Grant for the extension of the health sector in Malawi, 2009

Duration: 2009-2013

Budget: 10.000.000

The Government of Flanders contributes to the extension and reinforcement of the health sector in Malawi.

Duration and budget

From 2009 through 2013, Flanders annually invests 2 million euros in the Malawi health sector.

Problem definition

The public health sector in Malawi needs to be strengthened and extended. However, this requires long-term structural investments.

Practical implementation

The Flemish contribution is made in the form of sectoral budget support to Malawi. This aid is given in keeping with the principles of the so-called Sector-Wide Approach (SWAp), of which Flanders is one of the donors, next to Great Britain and Germany, amongst others. This means that the contribution is paid to the Malawian Ministry of Finance, which then passes on the funds to the Malawian Ministry of Health.

The SWAp is a relatively modern form of direct cooperation between the governments of the donors and the governments of the development partners. The key elements of an efficient SWAp are:

a clear sectoral policy with well-defined strategies
one programme and one budget, with a clearly specified planning of expenditure (Medium-Term Expenditure Framework (MTEF))
the government of the recipient country itself assumes the leadership in steering the process
a formalised process for the coordination and harmonisation of the reporting, budget, financial management and tenders between donors and the partner government
a monitoring system which measures progress and enhances the responsibilities of all the parties involved
local capacity building
the introduction of institutional reforms

Sectoral programmes are by definition dynamic and, because they depend on many internal and external factors, their process may be highly variable.

A number of success factors are:

  • a strong leadership of the partner government
  • a strong consensus between the government and donors at policy and management level
  • an acceptable level of macro-economic and political stability

The Malawi Government worked out the Health Sector Strategic Plan (HSSP) in cooperation with development partners, such as FICA. This is a concrete plan of action to further extend the health sector. The general aim is to offer all the people in Malawi a basic health package. This implies a minimum service that is provided free of charge to the entire population.