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To establish the prevalence of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) among mother–child pairs in Malawi and explore their geographical distribution and associated multilevel factors.
Design:
Cross-sectional study using secondary data from the 2015–2016 Malawi Demographic and Health Survey using a mixed effects binomial model to identify multilevel factors associated with DBM and TBM. Georeferenced covariates were used to map the predicted prevalence of DBM and TBM.
Setting:
All twenty-eight districts in Malawi.
Participants:
Mother–child pairs with mothers aged 15–49 years and children aged below 60 months (n 4618 pairs) for DBM and between 6 and 59 months (n 4209 pairs) for TBM.
Results:
Approximately 5·5 % (95% confidence interval (CI): 4·7 %, 6·4 %) of mother–child pairs had DBM, and 3·1 % (95 % CI: 2·5 %, 4·0 %) had TBM. The subnational-level prevalence of DBM and TBM was highest in cities. The adjusted odds of DBM were threefold higher (adjusted Odds Ratio, AOR: 2·8, 95 % CI: 1·1, 7·3) with a higher proportion of wealthy households in a community. The adjusted odds of TBM were 60 % lower (AOR: 0·4; 95 % CI: 0·2, 0·8) among pairs where the women had some education compared with women with no education.
Conclusions:
Although the prevalence of DBM and TBM is currently low in Malawi, it is more prevalent in pairs with women with no education and in relatively wealthier communities. Targeted interventions should address both maternal overnutrition and child undernutrition in cities and these demographics.
This chapter considers the structure of territorial cleavage from a national perspective. It focuses on patterns of polarization between regional electoral blocs, or “territorial oppositions,” in national politics. Axes of territorial cleavage arising between predominantly rural regions tend to take canonical forms associated with core–periphery politics in countries that are undergoing national economic integration and the growth of the central state. Stable axes of sectional competition, whereby leading regions square off against each other or against those on the periphery, are visible in the electoral data and in persistent policy cleavages in countries in this study. In broad outlines, these conform to models of territorial opposition in national politics advanced by earlier scholars (Lipset & Rokkan 1967; Gourevitch 1979; Bayart 2013). The analysis is built around four countries – Kenya, Zambia, Malawi, and Uganda – that serve as archetypes of different patterns of territorial opposition and core–periphery politics. Tanzania is a shadow case.
Chiefs in Malawi exercise significant authority based on legitimacy derived from the position's purportedly deep historical origins. But, does such legitimacy confer when a new chieftaincy is created from scratch? I address this question within the context of an ongoing cultural revival of the Lhomwe ethnic group in Malawi, which has included the appointment of many new Lhomwe chiefs and the creation of a Lhomwe paramount chieftaincy. Using a combination of in-depth interviews and original survey data, I explore the political drivers, mechanisms and implications of the this newly created Lhomwe chieftaincy. I find that its creation was driven by top-down, elite-led action rather than citizen demands, and that the newly appointed chiefs enjoy the most support among urban-based backers of the political party responsible for their appointments. This research contributes to historical work on the colonial-era creation of chieftaincies, but does so using a contemporary case of cultural engineering.
Although wildlife management models across the world have since the early 1980s shifted from top-down fortress conservation to different labels of people-friendly community-based conservation, their outcomes remain contested. This paper explores how, and in whose interests, approaches to wildlife conservation in Malawi have been reconfigured from fortress conservation to market–community collaborative management. Based on qualitative field data, we demonstrate how varying levels of community participation in the processes of wildlife conservation transformed the identities and interests of powerful groups of people regarding wildlife conservation in the Majete Wildlife Reserve. We highlight how commodification and monetarization of wildlife conservation served the interests of the emergent powerful groups whilst marginalizing those of the weak. The work indicates how new community identities with regard to wildlife conservation mask the power hegemonies that dictate mechanisms of inclusion and exclusion regarding natural resource use.
