Christian Health Association of Malawi · Christian Health Association of Malawi ‒ 2015–2019...

Christian Health Association of Malawi

Building Sustainable Church-based

Health Care in Malawi

2015-2019 Strategic Plan

This strategic plan was produced and printed with support from the United States Agency for

International Development through the Strengthening Health Outcomes through the Private Sector

(SHOPS) project.

DISCLAIMER: The author’s views expressed in this publication do not necessarily reflect the views of the United States

Agency for International Development (USAID) or the United States Government.


Area 14 Plot #13, Off Presidential Way, P O Box 30378, Lilongwe 3

+265 1 775 180/184 | [email protected] | www.cham.org.mw


mailto:[email protected]

http://www.cham.org.mw./

FOREWORD

Greetings,

The Christian Health Association of Malawi (CHAM)

celebrates its 50th-year anniversary in 2016! It is with

great pleasure that I present this 2015-2019 Strategic

Plan, that will inaugurate the next five years of

CHAM’s operations.

Since 1966, CHAM has remained a united body and a bona fide arm of the Church

in the provision of health care in Malawi. With this Strategic Plan, we renew our

commitment to being a vibrant and efficient partner to the Government and people

of Malawi in the delivery of quality health worker training and health care within the

framework of Universal Health Coverage. We will continue our focus on serving the

poor in rural, hard-to-reach areas, emulating the healing ministry of Our Lord

Jesus Christ.

This Strategic Plan also is a commitment to learn from our mistakes, especially from

the past 10 years, and to harness strategic opportunities to rebuild and reposition

ourselves as a modern, sustainable and efficient association. This will require

implementing fundamental changes in CHAM at governance and management down

to the service delivery level.

I call upon CHAM member Churches, health units and staff, CHAM Seceratriat, the

Ministry of Health and development partners to rally with us as we turn our vision

encapsulated in this Strategic Plan into reality. We need your support.

Rev. Father Peter Mulomole

Chairman, Board of Directors

PREFACE

The CHAM 2015–2019 Strategic Plan is entitled Towards Sustainable Church-based Health Care in Malawi. This title acknowledges CHAM as an arm of the Church in Malawi that is central to its health care ministry. The title captures our desire to reposition CHAM towards sustainability.

This Strategic Plan is intended for the entire association. Both members and stakeholders are expected to contribute at their

respective levels to the Plan’s successful implementation. CHAM Secretariat will spearhead and coordinate implementation.

Zero draft of this Strategic Plan was developed using extensive review of pertinent literature. The draft was refined through a widely consultative process with health facility staff and proprietors at the regional level, Government and development partners. The draft was further discussed jointly by the Board of Directors and Trustees and finally endorsed by the General Assembly.

The main thrust of this Strategic Plan is institutional and financial recovery of CHAM. Hallmarks of this recovery are a revised constitution and a financial recovery plan, respectively. Within the first two years of the Strategic Plan, these objectives together with strengthened human reosurces and rebuilt relationships with member units and partners will be realised to a great extent. After that time, a mid-term review will be conducted.

This Strategic Plan also embraces a new approach for CHAM Secretariat’s provision of technical support to member units. The old model relied mostly on conducting field visits to health units for hands-on supervision and mentorship; this required a lot of financial and human resources. This Strategic Plan departs from this model to one where the Secretariat primarily develops and provides tools, guidelines, minimum standards and capacity building. Close hands-on supervision shall then originate from the mid-level, i.e., health coordinators, to the health facilities. We believe that this approach is cost-effective and sustainable and agrees with CHAM Secretariat’s financial and technical capacity. Members will be encouraged to assume more responsibility in running the association.

This Strategic Plan was developed with financial support from the USAID-funded Strengthening Health Outcomes through the Private Sector (SHOPS) project. This support covered costs for consultants, consultative meetings and printing. The Malawi Health Sector Programme–Technical Assistance Component (MHSP-TA) (with funding from DFID) provided technical support through Options, mainly review of the drafts at various stages. Development of this Strategic Plan was made possible with the generous support of these partners, which we sincerely acknowledge. Individuals who personally contributed during the consultations and also whom we sincerely acknowledge have been listed in the Annexes.

Above all, we thank Our Lord Jesus Christ who, having said “the harvest truly is plentious but the labourers are few,” graciously considered us worthy to be co-workers with Him in His vineyard. Dr. Mwai Makoka Executive Director

Christian Health Association of Malawi ‒ 2015–2019 Strategic Plan ix

TABLE OF CONTENTS

ABBREVIATIONS AND ACRONYMS ............................................................................... XV

DEFINITION OF TERMS ................................................................................................... XV

EXECUTIVE SUMMARY ................................................................................................... XV

1. INTRODUCTION .............................................................................................................. 1

2. STRATEGIC PLAN DEVELOPMENT PROCESS ............................................................. 3

3. SITUATION ANALYSIS .................................................................................................... 5

Country Profile ........................................................................................................................... 5

CHAM’s Recent Historical Context ............................................................................................ 5

Strengths, Weaknesses, Opportunities, and Threats Analysis .................................................. 7

Challenges ................................................................................................................................. 8

4. VISION, MISSION, MANDATE AND CORE VALUES .................................................... 13

Vision........................................................................................................................................ 13

Mission ..................................................................................................................................... 13

Mandate ................................................................................................................................... 13

Core Values ............................................................................................................................. 13

5. STRATEGIC AREAS, GOALS AND OUTCOMES ......................................................... 15

Key Result Area 1: Good Governance ..................................................................................... 15

Key Result Area 2: Financial Recovery And Sustainability ...................................................... 15

Key Result Area 3: Networking And Advocacy ........................................................................ 15

Key Result Area 4: Human Resources Management .............................................................. 15

Key Result Area 5: Coordination And Technical Support For Health Services ....................... 15

Key Result Area 6: Monitoring, Evaluation And Research ...................................................... 16

Key Result Area 7: Training Of Human Resources For Health ............................................... 16

6. FINANCIAL PLAN .......................................................................................................... 17

7. IMPLEMENTATION ARRANGEMENTS ......................................................................... 19

8. MONITORING AND EVALUATION OF THE STRATEGIC PLAN .................................. 21

9. ANNEXES ...................................................................................................................... 22

Christian Health Association of Malawi ‒ 2015–2019 Strategic Plan xi

ABBREVIATIONS AND ACRONYMS

CHAM Christian Health Association of Malawi

DFID Department for International Development

ECM Episcopal Conference of Malawi

MCC Malawi Council of Churches

MOH Ministry of Health

MoU Memorandum of Understanding

SLA Service Level Agreement

Christian Health Association of Malawi ‒ 2015–2019 Strategic Plan xiii

DEFINITION OF TERMS

Proprietor: The head of a Church or a Church structure, e.g., a synod or a diocese,

in whom ownership of the assets is vested. The proprietor may be the Bishop,

General Secretary or President.

