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Mkandawire: We deliver all services required Mkandawire: We deliver all services required

A lack of resources hampering Health service delivery in Northern Malawi

Written by  Norbert Mzembe Apr 03, 2017

Communities surrounding Chilumba rural health centre in Karonga, in Northern Malawi, have complained over the tendency by authorities at the facility who allegedly demand a fee from patients for use of the ambulance.

They explain that they are often told the money is for the purchase of fuel for the vehicle, which is mainly used for referral cases.

The chairperson of Chilumba Health Advisory Committee (HAC), Kida Munthali is however expressing ignorance over the matter, saying his committee has not received any complaint regarding the same.

Munthali said; “I’m also learning it from you now that there is this problem at the hospital but I have never received any official complaint from any person here at Chilumba.” 

While noting challenges like the availability of a maternity wing, he commended the mutual relationship that has been cemented between health personnel and those that go to seek medical services at the institution.

This is particularly so for expectant women who have for the past years been preferring to deliver through traditional birth attendants (TBA’s) to nurses due to their alleged ill-treatment.

“I can now confirm that there is a great improvement in terms of provision of health services because nurses and all support stuffs perform their duties professionally unlike in the past when they could shout at patients without a reasonable cause,” said Munthali.

However, on a special note, he observed that the health institution lacks a spacious maternity wing as there is only one small room that accommodates hundreds of expectant women a situation which he described as a hindrance to most expectant women.  

The Malawi government through the district council pointed out that there really is some improvement in budget strategies which the district health sector uses for its routine operations despite financial hiccups that the sector encounters. 

The council’s monitoring and evaluation officer, Isaac Mkandawire said through decentralization, community members are empowered to participate in decision-making processes, planning and budget allocation for health projects.

While acknowledging the fact that government funds and other revenues are not enough to successfully cater for health service delivery, Mkandawire bemoaned allegations circulating that health service seekers especially on referral situations are requested to pay money for the purchase of fuel for the ambulance.

“After the enactment of decentralization policy in 1998, government devolved fiscal powers to district councils and indeed as a district we are able to come up with the budgets including the health budgets for every year and actually what we do is to engage communities at various levels to come up with budgets that are responsive to their needs but before we send it to central level, we submit it to the council for further scrutiny,” said Mkandawire.

Comparing the current financial situation to the previous one, Mkandawire said in 2016/17 they had a slight reduction in drugs budget due to economic challenges that the government is facing.

“We had to do with the ceilings which we were given but all the same, we managed to deliver all the services which are required to Karonga citizenry but of course with challenges because we are so much stretched in terms of financial budget for this year,” he explained.

Mkandawire however expressed satisfaction with how they come up with budgets as a district council beside some limitations to meet all development projects due to shortage of resources.

He added; “of course in terms of coming up with district budgets we are impressed because we conduct all the necessary consultations to come up with Karonga budget for health.”

Basing on the 2008 Population and Housing Census (PHC), Karonga district has a population of over 300 000 people and according to a Health Demographic Survey (HDC), Karonga District Hospital (KDH) caters for over 50 000 people from its catchment area.


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