Health Policy

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Open Access
Clinical Management of HIV in Children and Adults
(Malawi Government, 2019-01-01) Malawi Government: Ministry of Health
This addendum includes detailed policy updates for the 2018 Clinical Management of HIV in Children and Adults guidelines. The updates apply from April 2019 until publication of the next guideline edition which is scheduled for late 2020. This addendum does not fully replace the 4th edition of Clinical Management of HIV in Children and Adults guidelines for Malawi of 2018, but it should be used side-by-side with the 2018 guidelines. Updated content is shown using the same section numbering as in the main guideline document and this replaces the respective section. Oral Pre-Exposure Prophylaxis for HIV (PrEP) has been included as it relates to the prescription and monitoring of ARVs in Malawi. However, a detailed PrEP implementation guideline will be published as a separate document.
Open Access
Draft National Environmental Health Policy
(Malawi Government, 2010-05-01) Malawi Government: Ministry of Health
The Malawi Government is concerned about the high disease burden the country is experiencing. Most of these diseases are attributable to avoidable environmental risk factors. Malaria accounts for about 48% of all causes of morbidity followed by Acute Respiratory Infections (ARI) and diarrheal diseases at 17% and 8.7% respectively (HMIS08). The Ministry of Health has set out most of these as priority diseases in the Essential Health Care Package. The challenge therefore is how to reduce the disease burden through environmental health interventions. Environmental health encompasses the assessment and control of all physical, chemical and biological factors that can potentially affect the health of individuals. It is targeted towards preventing diseases and creating a health supportive environment. The Malawi Government adopted a National Environmental Health policy in 2011 in order to provide guidance on implementation of environmental health interventions. The policy ought to achieve the following: To increase the coverage of environmental health interventions in Malawi. To increase public awareness of environmental health issues in Malawi. To improve coordination and collaboration between various stakeholders in the implementation of environmental health interventions. The policy has been developed in line with international declarations which Malawi is a signatory and these are: Libreville Declaration on Health and Environment, held in Libreville in 2008, Ethekwini Declaration on Hygiene and Sanitation, 2008, Africa Health Strategy (of the African Union), 2007-2015, UN Millennium Declaration and subsequent Millennium Development Goals, 2000, Rio Declaration on Environment and Development, 1992 and the Alma-Ata Declaration on Primary Health Care, 1972. Environmental health activities are being implemented in the country by different partners. The activities have been implemented without proper guidance and direction. This even affected monitoring of the services since there was no standard for implementation of the activities. The policy has set out the core functions of environmental health which should guide every institution: Governmental or Non governmental that is implementing such services at all levels. It is my sincere hope that all stakeholders in the country will use this policy in order to contribute to the reduction of disease burden thereby improving MDGs 4, 6 and 7 and also the poverty levels and economic development in the country.
Open Access
Guide for developing national patient safety policy and strategic plan
(World health organisation, 2014-12-01) World health organisation, world health organisation
Patient safety practices result in measurable fiscal impact, save lives and decrease morbidity. So, why isn’t everyone insisting on such interventions everywhere? The answer is not simple. Patient safety concepts are not clear to those making decisions, research has not been done in many resource-poor settings to confirm data collected elsewhere, and many authorities still have the misconception that introducing patient safety practices is a luxury. Patient safety improvement requires a system change at all levels. Such a change needs a strong national policy accompanied with a strategic implementation plan to ensure the policy’s consistency and sustainability. As a basis for enforcing effective safety practices, a clear policy that serves as a reference and standard by which to judge the practices is critical. A national patient safety policy is essential but it must reflect the context and needs of the individual country. To avoid reinventing the wheel, patient safety policy must reference internationally approved and tested guidelines and policy recommendations. Policy-makers require an accessible resource for the task of developing the national patient safety policy and patient safety strategic plan in order that they are comprehensive as well as precise and yet uncomplicated and flexible. Such a resource ideally will be used both during the initial policy and strategic plan development and for their subsequent revision. This document outlines a four-step approach for developing a patient safety policy and a strategic plan:  situation analysis  national patient safety policy development  national patient safety strategic plan development  monitoring and evaluation of the implementation of the patient safety policy This document is intended for guiding the selection of patient safety policy points to ensure that the national policy is comprehensive and adequately detailed. Additionally, it can be used to define the key elements of the national patient safety strategic plan. It also lists indicators that can be adapted for monitoring and evaluation of the policy and strategy’s effectiveness at the point of care. Hospital situation analysis tools that may be useful in the assessment and monitoring of patient safety are included. It is anticipated that the systematic approach to patient safety as presented in this document will raise the profile of patient safety in the countries in the African Region and facilitate integration of patient safety priorities into national health delivery systems.
