Malawi
 2018/2019 REPORT
Contents
List of figures
List of tables
Foreword
Acknowledgements
Abbreviations and acronyms
Key findings from the Malawi HHFA
1. Introduction
2. Methodology
3. General service availability:
   infrastructure, health workforce,
   and service utilization
4. General service readiness
5. Service specific availability and readiness
.
6. Clinical quality of care
7. Client experience
              Counselled on HIV C+T

                    We ight measured

          Received iron/folic acid pills

             Me asured uterine height

             Blood pressure checked

Counselled on exclusive breastfeeding

      Counselled on diet and nutrition

          Tetanus toxoid asked about

        Me an number of components

                      All components

                                           0%   10%   20%   30%   40%   50%    60%    70%   80%   90%   100%
                                                              Proportion of ANC clients
                               Asked child age

                             We ighed the child

                     Physical exam conducted

                      Plotted height vs. weight

Couselled on countinuous feeding of sick child

       Told if child's height/weight is adequate

                              Me asured height

                 Me an number of components

                               All components

                                                   0%   10%   20%   30%   40%    50%    60%    70%    80%   90% 100%
                                                                    Proportion of under-five visits
8. Facility management
                                                                                               50%
Rude/disrespectful support staff
                                                                                               50%
             Consultation costs
                                                                                               50%
                 Opening hours

             Consultation costs                                                         46%


         Unavailable medicines                                                                49%


                 Opening hours                                                                                64%


             Long waiting times                                                   42%


            Unavailable doctors                                                                               64%


                 Opening hours                                                                                                   79%


             Long waiting times
                                                                    32%

            Unavailable doctors                                             39%

                 Opening hours                                                                                            72%

                                   0%   10%     20%           30%          40%       50%          60%               70%         80%    90%   100%
                                                                             Percentage of hospitals

                                              Private for profit    CHAM      Government             Malawi
                                               6.0
                                                                  5.3
Mean number of supportive supervision visits




                                               5.0
                                                      4.4

                                               4.0
                                                                             3.5

                                               3.0

                                                                                          2.0
                                               2.0


                                               1.0


                                               0.0
                                                     Ma lawi   Government   CHAM   Private for profit
                          100%                       97%                   100%

                                                                                             91%
                          90%    87%
                                       83%                                                     83%
                                                           81%                                                     Hospitals where
                          80%                                                                                      supervisor used a
                                                             73%                                                   checklist
                                             70%                                                       71%
                          70%
Proportion of hospitals




                                               60%                60%                                        58%   Hospitals where
                          60%
                                                                                                                   supervisor discussed
                                                                        50%       50%                              issues with health workers
                          50%

                          40%                                                                                      Hospitals where
                                                                                                                   supervisor observed
                          30%                                                                                      outpatient consultations

                          20%                                                                                      Hospitals having a
                                                                                                                   supervision log book
                          10%                                                                                      where supervisors write
                                                                                                                   their feedback
                           0%
                                  Government               CHAM         Private for profit         Ma lawi
  Availability of drugs


   Availability of staff


  Availability of drugs


Inadequate equipment


   Availability of staff


Inadequate equipment


  Availability of drugs


   Availability of staff


Inadequate equipment


  Availability of drugs


   Availability of staff

                           0%   10%   20%        30%         40%        50%         60%       70%   80%   90%   100%
                                                               Proportion of hospitals

                                        Private for profit   CHAM    Government     Ma lawi
                           100%


                                                  89%
                           90%
                                                                       86%


                           80%                                                        77%


                           70%
Percentage of facilities




                                   59%
                           60%

                                                                                               51%
                                                                                                         50%
                           50%


                           40%


                           30%


                           20%


                           10%


                            0%
                                  Ma lawi   Private non-profit   Private for profit   NGO   Government   CHAM
                          100%


                          90%


                          80%


                          70%
Percentage of hospitals




                          60%


                          50%

                                 39% 38% 41%
                          40%                  37% 38%
                                                         35%

                          30%


                          20%

                                                                              8%                         10% 11% 8%
                          10%                                    6%                                                                 5%
                                                                        4%                4%   4%                     5%    4%
                                                                                                    3%
                           0%
                                   Mo nthly      Quarterly        Bi-annually              Annually         Never          Others

                                                               Malawi        Government   CHAM
9. Conclusions and recommendations
Annex 1: Tables
Annex 2: Master facility list (MFL)
Annex 3: Questionnaire