Abstract

Floods are among the most frequently occurring natural hazards in Malawi, often with public health implications. This mixed methods study assessed the capacity for and implementation status of the disaster risk management (DRM) strategy for the health sector in Malawi, using flooding in the Nsanje District as a case. Data were collected using desk review and a workshop methodology involving key officials from government ministries, national and international development partners, and the academia. The results show that Malawi had recently strengthened its DRM institutional frameworks, with a pronounced policy shift from reactive to proactive management of disasters. Health sector personnel and structures were key contributors in the design and implementation of DRM activities at all levels. Development partners played a significant role in strengthening DRM coordination and implementation capacity. Lack of funding and the limited availability, and often fragmented nature, of vulnerability and risk assessment data were identified as key challenges. Limited human resource capacity and inadequate planning processes at district level impeded full implementation of DRM policies. These findings call for community-level interventions for improved coordination, planning, and human resource capacity to strengthen community disaster resilience and improve public health. The approach used in this study can serve as a model framework for other districts in Malawi, as well as in other low- and middle-income countries in the context of Sendai Framework implementation.

Highlights

  • Global disaster statistics for 2001-2018 revealed staggering economic damages at about USD 2 trillion and over 300,000 fatalities because of water-related disasters (Lee et al 2020)

  • The section presents the high-level institutional framework arrangements such as the role of the Ministry of Health followed by specific subnational level operational issues such as health facility and community resilience building intervention

  • Despite the strengthened institutional capacity for implementation of disaster risk management (DRM) interventions, this study revealed that lack of resources at the local government level often resulted in the incapacitation of these structures unless they were supported by nongovernmental organization (NGO) partners

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Summary

Introduction

Global disaster statistics for 2001-2018 revealed staggering economic damages at about USD 2 trillion and over 300,000 fatalities because of water-related disasters (Lee et al 2020). Evidence suggests that these disasters will continue to increase in both magnitude and frequency (Phillips et al 2015). Flooding is estimated to account for 40% of all natural hazard-related disasters worldwide causing about half of all deaths (Noji 1991; Ohl and Tapsel 2000). The 2010/2011 floods in Southern Africa affected about 150,000 people across nine countries and destroyed farmlands, housing, and social infrastructure including health facilities (WHO 2012)

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