250 140 120 MDG target 45 100 80 60 40 R² = 0.973 SWAp 1 2004 - 2011 20 0 1985 1990 1995 2000 2005 Year 2010 projection 34 2015 Deaths per 1000 live births 160 Deaths per 1000 live births Under 5 child mortality rates in Malawi trends and projection Infant mortality rates in Malawi - trends and projection 200 150 100 SWAp 1 R² = 0.971 2004 - 2011 50 0 1985 1990 1995 2000 2005 2010 projection 57 2015 2020 Year 2020 Figure [4]: Infant Mortality Rates in Malawi MDG target 78 Figure [5]Under five Mortality Rates in Malawi 107. These trends in infant and Under 5 child mortality rate demonstrate that there is a possibility that Malawi can reach the MDG targets for these two indicators. This will be possible if significant investments are made in child survival interventions. 108. Maternal mortality rate has decreased from 984/100,000 in 2004 to 675 /100,000 live births in 2010 with an increase in women delivering at health centres from 57.2% in 2004 to 71.5% in 2010. Data from maternal death audits from districts has shown that sepsis and Post Partum Haemorrhage were probably the most likely causes of death in the majority of health facility based mortality. 109. Unlike Child Health MDGs, Maternity MDG targets are unlikely to be met without significant additional investment to increase Emergency Obstetric Care (EmOC) access to many more pregnant women (Figure 6) and investment in family planning to reduce Total Fertility rates. Using data from the 2010 EmOC survey it is estimated that only half of the births requiring emergency care are receiving such care. Plans are in place to increase this access from 8% to 15% of births by 2016 by staffing and upgrading existing maternity units. The HSSP intends to increase operative deliveries from 4% now to 10% by 2016. 32 | P a g e