Mother, child and community in rural Malawi: Security-seeking behaviour and the role of Under-Five Clinics Academic Article uri icon


  • t was not yet noon, but the sun was already heavy in the sky as David, a community health worker, stood in front of the women who were sitting under the big tree outside the village headman's house. Many of the women were holding their young children, while younger babies were secured safely on their mother's back. After a short pause David looked at the women in front of him with a big smile and said, ''If you women continue to be pregnant all the time, we men will leave you and look for younger women because you will not be pretty any- more.'' The women and the health workers burst into laughter. Later, David would say to me, ''It is important to joke when you are talking about family planning, though some women will tell you it is not really a joke.'' The past few decades have seen a significant in- crease in the number of interventions and outreach pro- grams targeted at rural communities in the developing world. Both governments and NGOs have introduced a range of new health care services and programs to rural communities in the hope of improving access to health care. Among these services are Under-Five Clinics in rural Malawi, which provide vaccinations, weight moni- toring and health education to women and children. Under-Five Clinics offer an important window through which to examine how communities in rural Africa are responding to the influx of health services. Prevailing theory suggests that health-seeking behaviour in vulner- able populations is characterized by passivity. However, tremendous efforts on the part of women and community members to facilitate and participate in government- sponsored services such as Under-Five Clinics suggest the need for a broader view of health-seeking behaviour that attends much more carefully to local perspectives and the contexts in which individuals and communities operate. Abstract: Health care delivery has emerged as a major chal- lenge in global health. Despite unprecedented advances in medicine, as well as significant financial investments, innova- tions in health have yet to reach most of the world's popula- tion. Under-Five Clinics in rural Malawi offer a window onto how rural African communities are responding to new initia- tives in health care. This article claims that participation in Under-Five Clinics is part of a broader social process of secu- rity-seeking behaviour in which individuals work to improve their sense of human security in an environment of extreme poverty, lack of adequate employment and limited access to health care services.

publication date

  • January 1, 2015