It was inevitable that controversy would explode from Madonna’s visit to Malawi. As she arrived in the fourth poorest country in the world, intent on providing close to $5 million in education and other programs to aid indigenous orphans, she was in the process of adopting a child. The nation has a child mortality rate of 103/1000, an HIV infection percentage of 30%, and 14.2% of the population is already HIV positive.

While this particular adoption has been criticized by many factions, Benston Kilembe, director of child services, has repeatedly stated that Madonna and husband Guy Ritchie have followed all the normal and prescribed processes. An interim order was therefore granted for the adoption of the child, David Banda, through the High Court of Lilongwe.

In-country adoptions, also known as kin adoptions, were previously found to be effective but, Jini Roby, associate professor of social work at Brigham Young University, points out, “the kin system is now saturated and cannot adequately support the growing number of parentless children without external support.”
Abuse and neglect is not unheard of and, says Roby, "although [external adoptions] may not be the ideal situation, a permanent, stable home is still the better option." International adoption is a viable alternative.