Reducing child morbidity and strengthening health care systems - Malawi

Health Partners Southern Africa (HPSA) was subcontracted to Management Sciences for Health (MSH) to strengthen central hospital management systems by providing both full time and intermittent technical support over a four year period.

From 2003 to 2007 consultants from HPSA and Health Partners International (HPI) worked with the Ministry of Health (MOH) to facilitate the implementation of hospital autonomy and to strengthen central hospital management systems.

At the start of the project, there was only a rudimentary 'road map' for hospital autonomy outlining a few key steps; there was no shared understanding of hospital autonomy by stakeholders and management systems were poor.

The project assisted the MOH to:

 

  • establish a strategic framework
  • formulate an implementation plan for hospital autonomy
  • systematically strengthen all management systems.

 

This led to:

  • the development of the hospital reform policy (Draft National Policy on Hospital Reform)
  • the Hospital Autonomy Bill
  • a draft Trust Constitution for Autonomous Hospitals
  • new management systems for human resources, finances, revenue, clinical and non-clinical support services, pharmaceutical services, transport and so on.

As part of this project, HPSA consultants also worked with managers at Queen Elizabeth Central Hospital to streamline and standardise the process of referring patients between districts and central hospitals. We also worked to improve the quality of care at district level through training district-level clinicians. This was to address the way that the hospital was overwhelmed with patients coming directly to the hospital, having bypassed their nearest health facilities.

 

The initiative resulted in:

  • quick, reliable and efficient communication between referring clinicians and referral institutions (including the standardisation of referral forms)
  • an effective referral feedback mechanism
  • improved clinical management of cases at district-level prior to referral.


Other initiatives under this project: