According to the Malawi Demographic and Health Survey (2000), the HIV/AIDS epidemic in Malawi is one of the most severe in Sub-Saharan Africa. The Malawi AIDS Control Programme estimates that over one million people are infected with HIV in the country. Statistics show that younger women 15-24 years have the highest rates of HIV infection. Young women are especially vulnerable to HIV infection on many counts: a) In many societies, the socialization of children emphasize male dominance and female submissiveness in social relations, which extends to sexual relations. This submissiveness results in many young women lacking confidence and bargaining power to negotiate when, how and with whom they have sex, thus increasing their vulnerability to HIV infection. b) Young girls are socialized for the roles of wife and mother. Their activities are more closely circumscribed and they are more or less confined to the domestic context. This kind of socialization offers females a much smaller range of role choices and limits their economic opportunities. This results in female dependency on male economic support. This dependency, forces young women to get married early before they are mature enough to become wives and mothers. In addition, due to poverty, many young women are compelled to offer sexual services in exchange for food, shelter or money. This makes them very vulnerable to HIV infection. c) Finally, certain cultural practices which are imparted to young girls and boys during initiation, puts young girls and boys at great risk for HIV infection. This study was carried out at Mianga Tea Estate in Thyolo district. The aim of the study was to explore how female socialization renders young women vulnerable to the risk of HIV infection. In order to get as valid and reliable data as possible, a combination of methods was used to collect data for this study. The findings show that the girl child at Mianga is socialized into submissiveness. The girl child is socialized for the roles of wife and mother and these are considered inferior, where as the boy child is socialized into roles that are considered superior by society. The study has demonstrated that socialization into gender roles, which begins early in the child’s development, is reinforced through initiation rites. Initiation rites like chiputu for girls and thezo for boys between 7-10 years marks the beginning of sexual activity. Premarital sexual activity is encouraged after these rites, thus putting them at risk of HIV infection. Evidence from this study shows that the gender norms that emphasize male superiority and female submissiveness as well as the cultural practices that encourage early sex for girls and boys accelerate the risk of HIV transmission among young women. Effective HIV prevention strategies must therefore seek to address the gender imbalances that exist between males and females in society.

In Malawi, total fertility rate (TFR) has remained high at 6.0 children per woman. Use of modern contraceptive methods is lower at 42 percent than the current demand at 72 percent. This has resulted in high unmet contraception need, currently at 26 percent (NSO and ICF Macro 2011). The available evidence suggests that there are barriers to contraceptive use at both community and health service delivery level. This study was done in Mzimba District in the rural communities of Traditional Authority (TA) Mzukuzuku, and Mzimba District headquarters. The aim of the study was to understand the context of unmet family planning (FP) need among currently married women within the age group 15-49 years. Specifically the study sought to: establish the level of unmet FP need in Mzimba, identify socio-cultural factors that influence unmet FP need, examine health system factors influencing unmet FP need and explore community perceptions regarding use of modern contraceptive methods. This cross-sectional study employed both qualitative and quantitative methods which included a survey of currently married women; focus group discussions with users and non-users of modern contraceptive methods; and married men separately. In-depth interviews with key informants and clients exiting FP facilities were done. The findings of this study suggest that a combination of factors mitigate against use of modern contraceptive methods. Prominent among these are gender based power imbalances, social influences and health system barriers.