Malawi Health Sector Programme – Technical Assistance Component, Options Consultancy Services, 2018

1. Service Level Agreement
Programme:
Achievements, Challenges and
Recommendations
Malawi Health Sector Programme –
Technical Assistance Component
21st September 2018, Knowledge Café

2. Achievements
• SLA status: 58 signed contracts (2015/16) to 130 (2018)
• Utilisation of the facilities and services offered under SLA
– From MNH focus to Under 5 and Under 12 clinics in 2018.
• Ceiling Level and Budget Utilisation
- MK 800 Million (2015/16) to MK 2.8 billion (2017/18)
• Community and Client Perspective
“There is no discrimination in terms of the services offered here.
We are all treated equally regardless of whether we are on SLA
programme or normal paying services”
“I have been in the hospital for 2 days and was discharged free of
charge”

3. Achievements
• Systems in place
– 95% of facilities follow the laid down
procedures and processes
• Invoice preparation and timely submission
– 90% of facilities use prescribed format
• Clearing outstanding bills
– All cleared save last quarter and debts prior to
June 2015
• Up scaling of services under SLA
– 30 facilities offering wide range of services
and over 50% willingness to up scale

4. Challenges
• Transport
• Recruitment
• Flow of information
• Feedback mechanisms

5. Conclusion and Ways Forward
• Ensure all facilities have minimum
number of qualified personnel
• Finance DHO monitoring to CHAM
facilities
• Improve on communications
• Monitoring is essential
SLA program catalyst to universal health
coverage

6. Thank you!
Previously, we would
have to go to
Mangochi District
Hospital (131 KM
away from the facility
off road) to get
assistance for
deliveries and could
not access the same
service here because
we never had the
money. But thanks to
the introduction of this
programme, we are
able to now even get
the same service at a
facility closer to our
village.”