Open Access
Health promotion policy
(Government of Malawi, 2013-06-01) Republic of Malawi, Ministry of Health
Since the 1960’s the Ministry of Health has demonstrated its commitment to health education and health promotion in all aspects of public health in Malawi. An initial step in demonstrating its commitment was the establishment of the Health Education Section in 1969. At that time health education needs were few and less complex, hence the focus was on preventive health. For the past four decades, health education and promotion products and services have been an essential component of the Ministry’s strategies for addressing health issues Malawi, through the Ministry of Health, has over the years been responsive to the various UN Conventions and agreements aimed at promoting health. The 1978 Alma Ata convention on Primary Health Care (PHC) is one of the global strategies which the MOH fully supported by strengthening the Health Education Section (HES). The challenges of emerging communicable and non-communicable diseases have over the past two decades set dynamic changes in the health education needs, not only for Malawi but globally. These changes have led to a move towards prioritising health promotion. Furthermore, the current Health Sector Strategic Plan (HSSP) has recognized health promotion as an important component in the delivery of the Essential Health Package (EHP). The need for a Health Promotion (HP) policy is therefore timely to ensure a coherent approach that takes into account both intra-sector and inter-sector collaboration and coordination to address the determinants of health. At this juncture it has become necessary to put in place a national policy for HP to guide strategy formulation, programming and implementation by partners in health and all other relevant sectors. In addition the policy will clarify mandates of national and district level health promotion within the decentralised government setting. It is envisaged that existence of the HP policy will add value to the efforts of all stakeholders in delivering health promotion services in the country. I wish to urge all stakeholders to join the efforts in operationalizing the National Health Promotion Policy. The Government shall at all cost provide a supportive and enabling environment to ensure that all Malawians increase control over the determinants of health and thereby improve their health.
Open Access
Health sector strategic plan II 2017-2022
(Government of Malawi, 2017-01-01) Malawi Government: Ministry of Health
The Government of Malawi is committed to ensuring that people in Malawi attain the highest possible level of health and quality of life. This will be achieved by addressing social risk factors and ensuring universal coverage of basic health care, which is the constitutional obligation of Government. Health is also an important area for investment by development partners, private institutions and other organisations due to its catalytic effect to the economic sector. HSSP II development started at an opportune time when the Millennium Development Goals (MDGs) had just ended and the Sustainable Development Goals were launched. The HSSP II, therefore, incorporates the SDG agenda and builds on the attainment of MDGs 4 and 6, reducing child mortality and combating HIV and AIDS, Malaria and other diseases respectively; reduction in maternal mortality; and high coverage of certain key interventions such as skilled attendance at birth and immunisation. The HSSP II has used latest evidence and methods to revise the Essential Health Package that is more realistic than its predecessor packages and helps the public health sector to achieve higher total population health, increase financial risk protection and client satisfaction with health care. It is well known that health care provision in Malawi is highly dependent on external financing. The HSSP II has, therefore, focussed on strengthening governance of the health sector in order to improve efficiency and get the maximum out of existing resources i.e. human, financial and material. The HSSP II has also put to the fore exploration of domestic financing mechanisms, although it is still envisaged that development aid to the health sector will be critical to sustain the gains made. We, therefore, look forward to continued support from our development partners. As a strategic document that we have jointly formulated, it is my sincere hope that it will henceforth become the single most important point of reference for design of service delivery programmes, addressing social determinants, resource mobilization and health financing, as it embodies our dream for a better health care delivery system for all the people of Malawi.
Open Access
Health Sector Strategic Plan II Policy
(Malawi Government, 2017-07-01) Malawi Government: Ministry of Health
The Government of Malawi is committed to ensuring that people in Malawi attain the highest possible level of health and quality of life. This will be achieved by addressing social risk factors and ensuring universal coverage of basic health care, which is the constitutional obligation of Government. Health is also an important area for investment by development partners, private institutions and other organisations due to its catalytic effect to the economic sector HSSP II development started at an opportune time when the Millennium Development Goals (MDGs) had just ended and the Sustainable Development Goals were launched. The HSSP II, therefore, incorporates the SDG agenda and builds on the attainment of MDGs 4 and 6, reducing child mortality and combating HIV and AIDS, Malaria and other diseases respectively; reduction in maternal mortality; and high coverage of certain key interventions such as skilled attendance at birth and immunisation. The HSSP II has used latest evidence and methods to revise the Essential Health Package that is more realistic than its predecessor packages and helps the public health sector to achieve higher total population health, increase financial risk protection and client satisfaction with health care. It is well known that health care provision in Malawi is highly dependent on external financing. The HSSP II has, therefore, focussed on strengthening governance of the health sector in order to improve efficiency and get the maximum out of existing resources i.e. human, financial and material. The HSSP II has also put to the fore exploration of domestic financing mechanisms, although it is still envisaged that development aid to the health sector will be critical to sustain the gains made. We, therefore, look forward to continued support from our development partners. As a strategic document that we have jointly formulated, it is my sincere hope that it will henceforth become the single most important point of reference for design of service delivery programmes, addressing social determinants, resource mobilization and health financing, as it embodies our dream for a better health care delivery system for all the people of Malawi.
