For five years, a couple from Blantyre has lived with the emotional weight and uncertainty of childlessness. As years passed without a pregnancy, their desperation grew, driving them to seek answers across medical facilities and traditional practitioners alike.
Their search eventually led them to Mangochi District, where they consulted a traditional healer. The husband, who requested anonymity, recalled being given a pungent concoction with instructions to consume it over seven days. The treatment yielded no results, leaving them childless and facing steep financial hurdles.
“We have been told to seek further attention abroad and we are trying to raise funds,” he said, noting that specialised services are scarce and costly, with initial consultations alone reaching about K2 million.
A similar ordeal nearly fractured a marriage in Lilongwe’s Area 25. Emmanuel and his wife spent three years chasing the dream of a child through every available avenue. Having fathered a son in a previous marriage, Emmanuel admitted the childlessness haunted him, leading him to wrongly blame his wife for the situation.
“Our marriage was on the verge of breaking because I felt like my wife was the problem,” Emmanuel shared. Seeking medical intervention at Kamuzu Central Hospital changed everything. Following a diagnosis of tubal blockage and subsequent treatment, the couple is now parents to a one-year-old baby.
These experiences mirror the hidden pressures confronting thousands of couples nationwide. While infertility carries heavy social and emotional stigmas in Malawi, experts stress that public understanding of its medical roots remains limited. Furthermore, society frequently places the blame solely on women, ignoring the reality that biological factors affect both partners equally.
Kamuzu University of Health Sciences (Kuhes) Sexual and reproductive health lecturer, who is also a senior medical officer at Blantyre District Health Office, Zaziwe Gunda said infertility affects 17 percent of Malawian couples aged between 20 and 44.
He said while many know couples struggle to have children, there is still limited understanding of the medical causes.
Gunda said infertility is often blamed solely on women, despite the fact that causes can affect either partner.
He added that at Gateway Clinic in Blantyre, an average of eight couples seek medical help for fertility issues in a month.
“Among women, common causes include ovulatory disorders such as polycystic ovary syndrome, thyroid disease and premature ovarian failure. Obesity and other hormonal disorders can also interfere with ovulation,” said Gunda.
He said damage to the fallopian tubes is another significant cause, often resulting from untreated sexually transmitted infections such as gonorrhoea and chlamydia.
Professor of biomedical science and distinguished academician in male reproductive health at Kuhes Fanuel Lampiao said no recent research has been done on infertility levels, but quotes a 2017 one which shows infertility levels vary between 2 to 17 percent across the country.
He said the gravity of the problem is seen in couples seeking medical help, signifying that people are now aware of the problem at hand.
Lampiao said smoking, drug abuse and being overweight are some of the issues contributing to infertility.
“In recent times, there has been an increase in couples coming to the hospital to seek medical help for infertility which means that people now are able to understand that infertility like any other disease can be managed by medical professionals,” he said.
Ministry of Health director of reproductive health Owen estimates that about 10 percent of couples in Malawi experience infertility.
He said studies on the prevalence of infertility in Malawi have produced varying figures, ranging from eight to 20 percent, depending on the population and setting studied.
Chikhwaza said most of the available studies are relatively small and based on patients attending particular health facilities, making it difficult to establish a definitive national prevalence rate.
He added that the ministry will commission a study soon to ascertain the actual percentage on national level.
“Other studies would tell you 18 percent, others would say 20 percent, others would tell you eight percent, others would say 10 percent. That’s why, on average, you would put it at 10 percent,” he said.
Chikhwaza said health professionals prefer the term subfertility because many couples can conceive after the underlying cause has been identified and treated.
He said female factors account for a significant proportion of cases, with blocked fallopian tubes among the major causes.
Tubal blockage can result from infections, including untreated sexually transmitted infections, which can cause inflammation and scarring of the fallopian tubes.
For couples who do not conceive through conventional treatment, Chikhwaza said assisted reproductive technologies such as in-vitro fertilisation could provide another option.
However, he said Malawi currently faces limitations in providing assisted reproductive services.
“The government is trying to create legislation that would allow investment in the area of subfertility, specifically assisted reproduction,” he said
