The government medical service in Malawi: an administrative history, 1891-1974.

MANY departments of government in present-day Africa are the outcome of developments which reach back well into pre-independence times. In Malawi the development of the Ministry of Health can be traced to the very beginning of colonial rule, and as a distinct functional unit of central government it is almost as old as the Government itself. It is the purpose of this article to trace this development from the founding of the Protectorate in 1891 to the present day, by examining the changes in staffing, financing and policy. Although not dealt with in this administrative history, the part played by the various Missions has been considerable. Their doctors, nurses and hospitals have complemented those of the Government and have added much to the medical facilities.' The country was first named British Central Africa (1891-1907) and then Nyasaland (1907-1964) and, finally, as an independent state, Malawi. A small country of some 36,000 square miles, it has an economy overwhelmingly agrarian, and a population -which grew from about three-quarters of a million in 1891 to four and a half millions in 1974-overwhelmingly rural. Lacking mineral resources and industrial development, and relying heavily on the exportation of a few crops, it has never been wealthy. It is against this background that the history of the government medical service must be viewed.