Malawi’s health sector has made impressive progress in recent years. Child mortality has fallen significantly, vaccination rates remain high, and the country has shown a strong commitment to improving health despite ongoing economic pressures.

However, health inequalities, workforce shortages, climate-related pressures and fragile infrastructure continue to place strain on the health system across the country.

The emergence of new technology and AI also threaten to divide the world into those who can influence the foundational data upon which these systems are built and those who cannot.

Nurses and midwives are at the heart of the response in Malawi. However, with only around one nurse and/or midwife for every 2000 people, the workforce remains critically under-resourced. Strengthening the profession is about more than increasing numbers; it means creating opportunities for nurses and midwives to lead, conduct research and shape the evidence that drives better care.

The ambition to support stronger African voices in research sits at the centre of the growing partnership between the Royal College of Nursing (RCN) and the National Organisation of Nurses and Midwives of Malawi (NONM).

From partnership to evidence

Our current partnership was established in 2024 and since then, our focus has been on listening, building relationships and identifying areas where working together can make a meaningful and sustainable contribution to nursing and midwifery in Malawi and the UK.

One of the priorities that emerged was strengthening research leadership, evidence generation and dissemination, and supporting nurses and midwives to use evidence to improve practice. This included supporting the Malawi Journal of Nursing and Midwifery (MJNM), which has been under development since 2024.

In March, this work took another important step forward when colleagues from the RCN and Birmingham City University Centre for International Partnerships travelled to Malawi and worked alongside NONM, and Kamuzu University of Health Sciences to deliver a capacity-building workshop focused on nursing and midwifery research and publication. The launch of the journal represents the next stage of that work.

Why do we need evidence and whose evidence counts?

When we ask what is needed to improve patient outcomes, the immediate answer is often more resources: more nurses, more beds and more equipment. While these are vital and a clear priority, safe and effective care also depends on something less visible: evidence.

How do we understand staffing challenges in Malawi, disease burdens, rates of sepsis, antimicrobial resistance, or whether a nursing intervention has improved care? We know because someone collected the data, analysed it and shared their findings.

Evidence does not appear by chance. It must be generated, published and translated into practice. Yet much of the global evidence base is still produced by a relatively small number of well-resourced institutions, even though health care systems, resources and patient needs vary significantly across countries.

A 2026 review in the Journal of the American College of Cardiology found that just 3.9% of over 2,000 randomised controlled trials published in leading general medical journals between 2019 and 2024 were conducted exclusively in Africa.

Improving care in any setting requires evidence that reflects local realities. Nurses and midwives are uniquely placed to generate that evidence, and, through their daily work, they identify challenges, test solutions and drive improvements in patient care.

However, producing evidence is the tip of the iceberg and, in the background, nurses and midwives need opportunities to develop research skills, access mentorship, share their findings and contribute to the wider evidence base through credible platforms and professional networks.

The Malawi Journal of Nursing and Midwifery

The recent launch of the Malawi Journal of Nursing and Midwifery marks a significant milestone for nursing and midwifery scholarship in Malawi, providing a platform to advance evidence-based practice, professional leadership, research, and health systems strengthening.

The journal brings together thought-provoking commentaries on workforce development, professional regulation, collective bargaining, research, and nursing education, alongside policy briefs addressing priority issues such as maternal mental health and evidence-based practice.

The edition also showcases original research on breastfeeding, childbirth practices, infection prevention, and innovative models of care, including midwife-led obstetric ultrasound services.

Together, the articles highlight the critical contribution of nurses and midwives to achieving quality health care, strengthening health systems, and improving outcomes for communities across Malawi and beyond.

While a journal alone cannot solve the challenges of developing sustainable research capacity, it is an important step forward. It provides a space for Malawian nursing and midwifery voices to be heard, recognised and valued.

It is also about empowering nurses and midwives to lead change, shape policy and influence the future of health care. By investing in their knowledge, ideas and leadership, we are investing in stronger health systems and better outcomes for communities across Malawi.

You can find the Malawi Journal of Nursing and Midwifery here.

Sources

• Gaye B, Morsy MI, Kitara DL, et al. African Representation in Randomized Controlled Trials Published in Leading Medical and Cardiovascular Journals, 2019–2024. Journal of the American College of Cardiology. 2026.