Activist warns Malawi govt on hospital fees: ‘Tread carefully on public health sector reforms’

A vocal activist in the public health sector, Maziko Matemba has warned government to tread carefully on public health reform program, saying they should not hurt the poor.

Maziko Matemba, executive director of the Health and Rights Education Programme, Malawi

Maziko Matemba, executive director of the Health and Rights Education Programme, Malawi

Matemba was part of the high level meeting of government, donors and other health stakeholders.

He said suggestions to introduce fees in hospitals would harm the majority poor.

Malawi government has proposed a set of reforms for the health sector, among them the establishment of a health fund where it proposes visa fees, health-risk taxes on alcohol and cigarettes, health value-added tax (VAT), corporate health tax and fuel health levy to get additional revenue for the sector.

These proposed tax measures are expected to be sent to Cabinet before a bill on health is drafted and presented to Parliament for approval consideration. The bill would also propose the appointment of a board and management team for the fund.

Vice-President Saulos Chilima, who chairs the Public Service Reforms Commission (PSRC), said government should seriously explore ways of ensuring that everyone with the ability to pay contributes to financing of the Essential Health Package while keeping out-of-pocket payments as low as possible.

Principal Secretary in the ministry of Health MacPheralal Magwira backed vice president Chilima that the public health sector needs an on overhaul.

He said Malawi is the only country in the region where medicine is free in public hospitals.

“We are working at how we can approach thus,” said Magwira.

Malawi is increasingly facing a collapsing health public sector since donors withdrew aid. The country is facing a $1.3 billion (about K600 billion) deficit in the health sector between 2014 and 2016.

Chilima said it was not a secret that the health sector was facing many challenges, among them the silent threat of rapid population growth which has exerted pressure on these inadequate public resources.

He said goal of the Malawi Government, in line with the Sustainable Development Goals, is “to ensure universal health coverage.”

But to achieve this, Chilima said Malawi government will need “concerted aggressive efforts like we are doing as well as to increase our domestic revenue base from which we can finance health care.”

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28 thoughts on “Activist warns Malawi govt on hospital fees: ‘Tread carefully on public health sector reforms’”

  1. Shulushulu says:

    If Politicians were corrupt free, there wasnt a problem. Malawi’s economy would be improved. But since our leaders are so selfish ande very stupid, ndalama zimenezi zidzalowa mnthumba la wina. Ndalamazi sizizapindulira dziko koma anthu ochepa andale.

  2. Mbiri says:

    Some of these NGOs really derail development. This fool really believes we should continue giving free medicines and services? That is just rewarding lazy people for being stupid. Most of the poor people you claim to be advocating for are poor by choice anyway! Look…most Malawians have no income, are able bodied, have many children, don’t want to work but want handouts, cuts trees everyday and you want my hard earned money which is taxed to pay for their medicine as well?

  3. Nansani wa chingoni says:

    A lot of poor people pay already e.g in rural areas with only Mission hospitals, I see no issue with this move!

  4. Ngalamayi says:

    How can a government even think of charging for medical services when so many of its population live below the poverty line? If this government were also to develop a real welfare system, the population would have to confidence to reduce the number of children they have to look after them in their old age, knowing their children would have access to medical facilities and would stand a better chance of reaching adulthood themselves. Oh.. sorry… forgot! This government thinks sending large numbers of ‘envoys’ to expensive summits overseas, huge presidential cavalcades, are more important than the welfare of its people!

  5. Janjaweed says:

    It is disgusting! paying taxes on everything we do, but the money goes into pockets of the very few in the name of cashgate, introducing fees in hosipitals will make the berries of cashgate fanatics grow even bigger.

  6. choka phiri says:

    If Malawi felt to secure donors and tax payers money How are they going to secure hospital money. City Essembly can not secure city rates we pay. Look at city of LL. Bins are not picked. NO drainage outside houses. NO Street lights despite LL being Capita City. Where our6tax money go. Where our city rates go. There will be this question when The hospital payment will be introduce and not medicines. NO one trust Malawi government or people resiponsible to work with money. Good talking good idea but practicaly Nothing is good. Lets wait for good Malawians that is our children. Maybe they will love Malawi. I have waited to se Malawi and Malawians leave well but I will never see that in My life. Indepedence for poverty. Democracy to greedness and stealing. Ksmuzu was a diktator but we had good schools hospitals and food. What was wrong with that. What dos a human being want.

  7. choka phiri says:

    Tonde. Richard people will not go to government hospitals despite paying. U What The wont have good beds or factities. Its poor people who will still go to public hospitals. Most highly government will still go to South Africa. Paying tax money. Believe me.

