There has been an increase in disability prevalence in Malawi over the past three decades A 1983 National Statistical Office Survey of Handicapped Persons in Malawi, using head count and snowball sampling placed the rate of disability in the population at 2.9% and 10 years later it was estimated at 2%. However in a recent prevalence study in Mzuzu city, it was found that 154 out of the 780 children sampled (aged 0-18 years) have at least some kind of disability according to the Ten Question Questionnaire (a screening tool for disability in low income settings comprising five questions on cognitive development; two questions on motor development; and one question each regarding vision, hearing and seizures), representing 19.7% prevalence. The low prevalence in the earlier surveys may not have addressed multiple disabilities unlike in this study where a variety of disabilities including physical, intellectual and self-care were studied. In Mzuzu a significant burden of care was found among guardians of these children. Much of this related to stigma and cultural misconceptions about disability and its causes. Physical, social and psychological burdens were reported leading to children being locked up for fear of carrying heavy weight on the back as well as stigma; marriage disruptions and divorces between carers ; and general distress as a result of having a disabled child.