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Africa Health Malawi : Tackling the human resources crisis

Jul 032010

Lake Malawi

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Tackling the human resources crisis in Malawi’s public health system, Debbie Palmer; Department for International Development, UK, id21 Development Research Reporting Service, 2007

About the paper

Since the late 1990s, Malawi’s public health services have appeared to be heading for collapse due to declining staffing levels. The government launched the Essential Health Package in 2004 to help improve the health of the population, which includes scaling-up HIV and AIDS-related services. The biggest challenge facing the initiative is improving human resource levels.

The Commission for Macroeconomics and Health has highlighted how vital improved health is for economic growth and human development. As a result, the international focus has been on providing more cost-effective funding to improve health services and to strengthen national health systems. The link between staffing levels and improved health has been highlighted as the main ingredient that holds health systems together.

Malawi is one of Africa’s poorest countries. Although its health infrastructure is fairly well developed, this is in very poor condition. The public health sector has battled a rising demand for services caused by population growth and a high HIV and AIDS rate. Yet its health staffing levels, the lowest in sub-Saharan Africa, are not enough to maintain even a minimum level of care.

In 2004 the Malawian government declared the human resources shortage a crisis. The Ministry of Health launched an Essential Health Package initiative to tackle the 11 main causes of death and illness. Donors responded to the crisis by helping the country develop a complementary Emergency Human Resources Programme. A study by the UK Department for International Development’s Malawi office examined this human resources crisis. It assessed progress made within a year of implementation of the programme in April 2005.

The study found that:

Salary top-ups introduced to improve staff recruitment and retention helped reduce the flow of staff, especially nurses, from the public sector.

Good progress had been made with the recruitment and re-engagement drive, with 591 staff recruited externally by the end of 2005 and over 1,100 promoted internally.

The recruitment of stop-gap expatriate support included 19 people in place and the deployment shortly of a further 51 doctors and 15 nurse tutors.

Of the 1,000 Malawian health professionals who had left the public sector, 700 were willing to return due to top-ups, more flexible deployment and further training.

However, overseas migration of the most senior and experienced nurses continued in 2005.

In the past, donors have been unwilling to contribute to salaries and incentive packages for staff, due to concerns about donor dependency and project sustainability. However, this new approach has been successful in Malawi and has provided a number of lessons:

After it was shown that insufficient human resources prevented the success of donor-funded projects, two donors agreed to a comprehensive, outcomes-based approach for Malawi that included tackling staffing. Other African countries could also benefit from this approach.

The improvement of working conditions and management practices is as important as pay when it comes to improving staff morale and retention.

It is important to combine both short-term and long-term measures to ensure commitment to the programme. Salary top-ups, for instance, had an immediate effect.

This case illustrates the importance of management of industrial relations.

Malawi, and other African countries, will need to produce an excess of nurses to account for the ongoing migration of nurses overseas, and to track these trends.

The achievement of the Millennium Development Goals (MDGs) by 2015 will only be possible if we can successfully strengthen the capacity of health systems in middle and low-income countries.
http://www.eldis.org/id21ext/Insightshealth12art6.html

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In Africa Partnership and Collaboration is the Way Forward

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Jun 232010

[Photo credit: DFID - UK Department for International Development under a Creative Commons license]

Partnership and collaboration seem to be keywords in Africa discussions these days. The following press release from the NextGen Africa Forum hosted by Goods for Good explains a little why that trend is important.

New York, 17 June 2010 – Earlier this week Goods for Good hosted the NextGen Africa Forum at NYU’s Kimmel Center, where The Right Honorable Joyce Banda, Vice President of Malawi, gave an address on the plight of Africa’s 50 million orphans to an audience of 350 NGO’s, key experts in the field and other interested individuals.

The Forum was initiated by Goods for Good Founder and Executive Director, Melissa Kushner, in order to facilitate discussion the creation of partnerships for advancing Africa’s next generation. ” The issue is too complex for any one organization to tackle alone,” she explained. “We’re hosting NextGen Africa to encourage dialogue, partnership, and collaboration between organizations working towards the same goal of helping to create a better future for these children and their communities.”

