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Based on government statistics and interviews with villagers across Malawi this article argues that customary matrilineal and patrilineal land tenure systems serve to weaken security of land tenure for some family members as well as obstructing the creation of gender-neutral inheritance of lands. Data from the National Census of Agriculture and Livestock 2007and the 2008 Population and Housing Census are used to characterize marriage systems and landholding patterns of local communities. Marriage systems correspond to customary land-tenure patterns of matrilineal or patrilineal cultures. The differences between the two ways of land holding represent a challenge for land reforms aimed at unifying rules for land tenure and land devolution. Drawing on an analogy of the resilience of the patrilineal land holding system in Norway, we argue that it will be difficult to remove the preferential rights of lineage members directly. We recommend that, instead of creating a unified national system, existing land rights should be formally recognized and circumscribed by fair procedures. A well-designed landholding system should aim to ease the transitions of diverse customary tenure systems towards the requirements of a modern large-scale society. ; publishedVersion

This paper is about land tenure relations among the matrilineal and patrilineal cultures in Malawi. Data from the National Agricultural and Livestock Census are used to characterize marriage systems and settlement and landholding patterns for local communities. Marriage systems correspond to customary land tenure patterns of matrilineal or patrilineal land holding. The differences between the two major ways of land holding represent a particular challenge for land reforms intending to unify rules for land tenure and land devolution. The paper discusses the problems of formalisation and the idea of maintaining the diversity. If diversity is not respected there is a chance that some sections of society, especially communities with matrilineal land holding, might be victims of formalization. Based on analogy of the resilience of the patrilineal land holding system in Norway it is argued that a democratic system will have difficulty removing the preferential rights of linage members and it is recommended that the existing land rights are formally recognized and circumscribed by fair procedures. In a situation of diversity one goal of a well-designed land holding system should be to ease the transitions of the diverse customary tenure systems towards systems adapted to the requirements of a modern large scale society rather than to a unified national system.

This paper is about land tenure relations among the matrilineal and patrilineal cultures in Malawi. Data from the National Agricultural and Livestock Census are used to characterize marriage systems and settlement and landholding patterns for local communities. Marriage systems correspond to customary land tenure patterns of matrilineal or patrilineal land holding. The differences between the two major ways of land holding represent a particular challenge for land reforms intending to unify rules for land tenure and land devolution. The paper discusses the problems of formalisation and the idea of maintaining the diversity. If diversity is not respected there is a chance that some sections of society, especially communities with matrilineal land holding, might be victims of formalization. Based on analogy of the resilience of the patrilineal land holding system in Norway it is argued that a democratic system will have difficulty removing the preferential rights of linage members and it is recommended that the existing land rights are formally recognized and circumscribed by fair procedures. In a situation of diversity one goal of a well-designed land holding system should be to ease the transitions of the diverse customary tenure systems towards systems adapted to the requirements of a modern large scale society rather than to a unified national system.

Adolescents' views of and preferences for sexual and reproductive health services highlight promising directions and persistent challenges in preventing pregnancy and HIV and treating sexually-transmitted infections (STIs) in this population. Results from nationally-representative surveys of 12–19 year-olds in Burkina Faso, Ghana, Malawi and Uganda in 2004 show that contraceptive and STI services and HIV testing are still under-utilized. A substantial proportion of sexually-active adolescents do not know of any source to obtain contraception or get STI treatment, and social-psychological reasons (e.g., embarrassment or fear) and financial cost remain common barriers to getting services. Adolescents' preferences are overwhelmingly for public clinics, with strongly positive perceptions of confidentiality, accessibility and cost. Some gender and country differences exist, yet overall females and males' views are similar. Results highlight the need to inform youth about sources, increase availability of government health facilities and improve youth's access to them, especially by reducing social barriers.