Open Access
Health Sector Strategic Plan III 2023-2030
(Malawi Government. Ministry of Health, 2022-01-01) Malawi Government. Ministry of Health
The Health Sector Strategic Plan III (HSSP III) outlines the objectives, strategies and activities needed to build upon progress during implementation of the Health Sector Strategic Plan II (HSSP II) and accelerate Malawi’s progress in achieving Malawi’s Universal Health Coverage (UHC) targets by 2030. The HSSP III is motivated by Malawi 2063’s vision of self-reliance and outlines how the health sector will contribute to the human capital development and mindset-change pillars of the vision. In the spirit of inclusivity, the HSSP III development process was extensively consultative and participatory, ensuring that the prioritization of resources and outcomes in the plan reflect a shared vision. Notwithstanding a very challenging environment characterized by up to four waves of the COVID-19 pandemic, the health sector registered notable progress across impact level performance measures. For example, maternal mortality ratio was at 349 deaths per 100,000 live births in 2019 against the HSSP II target of 350 deaths per 100,000 live births; under-5 mortality rate was 39 per 1,000 live births in 2020 against the HSSP II target of 48 deaths per 1,000 live births; infant mortality rate was 29 per 1,000 live births in 2020 against the HSSP II target of 34 deaths per 1,000 live births; and the neonatal mortality rate was 19 per 1,000 live births in 2020 against the HSSP II target of 22 deaths per 1,000 live births. In addition, the HSSP II HIV incidence target of 2 cases per 1,000 adult population aged 15-49 years was surpassed and was at 1.21 in 2020. Despite such progress, however, significant gaps in population health, service delivery and health systems building blocks remain, and require addressing in order to meet UHC goals by 2030. The goal of the HSSP III, therefore, is to move towards UHC by improving health status, financial risk protection and client satisfaction. It is recognized, however, that resources for health care delivery are inadequate. The HSSP III has therefore defined a Health Benefits Package (HBP) previously referred to as Essential Health Package (EHP) in previous HSSPs to maximize population health given the limited available resources. The HSSP III has the following objectives across nine priority areas: 1. Service Delivery: Increase equitable access to and improve quality of health care services. 2. Socio-Economic Determinants: To improve overall health, environmental health and prevent disease through addressing social determinants of health and burden of disease. 3. Infrastructure & Medical Equipment: To improve the availability, accessibility and quality of health infrastructure and medical equipment at all levels of health care. 4. Human Resources: Improve the availability of competent and motivated human resources for health (HRH) for quality health service delivery that is effective, efficient, and equitable. 5. Medical Products and Technology: To improve the availability, quality, and rational utilization of medicines and related medical supplies, balancing among the 3 P’s: patients, products, and personnel. 6. Digital Health: To develop a sustainable and harmonized country led digital health system that covers all areas of service provision and enables efficient delivery of health services at all levels of the health system. 7. Research: To promote and coordinate a health research agenda in order to generate high quality evidence required to inform the development of health and health care delivery. 8. Leadership and Governance: To enhance effectiveness of leadership and governance at all levels of the health sector. 9. Health Financing: To set a well-governed health financing architecture that is able to mobilize adequate resources, distribute the resources in an efficient and equitable way, and strategically purchase services based on a well-defined benefit package in pursuit of UHC goals. Eleven reforms that are deemed game-changing, have been identified, informed by high quality evidence as well as extensive consultations. These are: in Service Delivery - transitioning from vertical programming to integrated platforms of care for service delivery; in Health Workforce – 1) implementation of a performance management system, 2) development of a harmonized in-service training system for human resources for health linked to continuous professional development, and 3) evidence-based matching of health workforce supply and demand; in Infrastructure and Medical Equipment – 1) upgrading of urban health centres to community hospitals to improve city primary and secondary care, and 2) equipment inventory management to achieve procurement and utilization efficiency; in Supply Chain - effective management and coordination across parallel supply chains while working towards greater systems integration through CMST by 2030; in Digital Health - scaling up of digital health systems; in governance – 1) implementation of a “One Plan, One Budget, One M&E” system, and 2) increase provider autonomy; and in Health Financing - strategic purchasing in health financing. The total cost of implementing the intervention matrix for all the eight years is estimated at US$31.2 billion (MWK 32 trillion) representing the full resource need before the prioritization. For the 2023/24 FY, although the need was $4 billion, it was estimated from resource mapping round seven that only approximately $690 million ($537.1 million fungible funding and $153 million non-fungible Government and donor funding) would be available in total. Therefore, the 2023/24 needs were prioritised down for to fit within the $537.1 million envelope estimated. Assuming conservatively that this level of funding persists, the HSSP III will realistically be implemented at $4.7 billion, with an acceptable margin of error, over the eight years. The implementation of the HSSP III will be based on an HSSP III operational plan that will draw from the HSSP III intervention matrix. The Health Sector Working Group (HSWG) will steer the “One Plan, One Budget, One Report” process. The district stakeholder forum will provide overall multi-sectoral and partner coordination at the district level. The Secretary for Health will oversee overall coordination of the sector, while designated directors at the national level will provide overall leadership of their respective thematic areas. The Director of Health and Social Services at the District Council shall provide overall technical coordination in line with Council governance arrangements. Government, Donors and Implementing partners will be guided by MOUs and a Code of Conduct. In order to effectively monitor the HSSP III, 1) the health information system will be decentralized to each decision-making entity at each level of the health system; 2) all partners in the health sector will align and harmonize their data systems to facilitate timely transmission of information to decision makers at all levels of the health system; 3) streamlined and interoperable digital health systems will be imperative; 4) All efforts shall be made toward digitalizing service delivery at the point of care and data shall be collected and extracted from these systems to support service delivery and timely and accurate reporting. HSSP III will be a living document and, in that spirit, MOH plans to publish digital versions of future editions of HSSP III on MOH website to ensure that latest evidence is translated into strategic priorities.
Open Access
Human Resource Development Policy for the Public Health Sector
(Malawi Government, 2010-01-01) Malawi Government: Ministry of Health
The Human Resource Development Policy is aimed at putting in place systems to ensure that training is well organised, transparent, fair and cost effective. The policy will serve as a planning reference and management tool for all investments in training and staff development. The development of the HRD policy is therefore a clear testimony of the Ministry’s commitment to training and staff development. The Ministry will create a conducive environment that will provide an opportunity to all health workers to continuously learn so as to equip them with the requisite skills to effective implement the Essential Health Package. The policy will also be used as a lens of continuous learning and an integral part of change in the Ministry particularly now when the Ministry is going through a number of reforms under the Sector Wide Approach. It is expected that the implementation of this policy will promote a culture of continuous learning and development. At the same time, building a professionally competent workforce in the public health sector in Malawi. The end result is a health sector that is continuously supplied with the appropriate skills mix and capacity to develop, support and implements targeted service delivery interventions at every level of the health care system. My Ministry therefore considers the development of this policy as big milestone and a catalyst for effective implementation of the Essential Health Package in the context of the Malawi Growth and Development Strategy.
