Authors : Chifundo Makweza; Noreen Clara Ng’ambi; George Chikondi Samu; Chimwemwe Kapito

Volume/Issue : Volume 11 - 2026, Issue 1 - January

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DOI : https://doi.org/10.38124/ijisrt/26jan715

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Abstract : As much as progress has been made in relation to the antenatal care visits and the immunization coverage, under-five mortality in Malawi continues to be high. The country carries a significant burden of avoidable illnesses among children, which indicates a serious failure along the path from the very first symptoms of disease to appropriate hospital treatment. The purpose of the present narrative review is to bring together existing evidence concerning three inter-related aspects: delays at the referral stage, failures of the system to effectively triage at triage time and PHC (Primary Health Care) infrastructure and workforce capacities to manage the most frequent childhood diseases. Presumably, the focus should be placed on what makes the child delay before arrival, on the weaknesses of the system at triage time and on PHC constraints regarding infrastructure and staffing. A systematic review was performed to extract literature data regarding timeliness of hospital arrival, care-system availability of resources and processes of care for childhood illnesses in Malawi. Systematic review of published peer-reviewed and grey literature was conducted from various databases; from 2010 to 2023, the searched yielded articles from Embase, PubMed, Global Health and African Index Medicus. Further identification and synthesis of pooled information were gathered from Ministry of Health bulletins, producing hospitals’ publications, programs’ briefs of major stakeholders. Results of the systematic review show that a larger proportion of admitted children to the hospital treated after more than 48hours of illness onset, and that approximately 60% of the primary health care facilities do not have oxygen. As such results show the glaring system inadequacies to support timely recognition, appropriate triage and access to essential treatments. Addressing the rootedness timely recognition, triage, and transport functions could shorten delayed presentation to hospital and can potentially support further steps to reduce preventable childhood mortality.

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