Health Sector Mid Year ReviewCrossroads Hotel27 April 2015

Dr. Charles Mwansambo

Chief of Health Services

Outline

Highlights for the Period

Health Sector Financing

Health Systems Performance

Performance of Health Service Delivery

Health Sector Reforms

Highlights of the Period

In the period of July – December, 2014 the Ministry continued to prioritize Maternal, Neonatal, and Child health.

There were three major emergencies: Responding to Floods, Controlling the spread of Cholera and Mitigating the threat of Ebola

The Ministry pursued a number of Health Sector Reforms to improve on the quality and efficiency of health service delivery.

Health Sector Financing

Resource Mapping Round Three showed that MK278.8 billion is available for the 2014/15 Fiscal Year.

MK71.8 billion (26%) comes from the MOH Pool, MK56 billion (20%) from NAC and MK151 billion (54%) are Discrete Project resources.

Health Sector Financing

Government contributed MK65.8 billion (92%) of the required MK71.8 billion SWAp Pool resources.

The balance of MK6 billion was predominantly contributed by the Norwegian and Flemish Governments.

Health Systems Performance

Health Systems Performance covers: Human Resources for Health, Health Infrastructure, Medical Equipment, and Drugs and Medical Supplies.

Human Resources for Health

MoH Continued with Implementation of integrated Human Resources Management Information System (iHRIS) to improve on data quality.

Improved overall vacancy rate with a drop from 47% to 45% through recruitment of 207 nurse midwives, 15 medical doctors, and 80 medical assistants – out of 534 graduates in the period.

Spent MK574,798,100 on 1,006 pre-service students.

Drugs and Medical Supplies

Sustained availability of essential medicines and medical supplies.

DfID has supported CMST with the outsourcing of Warehousing and Distribution to Imperial Health Sciences.

Drug quantification for 2014/15 FY was completed ($69 Million is needed for health commodities).

Essential Equipment The Ministry of Health released the Service

Provision Assessment (SPA) Report which shows availability of equipment as in the graph below:

Infrastructure Development

PROGRESS OF SELECTED PROJECTS:

Project Name StatusUmoyo Houses: 140 new staff houses and 5 flats

Progress at 60% and 50%, against targets of 60% and 30%, respectively

Central Hospital Rehabilitation

Progress at 70% (QECH), 0% (ZCH), 80% (KCH), 38% (MCH)

Nkhatabay District Hospital

Progress at 97%

Phalombe District Hospital

Consultant recruited, Contractor recruitment in progress

15 Health Centers Progress at 15%, against target of 30%

Health Service Delivery Performance

HOSPITAL ATTENDANCE, ADMISSIONS AND DEATHS:

Districts Central Hospital

s

Total

OPD attendances

5,024,404

364,572 5,388,976

Admissions

258,615 81,474 340,089

Inpatient deaths

5,639 3,468 9,107

Maternal Health

10.5% of pregnant women visiting ANC in their first trimester against target of 17% (HMIS)

87% deliveries with skilled birth attendant (2014 MDG Survey)

90% of births occurred spontaneously, 6.8% (C-section), 1.7% (Breech, vaginal), 1.4% (vacuum extraction) (HMIS)

Child Health

Fully Immunized Measles Pentavalent 30

10

20

30

40

50

60

70

80

90

100

Current Target

Perc

enta

ge (T

arge

t vs

Curr

ent)

PROPORTION OF CHILDREN IMMUNIZED AT DISTRICT LEVEL

MalariaMoH released the 2014 Malaria Indicator Survey report

Indicator 2012 MIS

2014 MIS

% of those suffering from malaria who have access to and are able to use collect, affordable and appropriate treatment within 24 hours of onset of symptoms

24 31.2

% of pregnant women who have access to and receive two or more doses of IPTp for malaria prevention

55 63

% of children under 5 years of age sleep under an ITN

56 67

% of pregnant women sleep under an ITN

51 62

% of outpatient suspected malaria cases who are confirmed by parasitological diagnosis

65 75

Diarrheal Diseases

212,538 diarrheal diseases, representing an Incidence Rate of 165 per 1,000 in under-fives

15% of diarrhea cases reported in Lilongwe, 8% in Blantyre, and 5% in Mangochi

Health Sector Reforms(More details in Session 2)

Activities include:

1. Reviewing the Partnership with CHAM

2. Establishing a Health Fund

3. Revitalization of Health Insurance Schemes

4. Reforming Hospital Operations, including Decentralisation

Thank You for Your Attention

QUESTIONS?

ANNEXES – ADDITIONAL SLIDES

Health Sector Financing• Only MK8.1 billion of the projected MK24.6

billion discrete resources were disbursed as at 31 Dec 2014

Discrete Donor

2014/15 Expected Disbursements (MK)

Disbursement for Mid Year (MK)

% Disbursed as at 31st December 2014 (MK)

Norway/FICA 5,202,003,261 4,205,743,959 81%

UNHCR 87,729,027 36,564,234 42%Global Fund (GF) 17,468,327,200 2,704,228,664 15%

CDC 1,867,095,646 1,148,144,102 61%

Total 24,625,155,134 8,094,680,959 33%

Human Resources for Health

• Promoted 524 staff to different positions in the reporting period of which 249 were Medical Assistants to Senior Medical Ass.

• Conducted promotional interviews as follows:– 1,350 HSAs to Senior HSAs– Fresh employees to fill 1, 350 vacant

positions to be created.

Human Resources for Health

• 5 Radiotherapists and 2 Medical Engineers sent to school under the Cancer Capacity Building Project.

• Obtained Establishment Warrant (EW) from the OPC to create 47 positions for laboratory technologists (90% of technologists who have graduated from different schools to be absorbed).

Essential Equipment• Status of Procuring Selected Equipment :

Equipment Type Status Cost CenterMammography Machines

Delivered, awaiting installation

Central Hospitals

Radiography Machines

In progress, advanced stage

KCH, MCH, QECH

X-Ray Machine, Tube In progress Salima, Karongathermos-luminescent dosimeter reader

Donated by IAEA KCH

5 Standby Generators

In Progress, 1 Delivered to Mchinji District Hospital

District Hospitals

2 Oxygen Plants In progress KCH, QECH

Malaria• Continued trend in reduction of Malaria

Incidence Rates

June, 2009 June, 2010 June, 2011 June, 2012 June, 2013 June, 2014 Dec, 20140

100

200

300

400

500

600

396

456484

371

332 332

223

Period

Incid

ence

Rat

e