%0 Journal Article
%T Health financing in Malawi: Evidence from National Health Accounts
%A Eyob Zere
%A Oladapo Walker
%A Joses Kirigia
%A Felicitas Zawaira
%A Francis Magombo
%A Edward Kataika
%J BMC International Health and Human Rights
%D 2010
%I BioMed Central
%R 10.1186/1472-698x-10-27
%X Data from three rounds of national health accounts covering the Financial Years 1998/1999 to 2005/2006 was used to describe the flow of funds and their uses in the health system. Analysis was performed in line with the various NHA entities and health system financing functions.The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. The country had not met the Abuja of allocating at least 15% of national budget on health. The percentage of total health expenditure from households' direct out-of-pocket payments decreased from 26% in 1998/99 to 12.1% in 2005/2006.There is a need to increase government contribution to the total health expenditure to at least the levels of the Abuja Declaration of 15% of the national budget. In addition, the country urgently needs to develop and implement a prepaid health financing system within a comprehensive health financing policy and strategy with a view to assuring universal access to essential health services for all citizens.The countries of the WHO African Region face critical constraints in financing their health systems to provide a basic package of cost-effective health care interventions deemed necessary to achieve the health-related Millennium Development Goals [1]. To improve the equity, efficiency and sustainability of their health financing mechanisms, many have undertaken health financing reforms as part of the broader health sector reform agenda [2].The reforms that were launched in the 1980's and 90's were mainly focused on cost-recovery or cost-sharing schemes that aimed at collecting contributions from the users of public sector health facilities mainly through out-of-pocket payments or user fees [1]. However, the experience of user fees for health care in the region showed adverse effects in the form of, among other things, decreased utilization
%U http://www.biomedcentral.com/1472-698X/10/27