A blue, burgundy and white patterned wrapper hides the swell of Joanna Banda's belly. Eight months pregnant, she has had just three of the five antenatal appointments she should have had. She is unlikely to attend her final three either, as she still has to save 3,000 kwacha (1.28) for a bicycle to take her six miles on rutted dirt tracks to the nearest health centre when she goes into labour.