Strategic Plan

The CHAM Constitution directs five governance structures: The Mother Bodies (MCC and ECM), Board of Trustees, Board of Directors, and the General Assembly and its technical committees. However, there is some lack of clarity in the roles and responsibilities between each structure. Also, membership roles of church governing organizations (CHAM’s proprietors) versus the health facilities themselves is somewhat unclear.

CHAM’s member units (health facilities and training colleges) also have challenges with governance. Many facility boards are untrained in management, and many lack health expertise and/or requisite professional expertise. These facility boards are also unincorporated in the overall CHAM governance structure – creating a gap in governance at the local level. 

This priority focuses on improving leadership and governance within CHAM. It focuses on improving communication and strengthening coordination in the health sector particularly with the goal of reducing duplication and fragmentation in the health sector. Leadership and governance involves the management of relationships between various stakeholders in health, including individuals, households, communities, firms, governments, nongovernmental organizations, private firms and other entities that have the responsibility to finance, monitor, deliver and use health services. It focusses on ensuring that strategic policy frameworks exist and are combined with effective oversight, coalition-building, regulation, attention to system design and accountability. The need for greater accountability arises both from increased funding and a growing demand to demonstrate results. 
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1. Ensure that CHAM facilities have all governance structures in place as required by CHAM constitution
2. Ensure that CHAM facilities have administrative and technical manuals in place as required by CHAM constitution
3. Ensure donors go through CHAM secretariat when dealing with CHAM members
4. Ensure all members of governance structures are properly trained
5. Ensure that members of CHAM governance structure attend meetings regularly
6. Institute fully functional internal procurement and disposal committees in CHAM facilities
7. Develop systems to enforce implementation and use of manuals and guidelines in CHAM facilities
8. Enforcement of work plans based and aligned to the strategic plan
9. Strengthening the relationship of CHAM secretariat and CHAM Facilities

Health financing and financial sustainability is fundamental to the ability of health systems to maintain and improve human welfare. At the extreme, without the necessary funds no health workers would be employed, no medicines would be available and no health promotion or prevention would take place. This priority focuses on increasing CHAM financial resources and improves efficiency in resource mobilization, allocation and utilization. It focuses on attempts to increase the sustainable finances available to the CHAM through both revenue raising and efficiency savings.
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1. Ensure the financial sustainability of CHAM secretariat
2. Ensure timely payment of SLA and salaries
3. Enforce implementation of internal control systems
4. Implement fiscal discipline to bring back donor confidence
5. Install a very comprehensive Payroll IT system
6. Encourage payment of annual subscription by members by:
7. Enforce AGM resolution.
8. Management and board to make visits to facilitate.
9. Introduction of incentives for best performers’ e.g. foreign trips, free drugs, recognition and projects.

Changing behaviors and social norms is more of a marathon than a sprint. Within any given population, individual members are at different stages regarding their readiness and/or willingness to adopt new behaviors. The marketing strategy explains the specific goals and desired outcomes of the marketing campaign. The branding strategy, which is one component of the marketing strategy, creates a solid, consistent brand for delivery of quality healthcare services in CHAM member units. It requires the development of a strong, positive, and emotional connection between population and the healthcare services provided by CHAM.
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While the overall marketing strategy is to foster a positive change in the perception of healthcare services delivery by CHAM members, it is imperative that CHAM make substantive and essential improvements in the provision of healthcare services by its CHAM members’ healthcare workers. The increased access to quality health services will encourage people to access and use the services from CHAM members. Two targeted marketing goals are recommended: one directed at CHAM members and their health workers, and the other at people in their catchment areas.

1. Set up an investment taskforce/ committee (resource mobilization) to explore the opportunities’ investments
2. Develop sustainable funding strategies
3. Promote and enforce membership and collection of membership fees
4. Develop marketing strategy
5. Create brand for CHAM members
6. Promote health infrastructure development and rehabilitation at CHAM secretariat
7. Ensure that CHAM members are receiving payment from health insurance institutions
8. Ensure that CHAM pension fund are used for own investment at CHAM secretariat
9. Conduct surveys that assess the engagement, awareness, attitude, and behavior of our audiences for each of the target campaigns
10. Run a microfinance business
11. Property development and ensure that they are properly maintained
12. Reinforce rental collections
13. Increase number of projects to increase collection of management fees
14. Set up business to manage CHAM business activities e.g. pharmacy and rentals.
15.  Employ Business Development Manager
16. Marketing of services provided by CHAM members 

CHAM health units employ about 10,000 staff members. The CHAM Secretariat maintains the payroll for these staff and manages salary grants from the Malawi government. In 2013, CHAM procured a more robust payroll software, and in 2014 conducted a verification exercise in all member units. This enabled CHAM to rid the payroll of suspected ghost workers and anomalies in job grades.

