By: Lloyd M’bwana
Public health sector remains critical for any country’s developmental agendas including Malawi as sick nation undermines social economic growth. This is the reason a serious leadership put its priorities on health over other issues with enough resources to run its facilities.
The case is different in Malawi where year in and year out, the health sector challenges are perennial contravening the Abuja Declaration which the nation signed that 18 percent of its national budget must go to health sector which until now that bench mark has not been reached.
No wonder the year 2015 , the country’s media was a washed with stories of dwindling standards of health sector including patients taking once a meal in a day, grounded of ambulances, failing to recruit health personnel and drug theft among others.
This is snap analysis of unpacking the public health sector with key highlights with hope when entering 2016 on challenges, achievements and policy direction Malawi government has taken regarding to the ongoing public reforms. This analysis will give policy makers recipe to come up with immediate intervention in the New Year.
Challenges
The year 2015 was welcomed with floods which hit over 15 districts whose impact was escalation of water borne diseases including cholera, malaria especially in the southern and lower shire districts of Phalombe, Nsanje and Chikwawa. Displacement of people due to floods resulted into communities living in camps where local and
International organizations came immediately with support. But health wise especially on provision of contraceptives such as condoms for Sexual Transmitted Infections (STIs) including HIV/AIDS prevention faced huddles as these services were insufficient. As the result unplanned pregnancies and increase on STIs were reported which according to health experts faulted the ministry of health for failing to plan and that could have done better in rescuing the villagers with quality services.
Earlier in the year reports were rife that most public hospitals ran out of blood due to insufficient of blood banks which Malawi Blood Transfusion failed to correct from the general public as the 26-60 age groups, the regularly blood donators did not come in large numbers which resulted into loosing lives.
The ministry of health in the year ending, complained over reports that there were increase cases of women living with HIV by continue bearing children defeating family planning methods which feared that a great risk was on the door if such women could not take required measures during pregnancies to protect unborn babies from catching the deadly virus.
The year 2015, will go down in the country’s history with unimaginable insufficient and national budget cuts which contributed to numerous challenges in public health facilities including drug shortages, failure to recruit health personnel, grounded of ambulances, shortages of food-resulting into patients having one meal in a day. Despite the calls from Parliamentary health committee urging government to increase budget allocation towards the health sector, nothing positive came out to bail out the sector from such a mess.
Surprising, in the year, the ministry failed to recruit health personnel to beef up the gap despite huge some of donor financial support government was spent in training them. Consequently, they sought for greener pasture in private health facilities of within and outside the country which according to health expert said the development was a lost opportunity for Malawi failing to capitalize already caught fish. However, due to government failure recruiting health personnel, drug and medical equipment supply shortages, doctors in public hospitals threatened to go on strike pressing government hard in making sure that issues affecting the health sector were dealt with.
Another, critical issued marred the health sector in 2015, reports of public drug theft were all over which contravened quality service delivery to the general populace who could not afford such services in private health facilities due to low income. Consequently, American Ambassador Virginia Palmer threatened to withdraw financial support on health support within a month if the situation was not to improve which made the ministry came into rescue to address the mess by installing CCTV cameras in all public health facilities storage-ware houses.
Achievements
Not all was rosy for the country in the year, 2015.There were some notable head ways achieved in the health sector. The nation managed to achieve the Millennium Development Goal (MDG) number four of reducing child mortality rate. This was attained through various interventions including government engagement with communities, chiefs and health organization plus passionate spirit and zeal demonstrated by the former President Joyce Banda on safe motherhood campaign.
Another notable achievement in the year was the Malawi’s court which sentenced a bogus doctor called Dr. Zizweni Mwafulirwa, 26 to six years in jail for presenting himself as a doctor while administering patients at Queens Elizabeth Hospital. Such jail term sent a warning to those who might want to try their luck in illegal deals running as medical doctors in all public hospitals that the laws would catch them if plan to do the same in future.
In a bid to counter against the deadly Ebola Virus disease which claimed lives in some parts of Western African countries, Malawi got financial support from World Bank amounting to US$7 million for prevention measures.
Voluntary Medical Male Circumcision (VMMC) campaign contributes to 60 percent to HIV/AIDS prevention gained momentum with many young and older men patronizing health facilities where such services were offered only that inadequate of medical staff derailed the whole exercise.
Another notable achievement, ministry of health registered was the suspension of over 64 health public officers towards the end of the year for swindling funds meant for Malaria Projects which American government offered. The suspension of these public health officers who were on forced leave received much applause from donors and the general public that government was making head way in bringing sanity in the health sector.
Policy Direction and developments or immerging issues
In the year, 2015 there were some notable policy direction MoH carried in line with the ongoing public reforms. In March, government came open proposing of the user fees in public health hospitals where patients would pay MK1, 500 when accessing services which Malawi Council for Trade Union (MCTU) trashed arguing that such policy
Direction was ill-times as the nation was going through economic turmoil though its objective was to improve the state of affairs in public hospitals which continue receiving insufficient funding.
However, government never came clearly as whether the policy was to be implemented though rumors flourished that some public hospitals rolled out the program.
In addition to this, the same ministry proposed to private all public health mortuaries in a bid to improve their condition through funds which would be generated upon running by private individuals which health experts welcomed the idea saying thorough consultation was need for its implementation.
Another interesting policy direction imaged in the year was, the proposal by a Member of Parliament (MP) for Ntchisi, Boniface Kadzamira that Malawi must embrace industrial Indian hemp (locally known as Chamba) which according to him would boast the country’s economic fortunes. The proposal received mix reactions from health
Experts and general public. Experts called for thorough research on the crops’ social-economic cost and benefit analysis before it legalized or continued with the ban as illicit substance. While other quarters of the society totally disagree with such proposals saying the country illiteracy levels were high that it would be difficult for some differentiate between industrial hemp and conventional Hemp.
In the year also Malawi government assured the general public that in April 2016 was expected to roll out universal eligibility for early treatment on antiviral therapy (ART) those diagnosed with the virus in a bid to contain the viral load. The assurance came as a relief to the country’s civil society organization on the fight again the pandemic HIV/AIDS which in September called government to swiftly come up with the policy which would facilitate those detected with the virus to start taking ART earlier that latter for better treatment. The policy call formulation derived from reports that most people diagnosed with HIV are told to wait until their CD4 count is reduced to below 500 which consequently led to deteriorating of their condition, eventually leads to death upon taking the ART lately.
Towards the year end, the nation witnessed the Ministry of Health issuing a decree that no any public health in-charge or District Health Officers could grant interviews journalists apart from the ministry’s national spokesperson arguing that there were conflict reports on health situation in the country. The ban did not go well with all media houses in the country urging the ministry to reverse the decision as it was counterproductive considering that a ministry’s spokesperson could not answer and know all issues from remote health centres but rather officials on the ground.
Conclusion
With insufficient of funding though donors pumped in MK13 billion towards, the year ending to caution food and drug shortages in the public health facilities, the sector still remains in tatters as government was finding it hard to meet ABUJA DECLARATION that national budget on health must be 18 percent. We are welcoming 2016 with the general debate that the nation should legalize industrial hemp to boast the country economic growth. It’s a wish for any Malawian to see quality health service delivery is provided with local made resources from taxes.
