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7/24/2019 Statement _ Medicines and patients' Food in hospitals
1/26
Malawi Government
STATEMENT BY
THE MINISTER OF HEALTH
HONOURABLE DR. PETER UMPALUME! MP
IN THE NATIONAL ASSEMBLY
ON
MEDI"INES AND PATIENTS# FOOD IN HOSPITALS
$%r&FEBRUARY! $'()
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Mr. Speaker, Sir, it gives me great pleasure and honour to present to the August
House, on the following issues; medicines and patients food in our hospitals.
In my statement, Mr.Speaker, Sir, I will report on the current status and I will
also highlight what my Ministry is doing as a response.
Mr Speaker, Sir, allow me to start with the drugs issue.
STATUS OF ESSENTIAL MEDI"INE * HEALTH SUPPLIES +EMHS,
AND PHARMA"EUTI"AL MANAGEMENT "HALLENGES
Mr S-eaer! Sir! allow me torief this August house on the !"ssential Medicine
# Health Supplies situation$ in the country.2
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I would like to present the availaility of medicines y specifically addressing
three topics%
&. 'he financing
(. )onsumption rate of those finances and
*. Actual availaility of medicines
(. T/e Finan0in1
Mr Speaker, Sir, In +une last year, this house approved a rug -udget allocations for istrictand )entral Hospitals of &/,///,///,///.// and 0,123,*0/,4&1.// respectively
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'herefore, for the first 1 months 5+uly 6 ec (/&07, 4,288,140,*02 was the comined drug
udget for 9uarters & and ( i.e. 0,///,///,/// and (,288,140,*02 for the istrict and
)entral Hospitals respectively.
:ovt disursed 4,*03,/48,334
A total of 2!%34!'25!442.'' was paid y MoH 5*,&3(,/4/,2*/.//7 and uarterly advance funding for the period & st +uly to *&st
ecemer (/&0 as detailed in 'ale & elow
Table 1. Payments by MoH and NLGFC
Date Re0ei
-t No.
MOH NLGF" Total
26/10/15 (*3 1*&,14/,2*0
)%(!)2'!6%3
(8?&&?&0 (8& &,031,/(0,8 (!34)!'$3!5
4
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&0 (3
*/?&&?&0 (8( (,133,333,3
33
$!)44!444!4
44
*/?&&?&0 (8* 2*0,***,*
**
6%3!%%%!%
%%/8?/&?&1@ (88 &,031,/(0,8
&0
(!34)!'$3!5
(3
Total %!(4$!'2'!6
%'
5!()2!''5!(
)2
2!%34!'25!4
42Note* this cheque relates to Quarter 2 but was collected in January 2016
lease note that while the decision to change the funding model for the drug udget wasmade in 9uarter &, the actual payments y MoH and
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'otal drugs sold and delivered to all pulic hospitals y )MS' during the period under
review amounted to 4,408,&83,*4/.(3 out of which drugs worth 1,/*0,44/,80*.22 and
&,4&2,*42,3&1.8& were delivered and invoiced in respect of istrict and )entral Hospitals
respectively.
Bhile the overall drug udget utiliCation was at 32.3D, istrict Hospitals eEceeded their
udget y (/.4D and )entral Hospitals underutiliCed their udget y *3.1D as detailed in
'ale ( elow.
Di7tri0tHo7-ital7
"entralHo7-ital7
Total
-udget 57 0,///,///,/// (,288,140,
*02
4,288,140,*0
2
eliveries 57 1,/*0,44/,808 &,4&2,*42,
3&1
4,408,&83,*4
/
Fariance 57 5&,/*0,44/,80
87
&,&(1,(31,88
(
3/,0(0,322
Fariance 5D7 5(/.4D7 *3.1D &.&D
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etails of deliveries of drugs to istrict and )entral Hospitals and analysis of udget
utiliCation are provided in the AnneE 'ale *.
I8 I am to 79mmari7e! Mr S-eaer Sir! t/e &ata on Finan0in1 an& 0on79m-tion
are 7a;in1 t/at t/e amo9nt o8 mone; t/at ;o9r /o97e a--rove& 8or &r917
8or t/e 8ir7t ) mont/7 +M2.6
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rug stock availaility at the central 5)MS'7 level averaged 1/D during oth 9uarters &
and ( of the (/&0?(/&1 financial year.
