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"role": "Stated strategy responsibility", "actor_family": "national", "display_claim_ids": [ "display-claim:aceb138f3ca0f1324910f65f" ], "display_source_ids": [ "display-source:MWI:8c2b891a55800fabe3415db8" ], "source_version_ids": [ "display-source-version:8601162fe611ccea8f44c9c9" ], "display_evidence_object_id": "display-claim:aceb138f3ca0f1324910f65f" }, { "actor_label": "District councils", "function_label": "District health-service management, planning, execution and monitoring", "role": "Stated decentralised responsibility", "actor_family": "subnational", "display_claim_ids": [ "display-claim:9ffc69889392973f7e728b30" ], "display_source_ids": [ "display-source:MWI:8c2b891a55800fabe3415db8" ], "source_version_ids": [ "display-source-version:8601162fe611ccea8f44c9c9" ], "display_evidence_object_id": "display-claim:9ffc69889392973f7e728b30" } ] }, "title": "National stewardship and district implementation are distinguished", "statement": "HSSP III describes a three-level system 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The legal text's reference to boards of governors does not establish current hospital autonomy.", "tags": [], "territory": "Malawi, named central and tertiary hospitals", "title": "A tertiary-hospital autonomy proposal is not evidence of complete autonomy", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://extranet.who.int/cpcd/sites/default/files/public_file_repository/MWI_Malawi_Health-Sector-Strategic-Plan-III_2023-2030.pdf" }, { "kind": "source_reference", "source": "Public Health Act", "url": "https://malawilii.org/akn/mw/act/1948/12/eng%402014-12-31" } ] }, { "analytical_mapping": { "mapping_basis": "Mixed-methods study of CHAM service-level agreements", "mapping_group": "relationships_and_networks", "mapping_id": "candidate-mapping:MWI:relationships-networks:cham-contracting-and-district-implementation", "source_projection_ids": [ "country-improvement-source:MWI:cham-service-level-agreements-2013", "country-improvement-source:MWI:decentralisation-machinga-2024" ], "support_state": "candidate_supported", "target_slot": "cham-service-level-agreements-and-district-implementation", "target_view": "public-private", "typed_fields": { "boundary": "These studies do not establish the current reach, payment status or operations of all CHAM agreements.", "reported_arrangement": "The 2013 study reports Ministry contracts with selected CHAM facilities for no-fee services through service-level agreements and states that implementation was delegated to District Health Offices.", "reported_case_limit": "The Machinga case study reports that the District Health Office coordinated an SLA but did not determine service prices." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Witter S, et al. BMC Health Services Research. 2013;13:335; Sambala EZ. International Journal of Health Policy and Management. 2024;13:7956.", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "market_structure", "networks", "ownership", "primary_care" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Ministry of Health contracts selected health facilities owned", "institution": null, "locator": { "description": "Witter et al., Abstract and Governance structures section; Sambala, Collaborating for Local Health Service Delivery section." }, "material_id": "material:867f78056bdf02a5efac7a76", "notes": [ "Keep national policy description, selected-facility evidence and the Machinga case-study finding separate." ], "origin": "candidate-analytical-mappings", "period": "SLA study published 2013 and reports arrangements since 2004; Machinga study covers 2004-2022", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "6e032d3b2a1ce91f87760c9c20798373cebfa7822fa268f5086fc30a0914da79" }, "statement": "A 2013 study reports Ministry service-level agreements with selected CHAM facilities and delegated district implementation. A later Machinga case study reports a district coordination role and a pricing decision boundary. Neither source establishes current nationwide agreement coverage.", "tags": [], "territory": "Malawi, with selected CHAM facilities; Machinga-specific findings are not national", "title": "CHAM contracting is documented, but current national scope is not established", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3751183/" }, { "kind": "source_reference", "source": "Decentralisation of the Health System Derailed by Organisational Inertia in Machinga, Malawi", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11365077/" } ] }, { "analytical_mapping": { "mapping_basis": "Joint Annual Review Report, 2023-24 financial year", "mapping_group": "time_and_reform", "mapping_id": "candidate-mapping:MWI:time-reform:direct-facility-financing-2023-24", "source_projection_ids": [ "country-improvement-source:MWI:joint-annual-review-2023-24" ], "support_state": "candidate_supported", "target_slot": "direct-facility-financing-pilot-and-scale-up", "target_view": "reforms", "typed_fields": { "accountability_boundary": "The same report describes a health-facility planning tool intended to support a One Plan, One Budget, One Report approach at facility level.", "boundary": "A reported pilot and planned scale-up do not establish full financial autonomy, spending flexibility or results at every facility.", "reported_reform_event": "The Ministry review states that Direct Facility Financing was piloted in Rumphi and was being scaled to 13 named districts." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Malawi Ministry of Health. Joint Annual Review Report, 2023-24 financial year. 2024.", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "facility_data", "governance", "primary_care", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Direct Facility Financing pilot in Rumphi", "institution": null, "locator": { "description": "Joint Annual Review PDF p. 43, Leadership and governance." }, "material_id": "material:691efdada479ecfc78ee46e0", "notes": [ "Do not equate a pilot or reported scale-up with full authority, sustained funding or improved service delivery." ], "origin": "candidate-analytical-mappings", "period": "Financial year 2023-24", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "6c7b0c24f5fd455d50af872dd50f7fa20e0a12526e39b8957f9e0b8e6a9d3b1c", "response_sha256": "6c7b0c24f5fd455d50af872dd50f7fa20e0a12526e39b8957f9e0b8e6a9d3b1c" }, "statement": "The 2023-24 Ministry review reports a Direct Facility Financing pilot in Rumphi and scale-up to 13 named districts. It also describes a facility planning tool. This does not establish financial autonomy or outcomes across all facilities.", "tags": [], "territory": "Malawi, Rumphi pilot and 13 named scale-up districts", "title": "Direct Facility Financing is reported as a pilot and scale-up, not complete autonomy", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.health.gov.mw/storage/resources/Annual%20Report%202023-24%20FY_FINAL_06122024docx%201.pdf" } ] }, { "analytical_mapping": { "mapping_basis": "HSSP III governance and decentralisation description", "mapping_group": "decision_rights_and_autonomy", "mapping_id": "candidate-mapping:MWI:decision-autonomy:district-planning-and-monitoring", "source_projection_ids": [ "country-improvement-source:MWI:hssp-iii-2023-2030", "country-improvement-source:MWI:local-government-amendment-act-2017" ], "support_state": "candidate_supported", "target_slot": "district-planning-execution-and-monitoring", "target_view": "decisions", "typed_fields": { "formal_boundary": "The legal repository verifies the cited 2017 local-government amendment Act but does not itself establish a complete health decision-rights matrix.", "reported_arrangement": "HSSP III states that district councils oversee management, planning, execution and monitoring at district level within the decentralised architecture." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Malawi Ministry of Health. HSSP III 2023-2030. 2023; Republic of Malawi. Local Government (Amendment) Act, 2017.", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "decision_rights", "governance", "government_responsibilities", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "District Councils oversee the management planning execution and monitoring", "institution": null, "locator": { "description": "HSSP III PDF p. 19, Governance structure; MalawiLII, Local Government (Amendment) Act, 2017, citation and document history." }, "material_id": "material:8875fd0a2f111edb488931e7", "notes": [ "Do not infer that districts control all health budgets, personnel, procurement or contracts." ], "origin": "candidate-analytical-mappings", "period": "HSSP III 2023-2030; Act 10 of 2017", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f", "response_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f" }, "statement": "HSSP III states that district councils oversee management, planning, execution and monitoring at district level. The cited legal repository confirms the local-government amendment Act but does not create a full health decision-rights matrix.", "tags": [], "territory": "Malawi, national policy framework and district councils", "title": "District councils are described as overseeing specified district functions", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://extranet.who.int/cpcd/sites/default/files/public_file_repository/MWI_Malawi_Health-Sector-Strategic-Plan-III_2023-2030.pdf" }, { "kind": "source_reference", "source": "Local Government (Amendment) Act, 2017", "url": "https://malawilii.org/akn/mw/act/2017/10/eng%402017-01-27" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://malawilii.org/akn/mw/act/2017/10/eng@2017-01-27/source.pdf" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://media.malawilii.org/media/legislation/12772/source_file/local-government-amendment-act-2017.pdf" } ] }, { "analytical_mapping": { "mapping_basis": "Malawi Health Sector Strategic Plan III, health service delivery and governance sections", "mapping_group": "actors_and_functions", "mapping_id": "candidate-mapping:MWI:actors-functions:three-level-ministry-architecture", "source_projection_ids": [ "country-improvement-source:MWI:hssp-iii-2023-2030" ], "support_state": "candidate_supported", "target_slot": "three-level-ministry-and-district-architecture", "target_view": "functions", "typed_fields": { "boundary": "The strategy does not provide a complete operational allocation for every programme, facility or local-government function.", "formal_arrangement": "HSSP III describes primary, secondary and tertiary services linked by a referral system, with Ministry oversight of named central hospitals and district councils overseeing management, planning, execution and monitoring at district level." