The United Nations Development Assistance Framework (UNDAF) concentrates activities in the critical areas of maternal and child health, reproductive health and epidemic prevention, with a key focus on increasing equitable and quality access to the Essential Health Package (EHP) through support rendered to the Health Sector Wide Approach (SWAp).
To contribute to achieving the health targets in the Malawi Growth and Development Strategy (MGDS) II, and subsequently the Millennium Development Goals (MDGs), the UN assists the Government of Malawi (GoM) by providing technical advice through the SWAp Technical Working Groups (TWGs) and the Health Donor Group, with a special attention paid to sexual health and obstetric care because MDG 5 (improving maternal health) remains off-course for 2015. The UN supports the implementation of the SWAp Programme of Work, especially in the areas of capacity building, disease surveillance, monitoring and evaluation, as well as integrated delivery of the EHP.
In particular, UN support focuses on ensuring the continuity and expanded community access to critical components of the EHP in under-served priority areas within 17 districts. District Health Offices, District Councils, community governance structures, with UN support, are developing capacity to implement Comprehensive Integrated Health Promotion, disease prevention and control interventions to reach under-served areas. In addition, the UN targets these same institutions for advanced capacity development to plan, implement, monitor and evaluate the new Health Sector Strategic Plan to ensure that the EHP is available to all.
UN support aims at increasing access to comprehensive sexual and reproductive health; strengthening child survival interventions; enhancing institutional capacity to deliver quality health services; strengthening mechanisms to improve healthcare seeking behaviour of individuals/communities; and fostering community involvement in health issues and multi-sector approaches in line with the Primary Health Care Approach, with a focus on rural and underserved areas.
The UN focus is on interventions that increase availability of and access to a wide range of nutrition services to break the intergenerational cycle of malnutrition. Resources are available for community health facilities at the district level targeting acute malnutrition in children under five through medical treatment and education on dietary needs of children, as well as amongst PLHIV. The UN programme supports expansion of micronutrient deficiency services for children and amongst pregnant and lactating mothers.
The UN provides GoM with technical support and advocacy expertise to ensure that Malawi’s Nutrition Act is developed, nutrition policies and guidelines are updated, and an enabling environment exists to improve nutrition amongst all vulnerable groups. Focus is on strengthening inter-sector coordination including the efforts of the various SWAps to promote nutrition friendly agricultural production, improve the effectiveness and efficiency of the national nutrition information system, promote prevention and treatment of chronic and acute malnutrition; promote infant and young child feeding, improve maternal nutrition to break the intergenerational cycle of malnutrition, and control micronutrient deficiencies.
On stunting, being a prevailing major problem, the UN is shifting its focus towards prevention programmes. GoM has adopted the Global Scale up Nutrition initiative – the 1000 days campaign – and UN is supporting it. The initiative encompasses nutrition through pregnancy and children in the first two years of life.
In particular, because stunting is still a major problem in the country, UN support is focused on the ‘1000 days campaign’ targeting pregnant women through to the first two years of the life of their children. This is being achieved through up-scaling high impact interventions and behaviour change communication. In selected underserved priority districts of Malawi, the UN is further ensuring that quality services are available to address micronutrient deficiency and moderate and severe acute malnutrition, delivered through health facilities, and that households are provided with the information and skills to improve their maternal nutrition, infant and young child feeding and care practices.
Water, Sanitation and Hygiene (WASH)
The UN supports national efforts to achieve the MDGs relating to increased access of disadvantaged households to integrated safe water supply, sanitation, hygiene and environmental health services.
UN engagement is moving upstream in dealing with national strategic issues such as working within a SWAp modality, sector coordination, and harmonisation of approaches, sector investment plans, and sector information systems including performance measurement, policy development and implementation. The UN works with other partners to support policy and systems development, guidelines and standards; strengthening of planning and implementation capacity at district and community level; mapping of water points; access to and safe disposal of waste and excreta; and mass campaigns for hygiene promotion.
In particular, the UN is developing capacity of district and city councils in 14 underserved areas to address the safe water, sanitation, hygiene and environmental health needs of the vulnerable rural and peri-urban communities.
It is also contributing to the child-friendly, rights-based school concept to ensure increased access of pupils to safe water supplies, hygiene promotion in a comprehensive school health programme and gender sensitive sanitation facilities.
The overall UNDAF priority is to ensure that all boys and girls, in and out-of-school, enrol, learn, are retained and complete, basic education by 2016. The UN advocates for all children in the age group 0 to 8 years, especially the most vulnerable in rural areas, to have access to quality Early Childhood Development (ECD) services.
A further priority is to ensure that the most vulnerable out-of-school non-literate adolescents and young people have basic literacy and numeracy skills particularly in underperforming districts.
The UN is contributing to improving early learning and primary school enrolments, quality of learning, and school completion rates. The National Education Sector Plan is the basis for the Education SWAp and a coordinated donor support to the sector through a common financing mechanism of which UN is part.
With UN support, the child friendly school concept is being institutionalised, with standards at each school defined around the following components: health and nutrition, school feeding meals, hygiene, water and sanitation; inclusiveness; child-centred, interactive and gender sensitive learning processes; strong partnerships with the community; and child leadership in governance.
Life skills for HIV prevention is being scaled up. In 10 under-performing districts (with the lowest education access, participation and equity indicators), the UN is providing direct support to primary schools so that they can rapidly attain child friendly school status. This targeted effort is improving equity of access for the marginalised; improving national averages which often hide disparities across the country; and accelerating achievement of the MDGs and Education For All goals.
The UN is supporting capacity development for the good quality delivery of TVET of both formal and informal settings. Such support is targeting those areas that hold the highest potential for future economic growth and employment growth.
The UN is work with GoM to ensure that national legal and regulatory frameworks for a national child protection system are fully developed and coordination mechanisms put in place and enforced. Mechanisms for the prevention and mitigation of gender-based violence are being enhanced.
The UN, together with Development Partners and GoM, is also addressing the huge human resources challenge in the sector, both nationally and at district level. The UN is working with the implementing partners to develop systems that ensure national and district institutions have sufficient capacity to deliver protective services for women and children and are held accountable for demonstrating results.
The UN priority is to ensure that children, young people and women are better protected from violence, abuse, exploitation, including child labour and particularly its worst forms, and neglect, and have access to an expanded range of protection services, by 2016, through availability of services, sufficient funding and presence of trained professionals.
Figures from the Malawi’s Child Labour National Action Plan indicate that 95 percent of children engaged in economic activities are based in rural areas; most child workers dropped out of school or combine work and education, and over three quarters of the children who never attended school are in rural areas. Children work both on plantations and family farms and the overwhelming majority of child labourers are unpaid family workers. Tackling this enormous development challenge represents a priority and also contributes to the achievement of UNDAF Outcome 2.4 on education.