Health Coordinator: An employee of the proprietor responsible for managing the

medical portfolio of the proprietor. The health coordinator also may be known by

other official titles, e.g., Health Secretary or Medical Director.

Health Unit: A health centre, community hospital, hospital or training college that is

a member of CHAM. The term is used interchangeably with “member unit.”

Mother Bodies: Church bodies that established and co-own CHAM, namely, the

Episcopal Conference of Malawi (ECM) and the Malawi Council of Churches.

CHAM Secretariat: The body that coordinates the association and implements

CHAM’s policies. The Secretariat is headed by the Executive Director and is located

in Lilongwe.

Christian Health Association of Malawi 2015–2019 Strategic Plan xv

EXECUTIVE SUMMARY

The Christian Health Association of Malawi (CHAM), an ecumenical umbrella

association of Church-based health services in Malawi, celebrates its golden jubilee

in 2016. CHAM coordinates health services and health worker training delivered by

the various Churches, provides leadership and support, and also liaises with the

Government and other stakeholders. Besides fulfilling the Church’s Biblical mandate

of promoting health, CHAM complements efforts of the Government of Malawi in

providing health care to nearly one third of the populationin rural areas and in

training a majority of the health workers.

The 2015-2019 Strategic Plan aims to realise financial and institutional recovery and

place CHAM on sustainable footing. The process for developing this strategy

involved a desk review of the Constitution of CHAM, minutes of meetings of the

Board of Directors and of the General Assembly and reports of evaluations including

the mid-term evaluation of the previous strategic plan. Consultations also were held

at all levels of the association and with various stakeholders.

The Strategic Plan has seven key result areas: (1) good governance, (2) financial

recovery and sustainability, (3) networking and advocacy, (4) human resource

management, (5) coordination and technical support, (6) monitoring and evaluation

and research and (7) training of human resources for health.

The primary audience for the Strategic Plan is CHAM collective, with the CHAM

Secretariat leading its implementation. Secondary audiences include the Ministry of

Health, donors and development and implementing partners.

Included in the Strategic Plan are an income and expenditure plan, implementation

arrangements and a monitoring and evaluation plan. The budget for implementing

this strategy is K106b, of which K92b represents the salary grant from Government

to staff in CHAM member units. The strategy will be financed from donor projects,

membership fees and rental income from property.

Successful implementation of this strategy will depend heavily on strong commitment

from members of CHAM at all levels—from the Mother bodies to the health facility,

from the Government to donor partners.

Christian Health Association of Malawi 2015–2019 Strategic Plan 1

1. INTRODUCTION

The Christian Health Association of

Malawi (CHAM) was established in

1966 as an ecumenical umbrella

association of Church-owned health

care units and health training colleges

in Malawi. It is co-owned by two

Church Mother bodies: the Episcopal

Conference of Malawi (ECM) and the

Malawi Council of Churches (MCC).

Established to promote the healing

ministry of Jesus Christ, CHAM offers

administrative and technical assitance

to support the provision of health care

services by member facilities. It is

governed by the Mother bodies,

General Assembly, Board of Trustees

and Board of Directors. Currently,

CHAM has 170 health facilities and 12

training colleges located throughout

the country, mainly in rural and hard-

to-reach areas. CHAM trains up to 80

percent of mid-level health

professionals in Malawi.

The CHAM functions support provision

of technical assistance for health

issues, coordination, capacity building,

facilitation, resource mobilisation and

standard setting. It represents CHAM

member units in policy discusions with

Government, development partners

and other implementing partners.

Since its establishment CHAM has

implemented four strategic plans. The

most recent five year strategic plan

(2010–2014) expired in December

2014. This Strategic Plan is meant to

guide implementation of the CHAM

mandate for the period 2015–2019.

CHAM MEMBER UNITS:

20 Hospitals

12 Training Colleges

20 Community Hospitals

90 Health Centres with

Maternity

40 Health Centres without

Maternity


2. STRATEGIC PLAN DEVELOPMENT PROCESS

Development of this Strategic Plan

began with the review of four sets of

documents: (1) the constitution of

CHAM, (2) Report of the mid-term

evaluation of the 2010–2014 Strategic

Plan, (3) minutes and reports of

meetings of the Board of Directors,

Trustees and of the General Assembly

and (4) reports of three evaluations

conducted in 2014 with technical

assistance from the Department for

International Development (DFID)

through Options (Annex 11). An Issues

Paper was generated from the

reviewed literature, and a zero draft

Strategic Plan was developed.

The zero draft Strategic Plan formed a

basis for six regional consultative

workshops: one with health facility staff

and coordinators and another with

proprietors, in each of the three

regions. The Ministry of Health and

development partners were also

consulted.

The final draft was then jointly

reviewed by the Board of Trustees and

Directors and was finally endorsed by

the General Assembly. Details of these

consultative meetings are provided as

Annexes 4 through 10.


