Health Workforce Optimization Analysis HRH...Health Workforce Optimization Analysis: Optimal Health...

Health Workforce Optimization Analysis: Optimal Health Worker Allocation for Public Health Facilities across Malawi

Ministry of Health CHAI Malawi April 2011

2 | PAGE Clinton Health Access Initiative (CHAI)

Table of Contents 1. Executive summary ......................................................................................................................................................... 5

2. Introduction .................................................................................................................................................................... 7

3. Methodology ................................................................................................................................................................... 7

3.1 Optimization model ................................................................................................................................................ 7

3.2 Data analysis ........................................................................................................................................................... 9

3.3 Ministry of Health and CHAM funded establishment ........................................................................................... 14

3.4 Ministry of Health and CHAM current staffing levels ........................................................................................... 14

3.5 Data validation ...................................................................................................................................................... 15

3.6 Limitations ............................................................................................................................................................. 15

4. Results ........................................................................................................................................................................... 17

4.1 National summary ................................................................................................................................................. 17

4.2 Medical officer ...................................................................................................................................................... 19

4.3 Clinical officer ........................................................................................................................................................ 21

4.4 Nursing officer ....................................................................................................................................................... 23

4.5 Nurse midwife technician ..................................................................................................................................... 25

4.6 Medical assistant................................................................................................................................................... 27

4.7 Health surveillance assistant ................................................................................................................................. 29

5. Recommendations ........................................................................................................................................................ 31

5.1 Increase funded establishment to meet demand ................................................................................................. 31

5.2 Scale-up training enrollment for critical cadres .................................................................................................... 31

5.3 Prioritize HCW deployment according to demand ............................................................................................... 32

5.4 Assess impact of formally task-shifting ART care from COs to NMTs ................................................................... 34

Annex 1. Health activity times for central hospitals ............................................................................................................. 35

Annex 2. Health activity times for community hospitals ...................................................................................................... 36

Annex 3. Health activity times for district hospitals ............................................................................................................. 37

Annex 4. Health activity times for urban health centers ...................................................................................................... 38

Annex 5. Health activity times for rural health centers ........................................................................................................ 39

Annex 6. HCW productivity ................................................................................................................................................... 40

Annex 7. Missing data ........................................................................................................................................................... 41

Annex 8. Sensitivity analysis ................................................................................................................................................. 42

Annex 9. HCW vacancy rates by facility ................................................................................................................................ 44


Table of Figures Figure 1. Current, funded, and optimal levels of national HCWs .......................................................................................... 6 Figure 2. Current versus funded establishment staffing levels .............................................................................................. 7 Figure 3. Timeline ................................................................................................................................................................... 8 Figure 4. Matching HMIS indicators with EHP services ........................................................................................................ 10 Figure 5. Facility type description ......................................................................................................................................... 11 Figure 6. Facilities selected for site visits ............................................................................................................................. 12 Figure 7. HMIS data validation ............................................................................................................................................. 15 Figure 8. National HCWs by cadre........................................................................................................................................ 17 Figure 9. National HCWs by facility type .............................................................................................................................. 18 Figure 10. Current, funded, and optimal levels of medical officers ..................................................................................... 19 Figure 11. Optimal staffing levels for medical officers by facility type ................................................................................ 19 Figure 12.Optimal staffing for medical officers by district ................................................................................................... 20 Figure 13. Current, funded, and optimal levels of clinical officers ...................................................................................... 21 Figure 14. Optimal staffing levels for clinical officers by facility type .................................................................................. 21 Figure 15. Optimal staffing for clinical officers by district ................................................................................................... 22 Figure 16. Current, funded, and optimal levels of nursing officers ..................................................................................... 23 Figure 17. Optimal staffing levels for nursing officers by facility type ................................................................................. 23 Figure 18. Optimal staffing for nursing officers by district ................................................................................................... 24 Figure 19. Current, funded, and optimal levels of nurse midwife technicians .................................................................... 25 Figure 20. Optimal staffing for nurse midwife technicians by facility type ......................................................................... 25 Figure 21. Optimal staffing for nurse midwife technicians by district ................................................................................. 26 Figure 22. Current, funded, and optimal levels of medical assistants ................................................................................. 27 Figure 23. Optimal staffing for medical assistants by facility type ...................................................................................... 27 Figure 24. Optimal staffing for medical assistants by district .............................................................................................. 28 Figure 25. Current, funded, and optimal levels of health surveillance assistants ............................................................... 29 Figure 26. Optimal staffing for health surveillance assistants by district ............................................................................ 30 Figure 27. 10-year national pipeline forecast for nursing officers and nurse midwife technicians ..................................... 31 Figure 28. Impact of 10-year intervention to increase the number of nursing officers and nurse midwife technicians ..... 32 Figure 29. Health care worker deployment prioritization .................................................................................................... 33


