Evaluation of Malawi's Emergency Human Resources Programme

Management Sciences for Health
EHRP and, as the MOH prepares for the next five-year POW, the issue of sustainability is
at the forefront once again.
The Emergency Human Resources Programme
The Emergency Human Resources Programme (EHRP), developed in 2004, is a six-year
comprehensive strategy to address the staffing crisis in the Malawi health sector. It was
intended to stop the flow of health workers out of the country and increase production
internally. As such, it focused on financial and non-financial incentives (including salary
top-ups), expanded pre-service education, the use of international volunteers, technical
assistance to improve management, and a more robust monitoring and evaluation system.
It was intended that this Programme would give the government time to address the root
cause of the HR crisis which was seen as an underlying lack of planning, management and
support to health workforce. The five elements of the EHRP are outlined in Table 2 below.
Table 2: Scope of the Five Elements 16
Element 1
Element 2
Element 3
Element 4
Element 5
Goals of the EHRP
Improving incentives for recruitment and retention of Malawian staff in
government and mission hospitals through a 52% taxed salary top‐up for
11 professional cadres, coupled with a major initiative for recruitment and
re‐engagement of qualified Malawian staff
Expanding domestic training capacity by over 50% overall, including
doubling the number of nurses and tripling the number of doctors and
clinical officers in training
Using international volunteer doctors and nurse tutors as a stop‐gap
measure to fill critical posts while more Malawians are being trained
Providing international technical assistance to bolster capacity and build
skills within the Ministry of Health‘s human resources planning,
management and development functions
Establishing more robust monitoring and evaluation capacity for human
resources in the health sector, nested within existing health management
information systems, which are being strengthened to support
implementation of the Essential Health Package
The overarching goal of the EHRP, as stated previously, was to address the staffing crisis
in Malawi and bring the country’s staffing levels up to a level comparable to that of
Tanzania. Individual goals and targets were set for each of the five elements of the EHRP
as follows.
16 Palmer, Debbie (2006), based on: Department For International Development. Improving Health in
Malawi: £100 million UK Aid (2005/6–2010/11). A Sector Wide Approach including Essential Health
Package and Emergency Human Resources Programme. Programme Memorandum, November 2004.
London, DFID, 2004.
EHRP Evaluation Final Report Page 10