Strengthening the health sector, Malawi
When the Government of Malawi set out its health sector reform agenda, it prioritised improving national health services and systems. Our Malawi Health Sector Programme – Technical Assistance (MHSP-TA) is providing expertise to enhance implementation of Malawi’s Health Sector Strategic Plan (HSSP 2011–2016).
We are supporting sustained change for more efficient, effective, equitable and accountable delivery of high quality health services to improve the quality of life of the people of Malawi. We work with the Ministry of Health, the Christian Health Association of Malawi and the National Local Government Finance Committee to improve health systems performance, particularly in three focus areas:
- Strengthening stewardship, coordination and action across the health sector, to improve the Ministry of Health’s governance and oversight of partnerships. We are promoting the strategic allocation of financial resources, reducing duplication and ensuring that the considerable resources available to the health sector have a direct positive impact on improving health outcomes.
- Enhancing financial management and democratic accountability in the health sector, leading to greater confidence within government, civil society, the private sector and communities that government institutions have the ability to use public and donor funds efficiently, appropriately and effectively.
- Strengthening health service planning and monitoring, to improve district planning processes through better use of health data, especially gender-disaggregated data and better supervision of health service quality by district and zonal teams.
- Following the 2013 Malawi public finance corruption scandal (‘Cashgate’), our project undertook a review of district and facility use of health resources. This resulted in tightening of management procedures and greater scrutiny of resource use at national and district levels. This has now become one of the health sector’s six reform areas.
- Project efforts to improve Malawi’s health sector financial management contributed to the 2013/14 sector audit showing a marked improvement in performance at district level.
- We supported the Ministry of Health to revitalise its most senior governance committee, the Health Sector Working Group, which has been meeting on a quarterly basis since March 2014.
- Together with the Clinton Health Access Initiative, we provided Parliamentary Committee members with guidance and support in analysing the 2015/2016 health sector budget in preparation for the parliamentary budget debates. This contributed to enhancing democratic accountability at the parliamentary level.
- We provided training on roles and responsibilities for the newly elected health and environment committees and the finance committees of the councils in eight out of the 15 MHSP-TA focus districts, enabling them to carry out their oversight role on behalf of their communities.
- We have supported the Christian Health Association of Malawi to overcome financial management challenges and develop a new strategic plan as a basis for future development of the organisation.
- Local-level accountability is being strengthened through an assessment of the roles and functions of Health Centre Advisory Committees. This is feeding into the design of a pilot training and mentoring programme at sub-district level, to strengthen health services accountability and community voice with a particular focus on oversight of drugs and medical supplies.
The financial audit 2013/14 showed a marked improvement at district level
We are strengthening accountability through District Council Health and Environment Committees
We have supported 6 Health Sector Working Group meetings since 2014