Definition of Terms

ART Antiretroviral therapy CHAI Clinton Health Access Initiative CHAM Christian Health Association of Malawi EHP Essential Health Package EHRP Emergency Human Resource Program EPI Expanded Program on Immunization HCW Health Care Worker

HMIS Health Management Information Systems HRMIS Human Resources Management Information System HRH Human Resources for Health HSA Health Surveillance Assistant HSSP Health Sector Strategic Plan

MOH Ministry of Health

WHO World Health Organization


1. Executive summary The Ministry of Health (MOH) engaged the Clinton Health Access Initiative (CHAI) to support MOH’s efforts to improve planning of human resources for health strategy as part of the upcoming Health Sector Strategic Plan (HSSP) taking effect from 2011-2016. In November 2010, MOH requested CHAI’s assistance to perform a Workforce Optimization Model to help MOH better understand its current and future health workforce needs for specific cadres at varying facility types.

In December, preliminary meetings were held with the MOH’s HR department and members of an existing Task Force that was established to update HR staffing norms to discuss the model design, the data collection process, and deliverables. Site visits were conducted at central hospitals, district hospitals, community hospitals, and health centers to collect data for the model inputs. The analysis used HMIS/HRMIS data along with HCW productivity estimates and information on ideal times needed to conduct common healthcare activities (collected during HCW interviews) to determine the optimal number of HCWs for Malawi based on current demand.

Potential applications of optimization analysis The results of this analysis will allow MOH to plan for increased capacity of specific cadres based on need. In addition, the workforce optimization analysis can also be used to:

- Provide optimal number of HCWs on a national or regional level - Inform national budget - Estimate the magnitude of HCW shortage - Forecast optimal workforce needs in the future - Inform future HRH planning and analyses, such as workforce allocation and HCW training needs

Areas for further policy consideration The outcomes of the workforce optimization analysis suggest four main recommendations:

A. Increase funded establishment to meet demand The Government of Malawi will need to increase its health workforce of medical officers, clinical officers, nursing officers, nurse midwife technicians, medical assistants, and health surveillance assistants by a total of 19,033 staff to meet the existing demand for health services from the population (See Figure 1). For some cadres, the funded establishment will need to be increased to accommodate this need. The optimal number of staff set out in this report will meet existing demand – not actual or perceived need. With service utilization (% of those ill seeking health services) in Malawi at 39% in MOH and CHAM facilities, a significant proportion of the population is not reflected in the HMIS data that was used to calculate demand for health services in the optimization model.1

1 Mangham, L. Who benefits from public spending on health care in Malawi? An application of Benefit Incidence Analysis to the Health Sector. Malawi Medical Journal. 2006; 18(2):60-65.


Figure 1. Current, funded, and optimal levels of national HCWs

B. Scale-up training enrollment for critical cadres

A quantitative analysis of Malawi-specific root causes determined pre-service training as the leading driver of the country’s nurse and midwife shortfall, and thus the best focus area for an intervention. Increasing the number of first-year students enrolling in BSCN, DN, and NMT training programs to 400, 100, and 1,230 respectively will result in a 194% increase the available nursing workforce by 2021. Supplemental interventions targeting graduation rates and public sector entry rates can also help close the gap over the next decade. Severe staffing shortages were also observed among clinical officers and medical assistants, suggesting a strategic increase in health training institution enrollment is needed to meet the minimum need for HCWs in Malawi.

