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York academics deliver affordable healthcare in sub-Saharan Africa

Photo credit: www.flags.net
Photo credit: www.flags.net
Photo credit: www.flags.net

Academics at the University of York have helped to equip Malawi, one of the poorest countries in the world, with a healthcare package for all its citizens. The project could potentially be used as a blueprint for other similar nations around the world.

Malawi continues to face significant  healthcare challenges, such as high infant and maternal mortality rates, the spread of sexually transmitted diseases like HIV/AIDS and outbreaks of contagious diseases such as tuberculosis and malaria. In 2004, a health package, called the Essential Health Package (EHP), was introduced, however its cost was far above what ordinary Malawians could afford, and it was never fully implemented across huge swathes of the country, leaving many areas, particularly rural ones, with little to no health coverage at all.

A team from the University of York’s Centre for Health Economics has now sought to change this, by creating a new $264 million healthcare package, using the data given by organisations such as the Ministry of Health in Malawi, the World Health Organisation (WHO) and international NGOs.

Research Fellow, Paul Revill, said:

“Malawi has always struggled with a very chaotic and fragmented system which has been subject to different trends and donor imposed preferences. Some things work well but the whole system collectively is not working well. This new EHP should indicate what is a priority. Top healthcare interventions include: male circumcision; management of obstructed labour; certain preventative therapies for HIV and treatment for TB in adults and children.”

Research fellow, Jessica Ochalek, added:

“The whole package is built around what is going to have the maximum population health impact. What we are not doing is telling the Ministry of Health in Malawi what to do. There are going to have to be some really important trade-offs. We have now provided them with a tool which allows them to quantify those different trade-offs. This is about empowering the Ministry of Health. It is an analysis of the data available and the evidence suggests this package would avert 49.5 million DALYs, assuming the interventions included in it can be delivered fully. It can also inform international funders of healthcare – the Bill & Melinda Gates Foundation has already expressed an interest in the work.”

Throughout, the team from the University of York worked closely with officials from the Ministry of Health in Malawi. MacPhail Magwira PhD, Secretary for Health in Malawi, said:

“We are highly appreciative of the work that the University of York has undertaken and we are sure it will contribute to improvement in health service delivery in Malawi. The efficient use of resources is one of the central objectives of the Ministry of Health and the framework developed by York contributes to that. The work also advances the Government’s commitment to providing an affordable package of health service delivery to all Malawians, free at the point of access. The Ministry of Health’s collaboration with the researchers at the Centre for Health Economics reflects the Government’s commitment to engaging with global leading experts in various fields in order to improve public service delivery and we look forward to continued future engagements.”

It has been estimated that $61 has the potential to avert one disability-adjusted life year (DALY) in Malawi. DALYs attempt to calculate the average number of years lost by the citizens of a country due to early death from preventable illnesses.