The strategic plan of the Department of Community Health, which is to become a School of Public Health, recognizes the importance of post-Masters professional development and has unfunded plans to offer continuing postgraduate development courses in public health, health management and a mentoring scheme for alumni and health managers.
Malawi is one of the 14 poorest countries in the world with a GDP per capita of $667 according to the 2008 UNDP Human Development Report. Its burden of disease, of which the largest part is due to a generalized HIV epidemic, is similar to other sub-Saharan African countries. The National Health Accounts (NHA) for 2006/7 show that expenditure on health care is approximately $18 per capita, insufficient to provide an essential health package (EHP) and to respond adequately to the HIV and AIDS burden.
The National HIV and AIDS response is coordinated by the National AIDS Commission (NAC) with funding from the Malawi government, bilateral partners and Global fund for HIV and AIDS, Tuberculosis and Malaria (GFTAM). Malawi has adopted a three-one approach to achieve the most effective and efficient use of resources to ensure rapid action and results based management. But the health sector has human resources capacity problem due to insufficient trained personnel and loss of trained and experienced staff as a result of push and pull factors including deaths from AIDS related diseases.
Quality strategic management and leadership are essential for effective and result centered management of social services in any country. The Malawi health sector does not have such leaders/managers and depends largely on technical assistance which is expensive and has failed to build the necessary leadership management capacity. The Malawi health system is overburdened with complex multiple health sector and government wide reforms as well as a changing and complex epidemiological regime. Also, it is argued that in a resource poor context like Malawi, well trained health care managers can act as a vehicle for optimizing the cost effectiveness of health care financing while maintaining quality health services. It is imperative that the health sector is led by a strong management stewardship with requisite skills and experience to maintain an equitable and efficient health service delivery system
The College of Medicine (CoM) produces medical doctors with limited management capacity but upon employment they are deployed straight into management positions in the public and private sectors creating a management crisis in the health sector. For sometime, there has been low investment in health services management and leadership development. To address the gap, COM in collaboration with ministry of health with financial support from CDC – PEPFER has come up with a fellowship programme for management and leadership capacity building for senior public health managers and other social science managers in HIV and AIDS services.