3. SITUATION ANALYSIS

Country Profile

During the period of this 2015–2019

Strategic Plan, Malawi is expected still

to be densely populated with the total

population projected at 16,832,910 in

2016 and 18,508,613 in 2019

(Population and Housing Census

2008). Despite having registered

significant progress, Malawi also has

poor health indicators, highlighted by

its failure to meet most health-related

Millennium Development Goals (4, 5

and 6). The 2010 Malawi Demographic

and Health Survey reported under-five

mortality rate at 112, maternal

mortality ratio at 675, and HIV

prevalence among the youth at 3.6.

Malawi also is highly affected by

poverty with nearly half of its

population living below the poverty

line. The country also is struggling to

cope with the effects of climate

change. Erratic weather patterns and

recent devastating floods continue to

have negative socio-economic impact

on the population, especially the rural

poor masses. Notably, about 80

percent of the population lives in rural

areas with subsistence farming as the

main source of livelihood.

CHAM’s Recent Historical Context

CHAM works in close partnership with

the Government through the MOH.

The Government has the constitutional

obligation to provide health services to

its citizens, and CHAM has the

Church’s Biblical mandate to promote

the healing ministry of Jesus Christ.

CHAM’s health facilities are located

predominantly in rural areas and are

critical in ensuring delivery of quality

health care to this sector of the

population. As a non-state actor,

CHAM has resource constraints which

limit its ability to deliver against its

mandate; services are not necessarily

funded directly and fully by the

Government.

CHAM signed an MoU with the

Ministry of Health in 2002 in order to

leverage each other’s strengths. The

MoU was meant to accelerate

attainment of Millenium Development

Goals. Among other issues, the MoU

also stipulated that Government would

pay salaries for staff working in CHAM

health facilities and that service level

agreements (SLAs) would be

established at the district level to cater

to specific service delivery areas to

increase the equity of health service

access.

6 Christian Health Association of Malawi 2015–2019 Strategic Plan

The previous Strategic Plan was

launched at the time CHAM lost donor

confidence and support due to year

2010 mismanagement. Resulting

financial contraints led to

unsatisfactory plan implementation

which also required ample human

resources to accommodate the hands-

on involvement approach of CHAM

Secretariat staff. CHAM is re-attracting

donor partners, strengthening its

financial and administrative

management and repaying debts and

other outstanding financial liabilities.

This Strategic Plan is meant to

consolidate these efforts and

reposition CHAM for the future.

At the facility level, user fees are

generally levied, unlike at MoH

facilities where there is no payment

from the people accessing the

services. The user fees are set low

because of Government-provided

salaries. Also, SLAs are in place to

further subsidise the user fees at the

district level where services are

provided. The District Health Office

reimburses 70 percent of the user fees

in arrears, and the health facilities

absolve the remaining 30 percent.

Government-supported disease

programmes, like HIV, malaria,

tuberculosis, childhood vaccinations,

are provided for free. Despite past

finance challenges, the MoU in general

and the SLAs in particular have

contributed significantly to health care

equity and access with resultant

improvements in population level

health outcomes.

The CHAM facilities face many

challenges. Procurement of affordable

and quality medicines and essential

supplies is costly. Not including

salaries, these materials account for

up to 70 percent of facilities’ annual

expenditures, leaving little or no room

for investment in infrastructure and

systems strengthening. Also, direct

donations to CHAM facilities from

overseas benefactors have dwindled.

Irregular and non-payment of SLA bills

as well as reduced ability for the local

communities to pay user fees due to

growing poverty has exerted further

financial strain on the facilities.


Limited housing, lack of incentives to

work in the rural areas and a staff

establishment that was fixed in 2002

have together undermined availability

of adequate and skilled health workers

in CHAM facilities.

CHAM training colleges remain the

backbone of human resources for

health (HRH) training in Malawi,

training up to 80 percent of mid-level

health professionals, mainly nurses

and midwives.

Over the past 10 years, most colleges

have more than doubled their student

intake demontrated by the

improvement of nurse to population

ratio of 3,500 in 2004 to 1,400 in 2012

(Norwegian Church Aid programme

report). Some colleges also are

introducing new training programmes,

becoming affiliated with local Church

universities.

Strengths, Weaknesses, Opportunities, and Threats Analysis

Factor Status

Strengths Ecumenical association of Catholic and Protestant Churches, long history

and established structures

Strongly recognized as government key partner in the health sector

Provide health services in hard-to-reach areas

Weaknesses Financial liabilities from the past, funding constraints compromising

programme delivery

High staff turn over at CHAM Secretariat and member units

Poor communication with member units, proprietors and partners

Roles and responsibilities of governance structures not fully defined

Weak systems, including financial management

Low utilisation of information technology

Opportunities Government and donor commitment

Technological advancements that provide various avenues for improving

systems and expanding access to health services

Use of economies of scale to reduce costs on drugs, essential supplies

and services


Serving the marginalised population in hard-to-reach areas

Threats Devolution and decentralisation of Government administration; Also an

opportunity depending on how CHAM is engaged

MoU between Government and CHAM not yet revised

Tendency of some partners to by-pass CHAM Secretariat when dealing

with member units

Challenges

Over the years, CHAM has grown its

membership and increased the

standards of some health facilities and

training colleges. Yet, environmental

changes and emerging issues (e.g.,

disease burden, decentralisation) in

the health sector are affecting the

management of CHAM. Further, the

Constitution that governs CHAM has

not been reviewed and revised to

accommodate such changes.

Governance

The CHAM Constitution directs five

governance structures: General

Assembly, Board of Trustees, Board of

Directors, technical committees, and

Mother bodies. However, there is

some lack of clarity in roles and

responsibilities between two Boards

and also between the General

Assembly and Mother bodies. Also,

there is no clarity as to who is a

member of CHAM: the proprietor or

the health facility. The health facilities

also have challenges with governance.

Most do not have boards or have

boards that are untrained without

clear terms of reference and lack

requisite professional expertise.

Further, the health facility boards are

not part of CHAM governance

structures.

There is an urgent need to address

governance in CHAM at all levels in

order to reposition CHAM as a robust,

self-sustaining association.

