The Malawian health sector has made important progress since the introduction in 2004 of a Sector Wide Approach (SWAp) in the health sector of the country. It has focused its health policies on the improvement of essential healthcare services for the population. The Federal Republic of Germany has been providing both financial and technical contributions to the SWAp.
Despite the progress, many targets remain unmet, and infant and maternal mortality remain unacceptably high due to a lack of access to good quality essential health care services. Patients still encounter difficulties in reaching facilities, and even when in facilities, may be faced with sub-standard service provision, a lack of staff, and of essential medicines. The Health Sector Strategic Plan (HSSP) 2011-2016 has placed an increased focus on the improvement of delivery and quality of health care services. To this end, the Ministry of Health (MoH) has proposed that a series of reforms be enacted in the health sector to devolve service delivery, and bring about efficiencies in the delivery of services. GIZ’s Technical Cooperation (TC) programme ‘Health system strengthening with a focus on reproductive health’ (10/2012 – 09/2016) supports the Ministry of Health in this endeavour with special emphasis on maternal and neonatal health.
The objective of the Technical Cooperation (TC) module ‘Health system strengthening with a focus on reproductive health’ is that - The Ministry of Health (MoH) in cooperation with non-state actors ensures effective and efficient health care of appropriate quality, with special consideration for the health of mothers and newborns. The three project components include: Quality Assurance; Human Resources (HR) Management and Development; Partnership with Non-state Actors.
The consulting services package includes:
Technical assistance in the development of hospital reform and autonomy policies;
Technical assistance and capacity development to the 4tertiary hospitals (Queen Elizabeth Central Hospital in Blantyre, Kamuzu Central Hospital in Lilongwe, Mzuzu Central Hospital and Zomba Central Hospital) and selected teaching institutions to enable them to implement hospital reforms.
Comprehensive stakeholder analysis to guide the reform process;
Policy advice on hospital autonomy and reform processes to MoH;
Support MoH in ensuring that a Cabinet Paper on Central Hospital Autonomy is developed and presented to Cabinet for approval;
Support MoH to establish systems, structure and capacity to guide and provide oversight for the hospital reform process;
Support MoH to put in place a Board of Trustees in each hospital;
Support the development of a detailed proposal towards central hospital autonomy including a strategic framework to decongest the central hospitals (CHs) and improve specialised care;
Advice to the CHs and selected institutions regarding the implementation of hospital autonomy and reform processes according to the relevant policies;
Conduct comprehensive situation analysis of central hospitals;
Pursue and assist the central hospitals with hospital reform process; support the restructuring of hospital care;
Provide expert advice to CHs to improve patient management, quality of care and client satisfaction;
Support CHs and HMBs with SOPs and guidelines to improve internal hospital management systems for efficiency, accountability and transparency in use of public resources;
Support CHs to establish systems, structures and capacity to improve hospital governance and operate as autonomous Public Trust Entities.