Service Level Agreement (SLA) is said to have increased timely access to maternal and newborn health services particularly in rural areas, Christian Health Association has said.
Cham head of Health Programmes Dr Titha Dzowela said this is evidenced by reduced maternal deaths, reduced neonatal deaths, reduced still births and reduced home deliveries in catchment areas surrounding Cham facilities.
Through SLA, all facilities under Cham provide free maternal and neonatal services to people around the facility’s catchment area.
He observed that the initiative has also increased utilization of services in Cham facilities on average by twofold.
“The service has also removed the economic challenges which households were facing as a result of paying for health services. SLA is very a good initiative, it enables us to reach out to the people we intend to serve who are mostly poor, we just need to work out on the system, for example on issues affecting the payment and also sustainability. On the long run we believe community health insurance is the way to go,” he said.
However, a visit to some of the Cham faciilities in Thyolo and Mangochi revealed that most facillities are facing serious financial challenges due to outstanding SLA bills by government.
In total government is owning Cham about K296 million in debts accumulated from June 2015.
According to Sister Michelina Kahwa of Koche Community Hospital in Mangochi, government is owing the hospital about K13 million in unpaid bills, a thing which is choking the facility in terms of ensuring quality service delivery.
Close to 3000 babies are born each year at the hospital and the total cost per delivery is K10 000.
But Dzowela disclosed that his office is currently working with the Ministry of Health and District Health Officers to ensure that all facilities have standard registers and report monthly according to the required indicators.
The challenge has been attributed to poor record and data keeping.
“CHAM secretariat advocated for the settlement of such debts specifically debts accumulated before June 2015, meanwhile government through MoH has committed to settle the debts with support from partners,” assured Dzowela.
He further explained that Cham in collaboration with government and its partners like the Health sector Joint Fund and Malawi Health Support Programme (MHSP)-Options through the SLA management Unit are working on establishing systems that will reduce the turnaround time for the payments to avoid accumulation of the medical bills.
Responding to a question in Parliament, Minister of Health and Population, Atupele Muluzi, said government needs K10 billion every year to fully finance the essential health package in all eligible Cham facilities to achieve universal coverage of health services.
Mchinji North East member of Parliament Alex Chitete expressed the need for government to extend the Service Level Agreement (SLA) between CHAM and government hospitals for non-communicable diseases which are common in communities.
According to Chitete the SLA which is there currently restricts other people who cannot afford to access the medicine in the Cham facilities because of a charge the facilities impose therefore denying them their right to quality health care which they pass in parliament.
In his response, Muluzi said the concern raised is quite true but the packages being asked needs resources from government to give to the Cham facilities hence restricting free services in Cham facilities to only maternal and neonatal services.
He said government doesn’t have resources to be able to support such services because of huge arrears that were accumulated in the past that government owes the Cham facilities.
“To fully finance the essential health package, it will require 14 million USD, currently the ministry is unable to cover the current SLA package and finances are being sourced from the development partners as the ministry has accrued a lot of debts with CHAM due to unpaid dues, at the moment it will be hard for the ministry to start covering non-communicable diseases at the facilities without assistance from our donors,” he said.