Govt misses 900 health posts target

Ministry of Health has missed the target to construct 900 health posts by 2022 as only 75 so far have been completed in the country.

The ambitious target was set in the Health Sector Strategic Plan (HSSP) II to build the new health posts in hard-to-reach areas for integrated provision of community services. Each health post was expected to serve three to five hard-to-reach catchment areas in line with the Ministry of Health’s goal for everyone to live within a five-kilometre radius of a health facility.

The HSSPII, which expired in 2022 and has since been succeeded by the HSSPIII, acknowledges that 56 percent of Malawians still cite long distance to health facilities as a barrier to seeking medical attention when taken ill.

In a telephone interview on Friday, Ministry of Health head of infrastructure Dr Sanderson Kuyeli said the 900 health posts target was a compromise to focus on areas in critical need of the facilities.

“A study that was conducted actually recommended 5 000 health posts, and they arrived at 900 after narrowing down to the critical numbers,” he said.

Kuyeli said so far, 75 health posts have been constructed between 2021 and 2022. He added that 20 of these have been completed with joint funding from the government and The Global Fund.

He said: “The government is working jointly with The Global Fund in constructing the 55 health posts. The Global Fund is investing K4 billion while the government invests K10 billion.

“We are also involving other partners like the Malawi Red Cross Society, private sector players and even councils. That is why we are talking of 75. 20 of them, including Mwanza, Neno, Thyolo, Mzimba, Phalombe and Ntchisi, among others, in the first cohort are at the completion stage.”

Kuyeli said the ministry is also working with partners to equip the facilities once completed. He said he is optimistic that they will achieve the 900-target by 2025.

On what the study considered when picking critical areas to benefit from the construction of health posts, Kuyeli cited a number of things, including access.

“We look at how easily people, can access a health facility. For some people it is a short distance but a very bad road to the facility; while for others, it is a longer distance but the road is good. And some facilities are cut off during rainy seasons. We also consider indicators in the area, such as mortality rates, infant or maternal mortality rates. When we look at these issues, we are then able to position,” he said.

But health rights activists have cast doubt that government will meet the 2025 target.

Malawi Health Equity Network executive director George Jobe, speaking in an interview, wondered whether the government should maintain the 900 target or revise it downwards, considering the demand for resources in other sectors in the aftermath of Cyclone Freddy.

 He said: “Citizens have a lot of hope in the 900 health posts that were promised as they will ease access challenges that some communities have.

“As civil society, we hold duty-bearers and government to account based on what has been laid down either through laws, strategic plans and policies. This is why an explanation and justification for review can be appreciated rather than maintaining the same number.”

Jobe further said to achieve the 900 target, they have been advising the government to allocate resources to complete stalled health facility projects.

He said: “We have a number of them in most districts, and some require just finishing with housing for health care workers and a few other things.

“So, there is need for just some rehabilitation or maintenance to facelift the structures.

“That way we can also have as many health posts close to the 900-target opened within a short period. Whether it is going to be a new project or completing a stalled one, the impact is the same helping Malawians in such communities to access health care services.”

In a separate interview, another health rights activist Maziko Matemba said with some communities still travelling between 15 and 20 kilometres to reach a health facility, the 900 target was a significant milestone made by the government as a commitment.

He said: “We know that there has not been a lot of movement in meeting those targets, leading to the extension of the deadline to 2025. But the government made a commitment and they need to ensure that all those facilities are constructed.

“We have pushed harder on health financing so that we have more resources for health, which in turn can help in building those facilities.”

Parliamentary Committee on Health chairperson Matthews Ngwale said for the past few years, efforts to construct more health have met challenges, including pandemics.

He said: “In 2019, we were hit hard by Covid-19 and the government invested every penny into the fight against the pandemic. So, naturally, the construction of the health posts was not on the agenda at that time. That situation prevailed until 2021. Unfortunately, in 2022-23 we were hit by cholera, which equally took most of our resources and therefore could not construct.”