Malawi Economic Justice Network (Mejn) has said the country’s budgetary allocations for health services fall short of the recommended targets set by global organisations such as the World Health Organisation (WHO).
In a report on the implications of the 2012/13 National Budget on delivery of social services, presented to the Budget and Finance Committee of Parliament on February 21, Mejn said Malawi’s per capita allocation stands at $10 (K4 000).
“Budgetary allocations for health services have been increasing at a slower rate than inflation, but the trend reversed in 2012/13 in which the total budget increased by 45 percent.
“Malawi is likely to meet its Millennium Development Goals (MDGs) targets on child mortality, child malnutrition and communicable diseases. However, it is unlikely to meet MDG targets on maternal health and reproductive health care needs urgent attention,” says the report.
In the 2012/13 budget, government allocated K1.6 billion (about $4.1m) specifically for the purchase of drugs for central and referral hospitals.
The approved current budget allocated K27.6 billion (about $78.9m) to the Ministry of Health whereas the Public Health Sanitation and HIV and Aids Management Sector received K48.7 billion (about $125m).
In the previous fiscal year (2011/12), government allocated K43 billion (about $110m) to the Public Health Sanitation and HIV and Aids Management Sector whereas in the 2010/11 budget, it got K45 billion (about $115m).
More money on drugs
Mejn further says the revised budget, which has since been withdrawn, allocated K6.1 billion (about $15.6m) additional recurrent allocations to key subsectors, almost K4 billion (about $1.1m) more towards drugs and medical supplies while K2.2 billion (about $5.6m) was for personal emoluments.
The health sector has been experiencing an acute shortage of essential drugs.
Mjen executive director Martha Kwataine described the allocations as inadequate, adding that it is high time people started paying for health services in the country.
Kwataine, while noting that the current funding is not only inadequate in nominal terms but also in real value, pointed out that the population boom is also stressing the system.
“Donors are withdrawing and they are justified, but for how long shall we rely on them while we do not show any signs of seriousness?
“Let Malawians start paying for their health, especially the high and middle income earners,” she said.
Change the system
Kwataine pointed out that the recent drug stock outs stem from funding challenges, poor systems and corruption.
She argued that as long as health care remains free, the power to demand for quality services will not be there.
Kwataine also urged government to get serious in its anti-corruption drive.
“We have people who were paid to supply drugs, but up to now they are yet to deliver the drugs. How about pharmacy technicians who were caught stealing drugs from public hospitals, but are still walking free because they have connections to the powers that be? Can we really achieve efficiency in the sector with this attitude?” wondered Kwataine.
Ministry of Health spokesperson Henry Chimbali said procedures such as request for quotations (RFQ) allow government to purchase drugs in little amounts.
“The budget allocation is also not adequate and may require adjustments in the wake of the devaluation of the kwacha.
“The best we are doing is to restock Central Medical Stores with drugs and supplies that can be used by all the facilities. This has to be an ongoing process to avoid creating a gap,” said Chimbali.
But he said paying for health services is something that is currently being debated upon, especially how it will be implemented.
“For now, what we are doing is strengthening revenue collection through private wing services in the hospitals such that the money is retained at the facility being generated.
“The money could be used to offset some immediate gaps that may exist and not necessarily waiting for Treasury funding,” said Chimbali.