Setting the tone for the evening, Vice President Joyce Banda started by giving numerous examples of how the situation in Africa is not hopeless. Interventions, when implemented properly, can and do have a real impact on the ground. “By working with local leadership – chiefs and local village leaders who are a powerful, critical mass of local leaders – important change can be made in communities. These leaders are the custodians of tradition. People listen to them because they are respected and have authority.” – she explained. Most pointedly, Vice President Banda highlighted a program spearheaded by her Foundation, which has reduced child malnutrition in Malawi from 20% to 2%.

Joyce Banda’s inspiring speech was followed by a Q & A discussion panel , complemented by Dr. Jane Aronson (Founder and CEO of the Worldwide Orphans Foundation), Ann Veneman (Former Executive Director of UNICEF) and moderated by Claire Gaudiani, author of The Greater Good.

“Working in partnership is critical. Different organizations with different goals constantly going into countries and doing their own thing doesn’t work,” said Ann Veneman. “We have to create collaborative, community approaches that will be sustainable over the long term.”

The general consensus amongst the panel and audience was that to address the issue of orphans and vulnerable children, you must first address the larger issue of poverty. For example, micro-finance programs can stimulate the economy, increase household income and provide parents with the means to better care for themselves, thereby reducing the risk of parents deaths and therefore orphans.

Increased parental income also enables the education of girls, who are customarily pulled from school first when faced with a lack of funds. When girls are unable to gain an education they typically marry at the age of 13 or 14, have children soon thereafter and enter the viscous cycle of lack of education, low income, poor nutrition including lack of pre-natal care and increased risk for early parental death.

But the concern that African orphan crisis is too large to confront with viable solutions was addressed unanimously by all parties. The resounding opinion was that “we must divide up the pie” and help one child at a time with culturally appropriate solutions.. There are many ways for individuals to become a part of the solution, starting with supporting www.goods4good.org. For just $10, Goods for Good can provide a child with the materials they need to gain an education. Joyce Banda explained: “Melissa’s nonprofit , Goods for Good, is partnering with people on the ground, and that’s the way to do it.”

About The Right Honorable Joyce Banda:

Joyce Banda is the first female Malawian Vice President. An influential advocate for women and children’s rights, she previously served as Minister of Gender, Child Welfare and Community Development and Minister of Foreign Affairs. Among other notable achievements, she received the International Award for Health and Dignity of Women by Americans for UNFPA and founded the National Association for Business for Women, a network of over 30,000 women. She also founded the Young Women Leaders Network, and the Joyce Banda Scholarship Foundation, which provides scholarships for secondary school children in Malawi.

About Goods for Good:

Goods for Good (G4G) is a 501(c)(3) non-profit organization founded in 2006 to promote the educational and emotional development of orphans and vulnerable children in developing nations. Through partnerships with international companies and grassroots organizations abroad, Goods for Good provides much needed school supplies, clothing and health and hygiene products to children in need while at the same time reducing waste at home. To date, Goods for Good has rescued and delivered over 120 tons of surplus goods reaching over 510,000 vulnerable children and their communities.

To learn more, visit www.goods4good.org.

Videos of the speeches and Q&A can be seen at: http://vimeo.com/goods4good/videos.

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Africa IMF Reports : Malawi 2010

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Jun 102010

Limbe, Malawi

[Photo credit: nchenga under a Creative Commons license]

IMF Reports for Malawi 2010

Country Report No. 10/87: Malawi: Staff Report for 2009 Article IV Consultation and Request for a Three-Year Arrangement Under the Extended Credit Facility
http://www.imf.org/external/pubs/cat/longres.cfm?sk=23771.0

IMF Survey: Malawi’s New IMF Loan Boosts Prospects for Sustained Growth

Malawi’s recent robust economic growth has enabled one of Africa’s poorest countries to make real strides in reducing chronic food insecurity and progress toward poverty reduction and development targets. However, rapidly rising imports and foreign exchange shortages threaten the country’s strong recent macroeconomic performance.
http://www.imf.org/external/pubs/ft/survey/so/2010/car033110a.htm

