Malawis health system awful, needs overhaul watchdog

Many Malawians especially in rural areas are at the risk of dying from curable diseases due to shortage of essential drugs in healthy facilities country wide, a coalition of civil society groups has observed. (pictured: rural health clinic)

Malawi Health Equity Network (MEHN) a coalition of civil society organizations advocating for improved pro-poor health policies said this Thursday in Blantyre during the presentation of its survey findings it conducted recently dubbed stop stock-outs in various districts around the country.

MEHN executive director Martha Kwataine said the problem has been strengthened by what she called lack of governments commitment to allocate enough funding to the health sector which she disclosed is below the required Abuja declaration of an allocation of a minimum 15 per cent.

In the 2009/2010 national budget government of Malawi allocated to the health ministry about 13. 24 per cent, just less than two per cent to reach the required 15 per cent allocation.

I think government is lacking seriousness on its commitment in the Abuja declaration to allocate a minimum of 15% of its national budget to have been made that the combined allocation to the ministry of health, the HIV/Aids department and NAC in this years budget has exceeded this benchmark.

However, this inflated figure poorly reflects funds available to health services for example large proportion of NACs funding is allocated to alternative programmes such as food security and education, observed Kwataine.

She added: At 13. 24% of the national budget, Malawi government is on the way to making meaningful steps in the right direction but a drastic increase is still required. Moreover NAC budget has been reduced by an enormous 40% and allocation breakdown of the remaining funds has been limited this leaves several unanswered questions as to how government intends scale up HIV/Aids prevention and treatment.

The MEHN director has also bemoaned poor management of drugs in the country adding that in their findings it was established that about 70 per cent of the countrys health facilities lack basic drugs like panado and aspirin a development she said is critical mostly in rural areas.

Poor management of the Central Medical Stores and its distribution networks has long been given a reason for the bottleneck. However, CMS has recently been granted autonomy and therefore it is critical time to address the operational problems of the past, Kwataine appealed.

On shortage of health workers, Kwataine observed that it is utter nonsense for the country to have a doctor- patient ratio of 1: 53, 662 and this has been made difficult with what she described as continued disproportionate congregation of health workers in urban cities which makes it impossible for quality health care delivery in rural areas.

According to information sourced by Nyasa Times, Malawi has a shortage of over 6,000 health workers most significantly nurse midwives despite training efforts by government to train more health workers annually.

Kwataine further disclosed that during the survey her organization found out that there are a lot of non-Malawians benefiting from the country free health care system especially in the bordering districts of Mulanje, Chitipa, Karonga and Mwanza.

Meanwhile, Kwataine called on government to increase health funding to a minimum of 15 percent of the national budget. Besides, she further recommended for the recognition of drug management committees in all health facilities as stipulated by public health Act.

We are calling on the government to increase drug funding per capita to a minimum of $5, treble the number of health workers trained and implement health worker hardship allowances among others, added Kwataine.

On his part, Central Medical Stores (CMS) southern region boss Billy Mwapasa while admitting to the critical issues raised by MEHN revealed that the problem of shortage of drugs in health facilities should not he attributed to his department saying CMS has over 85% of essential drugs in stock.

The problem here is the DHOs they make requisitions late and they expect us to act swiftly thats not the way we should do business. If DHOs were coming with their requisitions in time this problem would have been long dead by now. We have plenty of essential drugs at our warehouse but we cant just start disbursing the drugs without receiving requisitions, explained Mwapasa.

The government official also disclosed that plans are currently at an advanced stage to construct a state of the art national warehouse to be based in Lilongwe.

Currently, were faced with a problem of inadequate of warehouse facilities to store our drugs but the issue will soon be addressed as we have plans to construct a national warehouse ion Lilongwe, added Mwapasa.

And as one way of arresting drug theft the CMS is now delivering drugs directly to the health centres unlike in the past when health centres were collecting drugs at the district health office.

Records indicate that Malawi has one of the countrys worst healthy indicators with a life expectancy of 46 years; 807 maternal deaths per 100,000 births and over 1.5 million orphans and vulnerable children courtesy of the deadly HIV/Aids pandemic.

Post published in: Health

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