Malawi is a country located in the southern part of Africa; it has a population of about 19 million. About 50.6% of the people are living in poverty, and more than 24.5% are poorer (Edriss & Chiunda, 2017). Population health has been a big challenge facing Malawi for decades. The healthcare system is not stable to support and curb most of the communicable and non-communicable diseases prevailing within the nation. This leaves most people prone and vulnerable to most of the deadliest diseases like HIV/AIDS, Malaria, Neoplasms, Respiratory problems, and other infectious sicknesses. The rate of mortality is high for both adults and young ones due to poor and inaccessible health services. The paper will focus on how the Malawian health system and population health have been impacted by political status, technology, economic system, social and environmental factors, and philosophy. In addition, the research will cover most of the challenges encountered by the policy-makers in the country and possible strategies to overcome them.
Population Health and Health System of Malawi
Population health, factors in all the determinants such as culture, economic background of individuals, national economic performance, infrastructure, housing, level of education, access to food nutrition, and security system, among others (Youde, 2019). In the nation, a larger percentage of the citizens are not able to access their basic wants, therefore, lowering the health status of the people. Poor management across all departments resulted in a weak and unfavorable living standard for the people. Most regions in the country have a limited number of health facilities and poor housing systems.
In general, Malawi’s population health is low, creating room for disease prevalence in the country. A vast number of people are living below the global poverty line that is spending below $2 a day (Youde, 2019). Therefore, it has been difficult for the public to afford good medical services from good hospitals. The sick are exposed to sudden death because of poor treatment and disease management, making the country rank 185 out of 190 worldwide in terms of the healthcare system (Pittalis, 2020). Another contributing factor is the shortage of health officers in the country. Poor service delivery from unqualified personnel also raises health risks to the citizens.
The Malawian government offers free countywide healthcare services to its citizens. It has a national program, which ensures that the public access to medication through district hospitals, regional hospitals, and health centers within the local areas. The nation bases its health provision on Primary Health Care (PHC) (Makwero, 2018). Irrespective of the government’s effort to support the health sector, the nation’s health system is still lagging behind in terms of service delivery, making the country have a massive weight of disease infestation. PHC system is suffering from a shortage of workers, inconsistent services, lack of resources, and limited rural health service coverage.
The government initiated financial restructuring that would facilitate the development and transition to universal health coverage. The reforms are aimed at setting aside enough capital to enhance funding of the health program. There has been a continuous valuation of the health department by the government through National Health Accounts (NHA) to aid in determining, locating, and verifying the usage of health resources in the country to promote accountability and minimize misuse. Furthermore, Malawi’s government developed a network-based system that enables the country to monitor and examine the extent of the disease problem within its jurisdiction. Similarly, the webpage makes it easier for the authorities to report or pick information concerning the spread of a given sickness in the state through the District Health Information System.
Effects of Globalization on the Health System of Malawi
The term globalization lacks a clear definition but can be termed as the international interaction and interdependence between the countries within the globe or the inflows of people, ideas, and goods and services. It has impacts on political, socioeconomic, technology, and ideological differences in relation to the health status of a country. Globalization effects comprise positive and negative outcomes; it influences and dictates most essential departments of the nation. The country’s healthcare system is affected due to the factors discussed below.
National and Household Economy
Globalization plays a significant role in influencing government spending, changes in individuals’ income, variations in product prices, and foreign exchange rates. The effects then determine the level of national economic performance, which intern affects the nation’s health standard. The majority of Malawians have low household incomes, therefore, cannot afford the basic nutrition requirement for the family’s health development. The low income lowers the national economic output; hence, the government does not have enough resources to invest in the health sector.
The international connectivity brought about the emergence of worldwide policies that govern some aspects of the country’s government. Political globalization is the development of the global political structure. It has also led to the formation of nongovernmental authorities that influence the operation of the country’s government policies. Furthermore, the inflow of the internet in the country has made citizens unite and challenge the political moves of the country. Political globalization has reduced the influence and power of a national policy; therefore, it cannot formulate a restrictive policy that protects its citizens from risky health issues. The government must comply with set rules by World Trade Organization even if they are not favoring the country’s development.
Social and Environmental Factors
Social globalization is the integration and rapid increase in the movement of people, information, and ideas across the country’s borders. The social interaction resulted in transmissions of diseases and the emergence of new strains of sicknesses and viruses like HIV/AIDS and Covid-19 in Malawi. Communicable illnesses are spread faster, and this burdens the health system of the state. The cultural aspect of the society is greatly affected as locals tend to copy behaviors of the developed nations.
Globalization, on the other hand, has contributed to environmental degradation. There has been an increase in the rate of human consumption leading to the exhaustion of natural resources like forests, leaving vast land bare and exposed to soil erosion, decreasing the fertility and productivity of the land. Furthermore, many industrial activities in the country result in the emission of carbon gasses into the atmosphere, which in turn causes respiratory problems to people when inhaled.