Memorandum of Understanding

The Memorandum of Understanding

between the Ministry of Health and

CHAM was signed in December 2002,

yet has never been updated. Since

2011, there have been several futile

efforts to revise the MoU. Revison of

the MoU is a strategic priority for

CHAM, one that must consider

lessons learnt, a changing legal and

socio-economic environment,

enactment of the Public-Private


Partnership Act (2010) and the

shrinking fiscal space for CHAM.

Financial Sustainability

Specific to the financial

mismanagement suffered by CHAM, it

has been riddled with a large debt

burden and injured relationships with

Government, health units and

development partners. The U.S.

President’s Emergency Plan for AIDS

Relief (PEPFAR) through the Centers

for Disease Control and Prevention

(CDC) has been supporting CHAM

since 2009. Beginning in 2013, CHAM

restored funding relationship with the

Norwergian Church Aid, Dan Church

Aid and United States Agency for

International Development (USAID).

Importantly, new project funding has

been secured from the European

Commission as well as continued

funding from CDC. The United

Kingdom’s Department for

International Development (DFID)

through Options has also, since 2014,

begun providing technical support to

CHAM in the areas of financial

management and governance. Dating

to late 2014, CHAM has spent more

than K50million towards debt

repayments. Recovery is underway,

and systematic and sustained efforts

are vital to realise full financial and

institutional recovery.

As a member organization, CHAM

depends on membership fees for its

core activities and donor funds for

projects. Member units, facing their

unique challenges, show difficulty

paying membership fees.

Annually, CHAM collects less than 40

percent of expected membership fees.

Not surprisingly, direct financial

support from overseas to mission

hospitals has been reduced. Currently,

income from membership fees and

unobligated sources account for only

three percent of total income while

project funds represent 97 percent.

This significant difference suggests

that CHAM needs to diversify its

funding base.

In the first two years of this Strategic

Plan, CHAM will embark on studies of

various income generating

opportunities to ensure financial

sustainability. Also, CHAM will engage

donors in a new manner that examines

specific areas as well as core

operational costs which they may be

able to fund.


Coordination and Technical Support of Health Services

CHAM is mandated to provide

technical support to its member units.

Member units have not received

adequate support over the years

because of CHAM’s financial

challenges. However, technical

support to some member units is being

offered through projects. This model of

providing technical support has

centred on field visits, which require

ample money and personnel. The type

and modality of providing technical

support is being reviewed to ensure

that it is efficient and cost effective.

Most health facilities do not provide the

range of essential health package

(EHP) services requisite at their level

of health care. Limited capacity of

health providers, understaffing and

inadequate medical equipment hinder

EHP service provision. This reduces

the overall contribution of CHAM to the

health sector, especially with regard to

Universal Health Coverage. User fees

have also limited utilisation of EHP

services. When health facilities are

operating well, SLAs improve uptake

of specific EHP services, mainly

maternal and neonatal health care. Of

note is that, success varies from

district to district, and over time.

Service delivery is also hampered by

lack of reliable, affordable and quality

drugs, essential supplies as well as

equipment maintenance services.

There is however critical mass and

demand for reliable, affordable and

quality drugs, which CHAM will

consider leveraging 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.

Monitoring, Evaluation and Research

CHAM member units generate a lot of

data. However, CHAM’s present

information management systems for

data collection, processing, storage

and utilisation are inadequate. CHAM

collectively makes a large socio-

economic contribution to Malawi, but

CHAM is unable to tell its own story. In

addition, there is no agenda to guide

research efforts on pertinent areas and

to harness research opportunities from

academic and research institutions. In

2014, a Health Facility Assessment of

all member units was conducted

covering the five areas: infrastructure,

medical equipment, service delivery,

financial management and human


resources. These data will form

baseline for a database that shall be

maintained.

Advocacy and Networking

It is necessary for CHAM to lead key

advocacy, publicity, lobbying and

negotiating activities to establish

strong partnerships and mobilise

additional resources for its service

delivery. By strengthening its

networking role CHAM will be able to

raise its profile, enable active

participation of member units and

attract partners.

Development/Training of Human Resources for Health

CHAM membership includes training

colleges that provide pre-service

training to about 80 percent of

Malawi’s mid-level health

professionals, mainly nurse-midwives.

CHAM mobilises scholarships and

other material and technical resources

to support the training activities of

these colleges. Some partners,

however, design and manage their

own scholarships directly with the

colleges. Each college also recruits its

own students. Over the years this lack

of standardisation in recruitment

procedures and scholarship packages

has caused considerable confusion

with the public. Scholarship bonding

also is not enforced. Further,

graduates do not receive the quality of

training in CHAM colleges requisite for

admission into the University of

Malawi’s degree programmes.

Human Resources Management

CHAM health units employ more than

9,000 staff. CHAM Secretariat

maintains payroll for these staff and

manages the salary grant from the

Government. In 2013 CHAM procured

a more robust payroll software, and in

2014 conducted a verification exercise

in all the member units.

These developments have enabled

CHAM to rid the payroll of suspected

ghost workers and anomalies in job

grades, both of which had caused

major friction between CHAM and the

Ministry of Health.

At facility level, human resource

policies and practices vary across the

different Churches, proprietors and

member units.


In other cases, there are no written

guiding documents, with human

resource decisions at the discretion of

management. There is 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.


4. VISION, MISSION, MANDATE AND CORE VALUES

This strategic plan will be guided by

the following vision, mission, mandate

and core values.

Vision

Sustainable, quality and equitable

health services for all people in Malawi

as inspired by the healing Ministry of

Jesus Christ.

Mission

To coordinate member units by

providing administrative, technical and

financial support for better and

effective delivery of health care

services and training of human

resources for health.

Mandate

a) To coordinate health services

among all CHAM Units

b) To provide a link between CHAM

Units and Government in the

provision of health care services

c) To provide technical support to and

represent CHAM Units at different

fora

d) To ensure standards for provision

of quality health care

e) To mobilise resource and support

for capacity building

f) To advocate for policy change and

build partnerships in the interest of

CHAM units.