  8. choka phiri says:

    How many people Who eran an income in Malawiits good idea in a country where there are Jobs. Most elderly will get paid by their children Who earn very little. What about those Who dont? Malawi can not compare with other countries. Malawi should look itself. If it was not for corruption and Cash gates we Wold not have ended up here. My question is there any quarante that the system of paying will work. Is money going to be handled well? Malawians to Day can not afford to eat properly. Donald medicines are stolen by those should handledare The and sold to private. Before u introducerar this make sure u take measures of thieft which is a problem. It is a shame that it has reached to this stage 2015. Sterling has gone on many years now pool Citizens are paying the price. There is so mu h money in mansion busieness properties and yet you want poor people to pay. What a Crüe Word we live in. NO wonder people raise and do as The do in other countries. Bring back Cash Gate money. That will be solution number one. You are idiot. People without heads. Kasambala is bildning a big reaktion hall in area 47. With stolen or blood money. Azungu atopa nanu wanthu wankunda. Kuba basi. Eventuellt educated. Is it a race which is wrong? We are The only race which is very poor. Start question ourselved.

  9. Janjaweed says:

    Introduction of payments in hosipitals is un called for thing, what do you want to do with a poor Malawian who has to struggle with feeding up to six children, with a bag of maize bought @ mk10000, pay for their their school fees, the same person is being taxed in everything he buyes, so should you add an extra burden by making him pay for hospital services. Let us try to be genuin by not copying what other countries are doing, they have there own system of playing around with tax system or else you will masacre the poor populas.

  10. Victor Jumbo says:

    Malawi is one of the poorest country in the world with a big population. 51% of the population are illiterate with little or no jobs at all. 49% of the population are literate but not all of them are in jobs that satisfies or meet their needs. Many of hard working people lives on a less than a dollar per day. Which means it’s hands to mouth for the majority. Possibly, this one of the reasons why corruption is rampant in Malawi at present. People are trying to survive day by day because the jobs that they do are not paying well jobs. Having big families or one person looking after the whole clan put pressure and strain on the majority working class who now engages in shady deals in order to make ends meet. There are endless facts from all walks of life that prompts people to indulge themselves in dubious activities but to some it’s pure greedy, irresponsible, and lack of sound judgement to do what is right. But to start charging poor people in hospitals will only bring more misery and put lives at risks. People will die in their homes for being very poor to pay for their much life saving treatment. It is absurd just to know how poor the majority are in Malawi whose lives will be put on the lines if government hospitals will start charging fees. Check with your neighbours, Zambia. They too charge in government hospitals. Find out how many people die in their homes whose dead bodies ends up piling up in mortuaries floors. Malawi is not yet ready to start charging fees in hospitals now. There is a lot of things that needs to be done first. Eradicate corruption, improve people’s salaries, put effective control measures in hospitals so no one steals medication and equipments from hospital. Strong regulations should be put in place as regarding private hospitals and it’s medicines procurement processes. These are my little observations.
    Victor Jumbo

  11. Nankununkha sadzimva says:

    I think introducing a user fee is a good idea. However, this is not the ultimate solutions to the woes the health sector is grappling with. We need to put measures that promote prudent use of the little resources we have. For example, people(office holders) must be adequately didciplined for their misconducts. There is a lot of wastage at all levels in the health care delivery system let alone the whole civil service. The only added advantage of the fee will be that it will inject a sense of responsibility to the public on health issues. Remember, anything that is for free is less cared for. By the way, if poverty is the excuse for not to, have you not wondered that the same poor section of society pay services when they visit traditional healers?

  12. Tiyanjane says:

    I am happy with the private wing at Mzuzu Central Hospital. My only concern is about the possibility of all the revenue earned being remitted to Acct No. 1. A larger percentage of the earnings from the pay section should be used to support other services at the hospital. The goal should be to financially strenthen OPD 1 in order to widen patient utilization of the pay section.

    Secondly, I hope the health reforms will start with abosolute abolishing of government paid external medical care. This is one area where very few people use untold health budget to go die abroad. Malawi has even exported a dead citizen, just so his remains could come back in style. As someone recently said – this must stop

  13. That is the best way to go as a nation.No more freebies. People will automatically start controlling their appetite for more children as they will feel the pinch of bringing up the kids.The little we pay will go a long way in improving the quality of our medical services. The Mocambiquan brothers and sisters who flock to our free hospitals will contribute to more medicines once we start paying services. For once let’s forget politics and hope all political parties push for this agenda otherwise we are a country renowned for moving forward and backwards without any key direction-reason cheap political mileage.

  14. Has wa a Phiri kwa Chapananga, Chikwawa says:

    Moyo ukuluta panthazi pera(patsogolo). Things will just happen like that sitidzabwereranso mmbuyo ndiye mmaganizo mwina ndinene kuti kuli bwino sukulu ku pulimale ana adzilipira kuti ku chipatalaku kupitilire kukhala kwaulere. Chifukwa anthu sangalephere kulipira say K200 pa mwana pa teremu. Zinazi tidziziwona chifukwa munthu mmaganizo ukadzangoyamba kunena iiii sindingathe u send message to every part of the body to adopt by what has been created so inturn things really became imposible. Zikomo wawa.

