Human Resources

Challenge

The Malawi health sector is undergoing a severe human resources crisis: there are too few medical doctors, nurses and midwives. While considerable progress in training these cadres has been made during the last years, attrition remains a major concern. A study conducted recently identified causes of attrition among MoH personnel in the following order: death, resignation, dismissal and retirement. Currently, there are 19,000 health workers and vacancies for a further 24,000. Another major concern is the poor motivation and low job satisfaction of health workers. Finally, performance in HR planning, development and management remains weak.

Objective

In reaction to the crisis, the Ministry of Health and development partners set up the  Emergency Human Resource Plan with the aim of achieving short-term improvements and simultaneously pursuing long-term goals. MGHP supports this programme mainly in the areas of training and retention.

Approach

The MGHP supports the development of policies and strategies and their implementation. The different agencies each have a special contribution to make and collaboration between them is beneficial to all:

• Policy advice on the central level and its implementation at zonal and district level
• Organisational development at central and zonal level
• Contribution to capacity development through a Technical Assistance Pool (TA Pool)
• Pre- and in-service training
• Various incentives

Activities and achievements

• The six-year Emergency Human Resources Plan with its Pre-service Training Plan was a success. Between 2003 and 2007, Malawi recorded a 165% increase in pre-service training and a 79% increase in post-basic training. It also quadrupled the number of medical training places between 2003 and 2006.
• The College of Medicine and other training institutions have become examples of good practice through their contributions to pre-service training: the number of graduates trebled between 2002 and 2008.
• A tutor incentive scheme was put in place in CHAM training institutions in order to increase the number of tutors for the larger student intake and to maintain quality of teaching services.
• There was a 17% increase in employment in public services in 2008 compared to 2007.
• The Care of the Carer policy has been introduced, offering health staff protection and advice with regard to their exposure to HIV and AIDS and other diseases.