Currently, the rate of technological development is high, and the speed at which information or new idea spread through the internet website has increased too. This advancement makes it easier for the nations to innovate new machines that can detect the presence of a disease and help in vaccine research or treatment and diagnosis. With the help of the World Health Organization, the Malawian government is capable of using internet technology to record and capture details of the illnesses in the country.
Challenges Faced by the Policy-makers in Malawi
In the country, the policymakers are faced with many changes that make it difficult to implement an effective policy into the country’s system. Some of the challenges slow down the performance of the government, especially in delivering essential public services like health. Some of the common issues faced by policymakers are ineffective leadership, a high level of corruption, inadequate finances, limited human resources, and discontinuing policies.
The individuals behind making and implementing policies in the country are not collaborative. This makes the communication between them weak leading to ineffective policy design, absence of clarity, poor prioritization, and policy inconsistency during the whole process. The poor communication limits coordination and consultation amongst the leaders leading to individualistic approaches in policy-making. This makes the policies favor small groups of the society like the political leaders rather than the public interest.
Another common challenge facing the policymakers and the implementation process is rampant corruption. This factor comes through the bureaucratic circles in the nation and the political group (Giest, 2017). The state may come up with some policies that are intended to benefit the top leaders by siphoning the country’s resources for personal gain. A policy like Fertilizer Subsidy Programme played a significant role in diverting public resources to the hands of greedy and corrupt individuals.
Due to limited finances, the government cannot finance most of the sectors of the economy, including the health department. Lack of finances has made it impossible for policymakers to initiate and maintain continued support for the policy implementation in the country.
Limited Human Resources and Discontinued Previous Policies
The country does not have enough qualified personnel to aid in the formulation of effective policies in the nation. The public bureaucracy faces challenges of non-responsive resources that lower the capabilities of proper policy-making. In addition, there is the tendency of the authority to ignore the previous policies, especially when new management takes over control. This leaves the policies of the previous regime pending, and there yield no result to the public.
The lack of policy knowledge is a major contributing factor in coming up with unattainable goals by policymakers. In most cases, they overvalue the content of the policy-making to misjudge the implementation process. Unrealistic goals make it difficult for the policy to have an effect on the public, and therefore they remain inactive.
Lack of Commitment by Policymakers
The public servants’ attitudes towards the policy affect the policy-making process. Policymakers may come up with good policies, but the bureaucrats are negative about the ideas proposed by the policy; thus, they will not show commitment to the implementation of the guidelines. They lack the objectives to make the policy significant to the citizens making the whole process to be idle and ineffective. In most cases, they view the guidelines in terms of how they will interfere with personal interests ignoring the will of the public.
Alternative Strategies to Deal with Challenges Faced By Policymakers
The government of Malawi should put some measures in place to enable the country to tackle the challenges faced by the policymakers. For instance, when recruiting the officers in charge of policy formulation, the team should consist of individuals with leadership ability and can be able to coordinate the whole process by providing clear and correct information through an effective communication approach. Good communication allows for proper analysis of the proposed policies to evaluate them for the best pick.
Furthermore, the policy-making team should state clear policy objectives to avoid structuring ineffective laws that would favor a group of people while leaving the rest of the society vulnerable. Accountability assessment should be done by the government to ensure the resources allocated for policy implementation are used appropriately to deliver to the public, not going into individual pockets through corruption. Strict laws to curb corruption should be implemented by the state to lower cases of embezzlement of public resources. Moreover, the policymakers plus the government should ensure the set policies have realistic goals that can be easily attained when the policy is implemented.
Similarly, enough funds should be put in place to aid in the policy-making process and its implementation. Financing the policy institutions would make it easier for the leaders to make to conduct adequate training and research before deciding to make the policy. Lastly, the government should ensure that policies that were implemented must be complemented irrespective of change in governance to avoid discontinuation of previous policy regimes.
Globalization has dominated and influenced most operations in the country. With the increase in the development of technology, the government should adopt the usage to help manage the disease burden in the state. Furthermore, the government should design ways of managing the possible effects of globalization on population health and the general healthcare system of the nation. Finally, the country should set policies that would enable it to maximize its health advantages through globalization.
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Giest, S. (2017). Big data for policymaking: fad or FastTrack?. Policy Sciences, 50(3), 367-382. Web.
Makwero, M. T. (2018). Delivery of primary health care in Malawi. African Journal of Primary Health Care and Family Medicine, 10(1), 1-3. Web.
Pittalis, C., Panteli, E., Schouten, E., Magongwa, I., & Gajewski, J. (2020). Breast and cervical cancer screening services in Malawi: A systematic review. BMC Cancer, 20(1), 1-15. Web.
Youde, J. (2019). Globalization and Health. Rowman & Littlefield.