Malawi: An unlikely leader in the fight against population explosion

The year is 1992. The average Malawian woman had close to 7 kids. There were only 2 fertility clinics in the entire country and only about 7% of couples practiced any form of contraception. With a GDP per capita of $286 at the time, it appears the country paid most of its attention to the second part of the Biblical injunction: “be fruitful and multiply”.

Why was this a problem anyway?

We all love to see fireworks, except when they detonate while still on the ground or in our hands. And for Malawi, their population explosion was happening at the wrong end of the age pyramid. More teenage pregnancies meant a heavier financial burden on the working-age population, more girls dropping out of school and yes, you guessed it…more pregnancy-related deaths.

Intervention by contraception?

The Malawian government then stepped in and did the following:

• Created a family planning fund in the national budget with an estimated $400,000 annually dedicated to it.

• Mandated clinics and hospitals to offer family planning services.

• Rolled out access to self-injectable implants

• And wait for it, they converted their door-to-door immunization workers to family planning agents who would now go from door-to-door advising women on family planning instead. It's nipping in the bud at its finest.

Now what.

In the time since, Malawi has become the leader in contraceptive use in Sub-Saharan Africa with a use rate of 58%, almost doubling the average across other countries at 29%. The fertility rate now stands at 4 children per woman and is projected to go lower by 2030.

Side note: Malawi’s GDP per capita has since jumped to $645 in 2022, suggesting that you become fruitful when you divide instead??