Following a public outcry about Eric Aniva being hired to have sex with children, he was arrested, tried and convicted of attempting to engage in a harmful practice and also of engaging in a harmful practice, contrary to Malawi's Gender Equality Act. Aniva's trial attracted significant public attention and highlighted kulowa kufa, the cultural practice at the centre of his trial. This article revisits Aniva's trial. By focusing on the operation of the law in judicial processes as well as the dynamics of judicial decision-making, it demonstrates and concludes that Aniva's trial may have been compromised. Specifically, the article analyses the state's failure to identify and parade material witnesses notwithstanding the alleged multiplicity of Aniva's victims, the role of the media in the trial as well as the probable effects of the trial court's selective recourse to international human rights standards.
To reduce agriculture's carbon, land and water footprint, the diffusion of conservation farming methods is one commonly cited proposition. Yet the process of translating available information on new conservation farming methods into farmers' practices is often a black box in many studies. This understanding is critical to inform strategies for scaling these complex, knowledge-intensive, but necessary practices for improving agriculture's resource and climate balance sheet. By implementing a series of mediation analysis using data from 700 households in Malawi and 930 households in Tanzania, this study examines how an improved understanding of conservation agriculture (CA) principles is an important mediator in the pathway from extension contact to the adoption of two of the CA practices examined. For the adoption of conservation tillage, the share of the mediated treatment effect was in the 31.5–34.4% range, while it was 31.6–46.9% for the adoption of soil cover (mulching). Our results suggest that unless learning from external sources strongly correlates with improved farmers' technical understanding of new farming practices, private learning by doing must be a critical adjunct to other avenues of learning. Beyond the basic promotional goals, improving farmers' technical know-how needs to be the centerpiece of holistic efforts in support of conservation farming and similar knowledge-intensive practices necessary for agriculture's sustinability goals.
To explore patterns of post-malnutrition growth (PMGr) during and after treatment for severe malnutrition and describe associations with survival and non-communicable disease (NCD) risk 7 years post-treatment.
Design:
Six indicators of PMGr were derived based on a variety of timepoints, weight, weight-for-age z-score and height-for-age z-score (HAZ). Three categorisation methods included no categorisation, quintiles and latent class analysis (LCA). Associations with mortality risk and seven NCD indicators were analysed.
Setting:
Secondary data from Blantyre, Malawi between 2006 and 2014.
Participants:
A cohort of 1024 children treated for severe malnutrition (weight-for-length z-score < 70 % median and/or MUAC (mid-upper arm circumference) < 110 mm and/or bilateral oedema) at ages 5–168 months.
Results:
Faster weight gain during treatment (g/d) and after treatment (g/kg/day) was associated with lower risk of death (adjusted OR 0·99, 95 % CI 0·99, 1·00; and adjusted OR 0·91, 95 % CI 0·87, 0·94, respectively). In survivors (mean age 9 years), it was associated with greater hand grip strength (0·02, 95 % CI 0·00, 0·03) and larger HAZ (6·62, 95 % CI 1·31, 11·9), both indicators of better health. However, faster weight gain was also associated with increased waist:hip ratio (0·02, 95 % CI 0·01, 0·03), an indicator of later-life NCD risk. The clearest patterns of association were seen when defining PMGr based on weight gain in g/d during treatment and using the LCA method to describe growth patterns. Weight deficit at admission was a major confounder.
Conclusions:
A complex pattern of benefits and risks is associated with faster PMGr. Both initial weight deficit and rate of weight gain have important implications for future health.
As wars of liberation in Africa and Asia shook the post-war world, a cohort of activists from East and Central Africa, specifically the region encompassing present-day Malawi, Zambia, Uganda and mainland Tanzania, asked what role they could play in the global anticolonial landscape. Through the perspective of these activists, Ismay Milford presents a social and intellectual history of decolonisation and anticolonialism in the 1950s and 1960s. Drawing on multi-archival research, she brings together their trajectories for the first time, reconstructing the anticolonial culture that underpinned their journeys to Delhi, Cairo, London, Accra and beyond. Forming committees and publishing pamphlets, these activists worked with pan-African and Afro-Asian solidarity projects, Cold War student internationals, spiritual internationalists and diverse pressure groups. Milford argues that a focus on their everyday labour and knowledge production highlights certain limits of transnational and international activism, opening up a critical – albeit less heroic – perspective on the global history of anticolonial work and thought.