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Malawi Ministry of Health. Malawi Health Sector Strategic Plan III 2023-2030. 2023.", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "governance", "government_responsibilities", "hospital_organization", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "organized at three levels which are linked by a referral system", "institution": null, "locator": { "description": "HSSP III PDF pp. 18-19, Health service delivery system and Governance structure." }, "material_id": "material:9700ebd5259428ac34325d47", "notes": [ "Do not infer equivalent implementation across districts or a complete provider-level authority map." ], "origin": "candidate-analytical-mappings", "period": "Strategic plan period 2023-2030", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f", "response_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f" }, "statement": "HSSP III describes a three-level system linked by referral, Ministry oversight of named central hospitals, and district-council responsibilities for district management, planning, execution and monitoring. The plan does not establish a complete operational task map.", "tags": [], "territory": "Malawi, national, central-hospital and district-council levels", "title": "National stewardship and district implementation are distinguished", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://extranet.who.int/cpcd/sites/default/files/public_file_repository/MWI_Malawi_Health-Sector-Strategic-Plan-III_2023-2030.pdf" } ] }, { "analytical_mapping": { "mapping_basis": "HSSP III provider-mix table and the 2013-14 Malawi Service Provision Assessment", "mapping_group": "actors_and_functions", "mapping_id": "candidate-mapping:MWI:actors-functions:mixed-provider-ownership", "source_projection_ids": [ "country-improvement-source:MWI:hssp-iii-2023-2030", "country-improvement-source:MWI:spa-2013-14" ], "support_state": "candidate_supported", "target_slot": "mixed-provider-ownership-and-facility-census", "target_view": "public-private", "typed_fields": { "boundary": "Neither source supplies a current national share of visits, admissions, expenditure or workforce by ownership.", "observed_context": "The 2013-14 SPA counted 977 facilities and reported findings by managing authority, facility type and region.", "reported_context": "HSSP III describes public, NGO, private-not-for-profit and private-for-profit providers and says government owns the largest number of facility categories." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Malawi Ministry of Health. HSSP III 2023-2030. 2023; Ministry of Health [Malawi] and ICF International. Malawi SPA 2013-14. 2014.", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "facility_data", "hospital_organization", "market_structure", "ownership", "primary_care" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Government owns the largest number of all health facility categories", "institution": null, "locator": { "description": "HSSP III PDF p. 18, provider mix and Table 1; SPA PDF p. xxi, Key findings." }, "material_id": "material:bc879c6974ec6d3a63610da9", "notes": [ "Keep the SPA census period distinct from the strategy period. Do not transform provider counts into current service-use shares." ], "origin": "candidate-analytical-mappings", "period": "HSSP III 2023-2030; SPA fieldwork 2013-14", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f", "response_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f" }, "statement": "The strategy describes government, CHAM, NGO, private-not-for-profit and private-for-profit providers. The 2013-14 SPA counted 977 facilities and stratified findings by managing authority. These sources do not establish current activity or expenditure shares by ownership.", "tags": [], "territory": "Malawi, national", "title": "Provider ownership is mixed, while activity shares are not established here", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://extranet.who.int/cpcd/sites/default/files/public_file_repository/MWI_Malawi_Health-Sector-Strategic-Plan-III_2023-2030.pdf" }, { "kind": "source_reference", "source": "Malawi Service Provision Assessment 2013-14", "url": "https://www.dhsprogram.com/pubs/pdf/SPA20/SPA20%5BOct-7-2015%5D.pdf" } ] }, { "analytical_mapping": { "mapping_basis": "Ministry Joint Annual Review Report, 2023-24 financial