The application of EquiFrame in the analysis of sexual and reproductive health policies by Ivanova et al to a new thematic area, their selection of only some of the Core Concepts of human rights in health service provision and the addition of new vulnerable groups relevant to the purpose of their analysis, are all very welcome developments. We also applaud their application of EquiFrame to policies in countries where it has not previously been used, along with their use of interviews with policy-makers to produce a deeper understanding of policy processes. We argue that clear justification for the inclusion of additional, or replacement of some exiting vulnerable groups within EquiFrame should be accompanied by clear definitions of such groups, along with the evidence-base that justifies their classification as a vulnerable or marginalised group. To illustrate the versatility of EquiFrame, we summarise a range of ways in which it has been used across a number of regions; including a brief Case Study of its use to develop the National Health Policy of Malawi. While EquiFrame focuses on policy content, we preview a new policy analysis tool – Equity and Inclusion in Policy Processes (EquIPP) – which assesses the extent of equity and inclusion in broader policy processes. Together, EquiFrame and EquIPP can be used to help governments and civil society ensure that policies are addressing the much stronger emphasis on social inclusion, now apparent in the Sustainable Development Goals (SDGs).

Background: Epilepsy is a disability as defined in the 2012 Disability Act of the Government of Malawi.Objectives: This article explores the health-seeking behaviour of people with epilepsy in a rural town in southern Malawi and how having a person with epilepsy impacts on the households' productivity.Method: A snowball approach was used to identify persons with various forms of disabilities. The article is based on a bigger study carried out in Malawi which explored how persons with disabilities seek health care. In this bigger study, a total of 63 interviews were done with persons with disabilities or their guardians. Eight of the 63 interviews were with persons with epilepsy and this article is based on these interviews.Results: The study found that persons with epilepsy seek both traditional and modern medicines to treat the condition. Informants mentioned that barriers to accessing western treatment include lack of medicines, congestion at health facilities, lack of knowledge about epilepsy, misdiagnosis by health workers and the belief that epilepsy caused by witchcraft cannot be treated by western medicine. The study also highlights the wider impacts of epilepsy on the household such as the failure of children to attend school, children dropping out of school, stigma and discrimination and households being driven deeper into poverty as a result of seeking care for members with epilepsy.Conclusion: The existing barriers to accessing treatment for epilepsy can be addressed by using a combination of public education, simple treatments and regular reviews. Ensuring constant availability of drugs for the treatment of epilepsy is key to effective treatment of the condition. This would contribute to closing the treatment gap for epilepsy as advocated by the Global Campaign against Epilepsy.

This book explores the daily mobilities and immobilities of children and young people in sub-Saharan Africa. The authors draw on findings from rural and urban field research extending over many years, culminating in a 24-site study across three African countries: Ghana, Malawi, and South Africa. Wider reflections on gender, relationality, the politics of mobility, and field methodology frame the study. By bringing together diverse strands of a complex daily mobilities picture-from journeys for education, work, play/leisure and health, to associated experiences of different transport modes, road safety, and the virtual mobility now afforded by mobile phones-the book helps fill a knowledge gap with crucial significance for development policy and practice

SummaryA growing body of research suggests that orphanhood and fostering might be (independently) associated with educational disadvantage in sub-Saharan Africa. However, literature on the impacts of orphanhood and fostering on school enrolment, attendance and progress produces equivocal, and often conflicting, results. This paper reports on quantitative and qualitative data from sixteen field-sites in Ghana and Malawi, highlighting the importance of historical and social context in shaping schooling outcomes for fostered and orphaned children. In Malawi, which has been particularly badly affected by AIDS, orphans were less likely to be enrolled in and attending school than other children. By contrast, in Ghana, with its long tradition of 'kinship fostering', orphans were not significantly educationally disadvantaged; instead, non-orphaned, purposively fostered children had lower school enrolment and attendance than their peers. Understanding the context of orphanhood and fostering in relation to schooling is crucial in achieving 'Education for All'.

Africa's recent communications 'revolution' has generated optimism that using mobile phones for health (mhealth) can help bridge healthcare gaps, particularly for rural, hard-to-reach populations. However, while scale-up of mhealth pilots remains limited, health-workers across the continent possess mobile phones. This article draws on interviews from Ghana and Malawi to ask whether/how health-workers are using their phones informally and with what consequences. Health-workers were found to use personal mobile phones for a wide range of purposes: obtaining help in emergencies; communicating with patients/colleagues; facilitating community-based care, patient monitoring and medication adherence; obtaining clinical advice/information and managing logistics. However, the costs were being borne by the health-workers themselves, particularly by those at the lower echelons, in rural communities, often on minimal stipends/salaries, who are required to 'care' even at substantial personal cost. Although there is significant potential for 'informal mhealth' to improve (rural) healthcare, there is a risk that the associated moral and political economies of care will reinforce existing socioeconomic and geographic inequalities.