C. Prioritize future human resources for health funding for districts most in need

In order to expedite the provision of health services across Malawi to meet current demand, it is critical that the MOH has the data needed to identify the districts across the country most in need of additional HCWs. For this reason, the results of the optimization model have been incorporated into a deployment prioritization analysis (see Figure 29) designed to organize districts by demand (determined by vacancy rates, which was calculated as 1 – current/optimal staff) for additional HCWs. The advantage of the prioritization scheme is that when a certain type of HCW comes up for staffing (i.e. new graduates), it is clear which districts are in greatest need of that specific cadre. Hiring should be prioritized by cadre for districts exhibiting the greatest need.

D. Shift specific activities to lower-skilled cadres

Given that the MOH is currently operating with limited human resources for health, a rapid increase in workforce volume to meet the existing demand is unrealistic without significant investment. However, this optimization analysis can be used to identify complementary strategies that can be prioritized and implemented alongside training and recruitment to help meet short-term demands. A variety of task-shifting approaches have been introduced in other contexts to reduce pressure in overburdened health systems. A supplementary task-shifting analysis to investigate the

14,039

14,496 28,535

5,768 34,303

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

Current Staff Current Staff versus Funded Staff

Funded Staff (Establishment)

Funded Staff versus Optimal Staff

Optimal Staff

Vacancy rate between current and funded health staff is 49% [1 - (14,496/28,535)]

Vacancy rate between current and optimal staff is 41% [1 - (14,496 + 5,768)/34,303]

NATIONALSUMMARYNATIONALSUMMARY


relative effectiveness of this approach in Malawi will be conducted using the results from the optimization model, and shared with health planners at the MOH for further consideration.

2. Introduction The World Health Organization (WHO) recommends 2.28 doctors, nurses, and midwives per 1,000 persons in order for nations to provide essential health services and in turn achieve the Millennium Development Goals.2 With less than one HCW per 1,000 people, Malawi is one of 57 countries that does not meet the WHO’s criteria and is currently experiencing a critical HCW shortage.3

While Malawi’s Emergency Human Resource Program (EHRP) increased the total number of HCWs for 11 priority cadres from 5,453 to 8,369 between 2004 and 2009, vacancies remain among key cadres such as nurses and clinical officers.

Figure 2. Current versus funded establishment staffing levels

Cadre Number of Current Staff

MOH Establishment

CHAM Establishment

Current vs. Establishment Vacancy Rates

Medical Officer 95 208 74 66.3%

Clinical Officer 697 2,230 617 75.5%

Nursing Officer 622 1,013 82 43.2%

Nurse Midwife Technician 2,494 6,537 1,074 67.2%

Medical Assistant 688 792 253 34.2%

Health Surveillance Assistant 9,443 12,750* - 25.9% Source: HRMIS data. * Based on providing 1 Health Surveillance Assistant per 1,000 population In order for the MOH to meet national health workforce demands with limited financial resources, it is important for the MOH to strategically deploy HCWs. Thus, the primary goal of this workforce optimization analysis is to identify the most critical cadres to train and which districts in Malawi are most in need of these HCWs. This workforce optimization model calculates vacancy rates to indentify the cadres that require the most immediate attention from the MOH. The model uses demographic, HMIS, and HRMIS data along with information on HCW productivity and the activity times of common healthcare tasks to calculate optimal HCW coverage. Because MOH and CHAM (Christian Health Association of Malawi) are responsible for 86% of all health facilities in Malawi, the results outlined in this report will depict targeted staffing levels for select cadres at both MOH and CHAM facilities at national, district, and facility levels.

3. Methodology

3.1 Optimization model

2 World Health Organization. Working for health: An introduction to the World Health Organization. 2007. Available at (Accessed on 3 March 2011): http://www.who.int/about/brochure_en.pdf 3 Ooms G, Van Damme W, Temmerman M. Medicines without Doctors: Why the Global Fund Must Fund Salaries of HCWs to Expand AIDS Treatment. PLoS Medicine 2007; 4(4): e128. Available at (Accessed on 3 March 2011): http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0040128


This workforce optimization model uses Excel (Microsoft Office, Microsoft; 2007) to calculate the optimal number of HCWs required to meet the health demands outlined in the Essential Health Package (EHP) at MOH and CHAM facilities. This service demand method for determining workforce requirements has been recognized by the World Health Organization as an approach that will enable planners to use existing data sources to predict requirements for different categories of workforce by drawing on a range of workload indicators so that the demands of clients and health staff are met.4

