Malawi’s HSSP 2023-2028

Malawi’s HSSP 2023-2028

Introduction
The need for better health care services is a major problem in many African countries. Malawi is among the countries that need reforms in the health sector. With a population of around 17.5million registered in the 2018 census by the national statistical office of Malawi, there is an estimated upwards growth by 2.8% per year, which requires a strategic plan in healthcare. Malawi featuring among third-world countries, the Australian government is ready to help it come up with a better health care plan. In this case, there is a need to revise current Malawi’s Health Sector Strategic Plan (HSSP) II 2017-2022 to 2023-2028 HSSP.
Analysis of current Malawi’s healthcare plan
Health information systems.
Malawi’s data collection system has been strengthened by the ability of the ministry of health (MOH) to use the Health Management Information System (HMIS). This data transmission level is a success through the District Health Information Software (DHIS2), which offers valuable central data collection for the government. The weakness in such a system has been witnessed in the Malawi health sector’s private facilities. Many hospitals do not relay real-time data as they rely on manual transmission of data from clinics, which may be biased. There is an opportunity by the government to install web-based applications that can serve real-time data to the national health grid. The data transmission using a cloud-based system may face challenges from the available IT infrastructure. The poor network system in rural areas hinders the government from advancing its technology to health clinics and dispensaries.
Leadership and governance
The whole health system in Malawi is dependent on the national and district level of leadership. Through the office of the president and cabinet, there have been efforts made by technical working groups (TWGs) like the Individual Performance Agreements (IPAs), which ensures regular checks on issues about health. On the district level, the MOH entrusts District Health Management Teams (DHMTs to manage hospitals. However, these leadership services at the district levels are not sufficient since they are overworked. There is a plan to improve the working structure by training public health experts on leadership and assigning them to their relevant hospitals within their localities. This move is a nightmare to the government because it sites inadequate funds to initiate more training and stipend funds for salaries.
Analysis of internal factors
Healthcare services
Several health service provisions in Malawi are aimed at improving the lives of people. These include reproductive and adolescent health, maternal and child health etc. There has been a rise in teenage pregnancies leading to 143/1000 live births among adolescent girls (MOH, 2017). The government has strengthened the efforts to combat unwanted and early pregnancies by providing free contraceptives, which has shown a significant decline in the fertility rate of 4.3 by 2018. However, there has been resistance from a society based on contraceptives because of early marriage customs performed by some tribes. The government has a chance to improve awareness by sensitizing communities about the importance of family planning. The challenges facing the government in its plan to curb crude abortions are well stipulated by the ignorance of people towards learning.
Maternal and child healthcare have improved since more women attend clinics and later follow the government’s rule to deliver in hospitals rather than at home. This maternal care has improved since the government increased dispensaries around the country. Child health has improved since 70% of the facilities follow the Integrated Management of Childhood Illnesses (IMCI), which has helped curb regular child illnesses. There are still improvements to be done because the death rate for infants is still high. The government could leverage the integrated community case management to distribute child care services to more rural areas.
Diseases such as HIV&AIDS, Malaria, and Tuberculosis still pose a danger in Malawi. The government provides free antiretroviral therapy to the people. This effort has resulted in 86% successful testing of people with HIV, while 96% being suppressive of the virus in 2017(MOH, 2017). Tuberculosis is associated with HIV infections, which is well countered by the government. However, malaria remains untamed due to the favorable tropical climate in Malawi that hosts the deadly mosquitoes. Through NGOs, the government can reach out to people by donating mosquito nets as a preventive measure.
Major health system capacity concerns in Malawi
1. Healthcare infrastructure
As the population grows, there is a need for expansion in terms of healthcare infrastructure. Malawi has a poor network of hospital infrastructure. It is estimated that 24% of facilities have an ambulance. Also, an approximated service area of 8km2 per hospital is a poor way of delivering services. With the few hospitals in place, there is inadequate hospital equipment like water, toilets, electricity and technical tools. The existing facilities face demolitions over poor maintenance.
2. Human resource
There are no enough nurses, doctors and other health practitioners in Malawi. To have a better service delivery, the government needs enough expertise to deliver the services in hospitals. With few skilled clinical psychologists and consultant psychiatrists, these positions indicate the health sector’s dire situation in Malawi. In 2016 there was a vacant position for 8,457 practitioners in the health sector. This figure is huge at the same time, not adequate to ensure better service delivery.
3. Health Financing
According to UNICEF, the government expenditure on health by 2018/2019FY was US$35 million. The financial muscles in Malawi have been poor, leading to lower service delivery and strained expenditure on running costs. The financial expenditure per capita is standing at $10.4 US dollar, which is against the WHO standards of $86 US dollar. This means that there is an 8.2 gap in capital expenditure, which makes healthcare incapacitated. There is a need for improved donor funding, which would act as a healthcare stimulus program to revive nonprofit hospital facilities that rely on charity.
The government needs to include proper planning in ensuring many people are trained in the relevant fields and careers regarding health and hiring them. The government also needs to ensure there is an upwards trend in building new hospitals and upgrading existing district hospitals. The most important of all is the finances. The government should allocate more money to the health sector, which would boost general operations in the health sector.
Health priority based on demographic problems
According to the national statistics on deadly diseases, HIW&AIDS still ravages through Malawi with no sign of decline. An estimated one million people were found to be HIV positive in 2018 by UNAIDS. This is a high number that depicts the current state of health in the entire region. HIV remains the number one cause of more deaths in Malawi than any other disease. The government should plan how to counter this problem in the next HSSP. All the strategies used to tame the spread of HIV should be revisited and new policies to be drafted towards the fight of this disease.
Conclusion
In conclusion, the Australian government should learn the existing challenges in Malawi’s healthcare infrastructure, healthcare funding, Healthcare information system, human resource, and, most importantly, the resources to fight HIV. The provision of funds to Malawi would improve the capacity of the government to handle these challenges. Also, the partnership between research institutions in Australia and Malawi will advance studies on diseases affecting people. With any help from the Australian government, Malawi will one day realize its potential in handling HSSP.

References
Chersich, M. F., Newbatt, E., Ng’oma, K., & de Zoysa, I. (2018). UNICEF’s contribution to the adoption and implementation of option B+ for preventing mother-to-child transmission of HIV: a policy analysis. Globalization and Health, 14(1), 55.
Government of the Republic of Malawi. (2017). Health Sector Strategic Plan II (2017-2022)

Tags:

Comments are closed.