Socio-economic support for good health in rural Malawi.

OBJECTIVE To study the socio-economic support for good health among subsistence farmers in rural Malawi. DESIGN A cross-sectional survey. SETTING Lungwena, a rural area with 17,000 inhabitants in southern Malawi. PARTICIPANTS Seven hundred and ninety five pregnant women who attended the antenatal clinic at Lungwena Health Centre between June 1995 and September 1996. INTERVENTIONS Interviews about socio-economic conditions. Measurements of cultivated land areas and distances between home and the local health centre. MAIN OUTCOME MEASURES Proportion of households lacking literate adults, adequate water source and sanitation, easy access to modern health care or food security. RESULTS Only 14% of the interviewed women could read and write and half of the households had no literate members. Every fifth household was lacking both an access to safe drinking water and a proper sanitary facility. The distance to the health centre was more than 5 km among half of the households and only 37% had enough land to grow food for all family members. When other potential means of obtaining food were taken into account, 27% of the households had no food security. Numerous households were lacking more than one socio-economic prerequisites of good health: three or more were missing from a quarter of the families. CONCLUSIONS Socio-economic prerequisites of health were commonly missing in Lungwena. Subsequent health interventions should strengthen the investments into general poverty alleviation.