Malawi Government’s health reforms panel has said the proposed introduction of universal health user fees in the country’s hospitals will not be part of the Malawi Health Sector Reforms as the fees could hurt the poor.
Despite government stressing on several occasions that introduction of the fees was strongly being considered, a panel of experts currently reviewing the biggest health services reform agenda has said user fees will not be part of the reform areas under consideration.
In an interview on Thursday, Ministry of Health head of policy Dr Dominic Nkhoma, who is also sitting on the panel of experts, confirmed that the proposal on the universal health user fees was off the table.
Based on research by several international forums, he said universal fees will be contrary to the general spirit of the reforms whose overarching goal is to improve access to quality health services.
“We are, for example, discussing with Cham [Christian Health Association of Malawi] to allow facilities under them to provide free services as well, so it will be defeating that very idea to introduce user fees in all hospitals, certainly mandatory universal fees will not be good for the country,” said Nkhoma.
The proposal for user fees, which is partly being implemented on pilot phase in the country’s central hospitals through bypass fees for users who have not been referred from district hospitals or health centres, attracted stinging criticism from various civil society quarters.
In February, Minister of Health Dr Jean Kalilani told our sister paper The Nation that Cabinet was mulling over health fees introduction in all hospitals, but indicated that a final decision would depend on the recommendation from the panel.
“We know how decisive the matter is, but we are seriously looking at whatever ways we believe will best help improve health service delivery,” said Kalilani.
She also revealed that an initial proposal by the special task force recommends that new taxation on alcohol alongside the user fees be used to finance a health fund.
But global development and advocacy charity, Oxfam, warned government against heeding calls to introduce user fees in the country’s hospitals, saying the move would hurt the country’s poor.
Oxfam country director John Makina welcomed the news of the recommendation on Friday, saying government cannot afford to implement a move that would run contrary to other reforms.
During a drug crisis in 2013, some doctors and other health sector players who met former president Joyce Banda at Kamuzu Palace at an emergency meeting, also suggested introduction of partial user fees as one way of improving quality of health services in the country.
The explosive nature of planned introduction of health user fees in the country’s hospitals also led to cracks in the civil society with some mulling over legal action if government pressed ahead with the proposal.