Country’s Policy Intentions Documents — Malawi: Letter of Intent, Memorandum of Economic and Financial Policies, and Technical Memorandum of Understanding, January 26, 2010
http://www.imf.org/External/NP/LOI/2010/mwi/012610.pdf

Public Information Notice: IMF Executive Board Concludes 2009 Article IV Consultation with Malawi
http://www.imf.org/external/np/sec/pn/2010/pn1038.htm

Press Release: IMF Executive Board Approves Three-Year US$79.4 Million Extended Credit Facility Arrangement for Malawi
http://www.imf.org/external/np/sec/pr/2010/pr1052.htm

Country’s Policy Intentions Documents — Malawi: Letter of Intent, Memorandum of Economic and Financial Policies, and Technical Memorandum of Understanding, November 13, 2008
http://www.imf.org/External/NP/LOI/2008/mwi/111308.pdf

Country Report No. 09/16: Malawi: Request for a One-Year Exogenous Shocks Facility Arrangement – Staf fReport; Press Release on the Executive Board Discussion; and Statement by theExecutive Director for Malawi
http://www.imf.org/external/pubs/cat/longres.cfm?sk=22629.0

All information is from http://www.imf.org

To view and print pdf files you need the free Adobe Acrobat Reader which is available at http://www.adobe.com/products/acrobat/readstep.html.

For tracking globalization and its impact on individual economies, please see the new IMF Survey magazine online at http://www.imf.org/external/pubs/ft/survey/so/home.aspx News, views, and analysis from the IMF.

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Africa Malawi : Local Language Dictionary Released

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May 122010

Malawi landscape

[Photo credit: Shared Interest under a Creative Commons license]

(Charles Mpaka, Blantyre, 18 March, IPS) – With 35,000 entries, the new book which translates Chichewa to English (CE) and English to Chichewa (EC) is the first comprehensive dictionary of its kind in Malawi. It is new on the shelves of Malawi’s book stores and was published last year.

Chichewa is spoken by all ethnic groups in the country and was declared a national language in 1968. According to Dr Steven Paas, a Dutch researcher who compiled and edited the dictionary, Chichewa is an important daily communication tool for more than 15 million people in Malawi, Zambia, Mozambique, Zimbabwe and South Africa.

Read full article at http://www.ipsnews.net/africa/nota.asp?idnews=50717

[via OCPA News No 249]

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Border Jumpers : A few words about Malawi

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May 072010

Malawi: Lilongwe Wildlife Center

[Photo Credit: Nourishing The Planet used by permission]

Guest Post by By Danielle Nierenberg and Bernard Pollack, BorderJumpers.org

In Malawi, we visited the Lilongwe Wildlife Centre, a project supported by companies like the Body Shop, providing sanctuary space for rescued, confiscated, orphaned and injured wild animals of Malawi. While touring their facility we met Kambuk (which means “leopard” in Chichewa), who was soundly sleeping in his 2,500 sq meter backyard of fenced green landscape. He was rescued by the Lilongwe Wildlife Centre after poachers shattered his knee in Nyika National Park (making it impossible for him to ever return to the wild.) As we toured the facility nearly every animal we saw — from baboons to alligators — had a similar Cinderella story of overcoming insurmountable odds to survive and, in most cases, return back to the wild.

The Center is one of the leading organizations in Malawi pushing lawmakers to enforce and enact legislation in support of wildlife conservation and environmental protection. They also develop local partnerships and training programs with the farmers and communities surrounding national parks. The struggle between protecting wildlife and agriculture is becoming especially evident as drought, conflict, and hunger continue to affect sub-Saharan Africa.

Malawi may actually be best known for its so-called “Malawi Miracle.” Five years ago the government decided to do something controversial—provide fertilizer subsidies to farmers to grow maize. Since then maize production has tripled and Malawi has been touted as an agricultural success story. But the way they are refining that corn, says Kristof Nordin who demonstrates permaculture techniques at him home with his wife, Stacia Nordin, makes it “kind of like Wonderbread,” leaving it with just two or three nutrients.