  15. g says:

    Let malawians pay something towards health. Also set up a national health insurance scheme. All other countries are doing it. In fact it will cub the population growth too. Nothing for free. As long as it is run effectively, there is no problem. By virtue of living in the villages, it doesn’t mean people are poor. Some of the people living in villages are well off and not directly taxed when compared to certain civil servants. For as long as they see that the poor card works, they play along. The problem with Malawi is that 75 percent of the people are in the rural areas and do no form part of the national accounting system even when they are making some good amount of money. Hence Malawi GDP will always appear small and the poverty card used.
    That said they are the extremely poor who need special support

  16. John says:



  17. truth says:

    This is called population control for Malawi. Government knows people will die aakupangira dala, ma public services are not enough for the current

  18. chinkombaleza gumanyundo gowa says:

    You know the problems that are in health sector. Let it go you will see people managing. and taking care of themselves so that they don’t carelessly contract contagious diseases because they will know they are contributing to their own nation. Zaulere anthu amangoononga..

  19. mapwevupwevu says:

    Vocal activist? I never heard of him before this article! I thought you wanted to talk about the now defunct Martha Kwataine.

  20. Tonde says:

    Right move. I fully support this. This country for a long time has been let down by stupid politicians, donors and NGOs who make our population believe that things should be free and that they don’t have to work hard to eat, bath, get educated, sleep in a good house and get their chindoko and mabomu treated!!!

  21. Francis says:

    Mukuzunza a malawi omwe anakuikani pa mpando. Remember ambiri mwa amalawi are poor.

  22. dziko litukuke says:

    This is the way to go… people should pay so that they can demand a better service.. honestly i dont see the relevence of a free health system without essential health services. anthu amakagula mankhwala okha and even pay for lab investigations kusonyeza kuti ndalama ilipo ndithu mmatumba ngakhale anthu amene timati ovutika amakalipira kwa asing’anga.. Chilima and Magwira tiyeni nazo anthu azisamalika mchipatala…

  23. No Laughing Matter says:

    Stop the thieving first and introduce fees once is all ok

  24. chimayembe says:

    If this public reform was done in other countries like Tanzania by Magufuli, foolish Malawians would that is a strong leader not ours who is still sleeping. Now this done in our copuntry, surely some NGOs will take injunction against public hospital payment or Chakwera the leader of opposition has already bought an AK 47 for shooting this bill in August House. Dead country with dead citizens. FOOLISH.

  25. Andrew chimodzi says:

    The vice president is right.

  26. Angoni Awiri says:

    Yes, we need to mobilize local resources to cover the health sector. Matemba and his friends have no solution to the current problems. However, the reforms should not continue targeting fuel levies. We are over burdening the very same sector. Why did we ignore the paying wards for those who can afford? MASM is collecting a lot of money from individuals but all these monies go to Private Hospitals – but when the people are about to die they end up going to Public Hospitals. Lets have these paying wards at Public Hospitals but management should ensure equal treatment of patients.

  27. Friend says:

    People need to start contributing to their country , you cannot just sit in the village having 10 children , waiting for, free education, free medicine, free seed, subsidized fertelizer , free malata.

    As a working Malawian im tired of being taxed so much I pay for everything i consume, me and my collegues who pay taxes fund the Government through the taxes we pay, at the end of the day my country does not respect or consider my needs , it only the very very rich who get what they want and the very very poor who the Government love to give hand outs to.

    When are ACTIVIST going to tackle the reliance syndrome, in Malawi when are they going to enhance genuine rural development, and wealth creation for the poor not just talk !!!!! they dont want to because once Malawi’s poor is no longer poor they will have no job.

    Struggling from my poor roots, going to school on an empty stomach , I met several people who CHOSE not to go to school, they drunk, had several relationships , girls chose marriage to fishermen at 13 not by force but they were to lazy to pass at school.

    It is not fair ONLY orphans, disable, children and other disadvantaged groups who cant help themselves deserve our help. !!!!!!

  28. chikhadzula says:

    Chipatala tuyenela kumapeleka kangachepe, thats y Malawi sitikutukuka cz mtima ofuna za ulele unakhazikika mwaife, It’s high tym To start paying aliytle something, Malawi is the only Country gvn Free medicine pomwe ndife amphawi othelatu,, go To zambia, Mozambique, Tanzania,, akumabwela nkumazalandila thandizo Malawi.. Komatu Atupele anene kuti DZuka Malawi Dzuka

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