Service Level Agreement

The aim of the SLA program is 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 with an aim of achieving 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 toward improving health outcomes.

​Program Milestones and Deliverables

The program aims at achieving seven (7) well-defined outcomes within FY 2019/20 as follows: 

  • Consolidate and expand SLAs coverage in CHAM and other Health Facilities across Malawi; 
  • Enhance cooperation and coordination between MOH and CHAM at central and regional levels;
  • Secure program accountability and oversight including review- and evaluation practices; 
  • Strengthen the capacity, skills, and competencies of District SLA stakeholders to partner, oversee, manage, implement and utilize SLAs; 
  • Improve the quality of health service provision and care; 
  • Improve supportive supervision, program verification, and M&E and; 
  • Strengthen the organizational capacity of the SLA unit as well as the skills and competencies of individual staff.

SLA Program Management & Administration

​The SLA contracts are managed at two different levels; First between DHOs and CHAM Health Facilities at the district level, and second between CHAM Secretariat and MoH at the central level. During the period under review, a total of 6 new SLA contracts between DHO and CHAM facilities were signed bringing to a total of 152 out of 160 targeted facilities for 2019-2020, representing 95%. The remaining facilities were expected to sign their contracts in 2019 but failed due to budget limitations. Amongst the 152 facilities, 6 signed contracts with 2 DHOs since they are located in district boundaries, hence a total of 166 SLA contracts. Due to budget constraints, facilities were advised not to expand the scope of services under offer as well as to ensure that they implement services within their allocated ceilings. However, due to some commitments already made by CHAM facilities to the communities some changes were still effected that led to minor changes in the scope of services offered under SLAs by end of December 2019