BHF360° | DECEMBER 2021
R egional U pdate
malawi
Unity in diversity: Healthcare Funders Association of Malawi M
alawi is a country with low rates of medical scheme membership. According to the Malawi Demographic and Health Survey (MDHS, 2020), membership of all medical schemes accounts for less than 2% of the total population. There are both open and closed schemes operating on the Malawian market, with most closed schemes being those of government agencies and parastatals. There are a lot of challenges in the industry, including but not limited to lack of industry legislation; inconsistent and high tariffs; clinical practice-related challenges; emerging diseases challenges such as COVID-19; and fraud, waste and abuse. In view of these challenges, in June 2018, the medical schemes agreed to form an association, the Healthcare Funders Association of Malawi (HFM). The membership of HFM comprises all major play-
ers in the medical schemes industry to help deal with the various challenges outlined. The lack of legislation within the industry has led to several problems, such as an unlevelled playing field consequent on the unnecessarily high controlling power of healthcare providers. It is hoped that once HFM is fully functional, it will help push for legislation of the industry that will lead to market sanity for the benefit of all stakeholders, most importantly the members. In addition, healthcare providers took advantage of the market fragmentation in medical schemes to apply inconsiderate and expensive tariffs. However, the coming of HFM will control this tendency by implementing collective bargaining in respect of tariffs. Because of lack of legislation in the industry, there is a clinical practice challenge in that healthcare is normally
overserviced or overprescribed. This is closely associated with fraud, waste and abuse, which are estimated to account for 15-20% of total claims received by schemes. Therefore, HFM will help develop the necessary standards to curb these challenges and link with relevant bodies such as the Medical and Nurses’ Councils of Malawi, which regulate healthcare practice in the country. Finally, the emergence of COVID-19 further exposed the fragmentation of the schemes industry when institutions failed to come up with solutions to help their members. At one point, schemes used the pandemic as a marketing tool instead of helping to fight it. HFM will therefore bring all parties together to develop standards to address such shocks as they emerge. In conclusion, medicine is dynamic and it is there-
Fortune Kanyemba, Operations Manager, Medhealth fore imperative to unite in diversity through HFM to deal with both existing and emerging challenges such as COVID-19.
B O A R D O F H E A LT H C A R E F U N D E R S
65
