Malawi introduces hospital ‘bypass’ fees: Pegged at K1,500

Malawi government has 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.

Kalirani:  User fees

Kalirani: User fees

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

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

“Government has introduced these paying services in the major referral hospitals to address underfunding within the health sector,” he added

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.

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.

However, the issue of user fees remain contentious with  with Global Hope Mobilisation (Glohomo) executive director Caleb Thole criticised the introduction of consultation charges as a violation of access to free and quality healthcare services.

“Research has shown that user fees or any form of payment in a government hospitals is no an effective form of health financing as it is only capable of mobilising five percent to 10 percent of recurrent budgets,

“In the long run it also reduces efficiency of demand for health services through decreasing demand for appropriate health care among poorer and vulnerable groups and the beginning of bypass fee is part
of it, there is just no difference, the poor is paying anway,” Thole said .

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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This move is long, long overdue.


Malawi is the only country in this part of the world that offers free health service, This has resulted on additional pressure on our health service by patients from neighbouring countries

Weddington kamanga

Comment. Chikanakhala chanzeru kuti azilipilisa ku xool za primary kuposana ndi kuzipatala

Keen Observer

This is not a good move, to other people that’s a lot of money & people will be denied their constitutional rights to proper treatment when they’re sick. I was shocked that to get a death certificate for my departed Mum was K30, 000 at QECH in 2011. Why all that money??????

wankulu sanyera

This is a total lie. Who told you that? Or you were swindled. Death certificate is much less than 10 000 kwacha as of today. Osamanamiza anthu man muzalangidwa.

Arick Chiomba

how sensible is this? where do Malawians’ tax goes? is it not their right to choose where they can rightly be treated?

vintisinku seven mikango
vintisinku seven mikango

Yolipilayo ndiyogwira koma fée yake itakhala yochepa monga k200 kapena k500 kungoti amalawi tinazolowela kulandila za ulele


Paying is not a problem stop issueing manual receipts or else money is a goner

Team Chilima
This is not a pro poor strategy. I am so amazed how World Health Organization managed to keep this dull woman in their fold. The best is to establish a National Health Insurance Scheme where people will be contributing for their health care on annula basis as it is being done with MASM. For example the Health care card can cost K200 for say silver card holders.Then say K10,000/per for Gold card holders and K50,000 for platinum card holders. Of course you can include antenatal, maternity care and child health for the poor free of charge. The poor include everyone… Read more »
Kiss Wicked Lester

did you catch peter on that metal show?

Brave Nyanyaluwa

In the first place this started long time ago like 2009 at KCH skin department. It seems good but on the other hand no. In most cases these moneys don’t go to Govt they end up in people’s pockets. Its either an attendant or someone else. They issue GRs without a stamp etc. If they rectify this I stand to support it. Uku ndiye kuwapatsa danga kuti adye ndithu.

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