Most Malawians think of traditional foods, such as amaranth and African eggplant, as poor people foods grown by “bad” farmers. But these crops, being more nutritious and requiring less artificial fertilizer compared to hybrid varieties may hold the key for solving hunger, malnutrition and poverty in Malawi. Rather than focusing on just planting maize—a crop that is not native to Africa—the Nordins advise the farmers they work with that there is “no miracle plant, just plant them all.”

And indigenous crops can be an important source of income for farmers. Rather than importing things like amaranth, sorghum, spices, tamarinds and other products from India, South Africa, and other countries, the Nordins are helping farmers find ways to market seeds, as well as value added products, from local resources. “A lot of solutions,” he says, “are literally staring us in the face.” And as I walked around seeing—and tasting— the various crops at the Nordins’ home, it’s obvious that maize is not Malawi’s only miracle.

[Video Credit: Worldwatchag used with permission]

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Africa Economy : Regional variation in livelihood strategies in Malawi

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Mar 072010

Lake Malawi

[Photo credit: platours_flickr]

About the paper

Regional variation in livelihood strategies in Malawi, Hatlebakk,M. Chr. Michelsen Institute, Norway (2009)

An obvious pathway out of poverty for poor households in agricultural based economy is to supplement agricultural incomes with non-farm economic activities. This paper identifies livelihood strategies at the household level as a function of assets held in Malawi. In particular, the paper tries to identify factors that may enable the poor to leave the poverty trap that subsistence agriculture represents.

The paper reveals that land, household size, age and primary education are important determinants of livelihood strategies. The paper’s main findings are as follows:

the pure farming strategy is more likely, the larger is the farm

combination of farming with other activities is more likely in larger households
younger people are more likely to find non-farm jobs
completed primary education increases the chance of getting a salaried job
there is more diversification in livelihood strategies in the southern region, where poverty is higher, but southern households may do more low salaried work and household businesses
there are some differences between ethnic and religious groups, with households from the Muslim community being more likely to be engaged in household businesses

Equally important, the paper finds that some resources are needed to be able to conduct non-farm economic activities. It presents these two recommendations:

investment in primary education, taking into account the low initial level of education in Malawi, is probably a good investment for rural development

poorer farmers in southern region may learn from the more productive farmers in the central region, where there is more emphasise on cash-crop production, and also possibly combine agriculture with household businesses to a larger extent

[Via ELDIS]

How to get a copy

Available online at: http://www.eldis.org/cf/rdr/?doc=44646&em=030310⊂=agric

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Africa Economics Malawi : Much to Lose, Little to gain - Assessing EPAs

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Feb 232010

[Photo credit: Dust Mason]

About the Paper

Much to lose, little to gain Assessing EPAs from the perspective of Malawi, TearFund 2007

Economic Partnership Agreements (EPAs) between the European Union (EU) and African, Caribbean and Pacific (ACP) countries pose a major threat to development and poverty reduction. The ACP countries include some of the poorest countries in the world – 39 of the world’s 50 Least Developed Countries (LDCs). Yet EPAs will require the ACP to liberalise substantially all of their trade with the EU. The EU is also using EPAs to push its agenda on the so-called ‘Singapore issues’ that developing countries have refused to negotiate at the World Trade Organisation (WTO) for years.

The EPA negotiations are unbalanced. There is great disparity between the ACP and EU in terms of development and economic power. Also, there are fundamental differences in understanding between the ACP and EU of how the ACP-EU trade relationship can serve development purposes. ACP governments, parliamentarians and civil society are expressing increasing concern about EPAs, in terms of process, content and the potential impact on ACP economies and populations.

This report looks at EPAs from the perspective of Malawi. Malawi’s stakes in EPAs are high: as the single largest market for Malawi’s exports and a key source of imports, the EU is an important trading partner. For the EU, however, trade with Malawi accounts for a

mere 0.01 per cent of its world trade.1

This report shows that an EPA threatens to, inter alia:

reinforce Malawi’s position as an exporter of low-value, unprocessed commodities, undermining the Malawian government’s development strategy to ‘add value’ to agricultural goods and to develop a manufacturing sector
undermine regional integration between Malawi and its neighbours
lead to a significant loss of fiscal revenue and induce other major adjustment costs.