year", "mapping_group": "delivery_and_referrals", "mapping_id": "candidate-mapping:MWI:delivery-referrals:2023-24-facility-inputs-and-use", "source_projection_ids": [ "country-improvement-source:MWI:joint-annual-review-2023-24", "country-improvement-source:MWI:world-bank-nurses-midwives", "country-improvement-source:MWI:world-bank-hospital-beds" ], "support_state": "candidate_supported", "target_slot": "2023-24-facility-inputs-utilization-and-transport", "target_view": "delivery", "typed_fields": { "input_series_boundary": "World Bank API series report national nurse-and-midwife density for 2022 and hospital-bed density with most recent non-null observation in 2011; neither supplies facility-level staffing or ownership.", "observed_delivery_fact": "Within the MHHFA 2024 sample of 1,477 facilities, 2.7% had all basic equipment traced.", "reported_utilization": "The annual review estimates outpatient attendance at 1.1 visits per capita and national inpatient bed occupancy at 23.1% in FY2023-24." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Malawi Ministry of Health. Joint Annual Review Report, 2023-24 FY. 2024; World Bank, World Development Indicators.", "country_ids": [ "MWI" ], "coverage_domains": [ "authoritative_review", "facility_data", "hospital_organization", "market_structure", "patient_flows", "primary_care", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "only 2.7% of facilities had all basic equipment traced", "institution": null, "locator": { "description": "Joint Annual Review PDF pp. 8 and 14, Executive summary and Service delivery; World Bank API resources SH.MED.NUMW.P3 and SH.MED.BEDS.ZS." }, "material_id": "material:cd8e820cf2019a481b389c33", "notes": [ "Do not treat these aggregates as referral completion, quality at every facility, provider ownership, or operational autonomy." ], "origin": "candidate-analytical-mappings", "period": "FY2023-24 review; MHHFA 2024 sample; World Bank nurse series most recent non-null 2022 and bed series 2011", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "6c7b0c24f5fd455d50af872dd50f7fa20e0a12526e39b8957f9e0b8e6a9d3b1c", "response_sha256": "6c7b0c24f5fd455d50af872dd50f7fa20e0a12526e39b8957f9e0b8e6a9d3b1c" }, "statement": "The 2023-24 Ministry review reports that 2.7% of 1,477 MHHFA 2024 sampled facilities had all basic equipment traced, outpatient attendance of 1.1 visits per capita and bed occupancy of 23.1%. The dated World Bank inputs do not show facility-level staffing or ownership.", "tags": [], "territory": "Malawi, national; MHHFA is a 1,477-facility sample", "title": "Recent delivery evidence is denominator- and period-bound", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.health.gov.mw/storage/resources/Annual%20Report%202023-24%20FY_FINAL_06122024docx%201.pdf" }, { "kind": "source_reference", "source": "Nurses and midwives (per 1,000 people), Malawi", "url": "https://api.worldbank.org/v2/country/MWI/indicator/SH.MED.NUMW.P3?format=json" }, { "kind": "source_reference", "source": "Hospital beds (per 1,000 people), Malawi", "url": "https://api.worldbank.org/v2/country/MWI/indicator/SH.MED.BEDS.ZS?format=json" } ] }, { "analytical_mapping": { "mapping_basis": "HSSP III service-delivery organisation and bottlenecks", "mapping_group": "relationships_and_networks", "mapping_id": "candidate-mapping:MWI:relationships-networks:levels-and-referral-integration", "source_projection_ids": [ "country-improvement-source:MWI:hssp-iii-2023-2030" ], "support_state": "candidate_supported", "target_slot": "care-levels-referral-and-integration-boundary", "target_view": "delivery", "typed_fields": { "boundary": "It does not report a national referral-completion rate, waiting-time distribution or patient choice pattern.", "formal_arrangement": "The strategy organises services into primary, secondary and tertiary levels linked by a referral system.", "reported_limit": "The strategy identifies weak referrals across levels and lack of well-defined integration and streamlining." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Malawi Ministry of Health. Malawi Health Sector Strategic Plan III 2023-2030. 2023.", "country_ids": [ "MWI" ], "coverage_domains": [ "authoritative_review", "hospital_organization", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "weak referral systems across the levels of care", "institution": null, "locator": { "description": "HSSP III PDF pp. 18 and 33, Health service delivery system and Bottlenecks in Health Service Delivery." }, "material_id": "material:5e0668695d9208e240b949af", "notes": [ "Referral design and reported weakness must remain distinct from observed patient flows or completion." ], "origin": "candidate-analytical-mappings", "period": "Strategic plan 2023-2030; bottlenecks reported from prior HSSP II implementation", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f", "response_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f" }, "statement": "HSSP III describes primary, secondary and tertiary levels linked by referral, while identifying weak referrals and poorly defined integration across levels. It does