Core Values

CHAM’s core values are:

a) Unity of purpose in the framework

of its Christian identity and witness

b) Delivery of quality services

considering client centeredness,

gender sensitivity, and respect for

human dignity and rights

c) Participatory approach in

management as well as

accountability and transparency

d) Innovation and sustainability.


5. STRATEGIC AREAS, GOALS AND OUTCOMES

There are seven Key Result Areas in

this Strategic Plan. Goal and strategic

outcomes for each of these are as

follows:

Key Result Area 1: Good Governance

Goal: Effective and efficient governance of CHAM

Priority: Short-term

Strategic outcomes

a) CHAM Constitution revised

b) Generic governance manual for

Member Units in place

c) Fully functional boards in place for

CHAM and member units

Key Result Area 2: Financial Recovery And Sustainability

Goal: CHAM is a going concern.


Strategic outcomes

a) CHAM recovery plan developed

and implemented

b) Risk management guidelines

developed and implemented

c) Income generating subsidiaries

established and operational

Key Result Area 3: Networking And Advocacy

Goal: Engagement with members and stakeholders


Strategic outcomes

a) Communication strategy developed

and implemented

b) CHAM visibility at facility, district,

zonal and national levels improved

c) Enhanced networking with Ministry

of Health and development

partners

d) Strengthened partnership amongst

CHAM members

Key Result Area 4: Human Resources Management

Goal: Human resources management strengthened


Strategic outcomes

a) Human resource management

guidelines developed and

implemented

b) CHAM staff establishment revised

c) Conditions of service that attract

and retain qualified personnel

developed and implemented

Key Result Area 5: Coordination And Technical Support For Health Services

Goal: Accessible and quality health services provided by member units

Priority: Long-term

Strategic outcomes

a) Minimum standards developed and

implemented in pertinent areas


such as financial management, risk

management, monitoring and

evaluation, human resource

management, physical asset

management, and quality

improvement in health services

b) Strengthened service delivery in

member units

c) Pooled procurement of

pharmaceuticals and other support

services

Key Result Area 6: Monitoring, Evaluation And Research

Goal: Planning, research, monitoring and evaluation systems strengthened

Priority: Long-term

Strategic outcomes

a) Enhanced capacity at the

Secretariat, health Coordination

desks, training colleges and

member units in planing,

monitoring and evaluation,

research, management information

systems and knowledge

management

b) Enhanced use of information and

communication technology (ICT)

(HMIS, LMIS, Trainsmart, iHRIS)

c) Research strategy developed and

desseminated

d) Monitoring and Evaluation

Framework developed and

implemented

e) Results and best practices

regularly shared and utilised

Key Result Area 7: Training Of Human Resources For Health

Goal: Improve functionality of CHAM training colleges

Priority: Long-term

Strategic outcomes:

a) Harmonised scholarship and

bonding guidelines

b) Improved process for selecting

students into CHAM colleges

c) Improved capacity and quality of

CHAM training programmes


6. FINANCIAL PLAN

Implementation of this 2015-2019

Strategic Plan shall be financed from

five main sources (Annex 1). These

include core (unobligated) income from

membership fees, administration fees

from projects and rentals. Funding also

will be obtained from the Government

salary grant. In addition a specific

strategic outcome may be funded as a

stand-alone project.

Annex 2 is the summary budget, and

Annex 3 is a detailed expenditure

budget for the Strategic Outcomes for

the seven Key Result Areas over the

five years. The budget also includes

operational costs for the Secretariat

and Government salary grant for the

health facilities.


7. IMPLEMENTATION ARRANGEMENTS

This 2015-2019 Strategic Plan shall be

implemented in particular within the

context of the Malawi Health Sector

Strategic Plan 2011-2016 (HSSP), and

in general within the overal policy

guidance on health provided by the

Ministry of Health. Mid-term review of

this plan shall thus incorporate issues

in the successor HSSP.

CHAM Secretariat will be responsible

for operationalising this Strategic plan.

The Secretariat also will facilitate

implementation of activities related to

coordination with stakeholders and

Member Units. The Secretariat will

develop annual work plans and

budget, prepare progress reports, and

will report primarily to the Board of

Directors.

Board of Directors will provide overall

guidance in implementation of the

Strategic Plan. In this regard, the

Board will approve implementation

plans and receive quarterly progress

reports from management. The Board

will report to the General Assembly on

implementation of the Strategic Plan.

The Health Coordinators will be

responsible for supervising member

health units in the implementation of

the Strategic Plan, as well as provide

technical support to member units,

lobbying and advocating with

proprietors in terms of resource

mobilisation and policies.

Member Units will support CHAM in

resource mobilisation, technical

support and advocacy. They also are

service delivery units for health care

and training. They maintain and

provide information to CHAM on

human resource numbers and

accounts.

Implementing Partners will be

responsible for rendering technical

support to CHAM Secretariat and also

through CHAM Secretariat to member

units, in their respective areas of

competence.

.


8. MONITORING AND EVALUATION OF THE STRATEGIC PLAN

The Board of Directors will monitor

implementation of the strategic plan by

receiving quarterly reports from

Management. Besides monitoring

progress towards achievement of the

Strategic Outcomes, the Board will

monitor financial management,

including balance between income,

expenditure and debt repayment.

Periodic skills audit for the Board and

Management shall also be employed.

Furthermore, stakeholder satisfaction

surveys will be conducted to determine

effectiveness of internal and external

networking and engagement.

The Board will commission an

evaluation of the Strategic Plan early

in 2017 to assess progress towards

the financial recovery that shall be

emphasized in the first two years. The

strategic plan shall be revised in line

with findings of the evaluation. That

revision shall also take into

consideration any issues emerging

from the successor health sector plan.

9. ANNEXES

Annex 1. Projection of Income

All figures are to the nearest MK’000million

Income projection 2015 2016 2017 2018 2019

Membership fees 100,000 100,000 120,000 120,000 144,000

Projects 1,650,000 2,050,000 2,460,000 2,952,000 3,542,400

Administrative fees from projects 165,000 205,000 237,600 285,120 342,144

Rentals 13,250 15,238 17,523 20,152 23,174

Salary grant from MOH 10,200,000 13,260,000 17,238,000 22,409,400 29,132,220

12,128,250 15,630,238 20,073,123 25,786,672 33,183,938

Income Assumptions

Government salary grant will increase by 30% every year due to growth of the workforce and

salary adjustments.

