Depleted funding threatens hospitals

The public health sector has exhausted 60 percent of the funding allocated in the current financial year and donors have not been forthcoming to provide more in light of the looting of government resources, authorities have confirmed.

The approved budget for the Ministry of Health for the 2013/14 financial year was K42.2 billion, far below the K79.5 billion the ministry had requested, leading to a drop in the quality of health services evidenced by the shortage of drugs and medical supplies in public hospitals.

Minister of Health Catherine Gotani Hara confirmed on Friday at the opening of the joint mid-year review of the health sector in Lilongwe that more funding is needed to the end of the financial year in June.

Gotani Hara said discussions are underway with Treasury to deal with the funding gaps.

The 2013/14 health sector mid-year review report, which came under the spotlight on Friday, indicates that by December 31 2013, district hospitals had already spent K5.9 billion of the K9.9 billion allocated to district health offices (DHOs).

“This level of absorption implies that the hospitals will have a funding challenge to their operations to the end of the fiscal year bearing in mind the dynamic economic changes of the country,” reads the report.

The ministry, DHOs and central hospitals have also spent the K32 billion disbursed from the Sector Wide Approach (Swap) pool of donor funding out of the K52 billion budgeted for the year.

But this spending occurred before some donors delayed funding after revelations that billions of kwachas were siphoned from the government purse.

Signals from donors are that the prospects for more funding before June are remote.

Presenting the preliminary findings on the mid-term review of the Health Sector Strategic Plan, Dr Jap Koot, a donor representative from Norway attached to the Ministry of Health, said in the face of cashgate, it is unlikely that funding would be disbursed before the end of the financial year.

“I don’t have to remind people about cashgate here. On the part of pool funding, as far as partners are concerned, we will not come back,” said Koot.

Presenting an overview of the funding and expenditure status, director of policy planning and development in the Ministry of Health Dalitso Kabambe said the highest percentage of the Swap pool funding went towards salaries.

“At least 60 percent of the funds disbursed went to salaries. That means more money will be required so that all get salaries up to the end of the fiscal year,” said Kabambe.

This has been further exacerbated by low disbursement from donors who are not part of Swap, among them the African Development Bank, Unicef, UNFPA and the Centre for Disease Control as these only provided K1.6 billion of the expected K8 billion.

Kabambe said it is worrisome that the Global Fund, which was expected to disburse K3.3 billion in the 2013/14 financial year, and the General Alliance for Vaccine Initiative had not released any funding by December 31 2013.

But Gotani Hara was optimistic that although funding would be reduced, government would continue to engage donor partners and find other sources of funding.

“Although the resources into the Swap pool account were lower than expected in the period under review, government had scaled up resources from its own generation to ensure that the health sector is provided with budgeted resources,” she said.

Gotani Hara said in October 2013, the ministry sourced K3.2 billion from the Norwegian Government which went to central hospitals and DHOs.

Chairperson of the Health Donor Group Miriam Lutz asked government to improve on transparency and remain vigilant to avoid reversing the gains made in the health sector such as reduction of maternal and child mortality.

“All donors are working hard to respond to the ministry’s calls for additional assistance, but we also ask for increased frequency in details and financial reporting,” said Lutz.

Commenting on failure by the Global Fund to disburse funding, Lutz said it was a result of inadequate performance of grants.

She said this should set off alarm bells in government because it would jeopardise funding for HIV, malaria and tuberculosis.