Figure 3

The model synthesizes data from a range of sources: Health Management Information Systems (HMIS), Human Resource Management Information Systems (HRMIS), the EHP, expert MOH interviews, and HCW interviews. As outlined in , the entire optimization analysis was completed in four months with a break for the December holidays. Figure 3. Timeline

November 18, 2010 MOH engages CHAI to support workforce optimization analysis November 23, 2010 Methodology for optimization analysis prepared and reviewed by key contacts

within MOH Clinical Services and HR department for feedback. Copy of methodology provided to MOH.

November 25, 2010 Expert interviews conducted in preparation for data collection at 11 facilities

December 6, 2010 Data collection team consisting of MOH Clinical Services and HR staff as well as CHAI representatives is assembled, and data collection begins at 11 facilities.

December 16, 2010 Data collection completed January 21, 2010 HCW activity times collected by data collection team presented to clinical experts at

MOH for review and approval February 25, 2011 All model inputs – including current MOH and CHAM staffing and HMIS data –

finalized March 3, 2011 Preliminary results and draft report presented April 21, 2011 Final results and report presented

4 World Health Organization. Models and tools for health workforce planning and projections. 2010.


3.2 Data analysis To calculate the optimal workforce for each HCW cadre at each facility, let:

a = Number of minutes HCWs spend on each activity (Number of minutes spent on each activity per HCW) * (Proportion of time different cadres perform each activity)

b = Number of minutes required to meet demand for services at each facility a * (Number of times each activity is performed at each facility)

c = Number of minutes male HCWs available each year {(Percentage of male HCWs) * [(Number days per year) – (Public holidays) – (Vacation days) – (Sick days) – (Professional development days)] * [(Productive hours per day) * 60]}

d =

Number of minutes female HCWs available each year {(Percentage of female HCWs)* [(Number days per year) – (Public holidays) – (Vacation days) – (Sick days) – (Professional development days) - (Maternity days)] * [(Productive or patient-facing hours per day) * 60]}

e = Number of HCWs needed to meet demand for services at each facility each year b / (c + d)

In the future, the model can be updated with new data on the current number of HCWs and new HMIS incidence data to approximate the level of health demands at each facility. For this analysis, the most recent HMIS data available was used to calculate the staffing targets. Below is a detailed description of how the inputs above (variables a – e) were used to calculate the optimal number of HCWs in Malawi:

a = Number of minutes HCWs spend on each activity (Number of minutes spent on each activity per HCW) * (Proportion of time different cadres perform each activity)

The number of minutes each HCW spends on a health activity was determined by first selecting the activities that would be included in this analysis, which were then used to frame interviews with HCWs at a sample of health facilities in Malawi about how much time was required to provide these health services. Each step in calculating the number of minutes each type of HCW spends on health activities is outlined below. Activities Expert MOH interviews were conducted to establish which health services from the Essential Health Package (EHP) were a complementary match to existing HMIS data. First, the list of EHP services was matched to indicators in the HMIS data. Then, the activity categories – based on the general categories of care provided at each facility type in the EHP – were created to collect time data at interviews. Third, the HMIS indicators were condensed to match those activity categories, which also connect back to the EHP. Figure 4 illustrates how the HMIS indicators (for which there is data) were matched to EHP criteria.


Figure 4. Matching HMIS indicators with EHP services*

HMIS Activity Categories EHP: Hospitals EHP: Health Centers Under-5 Inpatient Admissions Treatment of opportunistic infections Prevention and treatment of cholera Elementary treatment of opportunistic

infections Over-5 Inpatient Admissions Treatment of opportunistic infections Prevention and treatment of cholera Elementary treatment of opportunistic

infections Normal Deliveries Antenatal care and normal delivery,

promotion of breast feeding Complicated Deliveries Management of complications of

pregnancies Pre-referral services for complications of delivery: sepsis, post-partum hemorrhage, etc.

