In July 2016, the Government of Malawi shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.
The government reports performing the following activities in support of its program and service delivery commitment:
The government of Malawi’s activities in support of developing a comprehensive sexual and reproductive health program for young people include the following:
- Malawi conducted an assessment and evaluation of Youth Friendly Health Services in 2013, and the results of which were disseminated in July 2014. These results were used to develop a Sexual and Reproductive Health and Rights Strategy for Young People.
- The newly developed standalone National Youth Friendly Services Strategy of 2015-2020 was endorsed by Senior Management Committee in the Ministry of Health in August 2015 and officially launched in September 2015. It is now a guiding document that is used for implementation.
- In addition, the National Standards on Youth Friendly Health Services 2015-2020 was finalized in October 2015. The revised Youth Friendly training manual is currently in the final stages of its development.
- In addition, the Ministry of Education has included age appropriate sexual and reproductive health information in primary school curricula as part of life skills education which pupils and implementation commenced in September 2014.
The Government of Malawi through its partners namely Population Services International (PSI), Banja La Mtsogolo (BLM), Strengthening Outcomes through Private Sector (SHOPS), and the Family Planning Association of Malawi (FPAM) has partnered with these organisations, which are engaging private clinics to provide family planning services by training the staff and providing FP commodities at a highly subsidized rate to those who are able to pay at all levels of health care delivery system. In approximately 308 private clinics, personnel have been trained in the provision of long-acting and reversible contraceptives throughout the country out of the targeted 300.
One of the core features in the management of the country’s health care delivery system is to ensure that there is an effective and integrated supply chain system. The Government of Malawi, through the Ministry of Health, with financial and technical support from donor partners is strengthening the forecasting and data management through several efforts:
- Training of all health personnel managing health products (medicines and other medical supplies) at all levels of health supply systems in Logistics Management Information System. The purpose of these trainings is to ensure that correct and timely data is available to make informed decision regarding supply chain
- Decentralization of the forecasting exercise commenced in 2013 where districts are now provided with technical knowledge and skills to conduct district forecasting and quantification. This forecasting is consolidated into a national forecast. All activities to ensure that there is a coordinated forecasting and data management in supply chain are ongoing and regularly monitored and evaluated to increase the efficiency.
- The supply chain for all commodities has greatly improved; family planning commodities are supplied to health facilities using consumption data based on Logistics Management Information System reports from each district and the distribution list compiled at a central level. By February 2014, stock out rates for family planning commodities were below 10%.
- Training of health personnel in managing health commodities in logistics management information system are still on-going with a bias towards family planning commodities at all levels.
- The Ministry of Health through Health Technical Support Services-Pharmaceuticals continues to take the lead in coordinating forecasting and health commodities data management at all levels of service delivery points.
- The supply chain for all commodities continues to improve greatly with family planning commodities stock out rates averaging below 5%.
- Districts are now encouraged to pull health commodities especially family planning commodities as to when their stocks are low though distribution lists are still compiled at central level. This is one way of ensuring districts are empowered in forecasting their requirements and ably manage their drug budgets.
- There is a Reproductive Commodity Security (RHCS) steering committee that meets on quarterly basis. Its composition includes different directorates in the Ministry of Health, Regulatory bodies, Private sector and professional association. The RHCS steering committee review issues of stock status, stock outs and advices on strategies that can be taken.
The Ministry of Health has engaged community and traditional leaders through the following activities:
- The Government of Malawi through the Ministry of Health has developed and endorsed a Health Promotion Policy where advocacy on increased community participation including FP services is mainstreamed through different local structures including the Traditional Chiefs Committee, Police Victim Support Unit and Community Action Groups (CAG). With the elections of Councilors and Chairperson of District Health Councils in all 28 Districts, the Ministry of Health appeals for more resources to orient them in monitoring and supervising all structures in mainstreaming FP championing.
- The Ministry of Health, through UNFPA with RMNCH Trust Funds, conducted advocacy with Ward Councilors, Chiefs, Church Leaders, Members of Parliament, CSOs, and village Maternal and Neonatal Counselors on issues of family planning in 10 out 28 administrative districts in Malawi. The advocacy meetings took place from September –November, 2015 and are scheduled to continue in 2016.
The Presidential Safe motherhood initiative also engages Chiefs and other traditional leaders in advocating and raising awareness on broad SRH issues including community participation in family planning.
The government reports performing the following activities in support of its financial commitment:
- The FP budget line was created for 2013/2014 financial budget, with an initial allocation of MK 1million. Since then the budget line has been increasing from 26 million Malawi Kwacha in the 2013/2014 fiscal year, to 60 million Malawi Kwacha in 2014/2015, 70 million Malawi Kwacha in 2015/2016, and 75 million Malawi Kwacha in 2016/2017.
- 99,264 vials of Depo Provera were procured using the 2014/15 budget and 40 million Malawi Kwacha of 2015/16 funds were used for the procurement of condoms and 20 million for Lignocaine, while 10 million were planned for capacity building for Implanon NXT.
The government reports performing the following activities in support of its policy and political commitment:
- Advocacy sessions have been held with different groups on the change of age of marriage from the current 15 years with parental consent to 18 years or above. Chiefs have signed a communiqué committing them to work with government to advocate for the same. The Reproductive Health Directorate and other stakeholders through relevant structures continued engaging the previous Parliamentary Committee on Health and Population as well as the Gender committee on the issue of raising the age of marriage. As a result, the age of marriage was increased from 15 years old to 18 years old in February 2015 and enacted by parliament. The Marriage, Divorce and Family Relations Act No.13 was published on 17th April, 2015 (ACT No.4 of 2015 assented by His Excellency, the State President, Prof Arthur Peter Mutharika on 10th April, 2015).
- The government, together with traditional leaders, civil society, faith-based organizations, development partners and the private sector has developed a five-year Family Planning Costed Implementation Plan to provide a road map for stakeholders to increase access to and demand for family planning services, thus enabling Malawians to achieve their reproductive intentions. This document was launched in September 2016.
- The forth coming government reforms will emphasize policy and coordination with local assemblies so as to strengthen their capacity to deliver in order to facilitate the implementation of the FP CIP.
- Malawi plans to widely disseminate and advocate for larger stakeholder awareness of the government’s FP2020 commitments and the implementation of a five-year FP CIP during the forthcoming 2nd Family Planning Leaders Conference.