Open Access
Human Resource for Health Strategic Plan
(Malawi Government, 2012-01-01) Malawi Government: Ministry of Health
The public health sector has an obligation to contribute to the overall developmental goal of the Malawi Growth and Development Strategy and, from an international perspective, the Millennium Development Goals (MGDs). The attainment of both of these development agendas is dependent on the health status and productivity of the people of Malawi. This is in line with what US Secretary of State said recently Oslo Conference on “Charting a New Path in Global Health” that the stability of any nation is tied up to the well-being of its people. It is pleasing to note that as a country, Malawi continues to register positive strides in a number of health indicators since the inception of the 6-Year Program of Work (2004-2010) through the Sector Wide Approach. However, some of our vital indicators like the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are unacceptably high and must be tackled aggressively if we are to sustain the nation’s stability. This will entail continued enhancement of the quality and access to health services for all segments of the population. The Ministry also recognizes that utilization of health services is critically dependent on what services are provided at each delivery point and the number and skills mix of human resources health that is available. Like the first strategic plan, the major focus of this plan is to increase the level of training outputs and also consolidate and sustain gains made from the implementation of a 6_year Emergency Human Resources Plan based on an equitable availability of competent and motivated health workforce that is effectively contributing to improvement of health services accessed by the people of Malawi. The Ministry Health recognizes that this is only possible under a framework of pursuing common vision and priorities for all partners in the health sector to pull together in planning, development, deployment and utilization of human resources for complementarity and synergy. Successful implementation of this HRH Strategy rests on true and honest partnerships, both within and outside the health sector including, but not limited to for- and not for-profit organizations, co-operating partners, etc. and that there is shared vision, mutual respect, transparency and recognition of contribution by all stakeholders. I call upon everybody from the government, co-operating partners down to the community to work together and amicably implement the plan. I am aware of the many challenges that be there during the implementation phase, but I am confident that with the concerted efforts and sustained commitment from government and all of us, the needs of the population and those of the service providers can be addressed.
Open Access
Human Resources for Health Country Profile Malawi
(Malawi Government, 2010-12-01) Malawi Government: Malawi Health Workforce Observatory
The Human Resource for Health (HRH) Malawi Country Profile is to serve as a tool for providing a comprehensive picture of the health workforce situation in Malawi. This has been achieved through the presentation of the current situation regarding health policies and management systems, the human resources management information system (HRMIS); and by providing the picture of previous and current stock of health workers in the country as a basis for baseline information on prevailing trends. The profile will therefore facilitate information sharing nationally and also for cross-country comparisons, especially in the Sub Saharan Africa, and contribute towards producing regional HRH country profiles. The task of updating the HRH Malawi Profile was basically a cross-sectional desk study that adopted descriptive and analytical methodologies where both qualitative and quantitative data and information were compiled from available reports, studies and statistics related to HRH from public and private health sector stakeholders. Personal consultations, telephone interviews and field visits were also conducted with identified representatives from different stakeholders to fill in the HRH information gaps. The establishment of a National HRH Observatory is currently strongly recommended to facilitate production, sharing and use of quantitative and qualitative information on HRH in order to support the development and implementation of the future HRH policies and plans. In future, one of the main activities of the National HRH Malawi Observatory will be to periodically update the HRH country profile. The current exercise of up-dating the HRH Malawi Country Profile is therefore a stop-gap measure in order to present a situational picture of the HRH in Malawi and facilitate a reasonable comparison of the HRH challenges and policy responses in Malawi with those of other countries in the region. Since Malawi is still in the process of developing and establishing the proposed National HRH Observatory, some of the data and information were not readily available to fill all HRH gaps. However, a few important consultations with experienced professionals well versed with HRH issues and the HMIS, from the Central Monitoring and Evaluation Division (CMED), were done to provide realistic estimates to fill such gaps. These estimations were validated either by important HRH peers in the HRTWG or from key personnel from the MoH and the health sector fraternity in the country.
Open Access
Infection Control and Waste Management Plan for Malawi Policy
(Malawi Government, 2016-03-14) Malawi Government: Ministry of Health
Malawi context and objectives of the Infection Control and Waste Management Plan Malawi, one of the sub-Saharan countries, continues to face high prevalence rates of preventable diseases such as HIV and TB1. While considerable success has been made in the health sector (Health Sector Annual Report, 2010; NSP, 2011-2016), there are imminent public health concerns such as emergence of Multi Drug Resistant TB (MDR-TB), Extremely Drug Resistant TB (XDR-TB), and TB/HIV co-infection rates. According to recent WHO reports2, Southern Africa has some of the highest TB/HIV co-infection rates in the world, ranging from 50% to 77% of the estimated burden. The mining sector is one of the sectors with potential risk factors such as: occupational and surrounding communities’ exposure to silica dust; confined, poorly ventilated working environment; cramped living quarters; and high HIV prevalence. On the other hand, potential risk factors for health-care centres or hospitals (including laboratories) include: occupational exposure to TB and HIV (ibid). Since the SADC declaration on Tuberculosis (TB) in the mining sector (2012), the Government of the Republic of Malawi has not moved significantly in its commitment to elimination of TB and improvement of environmental, health and safety practices and standards in the mining sector (National TB Programme, 2015, personal communication). It is against this background that the Government of Malawi, just like other SADC member states, has embarked on a Regional TB in Mining Project (five years project), which will involve three main components namely: 1) prevention, detection and treatment of TB; 2) disease surveillance; and 3) learning knowledge and innovation. The project further involves expansion and renovations of existing health facilities including laboratories. Due to the possible impacts (which include increased infection risks and waste management challenges) of project activities, an Infection Control and Waste Management Plan is deemed necessary. Thus, this Infection Control and Waste Management Plan (ICWMP) is prepared to facilitate implementation of appropriate infection control and waste management practices across the three relevant sectors of Health, Mining and Labour, (which include work practice and administrative measures, environmental/engineering control, and use of appropriate personal respiratory protection, and improved waste collection, storage, treatment and disposal practices) to avoid infection and environmental pollution. Specifically, the objectives of this ICWMP were to 1) develop Standard Operating Procedures and Waste Management Plans for laboratories based on a quick situation assessment and 2) review and update existing documentation on health-care waste management plans under bank funded health projects. Other objectives of the assignment were to undertake gap analysis of existing situation (environmental health control aspects) within the mines and medical waste management aspects within health facilities.
