Evaluation of Malawi's Emergency Human Resources Programme

Management Sciences for Health
Based on analysis of the data, the evaluation team has documented results and lessons
learnt from the Programme, and made evidence-based recommendations for strengthening
Human Resources for Health (HRH) systems and practices in Malawi’s public health
sector.
TECHNICAL APPROACH AND METHODOLOGY
In order to address the project objectives in the most comprehensive, cohesive and
consistent manner, the consultants adopted a multi-pronged consultative and clientfocused
process that was led by an EHRP Human Resource Task Force and chaired by the
Ministry of Health with representatives from various units in the health sector.
The evaluation included a combination of traditional research methods and other field
tested approaches to gather data. A variety of tools were employed during the data
gathering process. For quantitative data, primary source data was gathered from the MOH
and pre-service training institutions, reports and desk reviews. Qualitative data was
collected through focus group discussions and key informant interviews using a set of well
structured research questions derived from an Evaluation Framework designed by the
consultants. Additional qualitative data was gathered through an HRM survey of district
level managers, each of whom reportedly had significant responsibilities for HRM in
MoH, to identify competency gaps in HRM. Analysis of the data was conducted in
collaboration with the HR Taskforce.
KEY FINDINGS, COST AND IMPACT
Overall, the findings of this evaluation indicate that the EHRP successfully accomplished
its primary goal of increasing the number of professional health workers in Ministry of
Health and CHAM institutions. Across the 11 priority cadres, the total number of
professional health workers increased by 53%, from 5,453 in 2004 to 8,369 in 2009.
However, only 4 of the 11 cadres met or exceeded their targets, as set out in the original
EHRP design document. A hardship incentive package that was included as part of the
financial incentives was not implemented.
Total graduates from Malawi’s four main training institutions – the Christian Health
Association of Malawi, Malawi College of Health Sciences, Kamuzu College of Nursing,
and the College of Medicine – showed an overall increase of 39%, from 917 in 2004 to
1,277 in 2009. Physicians from the College of Medicine increased by 72%, from 18
graduates in 2004 to 31 graduates in 2009. Nurses increased by 22%, from 575 graduates
in 2004 to 699 graduates in 2009.
A summary of all components of the EHRP is outlined on the following page.
EHRP Evaluation Final Report Page 2