Rental income will increase by 20% every year.

Membership fees will increase by 20% every two years.

Projects will grow by 20% every year

Annex 2. Summary Budget for Key Result Areas

Key Result Area 2015 2016 2017 2018 2019 TOTAL CORE GRANT

Good Governance

8,000 12,500 2,000 1,000 1,000 29,000 12,000 17,000

Financial Recovery, Sustainability

18,500 16,250 10,500 11,000 11,500 69,750 49,250 20,500

Networking, Advocacy

22,500 60,000 29,001 35,750 43,438 194,689 117,622 77,067

Human Resource Management

14,000 19,000 6,750 8,250 9,750 57,750 15,000 42,750

Coordination, & Technical Support

52,250 55,207 52,180 56,236 58,961 279,834 36,225 243,609

M&E, Research 30,500 42,250 30,700 31,800 32,500 172,750 28,825 143,925 Training of Human Resources for Health

22,500 21,500 8,250 9,813 11,766 79,829 7,000 72,829

CHAM Secretariat Operational Costs

1,760,000 2,112,000 2,534,400 3,041,280 3,649,536 13,097,216 3,929,165 9,168,051

CHAM Units Salaries - MoH Grant

10,200,000 13,260,000 17,238,000 22,409,400 29,132,220 92,239,620 - 92,239,620

Total 12,128,250 15,598,707 19,911,781 25,604,529 32,950,671 106,220,438 4,195,087 102,025,351

Annex 3. Budget for the Key Result Areas and Strategic Outcomes

OUTPUT

FUNDS REQUIRED IN K'000

CORE GRANT 2015 2016 2017 2018 2019 TOTAL

1. Good Governance

1.1 CHAM Constitution is revised 4,000 5,500 - - - 13,000 2,000 11,000 1.2 Generic governance manual for

member units in place - 5,000 1,000 - - 6,000 - 6,000

1.3 Fully functional boards in place for CHAM and Member Units

4,000 2,000 1,000 1,000 1,000 10,000 10,000 -

Subtotal 8,000 12,500 2,000 1,000 1,000 29,000 12,000 17,000

2. Financial Recovery and Sustainability

2.1 CHAM recovery plan developed and implemented

8,000 3,250 2,000 2,000 2,000 19,250 9,250 10,000

2.2 Risk management guidelines developed and implemented

5,500 3,000 3,500 4,000 4,500 20,500 10,000 10,500

2.3 Income generating subsidiaries established and operational

5,000 10,000 5,000 5,000 5,000 30,000 30,000 -

Subtotal 18,500 16,250 10,500 11,000 11,500 69,750 49,250 20,500

3. Networking and Advocacy

3.1 Communication strategy developed and implemented

3,000 15,000 3,000 3,750 4,688 29,438 25,438 4,000

3.2 CHAM visibility at facility, district, zonal and national levels improved

6,000 30,000 7,500 9,250 11,313 68,063 48,063 20,000

3.3 Enhanced networking with Ministry of Health, development partners and key health sector stakeholders

5,500 6,750 8,313 10,391 12,113 43,067 10,000 33,067

3.4 Strengthened partnership amongst CHAM members

8,000 8,250 10,188 12,359 15,324 54,121 34,121 20,000

Subtotal 22,500 60,000 29,001 35,750 43,438 194,689 117,622 77,067

4. Human Resources Management

4.1 Human resource management guidelines developed and implemented

10,000 2,000 3,500 4,000 4,500 24,000 2,000 22,000

4.2 CHAM staff establishment revised

2,000 7,000 - - - 9,000 9,000 -

4.3 Conditions of service that attract and retain qualified personnel developed and implemented

2,000 10,000 3,250 4,250 5,250 24,750 4,000 20,750

Subtotal 14,000 19,000 6,750 8,250 9,750 57,750 15,000 42,750

5. Coordination and Technical Support for Health Services

5.1 Minimum standards developed and implemented in pertinent areas such as financial management, risk management, monitoring and evaluation, human resource management, physical asset management, and health services

6,250 12,207 7,813 9,766 5,000 41,036 20,518 20,518

5.2 Strengthened service delivery in units

45,000 41,500 42,367 43,970 51,461 229,298 8,207 221,091

5.3 Pooled procurement of pharmaceuticals and other support services

1,000 1,500 2,000 2,500 2,500 9,500 7,500 2,000

Subtotal 52,250 55,207 52,180 56,236 58,961 279,834 36,225 243,609

6. Monitoring and Evaluation and Research

6.1 Enhanced capacity at the Secretariat, health Coordination desks, training Colleges and Member Units in planning, monitoring and evaluation, research, management information systems and knowledge management

15,000 20,000 20,000 20,000 20,000 100,000 5,000 95,000

6.2 Enhanced use of information and communication technology (ICT) (HMIS, LMIS, TrainSMART, iHRIS)

2,000 2,500 3,000 3,500 4,000 15,000 5,000 10,000

6.3 Research strategy developed and disseminated

- 10,000 1,000 1,000 1,000 13,000 3,000 10,000

6.4 Monitoring and Evaluation Framework developed and implemented

3,500 6,000 2,500 2,500 2,500 17,000 7,500 9,500

6.5 Results and best practices are regularly shared and utilised

10,000 3,750 4,200 4,800 5,000 27,750 8,325 19,425

Subtotal 30,500 42,250 30,700 31,800 32,500 172,750 28,825 143,925

OUTPUT

FUNDS REQUIRED IN K'000

CORE GRANT 2015 2016 2017 2018 2019 TOTAL

Key Result Area: Training of Human Resources for Health

7.1 Harmonised scholarship and bonding guidelines

12,000 4,500 1,000 1,000 1,000 25,500 2,000 23,500

7.2 Improved process for selecting students into CHAM colleges

8,000 12,000 1,000 1,000 1,000 23,000 3,000 20,000

7.3 Improved capacity and quality of CHAM training programmes

2,500 5,000 6,250 7,813 9,766 31,329 2,000 29,329

Subtotal 22,500 21,500 8,250 9,813 11,766 79,829 7,000 72,829

Total 168,250 226,707 139,381 153,849 168,915 883,602 265,922 617,680

CHAM Sec operational costs 1,760,000 2,112,000 2,534,400 3,041,280 3,649,536 13,097,216 3,929,165 9,168,051