Open Access
Malaria Communication Strategy for Malawi Policy
(Malawi Government, 2009-11-01) Malawi Government: Ministry of Health
Malaria is a major public health problem in Malawi. It is the leading cause of morbidity and mortality in children under five years of age and pregnant women. It is the most common cause of outpatient visits, hospitalization and death. Malaria is also a developmental problem as it has a serious socioeconomic impact on families and the nation, through loss of work, school absenteeism and high levels of expenditures on treatment. The government of Malawi through the Ministry of Health and its partners are committed to controlling malaria in the country. As part of malaria control strategies, the Ministry has developed several guiding malaria documents one of which is the Malaria Communication Strategy for Malawi for 2009 to 2015. Using the strategy as a guide, behaviour change communication will lead to improved community uptake of malaria control interventions. The main malaria behaviours that need to be adopted and maintained by individuals, families and communities, include, among others, Malaria Case Management, Intermittent Preventive Treatment (IPT) of pregnant women with SP and malaria prevention with special emphasis on Insecticide Treated Nets/ Long Lasting Insecticide Treated Nets (ITNs / LLINs) and Indoor Residual Spraying (IRS). I am hopeful that concerted efforts to implement this malaria communication strategy with support of global, regional and national partners will enable Malawi to significantly reduce the health and socioeconomic burden of malaria.
Open Access
Malaria Policy
(Malawi Government, 2002-01-01) Malawi Government: Ministry of Health
Maiaria is the leading cause of morbidity and mortality, particularly in children under five years of age and pregnant women. It is the commonest cause of outpatient visits, hospitalisation and death. Malaria is also a development problem as it has a serious socio economic impact on families and the nation,, through loss of work, school absenteeism and high levels of expenditure on malaria treatment, especially by poor households, This policy marks an important milestone in malaria control and prevention in Malawi. Organised malaria control efforts started in 1984 with the establishment of the National Malaria Control Programme (NMCP) to spearhead the struggle against malaria as part of the response to the emergence of chloroquine-resistant Plasmodium falciparum. The NMCP led a systematic study of the efficacy of chloroquine and other antimalarial drugs. This resulted in the development of editions of guidelines for the management of malaria in ; vS5, 1936, 1994 and 1997. In the absence of a policy to guide activities, efforts and resources by the Ministry of Health and Population (MOHP) and partners nationwide, malaria control and prevention strategies and activities have been uncoordinated and incomplete. The launching of the Roll Back Malaria (RBM) movement through the Abuja Declaration, which was signed bv Alncan Heads of State and Government ;n April 2000, gave malaria a high profile globally, regionally and nationally. To achieve the Abuj a targets, RBM calls for concerted efforts through the development of partnerships. The expected increased number of stake holders in malaria makes a policy essential. The policy covers the main areas of malaria control and prevention, namely effective case management, especially in children under five years of age, use of insecticide-treated nets and other vector control measures as well as operational research and information, educa tion and communication. The policy also addresses crosscutting issues such as manage ment, financing and human resources; without improvement in these areas, enhanced nitiana control and prevention efforts will not succeed. The fourth National Health Plan emphasises the need to improve the health status of all people in Malawi by "strengthening coordination and collaboration between all health partners in supporting the district health care delivery structure as the main health care delivery system". The policy has been developed within the context of essential health care peekage and sector-wide approaches.
Open Access
Malaria Strategic Plan
(Malawi Government, 2005-01-01) Malawi Government: Ministry of Health
Malaria is a major public health problem in Malawi. It is the leading cause of morbidity and mortality in children under five years of age and pregnant women. It is the most common cause of outpatient visits, hospitalization and death. Malaria is also a development problem as it has a serious socio-economic impact on families and the nation, through loss of work, school absenteeism and high levels of expenditure on treatment. The government of Malawi through the Ministry of Health and its partners are committed to controlling malaria in the country. As part of the malaria control strategies, the Ministry has developed several guiding malaria documents one of which is the National Malaria Strategic Plan for 2005 to 2010. Using the Strategic Plan as a guide, Annual Action Plans will be developed every year. While the purpose of the Malaria Strategic Plan for 2001 to 2005 encompassed renewed efforts to reduce malaria morbidity and mortality in the context of multi-sectoral implementation of malaria control activities, the Malaria Strategic plan for 2005 to 2010 will focus on “scaling up” of malaria control activities in the context of the Essential Healthcare Package (EHP) and sector-wide approaches. The main strategic areas that have been identified for the scale-up of malaria control activities, include, among others, Malaria Case Management, Intermittent Preventive Treatment (IPT) of pregnant women with SP and malaria prevention with special emphasis on the use of Insecticide Treated Mosquito Nets (ITNs). I am hopeful that concerted efforts to implement this Malaria Strategic Plan with the support of global, regional and national partners will enable Malawi to significantly reduce the health and socioeconomic burden of malaria.
