Abstract
BackgroundNational health accounts provide useful information to understand the functioning of a health financing system. This article attempts to present a profile of the health system financing in Malawi using data from NHA. It specifically attempts to document the health financing situation in the country and proposes recommendations relevant for developing a comprehensive health financing policy and strategic plan.MethodsData from three rounds of national health accounts covering the Financial Years 1998/1999 to 2005/2006 was used to describe the flow of funds and their uses in the health system. Analysis was performed in line with the various NHA entities and health system financing functions.ResultsThe total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. The country had not met the Abuja of allocating at least 15% of national budget on health. The percentage of total health expenditure from households' direct out-of-pocket payments decreased from 26% in 1998/99 to 12.1% in 2005/2006.ConclusionThere is a need to increase government contribution to the total health expenditure to at least the levels of the Abuja Declaration of 15% of the national budget. In addition, the country urgently needs to develop and implement a prepaid health financing system within a comprehensive health financing policy and strategy with a view to assuring universal access to essential health services for all citizens.
Highlights
National health accounts provide useful information to understand the functioning of a health financing system
The countries of the WHO African Region face critical constraints in financing their health systems to provide a basic package of cost-effective health care interventions deemed necessary to achieve the health-related Millennium Development Goals [1]
With a human development index (HDI) in 2005 of 0.437, the country is classified with the group of low Methods The study is based on secondary data from three Malawi National Health Accounts (NHA) reports [18,19,20]
Summary
The study is based on secondary data from three Malawi National Health Accounts (NHA) reports [18,19,20]. Data Sources The three studies used both primary and secondary data for financial years 1998/99, 2002/2003-2004/2005 and 2005/2006 collected from institutions and a specialist survey of People Living with HIV and AIDS. The questionnaires were designed and used to collect the relevant information on utilization of various services, in particular for HIV/AIDS, reproductive health and child health (children age 0-5 years) and expenditure figures by source of finance/financing agent and function. Data on reported cause of morbidity or care seeking, number of bed days, discharge etc. were available in patient registers, and were in a very poor state
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