Doubts over Malawi’s Universal Health Coverage


Lack of basic supporting social services in rural  areas is contributing to the deteriorating health  delivery in the areas in question, some experts have said.

The experts say this is impeding on the country’s  agenda of achieving Universal Health Coverage  (UHC) as stipulated in the Abuja Declaration.

Some of the medical doctors, nurses and Health  Surveillance Assistants  (HSA) that we have talked  to, have complained that lack of water, better roads and electricity among others is frustrating and takes a toll on them as health workers.


In an interview Dr Anthony Chafunya from  Mitundu Community Hospital in Lilongwe Rural  said last week for instance he experienced three days of blackout, additional to the persistent water shortages and lack of quality road infrastructure which he said are reasons that make some people detest working in rural communities.

“Mitundu is where I stay and work. Basic amenities enhance our quality of life and therefore should be made available and accessible. Lack of the basic amenities has potential to deter UHC because the  community will be deprived of qualified human resource for health which is a basic component in Universal Health Coverage, since qualified staff will opt for urban areas,” said Chafunya in his social media post, adding:

“As a medical doctor working at a community hospital, I have to bear with poor roads, network and internet challenges, inadequate security, no banks or malls… It is a great sacrifice for a medical doctor to work at a community hospital.”


Asked on what should be done to improve the situation Chafunya said authorities should strengthen primary care service delivery because 85 percent of people live in the rural areas.

Suzane Mwafulirwa, an HSA in Chitipa, corroborated Chafunya’s sentiments saying there is need for investment targeting the health sector  in rural areas in particular.

She stressed on the need to recruit qualified  personnel like doctors in community hospitals,  ensuring drug availability, proper housing and  expansion of infrastructure.

On his part, health expert George Jobe who chairs  the committee on UHC has challenged authorities to invest in the health sector saying, its inadequacies have potential to paralyse the nation’s development agenda.

“There are what we call health determinants which frustrate health service delivery. Some roads are  so bad that they are deadly to patients in ambulances, and also to the health care workers.

“Some rural areas do not have mobile phone network which negatively affect the referral system and quality of life of people in general.

Talk of electricity, all that has to be corrected if we are

to get to the benchmarks for

UHC,” he said.

Principal Secretary in the Ministry of Health  Charles Mwansambo said government is committed to motivating the health workflorce by among other things providing adequate and well maintained infrastructure to support service delivery.

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