Open Access
Malaria Strategic Plan towards Universal Access Policy
(Malawi Government, 2011-01-01) Malawi Government: Ministry of Health
The Ministry of Health (MoH) is pleased to present the new Malaria Strategic Plan for 2011-2015. Malaria continues to be the number one cause of morbidity and mortality in our country, with an estimated six million cases each year representing about 40% of the burden of illness in our health facilities. It is not selective, and all of us are at risk. However, malaria is a disease that can be prevented and treated effectively. This new Strategic Plan covering the next five years will provide the leadership and evidence-based direction needed to move confidently toward elimination of malaria as a public health threat in Malawi. The primary goal of this new plan will be the achievement of Universal Coverage in the prevention and treatment of malaria, reducing by half the 2010 levels of malaria morbidity and mortality in Malawi by the year 2015. This means every citizen of Malawi will be reached with all malaria interventions including care and effective cure. Over the period of the previous Malaria Strategic Plan (MSP) 2005-2010, the National Malaria Control Programme (NMCP) and its partners achieved significant improvements in addressing this dread disease, which has challenged not only the lives of our citizens but also the economic development of Malawi as a nation. As just one example, in the last two years, the government and its partners distributed 3.7 million long lasting insecticide treated nets (LLINs) for prevention. And in the next five years ahead, we will distribute millions more of these bed nets with the goal of having one net for every two people, in line with international best practices. In addition we will introduce the nationwide use of Rapid Diagnostic Tests so that every suspected case of malaria will be properly and promptly diagnosed and treated. In addition, malaria program management, drug procurement, distribution, monitoring and evaluation, and service delivery will be strengthened so that all malaria interventions will be provided in an integrated manner at all levels of the delivery system, including in communities and homes. We have a particular problem with malaria in Malawi, which is our belief about the nature of this disease. We are very worried about a death from AIDS or TB, but when it comes to malaria, we have become too accepting of its presence in our lives. Our perception of this disease must change to the point that everyone understands that malaria is not inevitable: it can be prevented and controlled if we all know how and when to take action. Accordingly, we will deliver widespread behavior change messages and education campaigns to empower communities to take charge of their own health by increasing use of Insecticide Treated Mosquito Nets (ITNs), speeding up the seeking of treatment at a facility for malarial symptoms, and encouraging a health-supportive and timely response to malaria at the community and household level. We have been paying a heavy price for malaria in illness, death, malnutrition, and losses of economic and social well-being. I therefore challenge all Malawians - parents, children, leaders, civil servants, health workers, all - to learn about this disease and take up the fight to prevent it and treat it when it occurs. We can defeat this disease only when we all play our parts.
Open Access
Malawi Health Sector Strategic Plan
(Ministry of Health, 2011-01-01) Malawi Government: Ministry of Health
It is the desire of the Government of Malawi to have the highest possible level of health and quality of life for its citizens. Improving the health of the nation through the combined efforts of individuals, communities, organizations, our co-operating partners and the Government is therefore one of the key priorities. The formulation and launch of the national Health Sector Strategic Plan (2011-2016) build on the sustained gains made under the Program of Work (2004-2010). Considerable improvements in the delivery of an Essential Health Package (EHP) have been registered in reducing infant and child mortality rates, pneumonia case fatality and maternal mortality, and in maintaining high immunization coverage, among other areas. Unlike the Program of Work, this Plan has taken further measures to address the burden of disease by delivering an expanded EHP through public health interventions including but not limited to health promotion, disease prevention and increasing community participation. The Plan provides the framework that will guide the efforts of the Ministry of Health and all stakeholders over the next 5 years in contributing to the attainment of the Malawi Growth and Development Strategy (MGDS-II) and the Millennium Development Goals (MDGs). In cognizance of this, therefore, the emphasis will be on increasing coverage of high quality EHP services; strengthening performance of the health system to support delivery of EHP services; reducing risk factors to health and improving equity and efficiency in the delivery of free, quality EHP services in Malawi, thereby contributing to poverty reduction and the socio economic development of the nation. The successful implementation of this plan will depend on the continued dedication of staff in the Ministry of Health and those of its partner organizations. We welcome the support of our co-operating partners, we gratefully acknowledge their contribution towards the development of the HSSP and look forward to their continued support in its implementation. As a policy document that we have jointly formulated, it is my sincere hope that it will henceforth become the single most important point of reference for design of service delivery programmes, resource mobilization and health financing framework, as it embodies our dream for a better health care delivery system for all the people of Malawi.
