The SLA program aims to improve equity in access to Essential Health Package (EHP) services to the population served by CHAM facilities by removing the user fees charged. This program expands coverage for the EHP services to achieve Universal Health Coverage (UHC) for the poor population by making health services free at the point of delivery in CHAM facilities. Under SLAs, the MOH reimburses CHAM health facilities for providing an agreed package of essential health services free of charge to the community. Over the years the program is known for its positive contribution towards improving health outcomes.
PROGRAMME BACKGROUND AND OBJECTIVES
For the 2023/24 fiscal year, the motion benefited 178 SLA agreements, with 5 allocated to the Islamic Health Association of Malawi (IHAM) and 173 to the Christian Health Association of Malawi (CHAM), distributed among 165 facilities. There was a slight decline in participating facilities as some opted not to sign new agreements. However, around 13 facilities near district boundaries have agreements with multiple districts to serve broader populations. During this period, 72 facilities received support from HSJF partners, while 104 were supported by the World Bank and the Ministry of Health. The SLA mechanism is estimated to serve 5.7 million people, about 29% of Malawi’s population.
The anticipated health gains align with Malawi’s 2063 vision, aiming to improve health status and financial risk protection through better access, quality, and utilization of essential health services. Efficiency improvements in resource delivery, reimbursement processing, and partnerships at the subnational level will be monitored. The motion also supports the government in delivering the Health Benefit Package, improving service coverage linked to key health indicators.
OVERALL SUMMARY OF PROGRAM PRIORITIES
The SLA medical services program integrates medical products and health human resources to enable facilities provide essential health services from the basic health benefit package. The goal is to enhance equity in access to essential health package (EHP) services by eliminating user fees at CHAM facilities, thereby expanding coverage and aiming for Universal Health Coverage (UHC) for the poor population. Under SLAs, the Ministry of Health reimburses CHAM facilities for delivering agreed essential health services free of charge. SLA-supported facilities are distributed nationwide, with a higher concentration in central and southern regions due to greater population densities. The distribution is illustrated in the map below;