The Malawi Health Sector Strategic Plan (HSSP) (2011-2016) is the successor to the Program of Work (PoW) which covered the period 2004-2010 and guided the implementation of interventions aimed at improving the health status of the people of Malawi. The Ministry of Health (MoH), other government ministries and departments, Health Development Partners (HDP), Civil Society Organisations (CSO), the private sector and other stakeholders in the health sector were involved in the development and implementation of the PoW which was extended to June 2011 to allow for the final evaluation. The Mid-Term Review and the final evaluation of the PoW informed the development of the HSSP, whose overall goal is to improve the quality of life of all the people of Malawi by reducing the risk of ill health and the occurrence of premature deaths, thereby contributing to the social and economic development of the country.
Among the achievements during the period of the PoW, according to the 2010 Demographic and Health Survey has been the reduction in infant and child mortality rates from 76/1000 in 2004 to 66/1000 in 2010 and from 133/1000 to 112/1000, respectively. The maternal mortality rate reduced from 984/100,000 in 2004 to 675/100,000 in 2010 with an increase in women delivering at health centres from 57.2% in 2004 to 73% in 2010. There has also been a reduction in pneumonia case fatality from 18.7% in 2000 to 5.7% in 2008 and an increase in the proportion of children with acute respiratory infections taken to health facilities for treatment from 19.6% in 2004 to 70.3% in 2010. Immunization coverage is high: 81% of the children aged 12-23 months old were fully vaccinated in 2010. This is an increase in coverage of 26% since the 2004 DHS. There has also been an increase in coverage of the estimated population in need of ART from 3% in 2004 to 67% in 20111.
While sustaining the gains made under PoW, the HSSP has taken further measures to address the burden of disease by putting more emphasis on public health interventions, including but not limited to health promotion, disease prevention and increasing community participation. The Essential Health Package (EHP) has been expanded after taking cognizance of the increasing burden of disease arising from non-communicable diseases (some of them ‘lifestyle’ diseases), such as mental illness, hypertension, diabetes and cancers. As the EHP is being implemented, the main priority will be interventions that are cost effective, and expansion of services to the under-served. Despite the gains made there are still a number of factors that need to be addressed that negatively impact on the health of Malawians, namely the availability and quality of health services, access to health services and environmental and behavioural issues.