not quantify completed patient movement between these levels.", "tags": [], "territory": "Malawi, national health-service delivery system", "title": "Referral is the stated link between care levels, with documented system bottlenecks", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://extranet.who.int/cpcd/sites/default/files/public_file_repository/MWI_Malawi_Health-Sector-Strategic-Plan-III_2023-2030.pdf" } ] }, { "analytical_mapping": { "mapping_basis": "HSSP III reform agenda and WHO country-office report", "mapping_group": "time_and_reform", "mapping_id": "candidate-mapping:MWI:time-reform:hssp-iii-reform-agenda", "source_projection_ids": [ "country-improvement-source:MWI:hssp-iii-2023-2030", "country-improvement-source:MWI:who-malawi-annual-report-2024" ], "support_state": "candidate_supported", "target_slot": "hssp-iii-integration-and-provider-autonomy-agenda", "target_view": "reforms", "typed_fields": { "boundary": "Reported support and strategy direction do not verify complete nationwide reform implementation or effect.", "formal_reform_agenda": "HSSP III identifies integrated care platforms, provider autonomy and decentralised information systems as reform directions for 2023-2030.", "reported_activity": "WHO reports district implementation-plan support and quality-of-care scale-up activity during the stated reporting period." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Malawi Ministry of Health. HSSP III 2023-2030. 2023; WHO Regional Office for Africa. 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It also reports emergency transport at about nine in ten facilities offering normal delivery care. These findings do not measure completed referrals.", "tags": [], "territory": "Malawi, national facility census", "title": "The dated SPA describes a tiered referral design and emergency-transport availability", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.dhsprogram.com/pubs/pdf/SPA20/SPA20%5BOct-7-2015%5D.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Sustainable health care financing in Southern Africa : papers from an EDI Health Policy Seminar held in Johnannesburg, South Africa, June 1996. 1998. https://documents1.worldbank.org/curated/en/608111468758973303/pdf/multi0page.pdf", "country_ids": [ "MWI" ], "coverage_domains": [], "display_status": "shown_in_full", "document_type": null, "evidence_mode": null, "excerpt": "101 Prepared for the Ministry of Health Swaziland by Maphalala Nomaxhule United", "institution": null, "locator": { "physical_pdf_page": 5, "source_word_anchor": "101 Prepared for the Ministry of Health Swaziland by Maphalala Nomaxhule United", "source_word_count": 12 }, "material_id": "material:dbb5ccea87237197db7f908b", "notes": [], "origin": "global-corpus-excerpt-queue", "period": null, "publication_date": null, "publication_year": 1998, "record_kind": "corpus_page_anchor", "record_kind_label": "Corpus Page Anchor", "screening": { "previous_boundary_detected": true, "previous_visibility": "previously_not_projected" }, "source_layers": [], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "46dbe62e63aa9a6d3ebd4add65ce5594e570dbe4c951833a637ed0b2da3eaad5", "page_count": 193, "text_sha256": "78f4c255b25cc61686c15ba8e68eab996f8ec460921a911356f07138321f7c59" }, "statement": null, "tags": [ "control_knob:organization", "language:en", "source:World Bank Documents and Reports", "source_layer:global_literature" ], "territory": null, "title": "Sustainable health care financing in Southern Africa : papers from an EDI Health Policy Seminar held in Johnannesburg, South Africa, June 1996", "urls": [ { "kind": "stable_source_url", "source": "not supplied", "url": "https://documents1.worldbank.org/curated/en/608111468758973303/pdf/multi0page.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Sambala EZ. Decentralisation of the Health System Derailed by Organisational Inertia in Machinga, Malawi. International Journal of Health Policy and Management. 2024;13:7956. https://pmc.ncbi.nlm.nih.gov/articles/PMC11365077/", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "government_responsibilities", "networks", "primary_care" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "district health office was to coordinate service level agreement", "institution": "International Journal of Health Policy and Management", "locator": { "locator_type": "web_section_anchor", "source_word_anchor": "district health office was to coordinate service level agreement", "source_word_count": 9 }, "material_id": "material:6f6da78feef02754240f1f96", "notes": [ "This is a qualitative Machinga case study. 