Minister explains hospital user fees, health fund and reforms

Minister of Health Dr Jean Kalirani has explained that government will introduce paying fees in all its public hospitals to be used to finance a health fund to address underfunding within the health sector.

Dr. Jean Kalirani (r) Minister of Health and Dr. Charles Mwansambo l Chief of Health Services at the briefing - Pic. By Kondwani Magombo

Dr. Jean Kalirani (r) Minister of Health and Dr. Charles Mwansambo l Chief of Health Services at the briefing – Pic. By Kondwani Magombo

Malawi’s government hospitals offer free services to the citizenry. Often times the hospitals have suffered drug and medical equipment shortages – problems that have been blamed on lack of enough funding.

Kalilani said her ministry wants find means of bringing extra funds to improve health service delivery.

“There are four main areas of reform that my ministry is undertaken in order to contribute towards the ongoing public sector reforms. I am also aware that the contents of the reforms for my ministry have not been made widely public yet though they are currently being discussed within the health sector,” she said/

The Minister of Health said a number of studies have been undertaken both within and outside the country that have pointed to the need and importance of setting up such fund to support health service delivery.

“Another area of reform is to visualize medical insurance scheme in the country.  Our plan is to have many people on medical insurance scheme that will ensure all those with medical insurances ably access fee paying health services across the country,” explained Kalilani.

She said this will also help to decongest public hospitals as some people will opt for fee paying services.

Kalilani further said there will also be hospital operation reform which looks at three separate components which are making all Central hospitals autonomous and independent so that they have independent oversight bodies in form board of directors.

Then second one is to have the management of District Health Services separated from the management of District Hospitals and to have non-core services in public hospitals delinked from core services of hospitals so that non-core services are run in partnership with Public Private Partnership (PPPs)

The ministry will also review the partnership with Christian Health Association of Malawi (CHAM) as its fourth part of reform.

“The ministry is proposing review of the current arrangement between the ministry and CHAM. The current Memorandum of Understanding (MoU) dates back 2002,” she said.

Recently government introduced user fees for walk in patients in major public hospitals who seek treatment without being referred by either nearest health facilities which is pegged at K1500 per patient.

Mnistry of Health spokesperson Henry Chimbali said the fees would be levied on patients bypassing government health centres within their vicinity opting to access medical services at major referral hospitals.

Through the “bypass”, he said, the government wished to allocate 40 percent of the collected revenue from the charges towards hospital staff incentives and the remaining would be earmarked for maintenance.

Kamuzu Central Hospital (KCH) director Jonathan Ngoma said the fee called ‘bypass’ is a token designed to decongest the hospital and encouraging sufferers to seek treatment at the health centres.

Global development and advocacy charity, Oxfam, recently warned government against heeding calls to introduce user fees in the country’s hospitals, warning that the move will hurt the country’s poor.

Government was also urged in a local newspaper editorial to put in place measures that would ensure money made from the user fees from public health institutions indeed goes towards improving delivery of health services “and not towards enriching people who only care about their pockets even where they put a number of lives at risk.”

Currently, Ministry of Health has proposed introduction of health risk taxes on alcohol and cigarretes as one way of revenue generation measures to complement resources it gets from its partners and the national budget.

In the K780 billion revised 2014/2015 national buget, Parliament allocated K69 billion to the Ministry of Health. In contrast, the ministry’s total health expenditure was projected at K274 billion for the year.

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Boma ili silikudziwa mavuto aaMalawi komanso kuti angawathetse bwanji.Try and error means siithandiza mtundu wa a Malawi.Come 2019 let us vote for a Malawian oriented government to tackle Malawian problems in a Malawian way.


Effects of 92 and the imposed zero aid budget cheating pple


Well done. Zilibwino. Muchotsetso free and Primary education

mangochi kabwafu


Malawi National Congress

Do not let people count chicks before hatch.
Expect peoples thanks to ministry’s administration after complementation


Government must reverse this idea many people will die.


I agree with someone who has say govt should think of reintroducing paying school fees to all primary school, informally they are already doing it in terms bra bra bra fee. All what they can do is formalize it. Secondly may be anyone above 18 years should start paying tax. People can do maganyu to pay tax instead of kumayenda bawo from morning till dawn and kumamwa ma “rider”. I hope govt can collect enough money and be able to provide better services if all factors remain favourable, knowing kuti andale amasololanso kwambiri muthumba la boma.

Much as govt has powers to make a public policy, in this case this “user fees policy” it also has obligation to get wider views from its citizen in this so called democratic nation. I wonder if enough people were consulted on this matter. Much as we know that govt is struggling to provide better health services but its Citizen also has a stake in this process considering the majority of them are poor and they needed to be consulted in process so that they can own it and be aware in terms of the conditions of payments. In this… Read more »

Govt has already made a provision for the poor to access FREE medical services in the District Health centers and FREE treatment wen the POOR are REFERRED to Central hospitals but a penalty fee when they disregard that. Loud and clear. Wax in the ears go to yr nearby health center you don’t want to If you prefer CENTRAL hospital PAY K1500 bypass fee. It is at yr own discretion that you go to where you pay zovuta kumbetsa izi? Bwanji kusamvetsa kodi? Mukuchititsa manyazi

Khuth'upa o'Machemba
Kodi inu anthu a boma la DPP, enanu simuli ma nduna, ndiye boma silingakutumizeni ku zipatala za udolo, ku SausiAflika, mutadwala. Ndiye mukuti bwa pa nkhani iyi? Ngati DPP ichita zimenezi, azaluza baasi chisankho cha 2019. Anthu sangalole za usilu zanuzo. Ngakhale anthu a ku Sausi kuno, madela aja amene amati Lhomwe “belt”, anthu azatha kuvotela UDF baasi. Osati za manyi zanuzo. Mwayamba kutibowa heavy. Koma iwe Pitala wafuna Bingu akukalipire kuchokela kumanda eti? Umvesese bwino anthu m’mene akudandaula pa nkhani imeneyi. Ngakhale kwa Goliati, ku Chisoka, ku Chimvuu, ku Makande, ku Lucheza, anthu zakhulupira kuti iwe ungachite zimenzi. Kuti… Read more »

Government should re-introduce paying fee in all primary schools so that teacher should get incentives and the rest should be for. buying teaching and learning resources

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