Complications of the newborn Caesareans Management of complications of

pregnancies

Surgical Procedures Under-5 Outpatient Admissions

Complications of childhood diseases Curative services (based on treatment protocols and referral guidelines)

Case management of schistosomiasis Treatment of measles, malaria, severe

ARI, dehydration in under 5, dysentery, etc.

Over-5 Outpatient Admissions Referrals related for ear and eye conditions

Curative services (based on treatment protocols and referral guidelines)

Case management of schistosomiasis Treatment of measles, malaria, severe

ARI, dehydration in under 5, dysentery, etc.

Accidents and Emergencies Treatment of fractures and dislocations Treatment of dislocations and wounds Antenatal Clinic Visits Prevention of mother to child

transmission of HIV Antenatal care and normal delivery, promotion of breast feeding

Nutrition Nutrition rehabilitation Nutrition supplementation (iron, iodine, vitamin A)

EPI All interventions undertaken at the health center level

Childhood immunization (especially for missed opportunities)

Voluntary Counseling and Testing Program

Voluntary counseling and testing Advocacy on VCT

HIV/AIDS Program Administration of antiretroviral therapy (ART) for HIV/AIDS

Administration of antiretroviral therapy (ART) for HIV/AIDS

TB Program Treatment of tuberculosis (DOTS) TB treatment (DOTS) STI Clinic Treatment of sexually transmitted

infections Treatment of syphilis in pregnancy, syndromic management of STDs

Family Planning Offering contraception Provision of contraceptives including IEC * The following items included in the EHP were not included in the analysis since there is no corresponding HMIS data available with which demand for these services can be calculated: Blood bank and transfusion services, complications of abortions, basic radiology services, health education for behavior change, other public health interventions, disease surveillance, IEC (hygiene education, safe water, and sanitation), essential laboratory services, IEC (cross-cutting issues), disease prevention activities, advocacy on VCCT, and collection, aggregation, and use of health information.


In order to estimate the overall demand for HCWs, it was necessary to determine the individual activities that comprise the following health services selected from the EHP. For example, the individual activities that make up an outpatient admission include: add patient’s information into register; take weight, height, temperature; screen the patient; counsel patient on lab results; dispense and record medications. Six hospitals (three district and three community) had no data (zero) listed for the number of under 5, over 5, and total inpatient admissions as well as surgical procedures. Since these facilities still had data on inpatient days, it was assumed that this was the result of missing data and not due to these services not being provided at these facilities. The number of inpatient days at these six hospitals was matched to the closest number of inpatient days at similar hospitals, and the most comparable admissions volumes were then used to fill in the missing data for under 5, over 5, and total inpatient admissions and surgeries in the model.

Facilities Once the list of activities to be included in the analysis was finalized, the team needed to select the health facilities where interviews with HCWs would be conducted to determine the ideal time required to complete the aforementioned activities. There are four facility types in Malawi (health centers are separated into urban and rural), which are described in greater detail in Figure 5. Eleven facilities were chosen for site visits (two central hospitals, two district hospitals, three community hospitals, and four health centers).

Figure 5. Facility type description

The selected facilities were stratified to include both MOH and CHAM facilities, different levels of care (primary versus tertiary), urban versus rural facilities, and geographic representation where possible (see Figure 6). Site selection was also based on the number of patient encounters at each facility. In order to represent the demands placed on fully utilized health facilities, sites with significant volumes of patient encounters were chosen for the analysis.

Health facility type DescriptionNumber of MOH facilities in HMIS

Number of CHAM facilities in HMIS

Total number of facilities included in optimization model

Centra l hospi ta l Faci l i ties that focus on tertiary care, but a lso provide primary and secondary care. Equipped with operating theatres and employ ski l led specia l i s ts . Al l located in largest urban areas .

4 0 4

Primary referra l hospi ta l Dis trict level faci l i ties with beds for intens ive care and specia l i zed faci l i ties for surgery, chi ldbirth, x-ray, labs , pharmacy.

21 0 21

Community hospi ta l Community level faci l i ties that have inpatient wards , nutri tional rehab uni t, x-ray, labs , fami ly planning.

20 27 47

Urban heal th center Primary care faci l i ties located in urban areas (Li longwe Ci ty, Mzuzu Ci ty, Zomba Ci ty and Blantyre Ci ty) as defined by MOH HRH Census Report.