Although usually associated with events in Europe and North America, the events of the ‘global 1968’ were global in scope. This chapter shows how Tanzanian youths shared common ground with their contemporaries around the world in protesting against Cold War interventions in Vietnam and Czechoslovakia. In doing so, they drew inspiration from the landscape of radical ideas and texts of revolutionary Dar es Salaam. But in contrast to the dynamics of counter-hegemonic protest elsewhere, the Tanzanian government’s foreign policy meant that it could channel these radical critiques of superpower imperialism into its own nation-building project. The language of anti-imperialism could also be deployed against more immediate threats, as the case of Malawi’s claims to Tanzanian territory demonstrate. While recognising the significance of transnational Afro-Asian and Third Worldist solidarities in these movements, the chapter integrates these dynamics into a national story. The state circumscribed the autonomy of youth activism, especially when it risked upsetting Julius Nyerere’s carefully calculated foreign policy.
Expert evidence is an increasingly prominent feature of criminal litigation. Confidence in the reliability of such evidence is therefore vital to the integrity of the justice process. Of late, there have been concerns in most jurisdictions that liberal admissibility standards allow expert evidence of doubtful reliability to be admitted by courts, leading to miscarriages of justice. Consequently, most adversarial common law systems now apply reliability standards to the reception of expert evidence. Malawian law makes provision for the admissibility of expert evidence on mere production if the parties to the case consent. This article critically evaluates this position, arguing that it provides no safeguards for assessing the reliability of expert evidence, thereby making the criminal justice system prone to injustices and challenges related to the use of such evidence. It proceeds to consider how the law and the courts can enhance the reliability of expert evidence in criminal proceedings.
This chapter unpacks questions of judicial compliance in autocratic regimes. On what basis can we assume that judges will dutifully execute the autocrat’s agenda? What can autocrats do to ensure that judges do cooperate? To answer these questions, I focus on the obstacles African autocrats confronted in the postcolonial period when they attempted to use courts for repressive ends as well as the strategies and tactics they used to overcome them. I find that postcolonial autocrats faced a trade-off in judicial design: Professionalizing the judiciary restricted who was eligible to serve on the bench. Facing a shortage of locally qualified jurists, autocrats instead recruited judges from abroad. Drawing on a variety of archival sources, I show that African and British officials worked together to expand the supply of judicial candidates across the British Commonwealth, which not only undermined the power of indigenous African judges but also helped cultivate more compliant courts.
This article examines how and why anti-colonial activists in Nyasaland, now Malawi, seized on modernization theory to make their case for national independence in the early 1960s. As far as British officials were concerned, Nyasaland’s small size, large population, and agrarian character meant that it stood little chance of joining the modern, industrialized world. The Malawi Congress Party, however, saw their country differently, as a future “Central African Denmark.” This article argues that Congress’s Danish vision was part of an anti-colonial challenge to the industry-first development strategies that dominated early international development thinking. Congress thinkers, far from rejecting the modernization idea, flipped the framework from industry to agriculture, helping to open new possibilities for small, agrarian territories on the empire’s margins. The article concludes by showing how this agrarian counter-current in development thinking subsequently shaped the international community’s turn to market-friendly, agriculture-centered policies in the 1970s, though in ways that eclipsed the original anti-colonial vision.
