The Christian Health Association of Malawi (CHAM), a network of church-owned health facilities and training institutions, has presented two critical challenges to the government that are choking its hospitals and colleges.

The issues were outlined in a petition presented to the Secretary to the President and Cabinet (SPC), Colleen Zamba, by the CHAM Pension Fund Board during a recent meeting in Lilongwe.

According to the petition, since CHAM's payroll migration to the government in April 2023, pension contributions amounting to K4.6 billion have not been remitted to the service provider, Old Mutual.

“As per statutory regulations, CHAM had been consistently remitting both employers' and employees' pension contributions to Old Mutual before the payroll migration to the government. However, since the migration, which also transferred pension remittance responsibilities to the government, these contributions have not been remitted,” the petition reads.

Consequently, employees are unable to claim full benefits upon retirement and can only access benefits accrued up to March 2023. Administration fee arrears have accumulated to K55 million, affecting the growth of the CHAM pension fund since the funds are not being invested.

The second issue highlighted is under-staffing in CHAM hospitals and colleges. As of June 30, 2024, only 6,342 out of 13,092 established posts were filled, leaving 6,832 positions vacant, representing a 52% vacancy rate. These vacancies are due to deaths, resignations, retirements, and dismissals.

A recruitment freeze has been in place since 2022, only notionally lifted this year with a very small number of replacements authorized.

“The government's failure to authorize CHAM to fill these vacant positions from 2022 is affecting service delivery in its health facilities. Learning results and outcomes from CHAM training institutions are also affected, making it difficult for CHAM to contribute to the Health Sector Strategic Plan (HPSSP) III,” the petition states.

It further notes that CHAM health facilities have employed health workers using their resources to ensure continuity of service delivery, making it difficult to meet other obligations such as drug procurement.

CHAM Executive Director Happy Makala confirmed the meeting with the SPC to Zodiak Online, noting that, like other meetings CHAM held with the government, this one was very fruitful and the government has promised to address these challenges.

"I can confirm that the meeting took place and the two issues were indeed presented to the government through the SPC. However, let me quickly point out that this was not a strange or special meeting as we always meet with the government quarterly and as needed," said Makala.

Government Spokesperson Moses Kunkuyu stated that the meeting was one of the regular meetings between the government and CHAM and assured that the two issues presented would be given the seriousness they deserve. He emphasized the government's commitment to the welfare of all health workers, including those in CHAM institutions.

Meanwhile, Health Rights Activist Maziko Matemba has urged the government to address these issues, which are part of the Memorandum of Understanding (MOU) between CHAM and the Malawi Government.

“CHAM facilities and staff are very crucial to the country’s health system. As such, they need and deserve the government’s support,” said Matemba.

CHAM operates 194 health facilities and 11 colleges across Malawi, providing 30% of all healthcare in the country, including the majority of primary healthcare and almost all care in rural and hard-to-reach areas. It also trains up to 80% of middle-level healthcare providers in Malawi, with much of the care provided free to citizens under service level agreements with the government.