes to half of all child deaths.

In the 2018 Global Hunger Index, Malawi ranks 87th out of 119 qualifying countries. With a score of 26.5, Malawi suffers from a level of hunger that is serious.

The United Nations Development Programme report that although Malawi is self-sufficient in food production (except during droughts) the population has increased more rapidly than the food supply.

Umoyo will strive to create opportunities for sustainable local agriculture to improve local food supplies, and the ability to buy adequate food supplies.

Enterprise & Prosperity

Money may not be the answer to all problems. However, income enables people to influence the determinants of health in their favour. If they have sufficient income, they can build secure roofs over their heads, have access to clean water, and buy nutritious food for themselves and their families, seek healthcare, etc. Local industries create opportunities for local employment and income.

Physical Environment

Poor housing and sanitation are known to play a big role in the transmission of disease passed through water, food, or from person to person.


Only 80% of households have access to improved drinking water sources in Malawi, and only 16% of households have access to improved sanitation facilities.


Arranging for the provision of clean water supplies, adequate sanitary facilities and adequate housing is therefore one of the main frontiers in disease prevention in Malawi.

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Genetic Inheritance, Social Environment & Culture

"You are your father's son; you are your mother's daughter".

In fact, you are the son or daughter of the community in which you are brought  up as well!


Almost all diseases have multifactorial causes - usually an interaction of the genes inherited from parents, which may confer a predisposition to certain diseases, with environmental, social or cultural factors - which then triggers disease.

The following social/cultural/environmental factors are reported to be the most frequently associated with disease in Malawi:



Top 10 Risk factors for diseases in Malawi

Rank  Risk factor                               % of Total

  1.     Unsafe sex                                    34.1

  2.     Underweight mother/child              16.5

  3.     Unsafe water, sanitation & hygiene  6.7

  4.     Zinc deficiency                               4.9

  5.     Vitamin A deficiency                       4.8

  6.     Indoor smoke from solid fuels         4.8

  7.     High blood pressure                       3.5

  8.     Alcohol                                          2.0

  9.     Tobacco                                        1.5

  10.     Iron deficiency                              1.3 

Source:  Malawi Health Sector Strategic Plan 2011 – 2016

Some conditions are totally inherited if one or both parents carry a particular gene. Sickle cell disease and trait are cases in point for people of African origin. Umoyo will strive to disseminate more information about genetic conditions and the multifactorial nature of most diseases, and arrange for screening and counselling where appropriate.

Social Environment
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