Health Sector Strategic Plan III (HSSP III): Paving the Way for a Resilient and Equitable Health System in Malawi
Creating a Better Malawi Through Strategic Reform and Expert Collaboration
Malawi’s healthcare system stands at a pivotal turning point. Confronted by persistent challenges — from high maternal mortality rates and critical staff shortages to fragile infrastructure and heavy reliance on donor funding — the need for transformative, system-wide reform has never been more urgent.
In response, the Ministry of Health launched the Health Sector Strategic Plan III (HSSP III), a bold roadmap that charts Malawi’s path from 2023 to 2030 towards Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). Building on the lessons learned under HSSP II, this new strategy focuses on closing systemic gaps, improving service delivery, and ensuring no Malawian is left behind.
As part of this ambitious journey, CIPHER provided critical expert consultation, supporting the Ministry and its partners to design reforms that are practical, data-driven, and focused on real impact.
Why HSSP III is a Game Changer
Despite significant progress in recent decades, Malawi continues to face tough public health realities. Nearly 72% of Malawians live in rural areas where access to basic health services is limited. Maternal mortality remains high at 349 deaths per 100,000 live births, while neonatal mortality stands at 27 deaths per 1,000 live births.
In addition, Malawi’s disease burden is shifting — non-communicable diseases (NCDs) now account for almost 30% of all deaths, compounding the burden of infectious diseases such as malaria, TB, and HIV/AIDS. The COVID-19 pandemic further exposed vulnerabilities in critical care, emergency preparedness, and supply chain management.
Recognizing these realities, HSSP III aims to build a resilient, inclusive, and sustainable health system — one that can protect 19.9 million Malawians today and for generations to come.
Vision and Strategic Pillars
At its core, HSSP III is driven by a clear vision: an equitable, efficient health system that delivers essential services to everyone, everywhere. To achieve this, the plan focuses on four interconnected pillars:
1️⃣ Integrated Service Delivery
Ensuring that quality health services — from maternal care to chronic disease management — are accessible, especially in underserved rural communities.
2️⃣ Health Financing and Sustainability
Increasing domestic health funding from 9.3% to 15% of total government expenditure, while reducing dependence on donor funding, which has historically covered up to 70% of the national health budget.
3️⃣ Human Resources for Health
Investing in evidence-based workforce planning, harmonized in-service training, and stronger performance management to build a skilled, motivated health workforce.
4️⃣ Digital and Technological Transformation
Scaling up digital tools such as the Electronic Health Record (EHR) system to improve patient data management, streamline services, and strengthen accountability.
Key Reforms Underway
Integrated Service Delivery
HSSP III’s “One Plan, One Budget, One Report” framework harmonizes fragmented services at all levels — facility, district, and national. Pilot districts including Mangochi, Nkhotakota, and Rumphi are already integrating chronic care clinics, maternal and child health services, and comprehensive screening models.
Health Workforce Optimization
Facilities are implementing workforce matching to ensure the right mix of skills at the right place, while harmonized training and a robust performance management system keep health workers equipped and accountable.
Health Financing Innovations
To boost domestic funding, Malawi is exploring new revenue streams, such as earmarked taxes on airtime and alcohol. These resources will help fund priorities like direct facility financing and critical staff training.
Digital Health Expansion
Scaling EHR systems and modernizing data management will strengthen evidence-based decision-making and improve transparency in patient care.
Supply Chain Strengthening
Efforts to harmonize supply chains and integrate procurement systems will help reduce inefficiencies and ensure reliable delivery of medicines and equipment nationwide.
The Role of Expert Consultation
As a trusted technical partner, CIPHER provided specialist guidance during the design and planning phases of HSSP III. From advising on practical integration pathways for rural clinics to optimizing workforce strategies and digital health rollout, CIPHER’s input helped shape a plan rooted in local realities and global best practices.
This collaboration with the Ministry of Health, WHO, Gavi, Global Fund, and other global partners demonstrates how shared expertise can translate policy into real-world progress.
Measuring Success: Progress and Gaps
Early implementation shows promise:
- Integrated service delivery has begun in three pilot districts, with 11 facilities assessed for readiness.
- Strategic workforce planning is underway, though staffing and infrastructure gaps remain barriers.
- Digital systems like the EHR are expanding but need continued investment in connectivity and training.
- While donor and government alignment has improved, funding gaps persist for key reforms such as direct facility financing.
A Path Forward
To build on this momentum, the Ministry of Health and partners — with continued expert support from CIPHER — are prioritizing:
✅ Expanding integrated services to more districts.
✅ Closing the health financing gap with sustainable domestic resource mobilization.
✅ Regular capacity building to maintain a strong, adaptable workforce.
✅ Strengthening data systems to ensure the “One Report” framework drives informed decisions.
Together for a Healthier Malawi
HSSP III is more than a policy — it’s a commitment to deliver health for all Malawians, no matter where they live. Through strong partnerships, practical solutions, and shared accountability, Malawi is laying the groundwork for a resilient, equitable health system that can meet today’s needs and tomorrow’s challenges.
CIPHER is proud to stand with the Ministry of Health, UNICEF, WHO, and Malawi’s communities to make this vision a reality — creating a healthier, stronger Malawi for all.