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World Development Indicators, Hospital beds (per 1,000 people), SH.MED.BEDS.ZS, Malawi. Retrieved 22 August 2026. https://api.worldbank.org/v2/country/MWI/indicator/SH.MED.BEDS.ZS?format=json", "country_ids": [ "MWI" ], "coverage_domains": [ "facility_data", "hospital_organization", "market_structure", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "Hospital beds per 1,000 people", "institution": "World Bank, World Development Indicators", "locator": { "locator_type": "api_resource_and_field", "source_word_anchor": "Hospital beds per 1,000 people", "source_word_count": 5 }, "material_id": "material:97010b4bf20b643150fd1f8c", "notes": [ "Bed density is not an ownership, activity, quality, autonomy or referral-completion measure." ], "origin": "country-evidence-improvement-sources", "period": "Dated national observations returned by the API; most recent returned non-null observation is 2011", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "grey_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/json", "response_sha256": "2a26c096ee4e31c033f9562b0c52baa363141f73f812689ba7f65dbcc6318a31" }, "statement": "The API returns a dated national hospital-bed-density series for Malawi, with the most recent non-null observation dated 2011.", "tags": [], "territory": "Malawi, national indicator series", "title": "Hospital beds (per 1,000 people), Malawi", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://api.worldbank.org/v2/country/MWI/indicator/SH.MED.BEDS.ZS?format=json" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Government of the Republic of Malawi, Ministry of Health. Joint Annual Review Report, 2023-24 financial year. 2024. https://www.health.gov.mw/storage/resources/Annual%20Report%202023-24%20FY_FINAL_06122024docx%201.pdf", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "facility_data", "governance", "hospital_organization", "networks", "observed_referral", "patient_flows", "primary_care", "reform_history", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "only 2.7% of facilities had all basic equipment traced", "institution": "Government of the Republic of Malawi, Ministry of Health", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "only 2.7% of facilities had all basic equipment traced", "source_word_count": 10 }, "material_id": "material:7fa368662b9bf72a20418eb4", "notes": [ "Read reported indicators with their stated financial year, survey sample and service denominator. They do not measure provider autonomy or completed referrals." ], "origin": "country-evidence-improvement-sources", "period": "Financial year 2023-24", "publication_date": null, "publication_year": 2024, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "6c7b0c24f5fd455d50af872dd50f7fa20e0a12526e39b8957f9e0b8e6a9d3b1c", "response_sha256": "6c7b0c24f5fd455d50af872dd50f7fa20e0a12526e39b8957f9e0b8e6a9d3b1c" }, "statement": "The Ministry annual review reports HSSP III implementation measures, service-use indicators, facility-assessment findings and named pilot or scale-up activity during 2023-24.", "tags": [], "territory": "Malawi, national results with district and facility examples where reported", "title": "Joint Annual Review Report, 2023-24 financial year", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.health.gov.mw/storage/resources/Annual%20Report%202023-24%20FY_FINAL_06122024docx%201.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Republic of Malawi. Local Government (Amendment) Act, 2017, Act 10 of 2017. Malawi Legal Information Institute. https://malawilii.org/akn/mw/act/2017/10/eng%402017-01-27", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "autonomy", "decision_rights", "governance", "government_responsibilities", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "Local Government Amendment Act 2017", "institution": "Republic of Malawi, Malawi Legal Information Institute", "locator": { "locator_type": "web_heading_and_history", "source_word_anchor": "Local Government Amendment Act 2017", "source_word_count": 5 }, "material_id": "material:cd3291c63c3733f662758985", "notes": [ "Do not infer a complete health-function transfer, district budget authority or implementation performance from the repository entry alone." ], "origin": "country-evidence-improvement-sources", "period": "Act 10 of 2017, assented to 20 January 2017 and published 27 January 2017", "publication_date": null, "publication_year": 2017, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "1d830c1ca2c93e28673f468dc668d281edcf7d53853ec61beea673587e5c8bec" }, "statement": "The legal repository identifies the Local Government (Amendment) Act, 2017 and its official dates; the health-sector strategy separately describes health decentralisation under the local-government framework.", "tags": [], "territory": "Malawi, national local-government legal framework", "title": "Local Government (Amendment) Act, 2017", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://malawilii.org/akn/mw/act/2017/10/eng%402017-01-27" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://malawilii.org/akn/mw/act/2017/10/eng@2017-01-27/source.pdf" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://media.malawilii.org/media/legislation/12772/source_file/local-government-amendment-act-2017.