The public/private mix in the health care system in Malawi

Abstract

Herbalists traditional birth attendants and health counsellors make up the traditional subsector of health providers in Malawi while the government the Christian Health Association of Malawi and private for-profit providers comprise the modern subsector. This mix of public and private health care providers has in fact defined the provision of health care in Malawi from about 1930s to the end of the 1980s. The government however had long stifled the growth of the private for-profit sector through legislation and registration requirements. Recent policy changes easing the way for private health care provision date back largely to the 1987 Medical Practitioners and Dentists Act. The registration of medical practitioners has been liberalized and policies restricting private practice by government doctors have been relaxed along with early retirement. The concurrent emergence of a health insurance industry and the expansion of drug outlets have also helped to bring about the rapid expansion of the subsector. The Ministry of Health acknowledges the potential contributions of private providers and is reaching out to tap into their resources. This paper considers some of these developments and looks at the future of health care in Malawi identifying what is needed to continue a meaningful expansion of private health care services.