While dairy production has the potential to diversify smallholder agriculture and increase incomes, there are multiple constraints. One is the consistent provision of quality feed. High protein, leguminous fodder shrubs – also referred to as Fodder Tree Technology (FTT) – can help address this constraint, yet adoption levels are generally low. Implemented in Kenya and Malawi, the Shrubs for Change (S4C) project is employing several approaches to address this situation, including those informed by behavioral science. Given that approximately 500 shrubs per cow are needed to generate enough leaf matter to bolster milk production, promoting FTT at scale necessitates the production, distribution, and successful planting of large numbers of shrub seedlings. We implemented a field experiment in Malawi’s Southern Region in late 2021 to test the effectiveness of a social learning intervention intended to motivate dairy farmers to significantly scale up the production of FTT seedlings. This intervention involved meeting with dairy farmers in 39 randomly selected milk production zones to review the numbers of seedlings being produced vis-à-vis local demand, coupled with the development of action plans to address identified production gaps. While we find that this intervention increased the setting up of private nurseries by 10% (p < 0.05), it only increased overall seedling production by an average of 20 additional seedlings per dairy farmer (p > 0.1). We offer several explanations for this lower than expected and statistically insignificant result, which point to the need for iterative rounds of engagement with farmers when supporting them to take up FTT and other complex agronomic and sustainable land management innovations.
Theileria parva is an apicomplexan protozoan parasite that causes bovine theileriosis (East Coast Fever; ECF) in central, eastern and southern Africa. In Malawi, ECF is endemic in the northern and central regions where it has negatively affected the development of dairy industry. Despite its endemic status the genetic population structure of T. parva in Malawi is currently unknown. To obtain an understanding of T. parva in Malawi, we performed population genetics analysis of T. parva populations in cattle vaccinated with the Muguga cocktail live vaccine and non-vaccinated cattle using mini- and microsatellite markers covering all the four T. parva chromosomes. The T. parva Muguga strain was included in this study as a reference strain. Linkage disequilibrium was observed when all samples were treated as a single population. There was sub-structuring among the samples as shown by the principal coordinate analysis. Majority of the samples clustered with the T. parva Muguga reference strain suggesting that the isolates in Malawi are closely related to the vaccine component, which support the current use of Muguga cocktail vaccine to control ECF. The clustering of samples from non-endemic southern region with those from endemic central region suggests expansion of the distribution of T. parva in Malawi.
We wanted to identify factors related to dietary behavioural change among impoverished pregnant women in the face of nutrition education and counselling, describing what creates an enabling environment and barriers for dietary change.
Design:
We used qualitative data from a cluster-randomised maternal education trial and conducted a thematic analysis using a social ecological framework to describe the factors that influenced dietary adherence.
Setting:
Mangochi district in rural Malawi.
Participants:
We interviewed ten pregnant women and conducted four sets of focus group discussions with twenty-two significant family members (husbands and mothers-in-law) and twelve counsellors.
Results:
The participants’ experiences showed that the main barriers of adherence to the intervention were taste, affordability and poverty. The use of powders and one-pot dishes, inclusion of both women and significant family members and a harmonisation with local food practices enabled adherence to the intervention. We found it crucial to focus the dietary education and counselling intervention on locally available ingredients and food processing methods.
Conclusions:
Use of contextualised food-based solutions to combat maternal malnutrition was observed to be relatively cheap and sustainable. However, there is need for more research on local foods used as nutrition supplements. We suggest that investments need to be directed not only to nutrition education and counselling but also to the enabling factors that enhance adherence. The original cluster-randomised controlled trial was registered with Clinical trials.gov ID: NCT03136393.
In Malawi, the prevalence of intimate partner violence (IPV), or closely related violence, is estimated at 42% according to the 2015–16 Malawi Demography and Health Survey (MDHS). This study investigated the association between women’s autonomy in household decision-making participation as well as sexual autonomy and IPV among married and cohabiting women aged 15–49 years in Malawi. Secondary data were taken from the 2015–16 MDHS. Multivariate analysis was performed using a stepwise forward logistic (binary) regression model to assess the association of dimensions of women’s autonomy in the household and selected control variables with IPV. No association was found between dimensions of women’s autonomy in the household and IPV. However, other variables did have an association with some form of IPV, namely women justifying wife beating, having a jealous partner, being accused of unfaithfulness by their partner, having a partner who drinks alcohol and having a partner with another woman or more. In addition, religion, ethnicity, women education level and women’s occupation were found to be associated with the risk of experiencing IPV. The study recommends policy interventions aimed at supporting youth, especially girls, to complete secondary education before they marry or cohabit; the development of accessible and affordable psycho-social counselling specialists and platforms for married and cohabiting couples; nationwide rigorous advocacy and civic education on IPV; and enforcement of Malawi’s 2006 domestic violence law.
