Background: Malawi's National Malaria Control Programme (NMCP) is developing a new strategic plan for 2023-2030 to combat malaria and recognizes that a blanket approach to malaria interventions is no longer feasible. To inform this new strategy, the NMCP set up a task force comprising 18 members from various sectors, which convened a meeting to stratify the malaria burden in Malawi and recommend interventions for each stratum. Methods: The burden stratification workshop took place from November 29 to December 2, 2022, in Blantyre, Malawi, and collated essential data on malaria burden indicators, such as incidence, prevalence, and mortality. Workshop participants reviewed the malaria burden and intervention coverage data to describe the current status and identified the districts as a appropriate administrative level for stratification and action. Two scenarios were developed for the stratification, based on composites of three variables. Scenario 1 included incidence, prevalence, and under-five all-cause mortality, while Scenario 2 included total malaria cases, prevalence, and under-five all-cause mortality counts. The task force developed four burden strata (highest, high, moderate, and low) for each scenario, resulting in a final list of districts assigned to each stratum. Results: The task force concluded with 10 districts in the highest-burden stratum (Nkhotakota, Salima, Mchinji, Dowa, Ntchisi, Mwanza, Likoma, Lilongwe, Kasungu and Mangochi) 11 districts in the high burden stratum (Chitipa, Rumphi, Nkhata Bay, Dedza, Ntcheu, Neno, Thyolo, Nsanje, Zomba, Mzimba and Mulanje) and seven districts in the moderate burden stratum (Karonga, Chikwawa, Balaka, Machinga, Phalombe, Blantyre, and Chiradzulu). There were no districts in the low-burden stratum. Conclusion: The next steps for the NMCP are to review context-specific issues driving malaria transmission and recommend interventions for each stratum. Overall, this burden stratification workshop provides a critical foundation for developing a successful malaria strategic plan for Malawi.

Open waste disposal has a negative effect on local ecology, economy, and public health. Understanding factors influencing waste disposal decisions is necessary for developing solutions to curb open waste disposal. This paper discusses the associations between household’s social demographic and spatial characteristics with preference for domestic waste disposal. The paper also utilize this knowledge practical community action. This was achieved by gathering and examining a novel dataset of` the waste disposal patterns of 200 randomly chosen households in Malawi. We observed that households were likely to dispose of their waste openly when the residential unit was closer to an existing open waste disposal site. A multinomial logistic regression model showed that the likelihood of choosing waste disposal methods, such as private garbage collection services, is higher when the household head is a woman, the housing unit is owned by the occupants, and in the presence of a fence. We presented these findings to the neighbourhood community development committee. A short-term community waste management plan was created using a participatory community planning approach. The plan included co-designing waste disposal solutions with landlords, setting up community waste bylaws, and intensifying civic education activities. In conclusion, our study provides insights into the factors that influence households’ disposal behaviour. This unique case study highlights a potential approach for developing waste management policies using a bottom-up approach.