10 2 12

Rura l heal th center (includes materni ties )

Primary care faci l i ties that focus on community outreach, safe water and sani tation, heal th and hygiene education.

297 120 417

TOTAL 352 149 501


Figure 6. Facilities selected for site visits

Name Facility Type Zone District CHAM/MoH

Annual OPD Patient Volume 7/2009 - 6/2010

Patients Receiving ART Q1 2010

Kamuzu Central Hospital Central Hospital Central West Lilongwe MOH 184,576 499 Queen Elizabeth Hospital Central Hospital South West Blantyre MOH 481, 167 7,043 Machinga Hospital District Hospital South East Machinga MOH 148,394 3,510 Rhumpi Hospital District Hospital North Rumphi MOH 314,119 1,812 Chintheche Community Hospital Community Hospital North Nkhata Bay MOH 96,173 1,327 Madisi Mission Hospital Community Hospital Central East Dowa CHAM 20,470 812 Mtengowanthenga Hospital Community Hospital Central East Dowa CHAM 43,400 1,438 Ndirande HC Urban Health Center South West Blantyre MOH 139,748 n/a Area 25 HC Urban Health Center Central West Lilongwe MOH 112,268 1,390 Nsanama HC Rural Health Center South East Machinga CHAM 11,995 n/a Mikolongwe HC Rural Health Center South West Thyolo MOH 39,850 842


HCW cadres Once the HCW activities and health facilities were selected, interviews were conducted with HCWs to determine how much time they would ideally spend on each activity in order to deliver quality care necessary to achieve the EHP. To further validate the interview responses, staff were observed and timed while performing a variety of randomly selected activities to test the reasonability of the times given in interviews. Fifty-seven HCWs were interviewed between December 6 and 16, 2010. Staff from the following six cadres were selected by the MOH for the analysis (number of HCWs interviewed in parentheses, not inclusive of experts at district and central levels interviewed to validate data from cadres):

1. Medical Officer (5) 2. Clinical Officer (7) 3. Nursing Officer (8) 4. Nurse Midwife Technician (15) 5. Medical Assistant (10) 6. Health Surveillance Assistant (9)

Data collected from the eleven health facilities was aggregated by facility type in the model. Where HCWs gave ranges for their ideal times to complete tasks, an average was calculated for that range, which was then averaged with the corresponding responses from other HCWs (where applicable) to create one mean time per activity for each facility type. The averaged results were shared with clinical experts in the MOH at the facility level (e.g. District Medical Officers, District Nursing Officers) and headquarters level (e.g. Directorate of Nursing, Directorate of Clinical Services) and clinical experts working in health facilities to confirm the time needed to perform each activity. These expert interviews also provided information about the proportion of time spent by each of the cadres on an interchangeable activity, meaning an activity that requires services to be provided across more than one clinical cadre. For example, as outlined in Annexes 1-5, experts determined a) who is primarily responsible for performing the individual sub-activities and b) where overlap exists for sub-activities, how to allocate time between two or more HCWs. These responses were then used to assign proportions of time for the activities shared by two cadres. The number of minutes each type of HCW spends on each activity (a) was then calculated by multiplying the number of minutes spent on each activity per HCW by the proportion of time different cadres perform each activity.

b = Number of minutes required to meet demand for services at each facility a * (Number of times each activity is performed at each facility)

The HMIS contains data on the number of healthcare services provided monthly at each health facility across Malawi. Since the number of annual services is a key component of the model’s demand estimation, the monthly incidence data was converted to annual incidence (July 2009 - June 2010). The next step in the analysis was to determine the total HCW time required at each facility. The number of services provided annually at each facility (from HMIS) was multiplied by the ideal time needed to conduct each activity reported by HCWs (a) to produce the total HCW time required per facility (b).

c = Number of minutes male HCWs available each year {(Percentage of male HCWs) * [(Number days per year) – (Public holidays) – (Vacation days) – (Sick days) – (Professional development days)] * [(Productive hours per day) * 60]}