Although usually associated with events in Europe and North America, the events of the ‘global 1968’ were global in scope. This chapter shows how Tanzanian youths shared common ground with their contemporaries around the world in protesting against Cold War interventions in Vietnam and Czechoslovakia. In doing so, they drew inspiration from the landscape of radical ideas and texts of revolutionary Dar es Salaam. But in contrast to the dynamics of counter-hegemonic protest elsewhere, the Tanzanian government’s foreign policy meant that it could channel these radical critiques of superpower imperialism into its own nation-building project. The language of anti-imperialism could also be deployed against more immediate threats, as the case of Malawi’s claims to Tanzanian territory demonstrate. While recognising the significance of transnational Afro-Asian and Third Worldist solidarities in these movements, the chapter integrates these dynamics into a national story. The state circumscribed the autonomy of youth activism, especially when it risked upsetting Julius Nyerere’s carefully calculated foreign policy.
The COVID-19 global pandemic has had considerable health impact, including sub-Saharan Africa. In Malawi, a resource-limited setting in Africa, gaining access to data to inform the COVID-19 response is challenging. Information on adherence to physical distancing guidelines and reducing contacts are nonexistent, but critical to understanding and communicating risk, as well as allocating scarce resources. We present a case study which leverages aggregated call detail records into a daily data pipeline which summarize population density and mobility in an easy-to-use dashboard for public health officials and emergency operations. From March to April 2021, we have aggregated 6-billion calls and text messages and continue to process 12 million more daily. These data are summarized into reports which describe, quantify, and locate mass gatherings and travel between subdistricts. These reports are accessible via web dashboards for policymakers within the Ministry of Health and Emergency Operations Center to inform COVID-19 response efforts and resource allocation.
The Critically Endangered Chapman's pygmy chameleon Rhampholeon chapmanorum is endemic to the low elevation rainforest of the Malawi Hills in southern Malawi. Much of this forest has been converted to agriculture and it was uncertain whether chameleon populations have persisted. We used current and historical satellite imagery to identify remaining forest patches and assess deforestation. We then surveyed forest patches for the presence of this chameleon, and assessed its genetic diversity and structure. We estimated that 80% of the forest has been destroyed since 1984, although we found extant populations of the chameleon in each of the patches surveyed. Differentiation of genetic structure was strong between populations, suggesting that gene flow has been impaired. Genetic diversity was not low, but this could be the result of a temporal lag as well as lack of sensitivity in the mitochondrial marker used. Overall, the impact of forest loss is assumed to have led to a large demographic decline, with forest fragmentation preventing gene flow.
Trust between actors is vital to delivering positive health outcomes, while relationships of power determine health agendas, whose voices are heard and who benefits from global health initiatives. However, the relationship between trust and power has been neglected in the literatures on both international politics and global health. We examine this relationship through a study of relations between faith based organisations (FBO) and donors in Malawi and Zambia, drawing on 66 key informant interviews with actors central to delivering health care. From these two cases we develop an understanding of ‘trust as belonging’, which we define as the exercise of discretion accompanied by the expression of shared identities. Trust as belonging interacts with power in what we term the ‘power-trust cycle’, in which various forms of power undergird trust, and trust augments these forms of power. The power-trust cycle has a critical bearing on global health outcomes, affecting the space within which both local and international actors jockey to influence the ideologies that underpin global health, and the distribution of crucial resources. We illustrate how the power-trust cycle can work in both positive and negative ways to affect possible cooperation, with significant implications for collective responses to global health challenges.