Malawi Government has abandoned the flagship programme to construct 900 health posts na-tionwide, replacing it with a decentralised, demand-driven approach that has no national con-struction target.
Minister of Health and Sanitation Madalitso Baloyi confirmed in an interview that her ministry is no longer implementing the 900 health posts project launched by the previous Tonse Alliance admin-istration because district councils will instead determine where new health posts should be built.
“We don’t have targets,” she said. “What people will demand is what they will get through the district councils. It is upon demand.”
The announcement marks a significant policy shift from the previous government’s commitment to build 900 health posts to bring primary healthcare within a five-kilometre radius of every commu-nity.
Launched in 2020, the programme was scheduled for completion by 2022 but deadlines were successively pushed to 2025 and then 2030 after funding shortfalls stalled implementation.
By 2025, only about 200 health posts had been completed with support from development partners.
Baloyi said the Democratic Progressive Party administration expects decentralisation to deliver more health posts than the abandoned programme because communities are increasingly priori-tising health facilities through district councils and the Reformed K5 billion Constituency Develop-ment Fund (CDF).
“In each constituency you can see that two to three health facilities have been priori-tised just this year. By the time five years end it means we will be over 900 health posts,” she said.
She added that the ministry will only oversee health posts financed by development partners.
However, health sector stakeholders have cautioned that abandoning the national programme could undermine efforts to achieve universal access to primary healthcare.
Malawi Health Equity Network executive director George Jobe said councils should still prioritise the locations identified under the 900 health posts programme, warning that changing direction whenever governments change disrupts long-term development.
“It is unfortunate that sometimes when there is a new government, the focus and approach to some projects also change. We wish there was seamless transfer of projects,” he said.
For his part, Health Rights Education Programme executive director Maziko Matemba said the decentralised model could deliver more facilities if communities prioritise healthcare.
Government identified about 5 000 under-served locations nationwide and selected 900 most critical sites for the first phase.
In his 2021 State of the Nation Address, then president Lazarus Chakwera pledged to complete the 900 health posts and staff houses by 2022. However, inadequate funding repeatedly delayed implementation, with only K1 billion allocated in the 2022/23 National Budget and K2 billion in the 2024/25 financial year, leaving the programme heavily dependent on donor support.
