We have 10 specialist children’s wards:

Accident & Emergency unit (to be restructured and refurbished to meet the changing demand and needs) which are high dependency unit (to come on stream Spring 2021), medical Bay for chronically ill and neurological problems, special care for the very ill, oncology, orthopaedic, malnutrition treatment, babies born outside hospital, neo-natal with high dependency facility and Kangaroo Care for premature babies.

Also

One Stop Centre for victims of abuse – children, girls and women

Specialist outpatient clinics for HIV care, heart disease, neurological problems, sickle cell disease, TB, renal disease, diabetes, and general paediatrics

Factfile

	Malawi	UK	USA
Population	20m	67m	328m
GDP per cap	£300 $400	£32,500 $42,300	£50,000 $65,200
Mortality of under 5s per 1000 births	42	4.3	6.5
Life expectancy at birth m/f	61/67 yrs	80/83 years	76/81 years
Doctors/Nurses per 100kpop	4/44	280/810	260/1450

HIV & AIDS

As much as 10% of the population of Malawi may be infected.
There are an estimated 15,000 deaths per year related to HIV/Aids
Some 90,000 children may be HIV positive.
About 500,000 children are orphaned because of Aids.
Another 200,000 children are vulnerable because of HIV / Aids.
In comparison in the Uk 1200 children are HIV positive with less than 2 related deaths per annum.

Outcomes

Inpatient child mortality has fallen to around 4%; 20 years ago it was about 20%.

Our biggest causes of death are now in neonates – prematurity and birth asphyxia. We are working hard to improve neonatal care.

Child Mortality (per 1,000 live births)

	Malawi 2000	2020	UK Current	USA Current
Neonates (under 1 month old)	39	20	2.8	3.7
Infants (Under 1 year)	100	31	3.7	5.6
Child (Under 5 years)	173	42	4.3	6.5
Malawi child in-patient mortality	1 in 5	1 in 20	1 in 100	1 in 100
Maternal Mortality (per 100,000 births)	749	349	7	19
Life expectancy (years of age)	45	64	81	78.5
Male/female	43/48	61/67	80/83	76/81

_{Data sources include – World Health Organisation; UN Inter-Agency Group; World Bank}

It is very pleasing to see the trend of the numbers in Malawi but with still a long way to go and still many challenges ahead.

The care workload is seasonal. The hot rainy months of December to April or May bring such illnesses as malaria, typhoid, cholera, gastro enteritis and malnutrition – all against a backdrop of HIV/AIDS and stunted growth.

The mothers or grannies stay on the wards with their children and do much of the basic care. Little ones may need their mothers for breast milk.