'he low stock availaility was due to delays eEperienced in receiving medicines and
medical supplies ought with support from the epartment for International evelopment
5=I7 which were eEpected in the first >uarter ut shipments started arriving towards the
end of ecemer (/&0.
)MS' floated maGor procurement tenders in 9uarter & and contracts with suppliers were
signed in ecemer (/&0 and +anuary (/&1. eliveries under these tenders are eEpected in
9uarters * and 8. elays in concluding the tenders also affected stock availaility in oth9uarters & and (.
'he >uarterly advance payments to )MS' have assisted in giving confidence to that 'rust
therey improving its cash flow to enale not only to float tenders that are eEpected to
improve stock availaility ut also pay its suppliers within due dates.
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As stated aove, once the >uarterly advance payments are regulariCed, it is eEpected that
)MS' will have predictale cash flow proGections which assist in meeting its oligations and
improve drug stock availaility in 9uarters * and 8.
Dr91 Availa
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also see an improvement in the availaility of medicines used to treat the most
common illnesses that plague the countrys population.
At facility level we find that average stockout rates for tracked tracer items is
6>. 'his places availaility at aout 4$>of facilities that reported in the period.
'his is a decline from the doule digit stockout rate the system eEperienced a
year ago.
?/at are t/e 0riti0al item7 t/at 8a0ilitie7 are 7/ort o8
At central medical level, the maGority of shortages relate to antiiotics especially
the more powerful ones that should treat the narrow range antiiotic resistance
cases i.e. those that are resistant to commonly used antiiotics.
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At primary health care level, the maGority of cases relate to antiiotics 5narrow
range7 and anti malarial talets.
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from +ulec (/&0. A rough estimate of items ordered vs items delivered for
central hospitals stand at */D for MCuCu, (/D for )H and 81D oma.
Mr Speaker sir this may eEplain in part why central hospitals utilised only */D
of their udget.
Bhilst running stock availaility at */D y volume re>uirements is not a ad
thing in itself, this leaves us vulnerale should there e hiccups in the upstreamsupply chain. 'o increase stock availaility the logical solution is to )MS'
more finances so they have a lot more resources at their disposal.
Dr91 T/e8t an& 8ail9re to a00o9nt 8or &r917
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Mr Speaker sir, you have heard reports of drug theft cases all of which involve
ministry of health staff, e it clinicians, nurses or pharmacists. I want to report
that over the last 1 months, the ministry received reports of (2 drug theft cases.Mr Speaker sir, the ministry has taken a tough stand against drug theft and I have
no regret to report that all of them were suspended without pay. 'he maGority of
these cases are in court and frankly I dont see any possiility of these people
eing reemployed in the ministry again.
=urther Mr Speaker sir, we received reports of over consumption of malaria
drugs in &/ of our facilities. In some of these cases, consumption was 4 times
more than the reported malaria cases. Such huge anomalies can not e eEplained
y simply reconciliation errors considering that the maGority of these facilities
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were visited previously . 'he ministry suspended all staff involved in these
facilities on full pay pending audit. I am pleased to report that the audit was
completed last week and depending on their report further action may e takenagainst these individuals.
Mr Speaker sir, the ministry is of the opinion that the (2 cases of drug theft
reported last year are a tip of the iceerg. In order to unravel all drug related
theft, I instructed the ministry to set up a special unit 5you may call it the special
ranch7 to lead the fight against drug pilferage. Mr Speaker sir, the ministry is on
the verge of setting up this unit. 'his unit will sensitise the community on how
they can Goin the fight against drug theft, strengthen supervision of health
facilities, investigate all drug cases and prosecute hot cases. Jes , Mr Speaker,
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this unit will have its own lawyers to prosecute cases so we dont overurden
other government agencies. Be are eEpecting to receive K&.8m from
development partners to finance this unit. Be owe it to the neEt generation toleave the ministry of health in a etter state than we found it and we remain
resolute to do that. 'his is the time and we are the people that must end the theft
of medicines in our hospitals. Be in the ministry of health we are and will
continue to deal with this issue as per laid out government regulation. 'he days
where such people would e transferred to other facilities are gone.
