Improving health care delivery services and putting a smile on patientsJan 16, 2014
Apart from shortages of essential basic drugs and basic medical equipment, Malawi’s health delivery system is characterized by high vacancy rates of skilled personnel to deliver quality health services. In the country’s four central (referral) hospitals, the vacancy rate for specialist medical doctors stands at 89% while that of general practitioner doctors is 67%. The situation becomes more depressing taking into account government district and faith-based hospitals. For the past 9 years, UNDP Malawi Country Office, through its UNV Unit, has been involved in the recruitment of UNV medical doctors to bridge the gap while the Government’s Ministry of Health increased its training of local doctors to eventually takeover.
The Project has had significant impact and bringing smiles on a number of patients. The UNV doctors have filled human resource gaps created by the high vacancy rates. For example, slightly more than 50% of specialist doctors and 15% of general practitioners working in Malawi’s four central hospitals are UNV doctors. The deployment of these doctors has added to the existing stock of doctors in Malawi’s health sector and improved access and quality service delivery. Some of the UNV specialist doctors are actively involved participating in training undergraduate students at the University of Malawi’s College of Medicine. The College of Medicine is now graduating 60 medical doctors per year from an average of 18 in 2004. Almost 100% of practical physiotherapy practical training is run by UNV doctors.
The UNV doctors have also assisted in establishing specialized units in some of the hospitals where they are deployed. Notable specialized units are cardiovascular and diabetes disease management units at one central hospital and one district hospitals. An operation on a man who had lived with a unilateral complete cleft lip, an oral malformation that occurs during pregnancy, by a UNV dental surgeon brought some indelible memories on him. He confessed by saying: “Life was not easy for me when I was growing up. I noticed that I had an open mouth different from my peers and this made me very comfortable because my friends never got used to how I looked. Thanks to the doctor that operated on me”. Such confessions are a manifestation of the good work done by these doctors.
Despite the success stories, the UNV Doctors Project has had many challenges. Key among them was mobilization of funds. The Project has been supported by the Government of Malawi with financial from the Global Fund for the Fight against AIDS, Tuberculosis and Malaria (GFATM). The flow of these funds became more unreliable starting from 2012. By the second half of 2013, it was realized by the UNDP Country Office that the available funds would hardly retain the 44 doctors that were in the country. Decisions were made to repatriate all the 44 doctors by the end of December 2013. However, realizing the strategic importance of UNV doctors in health service delivery, the Government of Malawi released $1,059,851 as last tranche under GFATM. High level discussions between UND Country Office and the Royal Norwegian Embassy saw an additional funding of $1,636,500 towards the Project. These additional funds have allowed the Country Office maintain the same number of doctors and extend the Project activities to December 2014.