Malawi

Chapter III of the Constitution addresses the fundamental principles on which the Constitution is based. Under this chapter, section 13 refers to the obligation of the State to actively promote the welfare and development of the people by progressively adopting and implementing policies and legislation aimed at achieving a number of listed goals including gender equality, nutrition, health, the environment, education, the disabled, the elderly etc. Chapter IV is dedicated to human rights. It does not include a right to health per se. However it includes an obligation for the State to take all necessary measures for the realization of the right to development. Such measures shall include, amongst other things, equality of opportunity for all in their access to basic resources, education, health services, food, shelter, employment and infrastructure.

There is no reference in the Constitution to competences over health matters specifically. It is provided, however, that the executive is responsible for the initiation of policies and legislation and for the implementation of all laws (section 7); the legislature when enacting laws shall further the values explicit or implicit in this Constitution (section 8) while the judiciary has the responsibility of interpreting, protecting and enforcing the Constitution and all laws in accordance with the Constitution.

The main goal of the "Malawi National Health Policy 2018" is to improve the health status of all Malawians, and to increase client satisfaction and financial risk protection towards the attainment of universal health coverage (page 13).

The policy identifies several priorities and objectives, including improving service delivery, promoting preventive health, providing effective leadership and governance, increasing health financing, improving human resources for health, ensuring the availability of medicines and medical supplies, managing population growth through family planning services, and strengthening health information and research systems (pages 14-15).

In the "Introduction" and "Linkages with other policies, legislation and guiding principles" sections, the policy references several legislative and policy sources. The "Linkages with other policies, legislation and guiding principles" section specifically contains an overview of the legislative landscape for health and references documents such as the Constitution of Malawi (1994), the Public Health Act (1948), the Local Government Act (1998), the Medical Practitioners and Dentists Act (1987), the Nurses and Midwives Act (1995), the Pharmacy, Medicines and Poisons Act (1988), the Public Private Partnership Act (2011), the Public Financial Management Act (2003) and the Public Procurement Act (2003) (pages 6-8).

The policy identifies several legislative and regulatory actions as part of the policy implementation plan. For example, it emphasizes the need to develop specific packages of essential health services for tertiary, secondary and primary health facilities (page 32). It also provides for the reform of district health system policy guidelines in line with decentralization (page 38). Furthermore, the policy highlights the need to develop and enforce guidelines on the use of alternative medicines (page 44). It also includes a measure on the review of norms, guidelines and standards for health infrastructure and medical equipment to reflect the needs of all groups including people with physical and mental challenges, as well as children (page 46). In relation to population management, the policy proposes to develop guidelines for the integration of population concerns into development plans at national and local government levels (page 47).

The main goal of the Malawi Health Sector Strategic Plan III (2023-2030) is to improve the health status of all Malawians and increase client satisfaction and financial risk protection towards the attainment of Universal Health Coverage (UHC) (page 44).

The HSSP III identifies several priorities and objectives, including increasing equitable access to and improving the quality of health care services, addressing social determinants of health, improving health infrastructure and medical equipment, enhancing human resources for health, ensuring the availability and rational use of medical products, developing a sustainable digital health system, promoting health research, strengthening leadership and governance, and establishing a well-governed health financing architecture (page 46).

In the Introduction and Background Section, the plan references legislative and regulatory frameworks. They are the Constitution of Malawi which promotes the welfare and development of the people, the Public Health Act of 1948 which consolidates the law regarding the preservation of public health, the Nurses and Midwives Act of 1966 which establishes the Nursing and Midwives Council, the Pharmacy and Medicines Regulatory Authority Act of 2019 which provides for the establishment of the Pharmacy and Medicines Regulatory Authority and others (pages 18-19).

The HSSP outlines specific actions relating to laws and regulations in various sections. For instance, under objective 2 on strengthening preventive health services and capacity to address social determinants of health to reduce the burden on the health care system, the plan proposes several indicators such as enacting policies and laws to limit traffic accidents; creating legal and educational tools to prevent common non-traffic accidents; promote policies and laws that equalise gender discrimination; and create policies, operational plans and laws that limit deforestation to mitigate health and health system effects (pages 88-90). Furthermore, under objective 8 on leadership and governance at all levels of the health sector, the plan indicates an update and review of regulations, laws and guidelines every five years (page 101).