Councils fail test on health service delivery

Twenty-six out of 28 districts in Malawi are not doing well on drug requisition, which is one of the healthcare service delivery performance indicators.

This is according to a Local Authority Performance Assessment (Lapa) report for the 2020-21 financial year released on April 11 2022.

The report shows that Karonga and Nkhata Bay were the only districts that forwarded medical supplies’ requisitions to Central Medical Stores Trust (CMST) before the 10th of each month at least in 10 out of the 12 months in the year under assessment.

The assessment found that only seven percent of Local Government authorities forwarded medical supplies’ requisitions to CMST in time while the rest of the districts scored lowly as they did not meet this requirement.

“Comparatively, only one district (Nsanje) met this requirement,” the report reads.

According to the report, the majority of councils attributed failure to meet the indicator in question to delays in requisition approval processes and poor internet connectivity, coupled with regular downtime.

Mulanje District Commissioner Stallichi Mwambiwa, for example, lamented challenges with the data consolidation system, citing lack of personnel as a contributing factor.

“Collecting balances of drug stocks has not been easy. In order for our requisitions to be reflective of what is on the ground, and remitting the same data, is a bit of a challenge. In the long term, we would like to see recruitment of specialised staff for the exercise,” he said.

Mwambiwa, however, said, within their means, they were enforcing measures so that those entrusted with the job could be complying with set deadlines.

Malawi Local Government Association Executive Director Hadrod Mkandawire faulted the assessment tool for the poor indicators, adding that there was a need to migrate from manual to digital requisition system.

“Some councils have up to 30 healthcare facilities under them; all these have to balance their stock cards for each item manually. As such, this takes about two to three days at a minimum to complete; then, a particular health facility has to manually write a report to submit to the local authority by road.

“So, already, with the prevailing [problem of] understaffing, it is a tall order to meet the deadlines,” Mkandawire said.

The assessment was commissioned by the National Local Government Finance Committee through the Governance to Enable Service Delivery Project.