Open Access
Malawi Malaria Communication Strategy
(Malawi Government, 2015-01-01) Malawi Government: Ministry of Health
Malaria remains a leading cause of morbidity and mortality in Malawi majorly affecting children below five years of age and pregnant women. While this remains the case, the Government of Malawi is scaling up interventions aimed at controlling this situation through increasing access to malaria control intervention that include: the distribution of Long Lasting Insecticide treated Nets (LLINs), scaling up indoor residual house spraying (IRS) in selected districts, promoting the prevention of malaria during pregnancy through Intermittent Presumptive Treatment of malaria in pregnancy (IPTp) and increasing access to prompt diagnosis and effective malaria treatment at facility level. Recent studies have gathered evidence that despite the provision of these services, utilization of the same has not been optimum hence malaria continues to remain a problem in the country. It is in recognition of this that the Malawi’s Ministry of Health through the National Malaria Control Program has continued to invest in public information and education through the development of the Malaria Communication Strategy. The first generation of the communication strategy ended in 2014 giving rise to the review and re-writing of this second generation of the communication strategy for the period 2015 – 2020. The communication strategy is a guiding document for all partners to implement a unified and cohesive communication plan and allow for complementing programs among partners. The main focus of the strategy is to create social and behaviour change by examining barriers as to why individuals and communities are not adopting actions and behaviour that contribute to the prevention and treatment of malaria. Through this approach, we are able to devise innovative communication approaches to tackle the barriers. I am honoured that the Ministry of Health through the National Malaria Control Program recognized the need for consistency and coordination among partners implementing malaria behaviour change communication programs and involved them in the process of review and re-writing of this communication strategy. It is my belief that the strategy will play a critical role in increasing knowledge, attitude and practices towards malaria prevention and treatment and supporting our vision where “All people in Malawi are free from the burden of malaria”.
Open Access
Malawi National Health Information System Policy
(Malawi Government, 2015-09) Malawi Government: Ministry of Health
A culture of evidence-based management decisions would help us achieve highest level of efficiency in the provision of basic essential health care to all Malawians. To establish such a culture the health sector needs a robust Health Information System that provides reliable information as solid evidence for making rational decisions. The transition from Millennium Development Goals to the post-2015 Sustainable Development Goals within the context of Universal Health Coverage have emphasis on measurement and accountability which can only be achieved through a vibrant National Health Information System aligned to the Five-Point Call to Action in Measurement and Accountability for Results in Health endorsed at the Washington Summit of June 2015. However, our existing Health Information Systems are unnecessarily fragmented and are not capable of generating quality information at the time they are needed. Efforts have been underway, in collaboration with our partners, for harmonizing and synthesizing various data-management systems in the entire health sector. Despite those concerted efforts of key stakeholders, we continue to face challenges in the areas of data collection, data analysis, information dissemination, and information use. The problems with regard to data accuracy, timelines of reporting, analysis, and completeness continue to exist. The MOH and its partners have realized that our existing policies related to the management of health information systems are inadequate to address these issues and problems. As a way forward, the existing policies have been revised into a complete new policy that will guide the implementation of Health information systems in the country.
Open Access
Malawi National Cancer Control Strategic Plan 2019-2029
(Government Printing Press, 2019-01-01) Malawi Government
In Malawi cancer is of growing concern, causing significant morbidity and mortality due to lack of comprehensive cancer prevention, early detection, treatment and palliative care services. The IARC GLOBOCAN estimates for Malawi indicate total annual new cancer cases at 15,349, with 5966 cases among men and 9383 in women around 2012. Among women, the major cancers were; uterine, cervix (n=3684), Kaposi’s sarcoma (KS, n=997), esophagus (n=895), breast (n=762); among men, the major ones were KS (n=1810), esophagus (n=1094), non-Hodgkin lymphoma (n=695), prostate (n=349) and urinary bladder (n=309). Malawi has the highest age standardized incidence rate (75.9/100,000 women) of cervical cancer in the world, with the risk of one out of 14 Malawian women developing cervical cancer in her life time. The projected cancer burden might be underestimated due to inadequate cancer diagnostic services and underreporting of clinically diagnosed cases given that only 18% of all reported cancers had pathological confirmation. This national cancer control strategy will serve as the policy document for planning and implementing cancer prevention, early detection, treatment, follow-up and palliative care interventions at different levels of governance and for the efficient monitoring and evaluation of the cancer interventions. It outlines a multi-sectoral partnership to address key issues related to specific major cancer types, taking into consideration the disease burden, risk factor prevalence, available resources and a variety of stake holders. This Strategy aligns itself to the efforts of non communicable disease (NCDs), Clinical Directorate and National Health Sector Strategic Plans (HSSPⅡ) (2017-22) and other policy documents. The strategy aims to achieve a state of health for all the people of Malawi with low burden of cancer that would enable them to lead high quality and highly productive lives, boosting national development. It will provide strategic direction in implementing a coordinated and responsive cancer control framework leading to a reduction in incidence, morbidity and mortality and improved quality of life through effective partnerships and collaborations for prevention, diagnostics, treatment, palliation and financing of cancer control activities to improve the wellbeing of Malawians. To achieve the above objectives, planned interventions and monitoring and evaluation are organized into six thematic areas: 1) prevention; 2) screening and early diagnosis; 3) treatment and follow-up care; 4) palliative care and survivorship; 5) governance and financing; 6) cancer control research, monitoring and evaluation. The planned prevention strategies include; avoiding cancer causing chronic infections, tobacco use, reduce alcohol consumption, maintaining a healthy body weight, regular physical activity and consuming healthy diets. Primary interventions encompass those which reduce exposure to potential risk factors associated with cancers as well as immunization against infectious agents commonly associated with cancers such as human papillomaviruses (HPV) and