Health care financing and expenditure in Malawi : do efficiency and equity matter?
The Malawian sector spent about 3.3% of its GNP on health services in 1995/96. The public sector alone spent about 6.2% of its total revenue on health services and this is much high than most other Sub- Saharan African countries (e.g. Zambia, Kenya, Uganda). Despite such high levels of public expenditure, Malawi’s social and health indicators are among the worst in the world. The majority of the Malawian population suffer from a large amount of preventable illness and premature death which could be treated/prevented by simple inexpensive medical interventions. This scenario raises questions with regard to the government stated priority to primary health care and preventive health services. This investigation therefore was undertaken in order to quantify the total health care expenditure in Malawi and its distribution and then evaluate its equity and efﬁciency implications for the delivery of health services. The analyses focused on the public health sector due to the fact that the public health sector is the largest provider of health services in Malawi and its services are ﬁee of charge. It was therefore felt that a detailed analysis and evaluation of this sector could go a long way in improving the health status of the majority of Malawians within the resource envelope.
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