Last week we could read that government was unpleasantly surprised by numbers that predict a Malawian population of 40 million by the year 2040 if we don’t change our ways. It is clear that with the current situation, the country cannot sustain that number of people: there simply is not enough arable land for so many people in an agricultural society/economy. Our schools will be overwhelmed by the number of learners, and the hospitals cannot cope now. Let alone when our population almost triples.
What is surprising, though, is that government is surprised. A few years ago similar numbers were published. Then it was under president Bingu wa Mutharika. His government decided that an average of 6 children per woman was too much to sustain, but that the Malawian culture does value big families so an average of 4 children per woman was seen as a good compromise. Strange enough: this was all, there was no policy formulated, and of course the population kept growing at similar rates as before. Which should surprise no one: if no policy is implemented, no change occurs.
The previous minister of health, Jean Kalilani, had made some remarks about the population growing too fast before, when Kamuzu Central Hospital was overwhelmed by the number of patients. Now she started a modest policy of family planning, and see: there is a little allocation for family planning in the drugs budget.
Another worrying factor is the population control approach: we cannot cope as a country, so we need to control our population. The rights of individual women are not mentioned, or considered. While that is the point of entry we should take. Women’s self determination should be the leading principle.
If we take that approach, we should educate men and women on the consequences of big families, on the consequences of a lack of child spacing, of the consequences of early pregnancies, of all that. From an individual point of view, the country is not the sole responsibility of the individual, and anyway, it is not possible to convince an individual to go against their personal interests in the interest of the country. (This is clearly demonstrated by Cashgate: the individuals committed crimes that illegally kept the country undeveloped, but they did so because they let their personal interests prevail over patriotism, the law, and ethics.)
What we need to do:
- Make the full range of family planning available continuously in all clinics. That is: pills, condoms both male and female, IUDs, vasectomy and tubal ligation, cervical caps with spermicides, abortion, injectables, and implants.
- A campaign on radio with clear information on the advantage of a small family ( better two well educated healthy children than five that are undernourished, undereducated, and in ill health.) and information on family planning.
- A clear correlation has been established between the level of education of a woman and the number of children she chooses to have, so we need to send our daughters to school. We need to protect them from predatory elder men, including teachers.
- Include family planning in the school curriculum for the age group earlier than our children become sexually active. Since this tends to be earlier than many adults like me like to admit, I propose to do it at 10 years old, and again at 11, so they will understand and remember well.
- We need a system of child friendly services: both untrained health care staff and untrained shop keepers can be judgmental and refuse to supply family planning to unmarried adolescents, with often disastrous consequences (early pregnancies, which can cause fistula, school drop out and stigma and discrimination, as well as STIs including HIV/Aids).
It is clear our government has no funds and no expertise to carry this out successfully, but it will be possible to interest donors in a programme like this.