Service Delivery in Basic Health Care
Challenge
The Ministry of Health (MoH), with its major shortfall in human and other resources, is not in a position to provide sufficient health care for the entire Malawi population. On top of this, the few available resources are not optimally used in tackling the important health problems. This leads to insufficient service delivery on the ground, with poor improvements in the health status of the people.
Objective
To improve the effectiveness and efficiency of basic health services.
Approach
The MGHP uses a multi-level approach, coordinating efforts between the Ministry, the zones, and health care providers at different levels.
Activities and Achievements
- Cooperation between the MoH and the Ministry of Local Government & Rural Development (MLGRD) at ministerial level, as well as improved cooperation between central and district levels in the devolved sectors.
- Zonal Health Support Offices (ZHSO) contribute to capacity development in the districts in areas such as effective planning, proper implementation, monitoring and quality improvement.
- District Health Offices and District Assemblies encourage cooperation between the district health service administration and local assemblies. District health interventions are increasingly integrated into local structures, resulting in a closer collaboration between the District Health Officer (DHO) and the District Commissioner (DC).
- The capacity of District Health Management Teams (DHMT) is being further strengthened in the management of drugs, transport, and human resources.
- Health facilities’ supply of Basic Emergency Obstetric Care (BEmOC) equipment to CHAM health facilities is being scaled up, leading to improved safe delivery rates.
- Improved Hospital Management capacities: two pilot projects at Queen Elizabeth Central Hospital (QECH) in Blantyre and Kamuzu Central Hospital in Lilongwe were presented in some detail at the Malawi German Health Forum 2008 by Paul Downie and Roland Hogeschurz.
- Service Level agreements (SLAs) strengthen the cooperation between public and private providers, private providers consisting mainly of non-profit organizations. SLAs increase access to mother and child health services by making it possible to offer low or no-cost care.
- Care of the Carers: Supply of infection prevention materials (condoms, gloves, etc) with training in their use ensures a safer working environment and better quality of health services.