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.