Report paints gloomy health services picture


A Malawi Harmonised Health Facility Assessment (HHFA) indicates that availability of basic health services in Malawi is improving but remains below target levels as set by the World Health Organisation (WHO).

For instance, on average, facilities had 38 percent of the essential medicines and no facilities had all the 24 essential drugs.

Released last month by the Ministry of Health, the 2018/2019 assessment finds that many facilities lack trained staff, guidelines, equipment, medicines and commodities required to deliver health interventions.


“The 2018–19 Malawi HHFA survey generally shows an increase in the availability of basic health services in health facilities compared to the 2013 SPA [Service Provision Assessment]. Despite this increase, the survey shows that Malawi has not yet met the targets set by WHO with regard to infrastructure health workforce, in-patient bed capacity, and health provider caseload.

“This caseload is substantially higher than the caseload seen in other countries in the region including Kenya, Tanzania and Sierra Leone which were 13, 10 and 8 patients per day, respectively,” reads the report in part.

The 2018/2019 Malawi HHFA was conducted to ascertain the availability, readiness and quality of health service delivery in facilities to better understand existing gaps and identify potential approaches for improving health care services and ultimately health outcomes in Malawi.


The assessment was conducted between November 2018 and March 2019 in a census of health facilities and included 1,106 health facilities.

A total of 12,773 healthcare workers were observed for absenteeism, among others areas.

Meanwhile, health rights activist Maziko Matemba has challenged any leader who gets elected at the court-ordered presidential election to commit to devising ways that will see Malawi shifting directions in improving health service delivery.

“They have to make a strong commitment because once they get into power, they forget what they promised. What we need to know is how they are going to strike a balance between domestic and foreign resource and issues on policy guidance,” Matemba said.

The 2018–2019 Malawi HHFA is the second large-scale, systematic and detailed look at the status of health facilities in Malawi after the 2013 Malawi Service Provision Assessment.

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