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Public health strategy faces $500 million shortfall

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THE country’s recently launched health sector strategic plan, which requires $2.7 billion, has suffered a funding gap of close to half a billion dollars.

The Health Sector Strategic Plan 2017-2022, states that the budgetary commitments from government and grants from donors to the strategy will total about $2.2billion over the five years from 2017 but there is a shortage of $500 million.

The shortfall comes at a time when the country’s development partners have cut the planned contributions to the strategy. Malawi Health Equity Network (MHEN) has said the shortfall poses a major threat to the implementation of key activities envisaged under the plan.

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Principal Secretary in the Ministry of Health Dan Namarika confirmed in an interview on Thursday that the health funding is becoming major challenge for the government.

Namarika said this was because donors, who currently finance about 63 percent of annual financial requirements in the health sector, have constantly reduced their contribution in recent years, with further cuts expected.

He was quick to point out that discussions are underway with development partners to find ways of making the strategy work.

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“It’s only through dialogue between development partners that can improve aid effectiveness at the highest level hence we have agreed with them to form a Joint Harmonisation Group (JHG) to expedite alignment and harmonisation process in the health sector for Malawi,” he said.

He said JHG will guide the process, towards one-plan, one report and one budget. Namarika disclosed that the ministry is discussing with the United Nations, Germany, Norway, the World Bank, USA, the UK and African Development Bank to support the strategy.

The ministry will also hold talks with the Ministry of Finance and Ministry of Local Government regarding the strategy. Minister of Finance, Economic and Planning Development, Goodall Gondwe, admitted that the government is not in a position to finance the deficit.

“It will be difficult for me to comment as the [reviews in the] GONDWE—Government is not in a position to finance the deficit    WEDENIG—We scaled up our nutrition response strategy have not yet reached me. We will have to scrutinise it to see how realistic it is,” Gondwe said.

British High Commission has said Britain has maintained its level of support for the Malawi health sector. The commission said the spending on health has been fairly been constant since 2012.

United Nations Chidren’s Fund (Unicef) Resident Representative Johannes Wedenig also indicated that the funding has increased from $22.6-million in 2014 to $25.6 million last year.

A breakdown of the spending shows that most of the increase was on nutrition during a period of drought and flooding, which caused widespread hunger in Malawi last year, while direct spending on healthcare has fallen dramatically.

The figures provided by Wedenig showed that the outlay on nutrition, particularly for children, trebled from $4.8 million in 2014 to $15.2-million last year, while health spending decreased from $14.5 million to $7.8-million while Unicef’s spending on HIV and Aids alleviation fell from $3.2 million to $2.6 million.

“We scaled up our nutrition response to identify and treat malnourished children throughout the country, including through mass screenings and door-to-door visits,” Wedenig said.

“We also provided stocks of ready-to-use therapeutic food to health centres throughout Malawi, in order to treat children suffering from malnutrition.”

One reason for the sharp decline in funding for the health programme last year, he said, was that donor grants from the Norwegian government and Germany’s KFW Development Bank ended as programmes drew to a close. “We also did not have any large-scale procurement activities in 2016, which led to smaller expenditures than in previous years,” he said.

Malawi Equity Health Network Executive Director, George Jobe, has said the feeling among most donor countries is that Malawi is haemorrhaging public funds because of corruption and poor priorities in the allocation of resources.

The strategy, a partnership between the government and donors, aims at improving service delivery and access to health services between 2017-2022 by, among other things, constructing new health facilities, providing medical equipment and supplies, recruiting more health workers and refurbishing dilapidated facilities.

In particular, it seeks to remedy the vacancy rate in the health sector, estimated at 43 percent as well as constructing district hospitals in Lilongwe, Blantyre, Zomba and Mzuzu for the referral of patients from other facilities.

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