Malawi Health Sector Programme – Technical Assistance

When the Government of Malawi set out its health sector reform agenda, it prioritised improving national health services and systems. We provided expertise to enhance the implementation of its Health Sector Strategic Plan (2011–2016) through the Malawi Health Sector Programme – Technical Assistance (MHSP-TA).

We supported sustained change for more efficient, effective, equitable and accountable delivery of health services to improve the quality of life for the people of Malawi. We worked with the Ministry of Health, the Christian Health Association of Malawi and the National Local Government Finance Committee to improve the performance of health systems with a particular focus in three areas:

• Strengthening stewardship, coordination and action across the health sector, to improve the Ministry of Health’s governance and oversight of partnerships. We promoted the strategic allocation of financial resources, reducing duplication and ensuring that the considerable resources available to the health sector have a direct positive impact on improving health outcomes.
• Enhancing financial management and democratic accountability in the health sector, leading to greater confidence within government, civil society, the private sector and communities that government institutions have the ability to use public and donor funds efficiently, appropriately and effectively.
• Strengthening health service planning and monitoring, to improve district planning processes through better use of health data, especially gender-disaggregated data and better supervision of health service quality by district and zonal teams.

Project achievements

• Following the 2013 Malawi public finance corruption scandal (‘Cashgate’), our project undertook a review of district and facility use of health resources. This resulted in tightening of management procedures and greater scrutiny of resource use at national and district levels. This became one of the health sector’s six reform areas.
• Project efforts to improve Malawi’s health sector financial management contributed to the 2013/14 sector audit showing a marked improvement in performance at district level.
• We supported the Ministry of Health to revitalise its most senior governance committee, the Health Sector Working Group.
• We have supported eight of our focus districts to move from 0% reporting improved partner coordination in 2015 to 100% reporting improved partner coordination in 2016.
• We provided training on roles and responsibilities for the newly elected health and environment committees and the finance committees of the councils in eight out of the 15 MHSP-TA focus districts, enabling them to carry out their oversight role on behalf of their communities.
• We have supported the Christian Health Association of Malawi to overcome financial management challenges so that of their seven financial management indicators that scored ‘well below’ standard in June 2014, five were scored as ‘meeting standard’ and the other two ‘just below’ standard in September 2016.
• Local-level accountability is being strengthened through an assessment of the roles and functions of Health Centre Advisory Committees. This fed into the design of a pilot training and mentoring programme at sub-district level, to strengthen health services accountability and community voice with a particular focus on oversight of drugs and medical supplies.