At a time funding to government hospitals is fast dwindling, the country is grappling to attract private health investment even when there is an unquenchable demand for the services.
Despite attracting more than 300 foreign and domestic investments worth $6.5 billion (about K4.7 trillion) between 2011 and mid 2016, according to Malawi Investment and Trade Centre (Mitc), the health sector is yet to lure meaningful investors.
According to a 2011 assessment of the Malawi private health sector conducted by the Strengthening Health Outcomes through the Private Sector (Shops) with support from the United States Agency for International Development (USAid), a paltry three percent out of the 40 percent of health services provided by the private actors are purely commercial.
Christian Health Association of Malawi (Cham) provides the remaining 37 percent of the country’s healthcare.
The provision of healthcare by Cham translates to about four million Malawians while the figure for the private profit oriented providers could be growing on a daily basis.
In 2015, the Malawi Investment and Trade Centre (Mitc) outlined two projects on health in the investment compendium to do with the construction of two modern cancer treatment centres of about $12 million (K8.7 billion) each, but no single investor has come forward to express interest.
In an interview on Monday, Medical Council of Malawi (MCM) board chairperson John Chisi said Malawi has failed to make major investments in the health sector despite high demand for medical services mainly due to lack of drug manufacturing companies, lack of support and the country’s poor economic base.
He said: “Malawi has never made tangible health investments in the health sector except for a few major private hospitals such as Mwaiwathu, Blantyre Adventist Hospital, African Bible College [ABC] and a few others.
“This is so because as a country, we have only few drug manufacturing companies, a development which ups the cost of administering treatment. Again, the few potential investors that might be there lack support from the banks and insurance players.
“This coupled with our poor economic base, has made it extremely difficult for private firms to invest in the health sector.”
Chisi, who is also vice-president of Medical
Association of Africa and lecturer at College of Medicine (CoM), a constituent college of the University of Malawi and also runs a private clinic in Blantyre, said it could have been better if we had more commercial hospitals to reduce external travels for medical purposes.
“If we want to attract medical tourism, we need to look at this sector in terms of tourism as well as service delivery because countries which are doing well are the ones with private hospitals which have all the facilities and people pay according to their needs,” he said.
But with the increasing poverty levels in Malawi with the headcount poverty—the proportion of the population that lives below the poverty line—as per World Bank definition standing at $1.90 (around K1 300 at current exchange rate), attaining quality health services in private hospitals is just but a dream for a majority of Malawians.
Paul Chibingu, owner of Mtengo Umodzi Private Clinic in Blantyre and also a medical practitioner, attributed the lack of investments in the health care business to lack of courage and limitations to investing in the sector.
“The health sector is different from other sectors in such a way that to have an establishment, one has to be a certified medical practitioner. Unfortunately, we have been graduating a lot of doctors from College of Medicine, but most of them would rather be employed than think of having their own establishments,” he said.
Chibingu said most of the people lack exposure on how to run private businesses in the sector, but added that there as barriers “as you may put it, but it is just a matter of being courageous and the exposure”.
While admitting of the gaps existing in the private health sector, Minister of Health Peter Kumpalume decides to look at this issue from a different perspective.
“We have a lot of private clinics and hospitals in Malawi. We have also received a lot of interest from external investors for construction of state-of-the-art referral facilities.
“As for the medicines side, we have a number of local manufacturers and they continue to make extra investment in their premises such as Pharmanova and the Crown Group,” he said.
Medical Aid Society of Malawi (Masm) chief executive officer Sydney Chikoti in an interview on Tuesday said there is need for Malawians to embrace the concept of paying for medical services if the sector is to grow.
“The health insurance industry is still an infant industry with little growth and few subscribers. In a country with a total population of 18 million people, the notion of health insurance is yet to be absorbed by the majority of Malawians. n