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Government of the Republic of Malawi, Ministry of Health. Malawi Health Sector Strategic Plan III 2023-2030: Reforming for Universal Health Coverage. First edition, 2023. https://extranet.who.int/cpcd/sites/default/files/public_file_repository/MWI_Malawi_Health-Sector-Strategic-Plan-III_2023-2030.pdf", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "organized at three levels which are linked by a referral system", "institution": "Government of the Republic of Malawi, Ministry of Health", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "organized at three levels which are linked by a referral system", "source_word_count": 11 }, "material_id": "material:c9a7b78053813a91bb68a6ff", "notes": [ "This is a strategic plan. Its stated arrangements and reform intentions do not establish uniform implementation or measured patient movement." ], "origin": "country-evidence-improvement-sources", "period": "Strategic plan period 2023-2030; baseline material reports earlier periods where stated", "publication_date": null, "publication_year": 2023, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f", "response_sha256": "88b7d547be850d49d55ffb4aead7ec4d3ec082a42f1f9b550c13d08f1f69991f" }, "statement": "The Ministry strategy describes the planned health-sector architecture, provider mix, decentralisation boundaries, referral design and reform agenda for 2023-2030.", "tags": [], "territory": "Malawi, national health sector, including district councils and central hospitals", "title": "Malawi Health Sector Strategic Plan III 2023-2030", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://extranet.who.int/cpcd/sites/default/files/public_file_repository/MWI_Malawi_Health-Sector-Strategic-Plan-III_2023-2030.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health [Malawi] and ICF International. Malawi Service Provision Assessment 2013-14. 2014. https://www.dhsprogram.com/pubs/pdf/SPA20/SPA20%5BOct-7-2015%5D.pdf", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "facility_data", "hospital_organization", "market_structure", "observed_referral", "ownership", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "designed to be a census of all health facilities", "institution": "Malawi Ministry of Health and ICF International, DHS Program", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "designed to be a census of all health facilities", "source_word_count": 10 }, "material_id": "material:116b3e8ace135bc1791a93a2", "notes": [ "The census is dated 2013-14. 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World Development Indicators, Nurses and midwives (per 1,000 people), SH.MED.NUMW.P3, Malawi. Retrieved 22 August 2026. https://api.worldbank.org/v2/country/MWI/indicator/SH.MED.NUMW.P3?format=json", "country_ids": [ "MWI" ], "coverage_domains": [ "facility_data", "hospital_organization", "primary_care", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "Nurses and midwives per 1,000 people", "institution": "World Bank, World Development Indicators", "locator": { "locator_type": "api_resource_and_field", "source_word_anchor": "Nurses and midwives per 1,000 people", "source_word_count": 6 }, "material_id": "material:8cc75e11c812c3637cf061cb", "notes": [ "National workforce density does not show distribution, facility staffing, authority, patient access or referral movement." ], "origin": "country-evidence-improvement-sources", "period": "Dated national observations returned by the API; most recent returned non-null observation is 2022", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "grey_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/json", "response_sha256": "17c01f9b164b383f016c70d7aef613b0cdfe6d97a79c41483531eba3e4ba932f" }, "statement": "The API returns a dated national nurse-and-midwife density series for Malawi, including a 2022 observation.", "tags": [], "territory": "Malawi, national indicator series", "title": "Nurses and midwives (per 1,000 people), Malawi", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://api.worldbank.org/v2/country/MWI/indicator/SH.MED.NUMW.P3?format=json" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Witter S, et al. Promoting universal financial protection: contracting faith-based health facilities to expand access, lessons learned from Malawi. BMC Health Services Research. 2013;13:335. https://pmc.ncbi.nlm.nih.gov/articles/PMC3751183/", "country_ids": [ "MWI" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "market_structure", "networks", "ownership", "patient_flows", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Ministry of Health contracts selected health facilities owned", "institution": "BMC Health Services Research", "locator": { "locator_type": "web_section_anchor", "source_word_anchor": "Ministry of Health contracts selected health facilities owned", "source_word_count": 8 }, "material_id": "material:f914c249336e56bdeabca992", "notes": [ "The study covers selected facilities and a historical agreement period. 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Strengthening district health systems to achieve Malawi's decentralisation objectives: lessons learnt from Malawi's Blantyre Prevention Strategy.. 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