ArticleBMJ open2024
Service readiness for the management of non-communicable diseases in publicly financed facilities in Malawi: findings from the 2019 Harmonised Health Facility Assessment census survey.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- What happens when public primary care is ill-prepared to respond to non-communicable diseases: a mixed-method study of diabetes and hypertension care in urban Nepal.Journal of global health · 2026Article
- Measures to monitor the implementation of Essential Health Benefit Packages at a national scale.npj health systems · 2026Article
- Understanding the role of 'software' in health system capacity for non-communicable disease response: hypertension care in rural Coastal Kenya.Health policy and planning · 2026Article
- Power supply and ultrasound functionality in Malawi: findings from the 2019 harmonised health facility assessment.npj health systems · 2026Article
- Exploring factors affecting access to non-communicable disease medicines in low- and middle-income countries: a systematic review.BMJ public health · 2026Article
- Examining healthcare inequality for non-communicable diseases in Malawi: a hierarchical geospatial modelling approach.BMJ health & care informatics · 2025Article
- Preferences for Hypertension Care in Malawi: A Discrete Choice Experiment Among People Living with Hypertension, With and Without HIV.AIDS and behavior · 2025Article
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Authors and funding
11 authors at 7 institutions in 6 countries.
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Abstract
introductionNon-communicable diseases (NCDs) are rising in low-income and middle-income countries, including Malawi. To inform policy-makers and planners on the preparedness of the Malawian healthcare system to respond to NCDs, we estimated NCD service readiness in publicly financed healthcare facilities in Malawi.
methodsWe analysed data from 564 facilities surveyed in the 2019 Harmonised Health Facility Assessment, including 512 primary healthcare (PHC) and 52 secondary and tertiary care (STC) facilities. To characterise service readiness, applying the law of minimum, we estimated the percentage of facilities with functional equipment and unexpired medicines required to provide NCD services. Further, we estimated permanently unavailable items to identify service readiness bottlenecks.
resultsFewer than 40% of PHC facilities were ready to deliver services for each of the 14 NCDs analysed. Insulin and beclomethasone inhalers had the lowest stock levels at PHC facilities (6% and 8%, respectively). Only 17% of rural and community hospitals (RCHs) have liver and kidney diagnostics. STC facilities had varying service readiness, ranging from 27% for managing acute diabetes complications to 94% for chronic type 2 diabetes management. Only 38% of STC facilities were ready to manage chronic heart failure. Oral pain medicines were widely available at all levels of health facilities; however, only 22% of RCHs and 29% of STCs had injectable morphine or pethidine. Beclomethasone was never available at 74% of PHC and 29% of STC facilities.
conclusionPublicly financed facilities in Malawi are generally unprepared to provide NCD services, especially at the PHC level. Targeted investments in PHC can substantially improve service readiness for chronic NCD conditions in local communities and enable STC to respond to acute NCD complications and more complex NCD cases.
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