Specialists crisis in referral hospitals

Maziko Matemba

The country’s four referral hospitals are designed to handle health services which are beyond the capacity of health centres and district hospitals. But the main hospitals are themselves struggling due to chronic shortage of specialists

If Malawi’s four referral hospitals were to provide top notch health services, they need not less than 300 specialist doctors, experts say.

But they have less than 100 – a matter of serious concern to health practitioners themselves and health rights activists.


Kamuzu Central Hospital Director Jonathan Ngoma said the facility has only 34 specialists out of the required 194.

This, he said, is hampering the hospital’s work as some patients fail to access critical, quality health services.

“We have a challenge in specialists because we do not have enough at all,” Ngoma told Malawi News.


Mzuzu Central Hospital has six permanent specialists against the required total of 50.

Director of the hospital, Frank Sinyiza, said the shortage of specialists is critical to the extent that some departments have no specialist doctor at all; a situation he said is compromising provision of health services to the public.

“This is a tertiary facility and when patients are referred to the facility, they expect to get specialised services. Unfortunately, very few people can access the service they need because we have a limited number of specialists.

“Much as the hospital can hire specialist doctors on temporary basis, the measure is not sustainable and dependable,” he said.

Queen Elizabeth Central Hospital Director Samson Mndolo said they face a similar challenge of shortage of specialists but he asked for more time to cross check figures.

Zomba Central Hospital Director Saulos Nyirenda said the facility was designed to have over 50 specialists but they have only 10.

Nyirenda said the high vacancy rate is exerting pressure on the available specialists.

“As a tertiary hospital, we are supposed to be a teaching hospital. Specialists provide support to other practitioners but looking at the challenges, it means such services are compromised,” Nyirenda said.

Health rights activist Maziko Matemba said government should take the challenge seriously, saying central hospitals were designed to provide specialist services which are not available in districts, communities and health centre facilities.

Matemba said as the Ministry of Health is formulating health related policies, the issue of specialists should be given utmost attention.

“Government spends a lot of money sending patients outside the country to access specialised treatment. This can only be reduced if we have trained our own specialists and deployed them in central hospitals and suppor them with proper and adequate equipment,” Matemba said.

Ministry of Health spokesperson Adrian Chikumbe said the ministry is aware of the challenge, saying government is working on training more specialists to fill up the gap.

He also admitted that the shortage is suffocating delivery of critical health services to the public.

“Give me time to check with other departments to find out how many specialists we are training but it is quite a number of them, in different disciplines,” Chikumbe said.

According to a 2018 paper by Winston Masanjala titled Tackling Malawi’s medical brain drain, as of 2004, Malawi had 1.1 doctors and 25.5 nurses for every 100,000 people — so the entire country had only about 250 doctors.

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