How does healthcare work in Malawi, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in Malawi?

The average life expectancy in Malawi (around 60 years) reflects the challenges within the healthcare system. It struggles with underfunding, staff shortages, and limited access to medicines.
Healthcare is provided through both the public sector and the private sector (for-profit and non-profit facilities).
Roughly 80% of healthcare services are concentrated in the larger cities.
Pharmacies can be found in major cities such as Lilongwe and Blantyre, usually with a reasonable stock of medicines. In rural areas, they are scarce.
Emergency care is almost non-existent; private transportation is essential in most situations.
Traditional medicine continues to play an important role, especially in rural communities.

Malawi has a public healthcare system that is largely free of charge, funded by the government and international donors.
The healthcare system is structured into three levels: primary care through health centers, secondary care in district hospitals, and tertiary care in regional and national hospitals.
Expats can also access public healthcare via the NHIS (National Health Insurance Scheme).
Care comes with significant challenges: facilities are often understaffed, and shortages of medicine and equipment are common.
Basic care is delivered through health centers, which provide vaccinations, first aid, and routine treatments.
District hospitals offer secondary care but are often poorly equipped and overburdened.
Regional hospitals provide specialized care, but access is limited, and resources are insufficient.

The private healthcare sector has grown in recent years and provides important supplementary care alongside the public system. Many expats rely on it.
Private clinics generally offer better facilities, higher standards of care, and shorter waiting times. The downside is that costs are significantly higher than in the public system.
Another advantage is the reduced language barrier when dealing with private doctors.
For complex treatments, patients usually travel abroad, most often to South Africa or other neighboring countries, where more advanced options are available.

Malawi does not have a traditional family doctor or GP system as you might know it. Basic care is provided through health centers or private doctors in urban areas.
Foreigners usually choose a private physician in Lilongwe or Blantyre.

The number of dentists in Malawi is very limited. Only a handful are available.
Basic dental care is accessible in the major cities. For more complicated patients, private care is generally the better option (and the safer bet).
For advanced treatments, or sometimes even for basic ones, many foreigners travel outside the country, for example to South Africa or other countries.

Prenatal care is in principle free of charge and is supported by the government and NGOs.
However, a significant number of births still take place without professional medical assistance. Around 70% of women have little or no access to maternity care, often because the nearest clinic may be 9 kilometers away—a walk you’d rather not attempt while in labor.
Traditional birth attendants still play a large role in villages, despite official campaigns to encourage more hospital deliveries.
Complications such as high maternal mortality (among the highest in the world) remain a major issue, especially due to poor access to hospitals and a lack of medical equipment.
Expats generally choose to give birth abroad, safer and more comprehensive care is available.

Malawi is widely known as the “Warm Heart of Africa,” and the population is indeed hospitable and friendly.
Major political unrest or armed conflict is rare, but petty crime (pickpocketing, theft) does occur, especially at bus stations in Lilongwe and Blantyre. Carjackings are also reported.
It is not advisable to walk alone at night.
Police assistance is slow or sometimes absent.
Infrastructure and health risks are often more of a challenge than people’s behavior.

Only drink bottled or boiled water to avoid infections.
Malaria is a major risk; mosquitoes are relentless.
Other common health issues include schistosomiasis (bilharzia) from swimming in lakes and rivers, and gastrointestinal problems caused by poor water quality.
HIV/AIDS is widespread, and preventive measures are essential.

Driving in Malawi is an adventure: poor roads, potholes everywhere, and drivers who seem to consider brakes optional. Just over half of Malawi’s roads are paved.
Driving at night is especially dangerous due to unexpected obstacles: stray cattle, broken-down trucks without lights, and people walking in the middle of the road.
Public transport usually consists of minibuses so crowded that you’ll quickly make close friends.

Is the trip to Malawi and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

A good international health or travel insurance policy is essential, and practically mandatory, for any long stay in Malawi.
The likelihood of needing medical evacuation or repatriation is relatively high.
If you have private insurance, you can choose your own doctor in Malawi.
Read more about insurances for abroad on Expatinsurances.org.

Access:

Public

Check more