At a facility level, human resource policies and practices vary across different churches, proprietors and member units. In some cases, there are no written guiding documents with regards to human resources management. There is a need to provide minimum standards for human resource management, including conditions of service, training, remuneration, appraisal, housing and other pertinent guidelines. This will improve staff morale and retention, job satisfaction and, ultimately, quality of work.

​Improve availability, retention, performance and motivation of human resources for health for effective, efficient and equitable health service delivery is a key priority of CHAM. This priority focuses on improving the absorption and retention rate of health workers in the public health sector while also achieving an equitable distribution.

1. Ensure effective HR management for the CHAM
2. Ensure that annual performance-based assessment based on work plan from strategic plan is being conducted
3. Promote good management practices for CHAM secretariat staff.
4. Conduct needs assessment for CHAM staff
5. Develop technical programs to support health workers to improve efficiency
6. Provide trainings on emerging healthcare issues
7. Regulation and quality assurance health services
8. Develop conditions of service that attract and retain qualified personnel
9. Ensure transparency staff recruitment and promotions
10. Admission requirements into training schools should be equivalent to universities in Malawi
11. Teaching and research equipment in schools should be improved
12. Training school infrastructure should be improved

This priority is important because it supports and preserves CHAM’s identity and ensures the integrity of ̕the CHAM member units. Increase equitable access to and improve quality of health care services is one of the key responsibility of CHAM. The signing of MoU with GoM is based on CHAM commitment to continue providing healthcare services to hard-to-reach and marginalized communities irrespective of their ability-to-pay. 

​One of CHAM’s key functions is providing technical support to its member units. CHAM’s financial challenges in recent years have limited the organisation’s ability to provide this support in the current model. Traditionally, technical support has been delivered through field visits, which require ample money and personnel. The type and modality of technical support that is most efficient and cost-effective must be reviewed and evaluated.

Most health facilities within CHAM do not provide the full range of requisite essential health package (EHP) services, chiefly due to the limited capacity of health providers, understaffing and inadequate medical equipment. This reduces CHAM’s overall contribution to the health sector, especially with regard to Universal Health Coverage. User fees also limit utilisation of EHP services, although SLAs have improved uptake in relevant facilities. 

Service delivery is in CHAM facilities is hampered by the lack of reliable, affordable and quality drugs, essential supplies and equipment maintenance services. There is, however, a critical mass and demand for reliable, affordable and quality drugs, which CHAM hopes to leverage to achieve economies of scale, and in the process generate income in the form of commission for services rendered. Leadership, investment and technical support in this area are needed. 

1. Ensure quality health services within CHAM facilities
2. Develop standards in line with national standards
3. Conduct research and routine checks to identify critical emerging healthcare issues and develop practice guidelines to manage them
4. Set standards for provision of health services in CHAM members
5. Establish codes of conduct for their members 
6. Strengthen the linkages for a good referral system
7.  Develop guidelines for health infrastructure care and rehabilitation of all CHAM members​

Sound and reliable information is the foundation of decision-making across all health systems. The health information system four key functions namely data generation, compilation, analysis and synthesis, and communication and use. It collects data from health and other relevant sectors, analyses the data and ensures their overall quality, relevance and timeliness, and converts the data into information for health-related decision-making. Information is of little value if it is not available in formats that meet the needs of multiple users. Dissemination and communication are therefore essential attributes of the health information system. This priority focuses on improving and harmonizing data collection and management.

1. Ensure data is properly captured
2. Develop communication strategy
3. Establish research and dissemination committee
4. Explore opportunities that emerging technologies of social media can offer
5. Create toll line where people can seek advisory health services
6. Organize open days behalf of CHAM members
7. Enhance capacity of CHAM members in planning, monitoring and evaluation, research, and knowledge management
8. Develop and implement Monitoring and Evaluation Framework
9. Document and share results and best practices
10. Recruitment of Research Officer
11. Develop IT system for recording SLA receipts
12.  Develop database to record and share data
13. Monitoring of progress for implementation of strategic plan

Access to essential medicines as part of the fulfilment of the right to health, recognized in CHAM constitution. A well-functioning health system ensures equitable access to essential medical products of assured quality, safety, efficacy and cost-effectiveness, and their scientifically sound and cost-effective use. 

1. Develop systems in procurement, supply and storage, and distribution that minimize leakage and other waste of the drugs
2. Conduct facility-based survey to investigate the needs, availability and use  of medicines
3. Ensure that CHAM pharmacy has adequate supplies of medicines and commodities
4. Devise proper distribution systems for medicines and commodities to CHAM facilities
5. Provide online services such as ordering of drugs, advertising products in stock
6. Conduct survey for products prices for proper determination of prices at CHAM pharmacy
7. Develop capacity to set and negotiate prices