The construction industry accounts for a high percentage of occupational accidents, leading to violation of workers’ human dignity and labour rights. The situation is critical in developing countries owing to occupational health and safety (OHS) interventions being in their infancy and inadequacy in systematic implementation of OHS programmes. This study was concerned with obtaining a generic overview of implementation of selected OHS practices by construction companies in Malawi in order to identify underlying motivations for their implementation or non-implementation and determine OHS management techniques for improvement. A questionnaire was used to collect data, which were analysed using a combination of frequency distribution and categorisation of OHS implementation levels. The results revealed inadequacies in the provision of OHS facilitation services and training practices on construction sites and to construction workers, respectively. Further, the findings revealed workers’ negativity towards OHS practices and reporting of construction accidents to insurance companies despite a legal mandate to notify the OHS directorate. The study supports the notion that developing countries are poor at establishing and implementing OHS legislation and programmes. If properly utilised, the study may guide interventions for improving OHS management at company and national levels.