Projects & programmes: Healthcare delivery

Staffing the public health system in Malawi

In 2004 there were more Malawian doctors in England than in Malawi, which had 16 doctors and three nurses for every 100,000 people, fewer than any other country in Africa. The six-year Emergency Human Resources Programme (EHRP) was developed by the Ministry of Health and DFID to double the number of nurses, and triple the number of doctors in the country by 2011. This will be accomplished by increasing the capacity of training institutions—through a salary top-up and a non-financial incentive package—and by promoting a volunteer service to fill the gaps left by the training periods.

Approach

PwC was invited to place a governance and institutional development advisor in the DFID office in Blantyre to help the EHRP remain focussed on its objectives. This person would also assist on the drugs supply chain that is critical to the improvement programme.

Outcomes

Creating the infrastructure for training is generally on track: in 2005, the number of nurses—475—was almost double that figure in 2001. And the number of medical doctors increased from 16 to 53 in 2007. In the past two years 465 health professionals—who had left the public service—have promised to return to the field. Even though existing health management information systems are being fitted with a monitoring and evaluation component for human resources, there is still a long way to go.