Survival and retention strategies for Malawian health professionals

Thumbnail Image
Journal Title
Journal ISSN
Volume Title
University of malawi
This paper was produced under the theme of work on Human Resources for Health in the Regional Network for Equity in Health in east and southern Africa (EQUINET) in co-operation with Health Systems Trust South Africa. Malawi, like many southern African countries, is facing a critical human resources for health (HRH) crisis, preventing it from delivering acceptable quality health care services to its population. The reasons underlying the shortage of health professionals are multiple and include limited output from training institutions, high attrition rates resulting from migration and disease, and increased workloads because of HIV and AIDS. Despite the increasing levels of migration of health professionals from Malawi which have caught international attention, many continue to serve their country. The challenges encountered by these health workers (which may eventually become push factors), and the coping or survival strategies that they utilise deserve attention if any meaningful solutions to retain health professionals in Malawi are to be developed. Health professionals employ a range of survival strategies including: • reliance on per diems/allowances from workshops and seminars • saving on stipends from long-term training programs • business activities • working in places where the cost of living is perceived to be lower • pilfering of drugs • dual practice (working in both private and public sector), • consultancy work • being paid for work not done at one institution while working for another employer. In order to retain health professionals in Malawi, we advocate for: • debt relief and advocacy toward the IMF and World Bank to end restrictions on hiring and increasing remuneration for health workers; • mandatory public sector employment after graduation from health training institutions; • strengthening of the health professionals’ association to enhance unionism and collective bargaining; and • provision of free anti-retrovirals (ARVs) to health professionals.