T/e P/arma0; an& Me&i0ine7 Re19lator; A9t/orit;
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Mr Speaker sir you may recall that we have een talking aout a new ill with
stiffer penalties for those caught stealing medicines. Be have amended the ill
and we have also aligned it with international standards so the oard will nowecome a regulatory authority. 'he ill was resumitted to the Ministry of
+ustice and )onstitutional Affairs for drafting. Be are optimistic that the ill will
e taled at the neEt sitting of parliament.
FEEDING OF PATIENTS
Mr S-eaer! Sir! an& Hono9ra
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situation of food for patients in our hospitals has een a suGect of media deate
over the past few weeks.
A few days ago, I contacted the istrict Health Lfficers to give me an update on
the current status of food for the patients in our hospitals. I further asked them to
provide hospital ed occupancy as well as their food udget allocation so we can
compare the food situation with numer of in patients and the allocated money.
=rom the reports that we have received, most hospitals are at present providing
patients with ( meals a day. 'he ideal is, of course, three meals a day. Aout 02
percent 5&8 out of (87 of districts provide ( meals a day to their patients and *2
percent of them 53 out of (87 provide * meals a day
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ow I want to draw your attention to the analysis as detailed in the attached
"Ecel sheet.
?/at are we &oin1
&. As a Ministry we want to know the eEact amount hospitals spend
on food on a regular asis. =or that reason I have asked all HLs18
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to report to me monthly on how much they have spent on patient
food and on what items. 'his will help us map the est
interventions.
(. 'he Ministry of Health has received and will e receiving funds
from certain evelopment artners 5s7 in respect of new fund
called the Health Services +oint =und 5HS+=7. 'he HS+= is a
funding mechanism designed to receive funding from multiple s
and uses elements of :overnment systems 5such as planning,
udgeting, procurement, reporting7 ut maintains a parallel funds
flow with strong fiduciary and procurement oversight and controls.
It is designed as a means to efficiently and securely channel
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funds to approved, priority government udget lines? activities;
reduce fragmentation of support; and strengthen government
fiduciary and related systems, as long as s deem it not feasileto use alternative mechanisms for channelling funds that are more
fully integrated with :overnment financial systems.
'hese funds have and will take off pressure which some of our
HLs were facing in terms of paying for utilities, fuel for
amulances and Service
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*. As a Ministry, we have intensified monitoring of eEpenditure in our
facilities so that we can detect misuse and the usual disciplinary
action can e taken.
8.
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the resources we have and under the ale leadership of our State resident, His
"Ecellency rofessor eter Arthur Mutharika, :overnment is committed to do all
that is necessary to ensure that we deliver and guarantee >uality health servicesconsistent with improving the >uality and life eEpectancy of all Malawians.
Mr Speaker Sir, and Honourale Memers, I thank you all for your kind
attention.
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A""S
'ale *.
DRUG BUDGET
ALLO"ATION AND
"ONSUMPTION FOR @ULY
TO DE"EMBER $'(3
$'(3() Ann9al
B9&1et
Total invoi0e7 @9l; to
De0em
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khota ota HL *82,21(,*((.&4 &38,204,222./3 01
tcheu HL *3/,428,/43.(8 *8/,*&1,4(/.41 24
tchisi HL (&0,/*2,00(.4/ &4&,223,8*0.&3 2/
edCa HL 804,130,82/.&0 (23,2*(,(88.// 1*
Salima HL */0,/08,83&.24 &**,&&&,404.30 88
S9
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eno HL (&2,0/&,(&8.(8 &1&,010,/&&.31 48
sanGe HL (80,4&*,*02.1& &*(,3/&,/4&.08 08
oma HL 804,&14,882.31 &24,13(,//1.3* 8&
S9
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"ENTRAL HOSPITALS
amuCu )entral Hospita &,244,*8*,*&8.// 43&,&08,130.24 8(
9ueen "liCaeth Hospital &,32/,233,8&3.// 8/*,03&,/21.2( (/
oma )entral Hospital 28/,///,///.// &2&,28&,*43.(* ((
oma Mental Hospital &2&,304,*84.// 0(,0&4,2&/.1( (3
MCuCu )entral Hospital 2/3,&0/,1*1.// (23,(4*,38*.24 *1
TOTALS 3!)64!%3'!2().'' (!2(6!%26!4().5( %'
GRAND TOTALS (3!)64!%3'!2().'' 2!235!(54!%2'.$4 54
26
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