Hepatitis-B viruses. Integrating the various forms of interventions into other programs will likely give optimal public health benefits, with minimal costs and long-term cancer control benefits. Some areas of possible integration include sexual and reproductive health initiatives, human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) control programs, national immunization programs to improve uptake of HPV and Hepatitis B vaccinations, occupational and environmental health initiatives and other lifestyle modification programs targeting the general public. A multi-sectoral approach is critical in the context of tobacco control, since Malawi has some key challenges as tobacco farming and exports are major contributor to Malawi’s economy and the country has not yet ratified WHO Framework Convention on Tobacco Control. Recently, Malawi has completed HPV vaccination of around 23,000 girls aged 9-13-year-old girls with high coverage and is planning a national scale up is underway. A national HIV prevention strategy for the period 2015-2020 is currently being implemented to achieve the UNAIDS 90-90-90 targets by 2020, which will have important implications for the prevention of Kaposi’s Sarcoma. Cancer detection at its early stages enables treatment that is generally more effective, less complex and more affordable, resulting in long-term survival and high cure rates with good quality of life. Early detection involves two major approaches, namely screening involving detection of preclinical disease in asymptomatic people and early diagnosis involving early detection in symptomatic patients. These two are fundamentally different in resource and infrastructure requirements, impact and costs, but require prompt linkage to treatment and follow-up care without delay. In response to the high incidence and mortality from cervical cancer, Ministry of Health and Population (MOHP), is implementing nationwide visual inspection screening with acetic acid (VIA) for cervical neoplasia as part of the Cervical Cancer Control Program (CECAP) in collaboration with its stakeholders. Efforts are taken to expand and improve the coverage of VIA screening and treatment of screen positive women. With a judicious combination of HPV vaccination and screening, Malawi can anticipate dramatic future reductions of cervical cancer. Infrastructure and trained human resources for major cancer treatment modalities such as surgery, radiotherapy, chemotherapy and hormone therapy are grossly inadequate or lacking in Malawi with consequent poor survival outcomes. Type of cancer, stage at diagnosis and quality of treatment and follow-up care are important determinants of treatment outcomes. Efforts will be taken to improve availability and access to cancer early diagnosis and treatment and it is anticipated that most cancer patients will get optimal, resource appropriate Treatment and care in due course. Cancer treatment in Malawi is anticipated to take new dimension with the development of the National Cancer Treatment Center (NCTC) in Lilongwe which is due to open in 2020. The operationalization of the cancer centre will be the single most important initiative in the national cancer control program of Malawi given the fact that cancer treatment is currently highly fragmented and provided in overextended hospitals with limited infrastructure, consumable supply chain problems and limited skilled and experienced human resources. The cancer center is planned within the campus of Kamuzu Central Hospital (KCH), as a matrix type of cancer centre with its own cancer surgery, radiotherapy, chemotherapy, hormone therapy, palliative care, medical records and hospital cancer registry services and sharing pathology and other allied diagnostic and super-specialty treatment services with KCH. Cancer services are provided with highest quality of care in cancer centres that are autonomous, without administrative and beaurocratic entanglements and hitches. It is important that the proposed National Cancer Treatment Center should be an autonomous body with its own governing and scientific councils for is efficient functioning. Government of Malawi recognizes the importance of palliative care to improve the quality of life and symptom burden for all patients and families affected by life threatening illnesses including cancer. In October 2014, MOHP, Government of Malawi formulated a national palliative care policy to take forward the national agenda for the health sector. The National Cancer Control Strategy will heavily rely on the implementation of the national palliative care policy including appropriate access to immediate release morphine for the treatment of severe cancer related pain to achieve tangible progress in extending high quality appropriately staffed palliative care services across Malawi. The national cancer control strategy and its monitoring and evaluation shall be implemented in a program mode under the supervision of a national cancer control coordinator supported and advised by the cancer control advisory committee. Monitoring and evaluation forms an essential component of the cancer strategy and will seek to link and benefit from existing systems such as population based cancer registration, hospital registries, medical records departments, cross sectional surveys, follow-up studies and case series. The inputs of interventions and the evaluation of outcomes will be monitored and evaluated using short-term (1-2 years), medium term (3-5 years) and long term (5-10) time lines. The National Cancer Control Strategy will risk remaining a paper tiger unless it is linked with planned budget outlays and budget lines to support its implementation and evaluation.
Open Access
The Malawi National eHealth Strategy
(Malawi Government, 2014-04-01) Malawi Government: Ministry of Health
In order to strengthen the implementation of Health Management Information Systems (HMIS), the Ministry of Health completed the development of the Health Information Systems (HIS) Strategy in 2013. The aim of the strategy was to address HMIS weakness in support of the Health Sector Strategic Plan (HSSP). Recognizing that addressing these weaknesses in the information age required a comprehensive computerization process, the HIS strategy recommended, as one of its strategies, to have an eHealth Strategy developed. This eHealth Strategy is therefore a fulfillment of the HIS Strategy action item. The eHealth Strategy aims at building the foundations for ICT infrastructure, implementation of ehealth solutions, facilitating adoption of new ehealth solutions and enhancing governance in the implementation of this strategy. The strategy identifies national ehealth information standards, computing infrastructure, national connectivity services, identification and authentication, reliable power supply and information protection as foundations for ICT infrastructure. The ehealth solutions, which represent the tangible means to interact with the health system electronically, include national priority ehealth solutions, telehealthcare, individual electronic health records and continuous professional development using e-learning. The MoH is thankful to the team that developed the strategy. The team comprised representatives from Ministry of Health, I-TECH Malawi, Baobab Health Trust, Luke International Norway, the CDC and the eGovernment department. Special thanks to WHO which substantially financed the strategy development process, the CDC and I-TECH Malawi also for their financial support.