A report by Wemos Foundation has shown that total spending on health in Malawi, Uganda and Tanzania is far below the recommended $86 (about K63 000) per person, which is supposed to be raised from public sources alone.
Titled ‘How Healthy Is A ‘Healthy Economy’? Incompatibility between current pathways towards Sustainable Development Goal (SDG) 3 and SDG8’, the report shows that government health expenditure in Malawi is just $8 (about K6 000) per person.
The result, according to Malawi Health Equity Network (Mhen) executive director George Jobe, is failure by government to recruit more health workers, inadequate equipment, nonfunctional machines, difficulties in accessing centres and meeting essential health package.
In an interview, he said the situation remains dire, and the starting point is for government to meet the 15 percent budgetary target as set in the Abuja Declaration, because the per capita target is still low.
“Internationally, people are looking at spending per capita, but for us, what we have been advocating for is the 15 percent Abuja Declaration, considering the economy,’ said Jobe.
He added: “The danger is that we have inadequate health workers, equipment that is mostly not functional, people are still walking over 10 kilometres to access health services and we are not meeting the essential health package. We need to up our socks, or expect the worst.”
Health rights activist Maziko Matemba, in an earlier interview, said the trends in Malawi on health financing were scary.
However, Ministry of Health spokesperson Joshua Malango argued that Treasury allocation is increased in each financial year. He further explained that the ministry is developing a health financing strategy and exploring more ways of increasing health financing, such as the creation of the health fund and national health insurance.
When presenting the 2019/20 National Budget, Minister of Finance, Economic Planning and Development Joseph Mwanamvekha said the health sector ranks third in terms of size of budget allocation, after allocating it K101.0 billion, up from K89.9 billion in 2018/19 budget.
He said: “The sector continues to benefit from the increased allocation of resources from the Health Sector Joint Fund.
“An amount of K25.9 billion has been allocated for procurement of drugs, of which K10.6 billion is for central hospitals and K15.3 billion is for district hospitals.”
Malawi surpassed the Abuja target in 2007/08 (16.6 percent), 2009/10 (15.1 percent) and 2010/11 (15.8 percent) when the sector was apportioned K45 billion.
In the 2013/14 budget, Capital Hill allocated about K76.2 billion to the sector representing 12 percent of the total budget, but the actual figure directly injected to the Health Ministry was K42.685 billion, a meagre 6.5 percent of the national budget.
The Malawi Health Sector Strategic Plan (2017-22) corroborates that health care financing in Malawi remains unsustainable and unpredictable.