CHAM UNITS salaries - MOH grant 10,200,000 13,260,000 17,238,000 22,409,400 29,132,220 92,239,620 - 92,239,620

Total expenditure budget 12,128,250 15,598,707 19,911,781 25,604,529 32,950,671 106,220,438 4,195,087 102,025,351

Annex 4. Participants to Consultative Meeting with Health Coordinators and Health Facility staff in the Southern Region held at Grace Bandawe Conference Centre, Blantyre on 3rd February 2015

Name Health Facility/Coordination Desk

1 Florence Chipungu Adventist Health Services

2 Mary Katumbi Adventist Health Services

3 Joe Jedegwa Blantyre Synod

4 Ulanda Mtamba Blantyre Synod

5 Emily Kayimba Chikwawa Diocese

6 Grace Monjeza Chingazi Rural Hospital

7 E. Chiomba Chipini Health Centre

8 Victor Mnelemba Dioceses of Upper Shire

9 Allan Majanga H. Parker Health Centre

10 D. Chiona Holy Family College

11 Ethel Chimaliro Holy Family Hospital

12 Sr. Anna Balley Kalemba Community Hospital

13 Blessings Nyahoda Lulwe Health Centre

14 Spykman Banda Lulwe Health Centre

15 Sr. Rhoda Bendala Magomero Health Centre

16 Aubrey Mateyu Malabada Health Centre

17 Elizabeth Moyo Malabada Health Centre

18 Agness Dzimbiri Mangochi Diocese

19 Peterkins Chisoni Mangochi Diocese

20 Henry Laymaman Mayaka Health Centre

21 Sr. Florah Manja Mayaka Health Centre

22 Ken Loga Mitsidi Synod

23 Esther Chilunga Mlambe Hospital

24 Mary Chikopa Mlambe Hospital

25 Chipiliro Chikhaula Mpiri Health Centre

26 Pearson Soka Mulanje Mission College

27 Robert Bakuwo Mulanje Mission College

28 Susan Sundu Mulanje Mission College

29 Godfrey Suya Nankhwali Health Centre

30 Maggie Mwaha Phalula Health Centre

31 Dr. Zahra Ismail Pirimiti Community Hospital

32 Asunga Kawere Seventh Day Baptist

33 Patrick Wella Seventh Day Baptist

34 Maxwell Pangani St. Luke’s College

35 W. Boma St. Luke’s Hospital

36 Wellington Ndilande St. Martin Health Centre

37 Peter Nambwale St. Martin’s Hospital

38 Vincent Chalila St. Martin’s Hospital

39 Wiseman Vanwyk St. Martin’s Hospital

40 Kennedy Jailos St. Montfort Hospital

41 Grace Makonyola Zomba Diocese

Annex 5. Participants to Consultative Meeting with Proprietors in the Southern Region held at Grace Bandawe Conference Centre, Blantyre on 4th February 2015

Name Proprietor

1 Fr. Boniface Tamani Archdiocese of Blantyre

2 Rev. Moyenda Kanjerwa Blantyre Synod

3 Bishop Peter Musikuwa Chikwawa Diocese

4 Bishop Brighton Malasa Diocese of Upper Shire

5 Grace Monjeza Evangelical Brethren Church

6 Ps. A. Wyson Evangelical Brethren Church

7 Fr. A. Nkhata Mangochi Diocese

8 Patrick Wella Seventh Day Adventist

9 Fr. Leonard Namwera Zomba Diocese

Annex 6. Participants to Consultative Meeting with Health Coordinators and Health Facility Staff in the Central Region held at Pacific Hotel, Lilongwe on 13th February 2015


1 Rev. B. Mponda Anglican Diocese of Lake Malawi

2 Sr. Christina Chikaiko Bembeke St. Anne’s Health Centre

3 Derek Chilupsya Chigodi Health Centre

4 Godfrey Soko Daeyang Luke Hospital

5 Robin Ngalande Dedza Diocese

6 Sr. Julita Chakana Francisco Palau Hospital (Mtengowanthenga)

7 Sr. Florida Gundasi Ganya Health Centre

8 Tendace Suya Gowa Health Centre

9 Sr. Victoria Ogu Kasina Health Centre

10 Fr. Epiphany Bwanali Kaundu Health Centre

11 Nyembezi Kayira Kaundu Health Centre

12 Alison Westphal Lutheran Mobile Clinic

13 Robert Jones Madisi Hospital

14 Justin Chamera Malembo Health Centre

15 Rex Mambo Malingunde Health Centre

16 Sr. Armande Lukamba Matumba Health Centre

17 M. Chikuse Mikondo Health Centre

18 Moya Worries Mlanda Health Centre

19 Bright Josiya Mua Mission Hospital

20 Patrick Machado Mua Mission Hospital

24 Grace Massah Nkhoma College

21 Agness Nyanda Nkhoma Hospital

25 Belito Madetsa Nkhoma Hospital

22 Paul Mekani Nkhoma Hospital

26 Stancellous Kumwenda Nkhoma Hospital

23 Wisdom Gwaza Nkhoma Hospital

27 Yoas Mvula Nkhoma Synod

28 Enock Kauye Nsipe Health Centre

29 Sr. Rose Guevarra Our Lady of Mt Carmel-Kapiri

44 Sr. Esther Namahella Sr. Teresa Community Hospital

30 Peter Minjale St. Andrews Hospital

31 Aubrey Wande St. Andrews Hospital

32 Chosani Luke Mtawali St. Anne’s Hospital

33 Emmanuel Matias St. Anne’s Hospital

34 M.H. Kapatuka St. Anne’s Hospital

35 O. Kapachika St. Anne’s Hospital

36 Piyo Godfrey Dimba St. Anne’s Hospital

37 W.A.K. Banda St. Anne’s Hospital

38 Sunshine Mfungwe St. Faith Clinic

39 Ringo Kanshulu St. Gabriel Hospital

40 Margret Kachikweza St. Josephs Ludzi Hospital

41 Sr. Beatrice Chidatha St. Josephs Ludzi Hospital

42 Sr. Christina Chakalamba St. Michaels Guilleme Hospital

43 Vincent Sakala St. Michaels Guilleme Hospital

Annex 7. Participants to Consultative Meeting with Proprietors in Central Region Held at Pacific Hotel, Lilongwe on 14th February 2015

