USAID Mission Director Remarks at Malawi Demographic Health Survey Symposium – March 15, 2017



  • The Honorable Goodall Gondwe, Minister of Finance for Malawi
  • The Honorable Dr. McPhail Magwira, Secretary for Health for Malawi
  • Mrs. Mercy Kanyuka, Commissioner of the National Statistical Office for Malawi
  • Officials from Government and Development Partners
  • Representatives from Non-governmental Organizations and Civil Society
  • Ladies and gentlemen

I am very pleased to join you this morning for the launch of the 2015-16 Malawi Demographic and Health Survey (MDHS). The United States Government, through the U.S. Agency for International Development, has supported the government of Malawi in designing, implementing and analyzing the results of the MDHS since 1984.  We can all be very proud of our collective effort and the results represented by the data.  Today, I want to share three brief, but important points.

The MDHS is more than just data – it is a valuable tool for allocating resources to the most successful health care interventions and activities.  Let’s remember – data does not improve the lives of millions of Malawians. Rather, data becomes a tool to inform our programmatic decisions.  With accurate and timely data we can better direct our limited resources to the most efficient and effective health interventions.  At the same time, data tells us which approaches are ineffective, which approaches need modification and which approaches need elimination.

Of course, data from the MDHS represents people. Nothing is more important than saving the life of a mother, supporting a teenage girl to avoid an unplanned pregnancy, helping a child avoid a chronic disease, or improving the quality of life for an HIV-positive Malawian.  We don’t have time or resources to waste on failed approaches.

The MDHS shows impressive gains in key areas – however, Malawi’s population growth rate threatens to reverse these gains.  As I reviewed the MDHS, I was struck by several significant achievements. We have improved the health of mothers and children; we have made strides in addressing Malawi’s HIV prevalence rate; and we have reduced the mortality rate for children under five – becoming one of the few countries in the world achieving Millennium Challenge Goal 4.

I was particularly pleased to learn that more and more Malawian women are using modern birth control methods, which contributes to slower population growth. Unfortunately, the population growth rate in Malawi is outpacing economic growth. The UN projects that the population in Malawi will grow to 41.2 million by 2050, jeopardizing the gains reflected in the MDHS and complicating our efforts to provide adequate healthcare and educational opportunities to all Malawians.

Studies indicate that if Malawi can voluntarily reduce its fertility rate further, it could harness what is called the demographic dividend, by which the current very youthful population in Malawi grows into one dominated by working age adults, allowing the economy to grow much more quickly than it would otherwise. In other words, a youthful population provides Malawi with an opportunity to achieve socio-economic development, provided the growth rate can be further slowed.  There is no time to wait.  We must act now.

With almost half of Malawians under 18 years old – we must aggressively engage youth, especially adolescent girls and young women, to accelerate the decline of Malawi’s population growth.  So how do we do this?   By improving the quality and reach of sexual education for our youth – young women and men can make more informed reproductive choices.  By providing access to modern contraceptives for all sexually active people in Malawi – birth rates will decline more rapidly.  By continuing to lower childhood mortality rates – couples will choose to have smaller families.  By keeping young girls in school – we help reduce teenage pregnancies.

By creating youth-oriented health clinics that are welcoming for young women and men – we are more likely to delay pregnancies, improve antenatal care for young women who become pregnant, and enhance the nutrition and care of newborns and mothers. Again, the time to act is now – there is no time to wait.

Before closing, I would like to point out a fairly obvious, but perhaps unspoken idea. Since moving to Malawi a few months ago, I have often been asked why does the United States care about creating a healthy and prosperous Malawi?  Why does America invest so much time and energy in a small landlocked country in sub-Saharan Africa? My answer is simple:  A healthy and prosperous Malawi is good for America.  A strong health infrastructure in Malawi helps protect America from transnational epidemics like HIV.  Healthy Malawians are the centerpiece of a prosperous economy which in turn creates opportunities for U.S. businesses.  A healthy and prosperous Malawi contributes to regional stability, reduces the likelihood of armed conflict, and mitigates the likelihood of a refugee crisis. So as we look toward the future, Honorable Minister, I assure you the United States stands ready to help.

In closing, I would like to leave you with these few key points:

  • We must use data, like that contained in the MDHS, to direct resources to the most effective and efficient health care interventions and activities;
  • We must act now, through voluntary measures, to further reduce Malawi’s population growth rate or risk erasing recent health sector successes;
  • We must intensify our efforts to encourage youth, particularly adolescent girls and young women, to make better decisions about their reproductive health through universal access to modern birth control, comprehensive sexual education, and youth-friendly health clinics that nurture good reproductive choices.
  • The time for action is now.

Thank you.