Given the threat that EPAs pose to development and poverty reduction and considering the concerns being raised by stakeholders across the ACP, we make a number of recommendations outlined overleaf.

Produced by: Malawi Economic Justice Network (2007) together with TearFund

How to get a copy

Download paper online at: http://tilz.tearfund.org/webdocs/Website/Campaigning/Policy%20and%20research/much_to_lose_little_to_gain.pdf

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Africa IMF Reports : Malawi 2009

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Feb 032010

Limbe, Malawi

[Photo credit: nchenga under a Creative Commons license]

IMF Reports for Malawi 2009

Press Release: Malawi — Press Statement at the end of the IMF Staff Mission
http://www.imf.org/external/np/sec/pr/2009/pr09396.htm

Press Release: Statement at the Conclusion of an IMF Staff Mission to Malawi
http://www.imf.org/external/np/sec/pr/2009/pr09105.htm

Country’s Policy Intentions Documents — Malawi: Letter of Intent, Memorandum of Economic and Financial Policies, and Technical Memorandum of Understanding, November 13, 2008
http://www.imf.org/External/NP/LOI/2008/mwi/111308.pdf

Country Report No. 09/16: Malawi: Request for a One-Year Exogenous Shocks Facility Arrangement – Staf fReport; Press Release on the Executive Board Discussion; and Statement by theExecutive Director for Malawi
http://www.imf.org/external/pubs/cat/longres.cfm?sk=22629.0

All information is from http://www.imf.org

To view and print pdf files you need the free Adobe Acrobat Reader which is available at http://www.adobe.com/products/acrobat/readstep.html.

TAKE A LOOK: For tracking globalization and its impact on individual economies, please see the new IMF Survey magazine online athttp://www.imf.org/external/pubs/ft/survey/so/home.aspx News, views, and analysis from the IMF.

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Africa Environment Malawi : Country Assessment

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Jan 292010

About the paper

Baseline study: country assessment of the state of the environmental movement in Malawi
Authors: Munyenyembe,M.P.; Kalowekamo,F.M. Produced by: Development Fund, Norway (2008)

This paper examines the obstacles that face the implementation of environmental policies in Malawi. It presents some recommendations in order to advance the growth of environmental movement and its linkages with other players.

The paper shows that from mid-1990s, the environmental movement in Malawi has registered tremendous growth. The Government of Malawi has initiated many programmes to mitigate negative impacts on the environment such as review of legislation and policies. These new policies have created an enabling atmosphere for environmental advocacy by promoting cooperation between Government, local communities, NGOs and the private sector.

Nevertheless, in trying to bring about changes in environmental policies, the civil society encounters many problems: resistance to change, lacking of developmental component in conservation projects, the concentration of NGOs in the cities, and competing government priorities.

The paper concludes that civil society has a crucial role to play in environmental management in Malawi. However, the paper suggests some recommendations to enhance its effectiveness:

civil society should commission an economic valuation exercise with the purpose of attaching monetary value to natural resources

civil society organisations should build the capacity of their employees in terms of knowledge, skills and numbers

the government should try and balance socio–economic development with management of the environment

civil society organisations need to be focused in their advocacy work on policy issues

civil society organisations should improve their work through collaboration by forming networks of environmental NGOs

civil society organisations on the environment need to step up their advocacy campaigns that aim at integrating considerations of good governance and sustainable use of natural resources at all levels.

How to get a copy

Download PDF of Baseline study: country assessment of the state of the environmental movement in Malawi

Via Eldis.org

Africa Politics : Gay Issues in Malawi and Uganda

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Jan 202010

Malawi coast

[Photo credit: platours_flickr]

The following Guest Post by J Kainja addresses one of the controversial issues that is concerning many people in Africa at the moment. You may not agree with what he says, but the questions he asks are good ones and deserve consideration.

Gay Rights in Africa: What is the Donor Community Up To?

