REPRODUCTIVE HEALTH POLICIES IN

NATIONAL POLICY PAPERS IN MALAWI

PRESENTATION OUTLINE

•Introduction/basic facts about Malawi •SRH situation in Malawi •The Reproductive Health Unit in Ministry of Health•Malawi Growth and Developments Strategy•Health Sector wide Approach•Country Coordinating Mechanism

BASIC FACTS ABOUT MALAWI

• Country in south-eastern Africa, formerly British protectorate (independence in 1964)

• bordered on the north by Tanzania, on the east by Lake Malawi, on the south-east and south by Mozambique, and on the west by Zambia

• Population currently at 13.1 million• Currently head of the African Union

SRH SITUATION ON MALAWI

• High disease burden; more so among women

• Mostly due to acute conditions at childbirth

• Maternal conditions account for 18% of disease burden in women of reproductive age

• HIV contributes a further 16% to the disease burden in women (infection after childbirth or abortion is #1 cause of deaths)

SELECTED SRH PARAMETERS

Total Population 13 million

Rural population 83%

MMR/100,000 live births 807

Total Fertility Rate 6.0

Contraceptive Prevalence Rate (%)

41 (Including 3% for traditional methods)

SRH PARAMETRES …

Neonatal Mortality Rate per 1,000 live births

33

Infant Mortality Rate per 1,000 live births 72

U5MR/1000 live births 122

Coverage for skilled attendant at delivery (%)

56

MALAWI GROWTH AND DEVELOPMENT STRATEGY (MGDS) – 2006 to 2011

• Agriculture and food security

• Irrigation and water development

• Transport infrastructure development

• Energy generation and supply

• Integrated rural development

• Prevention and management of nutrition disorders, and HIV/AIDS

• An overarching operational strategy for Malawi designed to attain the nation’s Vision 2020

• Developed with strong linkage to MDGs• Emphasis on six key priority areas of

MGDS …Cont’

• Reduced maternal and infant mortality• Reduced population growth rate • Reduced total fertility rate • Increased contraceptive prevalence rate

• Has five themes: Economic growth; Social protection; Social development; Infrastructure development; and Improved governance

• Health and population is a key priority under social development – with most targets related to reproductive health

• Areas of focus include the provision of the essential health package, and development of health infrastructure

• Key performance indicators are:

IMPLEMENTATION, AND MONITORING OF MGDS

• All government arms submit budgets that are in line with the MGDS

• National economic committee in place to ensure effective coordination to avoid duplications and overlaps of cross-cutting issues

• Public-civil society partnerships in place• Line ministries prepare progress reports• Reproductive health unit in Ministry of Health coordinates

implementation and reporting of SRH activities• Economic planning ministry documents all progress bi-

annuly and annually• Parliament comments on progress before presentation of

next budget

• A funding mechanism for programme of work for health service delivery system

• Basket funding approach is used where directorates plan their activities and draw funds from the pool

• The initiative was introduced in 2004 and the current programme of work is for 6 years (2004 - 2010)

• Some donors contribute funds to the SWAP

THE HEALTH SECTORWIDE APPROACH (SWAp)

SWAp PILLARS

The initiative has 6 pillars:• Human resource development• Pharmaceuticals• Essential equipment and supplies• Infrastructure development• Routine operations at service delivery level• Central institutions, Policy and systems

development

SWAP OPERATIONAL STRUCTURE

• SWAP Governance is through Technical working groups (TWG) e.g. Health Donor group, sexual and reproductive health, human resource and infrastructure

• The TWGs membership include Ministry of Health Directors, Partner NGOs, and regulatory

• TWGs discuss policy and implementation issues and make recommendations to the directorates

• Monitoring is done continuously and there are two SWAP review meetings per year

THE COUNTRY CORDINATING MECHANISM (CCM)

• This is a group that oversees and advises direction of global fund projects

• The team gets advice from National Technical Working Groups e.g (SRH, Gender, research and others)

• CCM reports to global fund on progress in all areas including SHR

Guidelines for Community Initiatives for Reproductive

Health May 2007

Government of the Republic of Malawi 14

Reproductive Health Policy 2002

Government of the Republic of Malawi

National Reproductive Health Strategy 2006 –

2010

Government of the Republic of Malawi

Roadmap for the Acceleration of the

reduction of maternal and Neonatal Mortality

and Morbidity

Government of the Republic of Malawi

Maputo Plan of Action 2007 - 2010

Government of the Republic of Malawi

Implementation Plan for Sexual and Reproductive

Health 2007 – 2010

Government of the Republic of Malawi

SOME SRH POLICY DOCUMENTS FOR MALAWI

Key interventions to reduce maternal and Key interventions to reduce maternal and neonatal mortality neonatal mortality

• Emergency obstetric care services

• Family Planning

• Skilled attendants during pregnancy and childbirth

• Essential newborn care

• Early PNC

• Community MNCH initiatives

• Effective referral system using E Ranger Motor Cycle

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