HFG Project TB Strategic Purchasing Activity: Malawi Assessment Technical Report

Resource Type: Report
Authors: Peter Cowley, Sheila O’Dougherty, Sara Feinstein
Published: 10/30/2015

Resource Description: 

The purpose of the USAID HFG TB Strategic Purchasing Activity is to identify and recommend small improvements in TB purchasing/provider payment and related public finance management (PFM) mechanism to better target country health budgets towards priority TB services for the poor in USAID TB priority countries. This technical report summarizes the rapid assessment findings, conclusions, recommendations, and possible next steps from stakeholder consultations held in Malawi from May 18-29.

The three health financing functions are revenue collection, pooling and purchasing. Revenue collection is the source/level of funds, pooling is the accumulation of prepaid revenues on behalf of a population and purchasing is the transfer of pooled funds to providers on behalf of a population. The main focus of the HFG/TB Activity is the health purchasing function, specifically provider payment systems and PFM mechanisms. This rapid assessment focuses more on domestic revenue health purchasing and PFM at the district level as other USAID investments are supporting NTP and Global Fund grant implementation. This assessment emphasizes public funding as public funding is critical to pro-poor priority public health services especially TB.

This rapid assessment is not intended to be a literature review or formal study. Stakeholder consultations are the main vehicle for identifying and recommending small TB purchasing and PFM improvement steps for possible further in-depth analysis and implementation. The rapid assessment technical report is organized into five sections: 1) introduction; 2) TB continuum of care gaps; 3) overall strategy and sequencing; 4) shorter-term TB purchasing and PFM steps; and 5) relationship between shorter-term steps and longer-term public service and health reforms.

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