January 20, 2010 1:55pm, previously posted at Eldis Community Blogs

The dictatorial manner in which the donor community is handling gay issues in Malawi and Uganda clearly shows that they are not driven by Africa’s best interests but rather, pushing their own agenda. This is a wake up call for African nations to rethink donor intervention in African affairs.

The issue of gay rights in Malawi and Uganda has recently received unprecedented international attention, and rightly so. Two separate issues have ignited the debate within the said countries and condemnation from the international community.

First is Malawi’s arrest of two gay men after their alleged wedding, which according to Malawi authorities was against the law and a crime punishable by up to 14 years imprisonment. On the other hand, Uganda has been criticised for its ‘private members bill’ that proposes to punish all gays with life imprisonment.

There is a famous concept that the world is not a bad place because it has bad people but it is because of the good people who do not stand up against evil. In the spirit of this saying, I find it appropriate that international community, including reputable organisations like Amnesty International have stood up for the rights of gay communities, and they have duly called for the release of the arrested homosexuals in Malawi.

Meanwhile, the issue has not only highlighted the huge cultural and ideological gulf between the West and the East, but it has also opened a whole bucket of worms that could have some serious implications on international relations.

According to Timesonline, Uganda’s president, Yoweri Museveni, has distanced himself from an anti-homosexuality bill currently before the Ugandan parliament in Kampala after pressure from the Prime Ministers of Britain, Gordon Brown, and Canada, Stephen Harper, and the United States’ secretary of state, Hillary Clinton.

Timesonline has also reported that United Kingdom’s ‘Queen’s music composer’, Sir Peter Maxwell Davis, has called on the Scottish government to suspended its aid to Malawi until the government of Malawi frees the gay couple currently in custody under anti-gay laws.

Malawi’s Information Minister Leckford Mwanza Thoto holds that the gay couple have broken the laws of the land, hence the ‘government cannot interfere in the court process’ [presumably emphasising the separation of powers]. The minister also adds: ‘we depend on our Western friends, yes, but we are a sovereign country.’

As much as I believe the Western countries are acting in the interest of the gay community, I also think that this case has exposed the fragility of Africa’s so called independent countries. Scotland contributes £3 million of the forty percent budgetary support that Malawi gets from the donor community. In 2008 / 2009, the Ugandan government received £35 million in budgetary support from the UK government. The donor community consequently feels that the African countries [receiving support] must toe their line.

The gay rights issue is cultural if not an ideological. There should be a rational discussion to find ways of dealing with it. Threatening Uganda and Malawi with aid freeze / withdrawal may get the donor community their intended results but it will not change people’s ideologies and beliefs. This can only be done through discussion as equal partnered.

The West must not imply that they are the all consuming ogres of knowledge to do the teaching but not the learning from ‘others.’ Such a mentality and will only breed resistance.

Africa is a home to 17 million Internally Displaced Persons (IDPs) who according to Displacement Monitoring Centre (IDMC), often have very limited or no access to food, employment, education and healthcare. The IDMC further states: “large number of IDPs are caught in desperate situations amidst fighting or in remote and inaccessible areas cut-off from international assistance. Others have been forced to live away from their homes for many years, or even decades, because the conflicts that caused their displacement remained unresolved.”

IDPs are people who are forced to flee their homes but who, unlike refugees, remain within their country’s borders. While refugees are eligible to receive international protection and help under the 1951 Refugee Convention and the 1967 Protocol, the international community is not under the same legal obligation to protect and assist the IDPs.

How does the donor community and indeed the international media explain their reluctance to fight for the rights of these IDPs when they can do it for the gay community?

Museveni has backed down on the proposed anti-homosexual bill under pressure from the donor community; but why did the very same donor community fail to react when Museveni failed to protect an estimated 2 million of his people displaced by the Lord’s Resistance Army in northern Uganda?

The donor community has powers to force policy changes but when it applies double standards, Africans must question what it is up to.

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IMF Reports for Malawi 2010

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Lake Malawi

About the paper

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Available online at: http://www.eldis.org/cf/rdr/?doc=44646&em=030310⊂=agric

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About the Paper

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IMF Reports for Malawi 2009

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About the paper

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Gay Rights in Africa: What is the Donor Community Up To?

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