Name Proprietor

1 Canon Emmanuel Makalande Anglican Diocese of Lake Malawi

2 Emmanuel Kanyama Dedza Diocese

3 Robert Manda Korean Church Mission

4 Mons. Francis Sonkhani Lilongwe Archdiocese

Annex 8. Participants to Consultative Meeting with Health Coordinators and Health Facility Staff in the Northern Region held at Mzuzu Hotel, Mzuzu on 20th February 2015


1 C. Chule Anglican Diocese of Northern Malawi

2 Chimwemwe Tebulo Anglican Diocese of Northern Malawi

3 Rachael Manda Anglican Diocese of Northern Malawi

4 Nicholas Nyirenda Atupele Community Hospital

5 Lyn Dowds David Gordon Memorial Hospital Livingstonia

6 Mike Nkhwazi David Gordon Memorial Hospital Livingstonia

7 Esau Kasonda Ekwendeni College

8 Esther N. kawerama Ekwendeni Hospital

9 Jeffrey M. Mwala Ekwendeni Hospital

10 Jessie M. Chihana Ekwendeni Hospital

11 Ken Nkhata Ekwendeni Hospital

12 L. Ngulube Embangweni Hospital

13 Transizio Jere Embangweni Hospital

14 Stephen Chitaya Hope Clinic

15 Sr. Teresa Custom Karonga Diocese

16 Thomas Nyondo Karonga Diocese

17 Treeza Iman Karonga Diocese

18 Overton Khamisa Kaseye Community Hospital

19 Tionge Mhango Kaseye Community Hospital

20 Sr. Theresa Mbizi Katete Community Hospital

21 Mike Chipeta Lusubilo Orphan Care Project

22 Salome Munthali Mzambazi Community Hospital

23 Xavier Mkandawire Mzambazi Community Hospital

24 George Matope Mzuzu Diocese

25 Peter Mwaipape Mzuzu Diocese

26 Sr. MM. Nyirenda Nkhamenya Community Hospital

27 Denis H Kanyinji St. Anne’s Health Centre Chilumba

28 Sr. Theresa Msukwa St. Anne’s Health Centre Chilumba

29 Isaac C. Ziba St. John of God College

30 B. Mbakaya St. John’s College

31 Charity Chimkono St. John’s Hospital

32 William Moyo St. John’s Hospital

33 Ndhlomu St. Patrick’s Health Centre

34 Francis A. Vuma St. Peter’s Hospital Likoma

35 Mathias Londo St. Peter’s Hospital Likoma

36 Sangster Nkhandwe Synod of Livingstonia

Annex 9. Participants to Consultative Meeting with Proprietors in the Northern Region Held at Mzuzu Hotel, Mzuzu on 21st February 2015

Name Proprietor

1 Bishop Fanuel Magangani Diocese of Northern Malawi

2 Mons. Dennis Chitete Karonga Diocese

4 Fr. Albert Mughogho Mzuzu Diocese

3 Rev. Levi Nyondo Synod of Livingstonia

Annex 10. Central Team Facilitatiting the Consultative Meetings

Name Position

1 Dr. Mwai Makoka CHAM Executive Director

2 Mtemwa Nyangulu CHAM Head of Health Programmes

3 Mary Ching’ang’a CHAM Head of Finance

4 John Mataya Consultant

5 Aleksandr-Alain Kalanda Consultant

Annex 11. Literature Reviewed

CHAM (March 2013) CHAM Reader for Board of Directors.

CHAM (2013) Annual Report.

CHAM (2002) Memorandum of Understanding between Government of the

Republic of Malawi and the Christian Health Association of Malawi.

Deutche Gesellscahft fur Technische Zusammenarbeit-GTZ, (2010) Sustainable

Structures for Health Sector in Malawi, Evaluation Report for the CHAM

Strategic Planning Process.

CHAM (Nov 2014), CHAM Joint Board of Trustees and Directors Meeting Held on

Friday 7th November, 2014.

CHAM (August 2014), Joint Board of Trustees and Directors Meeting Held on

14th August 2014.

Bakhethisi Mlalazi (2014) Report on Situation Analysis of Christian Health

Association of Malawi (CHAM) Secretariat’s Human Resource Management.

Options, Malawi Health Sector Programme (MHSP) Technical Assistance

Component.

Roger Drew (2014) CHAM Institutional Relationships Analysis Report. Options,

Malawi Health Sector Programme (MHSP) Technical Assistance Component.

Derek Reynolds (2014) Report On Financial Management Specialist To CHAM

Secretariat. Options, Malawi Health Sector Programme (MHSP) Technical

Assistance Component.

CHAM (2013) Mid-Term Evaluation of CHAM Strategic Plan (2010-2014) report.


Area 14 Plot #13, Off Presidential Way, P O Box 30378, Lilongwe 3

+265 1 775 180/184 | [email protected] | www.cham.org.mw

mailto:[email protected]

http://www.cham.org.mw./

Date post:	24-Aug-2020
Category:	Documents
Upload:	others
View:	3 times
Download:	0 times

Christian Health Association of Malawi · Christian Health Association of Malawi ‒ 2015–2019...

Documents