In 1977, the World Health Assembly decided that the main social target of governments and of WHO should be the attainment by all the people of the world by the year 2000 of a level of health that would permit them to lead a socially and economically productive life. In other worlds, as a minimum, all people in all countries should have at least such a level of health that they are capable of working productively and of participating actively in the social life of the community in which they live.
Sadly, this remains only a dream for the rural majority populations of most of the developing world. The subsequent Millennium Development Goals achieved uneven progress and results between countries. Currently, the Third 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.
Although most rural areas in Africa today have a physical health facility, personnel capacity remains a big problem. The Malawi Health Sector Strategic Plan 2011 – 2016 reports the following as the top ten causes of deaths for those in contact with
health care services in Malawi:
Malawi Top 10 Causes of Death (CDC website)
Lower respiratory infections
Ischemic heart disease
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.
Malawi has been ranked as one of the lowest-performing nations for literacy in sub-Saharan Africa. Malawi’s literacy rate has decreased to 62.14% in 2016, with a male to female rates of 69.75% and 55,2% respectively. This ratio increases with age. In those aged 15 -24 years, the literacy rate is 84.3%, with only a marginal difference between males and females. The primary school enrolment rate is reported as 90.7%, with a gender parity ratio of 1.0.
Only 35% of children in Malawi complete primary school.Under-provision of education beyond primary school stunts the development of most African countries today. However, in Malawi, this has to be balanced against the high unemployment rate (61%) in those who achieve secondary education.
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. Maize accounts for over 80 percent of cultivated land, and the country produces an average of 3 million tons of maize annually - above the 2.3 million tons level needed for self-sufficiency. However, widespread food shortages are commonly experienced during lean seasons, leading many rural households to suffer from chronic food insecurity and malnutrition.
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.
Traditionally, Malawi is a fish-eating nation. Although Malawi is blessed with the ninth largest lake in the world and the third largest and second deepest lake in Africa, overfishing has resulted in the collapse of the fishery in the lake Owing to the Tilapia (Chambo) scarcity on the market, its prices have risen to unaffordable levels for the most Malawian people. Fish consumption fell from 14.2 kcal/capita/day in the period 1961-71 to 8.4 kcal/capita/day in the period 2001-2007. Meat consumption marginally increased, and vegetable consumption marginally decreased during the same period.
Umoyo will strive to create opportunities for sustainable local agriculture to improve local food supplies, and the ability to buy adequate food supplies.
Agriculture, Food Security & Nutrition
Prosperity enables people to do so much 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.
Malawi is one of the poorest countries in the world with a low human development, ranking 171 out of 189 countries on the 2017 Human Development Index. In 2017, about seventy-one per cent (71%) of the population still lived below the income poverty line of US$1.25 a day. Eighty-one per cent (81%) of all persons aged 15 years and over are subsistence farmers without a regular income.
It would appear that having an education only marginally changes the opportunity for paid employment, as 61% of those who have had a secondary school education also get by as subsistence farmers. Identifying local talent and skills for establishing small scale local enterprises will therefore be central to Umoyo's activities.