Minister of Health and Sanitation Madalitso Chidumu Baloyi’s order that all district hospitals should open paying wings to maximise local revenue drew caution from some players in the health sector.
The minister made the order during the integrated health sector joint annual review meeting on January 22 2026 in Lilongwe and International Coalition on Health Financing Advocacy chairperson Maziko Matemba instantly stated that Universal Health Coverage(UHC) is fundamentally about equity.
He stressed that the UHC protects the poor and vulnerable by prioritising limited resources toward those who would otherwise be left behind.
Said Matemba: “It is time to move from strategy to action by operationalising the Health Financing Strategy reforms. For example, the introduction of national health fund and hospital autonomy also ensuring that those who can afford to pay through insurance and other mechanisms do so while safeguarding access for the poor.”
Samson Mvula, a resident of Baka in Karonga, who was admitted to Karonga District Hospital in January this year due to malaria, is one of many who feel being poor is not helping matters in the face of paying services.
He said he spent four days at the facility and that his friend, who works at the hospital as a nurse, facilitated his quick access to treatment and admission.
Recalled Mvula: “On the first day, I received the necessary treatment because a friend saw to it that I be treated. On Saturday, I got no attention and so, Sunday evening, I had to call that friend who also called those who were on night shift to help me.
“However, when one of the medical staff came to me, he said that some medicines were not available but he could sell me his so that he could use the money to buy a replacement of the drugs.”
At the same hospital, a Songwe Border resident Blessings Chimbalanga, who in December was at the paying ward with his wife for delivery, touted the ward as an important but affordable section for patients who can afford the service.
He said: “Although the section has few and small rooms, it offers quick, reliable and up to standard service which is value for money. I stayed there with my wife for five days and got quick and reliable service at K485 000.
“However, the hospital administration has to expand the paying ward and separate male and female wards to ensure privacy.”
Ntchisi district drector of health and sanitation services Alexander Chijuwa said the district hospital suspended the paying services two years ago after facing some challenges.
He said: “Due to limited spaces, the institution was using same rooms for both paying and non-paying patients. Those paying could simply jump the lines and sit in front to be helped first and that created challenges.”
Dedza DHO spokesperson Mwayi Liabunya said the facility which had tried to offer optional paying services in 2020, stopped the services due to lack of infrastructure and equipment.
Mchinji DHSS Yohane Mwale also said they have not yet started offering OPS, but could not tell reasons, or when the same will commence, besides saying plans were underway for the same.
Under paying arrangement, hospitals are authorised to allocate up to 40 percent of the total revenue generated for healthcare worker incentives, while the rest is for operations.
