Health is one of three priority sectors for Norway in Malawi. The sector is heavily dependent on donor funding, as around 80% of the resources in the sector are from external sources. In 2017 the Embassy contributed with 114,1 million NOK. Norway is an important bilateral partner. Other central donors to the sector are the UK (DFID), USAID, KfW and GiZ. Important multilateral partners are UNICEF, UNFPA and WHO. Global initiatives such as GAVI and GFATM also provide substantial funds to the sector.
New-born- and child mortality has been reduced in recent years. The reasons for this are improved access to vaccines and health facilities in rural areas. Today around 90% of all deliveries take place in health facilities. This has led to a reduction in child mortality, but still many new-borns and children under five die of preventable causes, such as infections, diarrhoea and malaria. Maternal mortality is still high in Malawi – 574 out of 100 000 mothers die of pregnancy related causes each year. This amounts to 10-12 mothers every day. 17% of these are due to complications after unsafe abortions.
Although there has been a 70% increase in graduating health workers from 2010 to 2015, there is a 45% vacancy rate in the public health sector. Most health workers work in hospitals in urban areas, although over 80% of Malawi’s population live in rural areas.
These numbers show that although there is some development in a positive direction, the health sector is still facing challenges in the years to come. Norway wishes to be a long-term partner for Malawi and support the Government of Malawi to provide basic health care services to the country’s population, and thus working towards achieving the Sustainable Development Goal on health.
The goal for Norway’s bilateral cooperation with Malawi in the health sector is to contribute to improved health services and increased quality of health personnel, to make the highest attainable standard of health services available to Malawi’s population.
We do this by:
- Strengthening the Malawi Government’s ability to implement its health sector plan
- Increasing capacity to train health personnel and manage health personnel deployment
- Strengthening service delivery for maternal and child health
- Improving service delivery for family planning i.e. sexual and reproductive health and rights, especially for adolescents
We do this through:
- The Embassy is currently one of three donors (together with DFID and KfW) supporting Malawi’s Ministry of Health (MoH) though the Health Services Joint Fund (HSJF). It is a funding mechanism in support of the government’s priority budget lines, for the implementation of the Health Sector Strategic Plan 2017-2022. Through the HSJF Norway has, among other things, paid for the procurement of vaccines as well as for water and electricity at health facilities. The funds are channelled through commercial banks with fiduciary and procurement oversight provided by the donors. The current HSJF agreement runs through 2020 and amounts to 238,9 million NOK. The Embassy is planning to renew the agreement when it expires, supporting the implementation of the HSSP II through the HSJF for three more years.
- With financial support from the Government of Norway, Clinton Health Access Initiative (CHAI) together with MOH in Malawi have partnered with nine nursing and midwifery training institutions to support training of nurses and midwives. At the start of 2017, over 1 000 nurses and midwives are undergoing nursing and midwifery training through this program. We are projecting that once these trained health workers get deployed they will significantly reduce the existing gaps in the nursing and midwifery health workforce, and will positively contribute to efforts for reduced maternal and neonatal morbidity and mortality. The agreement amounts to 132 million NOK for the period 2013-2018.
- By funding through several agreements with the Embassy, the country office of the Norwegian Church Aid has built an Intensive Care Unit and a High Dependency Unit at Kamuzu Central Hospital in Lilongwe. Six new operating theatres will be finished in 2018, also with funds from the Embassy.
- The Embassy also has a long-standing cooperation with the College of Medicine. Through the College, Norway has funded the training of medical doctors, surgeons, obstetricians and other health personnel. Norwegian funding has also gone towards building a library and student hostels at the College.