World Bank approves US$210m for Malawi’s Essential Health Services

World Bank has approved US$210 million to enable the Malawi Government bolster its delivery of essential health services and strengthen safety net provisions for the country’s poorest and most vulnerable communities.

The approval has been made through two International Development Association (IDA) grants, which will finance a $100 million emergency operation to protect the delivery of essential health services; and a $110 million operation to scale up and strengthen national safety nets.

In a statement issued on Wednesday evening, the World Bank says in the midst of multiple crises, including the ongoing cholera outbreak, the Malawi Emergency Project to Protect Essential Health Services (EHS) will help Malawi’s health sector maintain the delivery of emergency health services particularly for the most vulnerable populations.

Hugh Riddell with President Chakwera

Malawi’s health sector workforce remains strained by Covid-19 and now facing an exponential spread of cholera, with a case fatality rate three times higher than historical trends, the project will specifically make available resources to cover the salaries of front-line health service providers at the district level and the operating expenditures such as fuel and energy that are necessary to keep health facilities running and ambulances operational. It will also help supply and support the delivery of essential health medicines to health facilities across the country.

The operation comes at a time when health facilities are experiencing stock-outs of critical drugs and medical supplies, as depleted foreign currency reserves have impacted pharmaceutical imports.

The second additional financing for the Social Support for Resilient Livelihoods Project (SSRLP) will scale up and strengthen existing shock responsive safety nets in Malawi.

“Specifically, the operation will finance (i) a national 3-month emergency cash transfer for the 300,000 beneficiaries of the existing Social Cash Transfer Program (SCTP), (ii) a 3-month horizontal expansion for 105,000 beneficiaries in urban hotspots; and an expansion of 85,000 beneficiaries of the Climate Smart Public Works program.

“In addition, the operation will lay the foundation for increased donor harmonization and government leadership of the SCTP through the milestone establishment, with the support of several of Malawi’s key international Development Partners, of the Social Protection Multi Donor Trust Fund and expand coverage of Malawi’s social registry known as the Unified Beneficiary Registry (UBR) and electronic payments of cash transfers and public works wages,” reads part of the statement.

World Bank Country Manager for Malawi, Hugh Riddell, said the two approvals will enable IDA to front-load emergency financing for Malawi’s poorest and most vulnerable to ensure community resilience through a highly challenging economic period for the country. While securing front-line health services and scaling safety nets is a direct response to the crisis, these projects are also designed to strengthen Malawian-led delivery systems, financial transparency and accountability and citizen engagement.”

Recent public health emergencies including the COVID-19 pandemic, a polio outbreak, and an ongoing cholera outbreak threaten to reverse the progress made in health outcomes and continue to strain Malawi’s health system amid shortages of health workers, financial resources, and essential drugs and supplies.

This just-in-time financing for emergency health services in the areas of reproductive, maternal and child health, life-saving vaccines, nutrition, and HIV/AIDS services will help sustain the gains accrued over the years.

The overlapping and interrelated shocks that are being experienced – from climate events to price shocks – are expected to increase food insecurity across Malawi through the 2022/3 lean season. Therefore, additional investments to scale-up safety nets for different profiles of poor Malawians, will help to build their resilience and mitigate the compounded negative effects of these shocks to enable a quicker economic recovery.

In his remarks, Malawi’s Minister of Finance and Economic Affairs, Sosten Gwengwe, said the deepening of the current macroeconomic crisis is leading to a deterioration of essential health services across a system that has not yet recovered from the impact of the COVID-19 pandemic and with an unprecedented 3.8 million people facing acute food insecurity, the proposed SSRLP AF2 provides timely and wider coverage of shock-responsive safety nets to more affected people and for longer periods than under the regular programs.

Gwengwe added that the combined financing consolidates efforts of the World Bank Group and other partners to strengthen health systems, policies, and institutions that will help the country weather the impacts of potential future climate disasters and public health emergencies.

The World Bank’s International Development Association (IDA), established in 1960, helps the world’s poorest countries by providing grants and low to zero-interest loans for projects and programs that boost economic growth, reduce poverty, and improve poor people’s lives.

IDA is one of the largest sources of assistance for the world’s 74 poorest countries, 39 of which are in Africa. Resources from IDA bring positive change to the 1.3 billion people who live in IDA countries. Since 1960, IDA has provided $496 billion to 114 countries. Annual commitments have increased steadily and averaged about $34.7 billion over the last three years (FY20-FY22), with about 70 percent going to Africa.

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