As outlined in Annex 6, productivity per HCW was calculated by determining the total number of days the HCW will work during the year (260 days for all health facilities) and subtracting all possible days the HCW may not be working (i.e. public holidays, vacation days, sick days, training days, days spent on community outreach, days spent supervising or working on other tasks, and for women – maternity leave). Vacation days were applied based on standards for HCWs set


out by MOH, and public holidays were standard across all HCWs (11 days per year). As MOH does not have a policy on allowable sick days, or data on training days taken for HCWs, comparable figures were applied from a similar Zambia study conducted in 2008. Finally, the number of available minutes HCWs performed patient-facing tasks (c) was determined. The adjusted productive days per year were multiplied by the hours per week HCWs spend working directly with patients, and then by minutes/hour to determine available minutes per year. The available minutes per year are ultimately used to determine the number of HCWs required to perform the essential activities at each type of health facility.

d =

Number of minutes female HCWs available each year {(Percentage of female HCWs)* [(Number days per year) – (Public holidays) – (Vacation days) – (Sick days) – (Professional development days) - (Maternity days)] * [(Productive or patient-facing hours per day) * 60]}

The calculation to determine the productivity for female HCWs (d) was similar to how productivity for male HCWs was formulated, but was adjusted to include the potential for maternity leave. Per MOH maternity leave standards, allowable maternity leave is 90 days. To determine the percent of pregnant HCWs at any given time, the annual number of children born in Malawi was multiplied against the number of women of child-bearing age, and applied to the percent of females per cadre sourced from MOH HRMIS.

e = Number of HCWs needed to meet demand for services at each facility each year b / (c + d)

Finally, total HCW time per facility type (b) was divided by productivity or number of available working minutes per cadre (c + d) to determine the number of HCWs needed to provide care at each facility (e).

3.3 MOH and CHAM funded establishment

The number of funded positions—or the Government-approved establishment—was provided by the MOH’s Human Resources section and CHAM. The MOH receives an allocation of funding from the Ministry of Finance and National Planning with which to recruit and employ HCWs – the sum total of recruitment and position allocation by cadre and by facility comprise the Government’s approved establishment. As outlined in Figure 2, the MOH’s Funded Establishment for the 352 health facilities included in this analysis have available funded positions for 208 medical officers, 2,230 clinical officers, 1,009 nursing officers, 8,053 nurse midwife technicians, and 792 medical assistants. The 149 CHAM health facilities included in this analysis have funded positions available for 74 medical officers, 617 clinical officers, 186 nursing officers, 2,363 nurse midwife technicians, and 253 medical assistants. Approximately 12,750 health surveillance assistants have been allocated to provide care in Malawi based on the existing ratio of 1 HSA per 1,000 persons. Since the funded establishment is limited by budget restrictions, it should not be interpreted as representative of the true demand for health services. The establishment does provide the number of HCWs that the current MOH budget can support, so it is useful to compare against the optimal number of HCWs.

3.4 MOH and CHAM current staffing levels

Data on current staffing levels were collected for MOH and CHAM facilities. Because one cadre is comprised of several different job titles (i.e. Nurse Midwife Technician is comprised of nurse technician, nurse midwife technician, senior enrolled nurse, senior enrolled nurse/midwife, senior nurse technician, enrolled nurse, and enrolled nurse midwife), these various job titles were added together to make up one total number for each cadre at each facility. The study


focused on patient-facing staff only and job titles related to staff involved in primarily administrative functions were ignored, as their day-to-day activities could not be linked directly to patient incidence data in the HMIS.

3.5 Data validation The HMIS data that was categorized to fit into the activity categories for the model was validated with other data sources to ensure the validity of the model inputs. As seen in Figure 7, a comparison was conducted between the raw data collected from the HMIS department and the HMIS Bulletin Annual Report. Indicators that could be directly traced from data extracted from HMIS and the HMIS Bulletin Annual report were compared. Below are the HMIS totals used in the model compared to the HMIS Bulletin Annual Report, along with the percent difference between the two samples. For indicators that were compared against the HMIS Bulletin Annual Report, the percentage differences noted were deemed insignificant for all but two indicators (TB cases, STI cases, and Complicated Deliveries). To assess the robustness of the conclusions from the inputs used in the model, a sensitivity analysis was conducted on the activity times and the HMIS data used in the model by examining the 95% certainty intervals from 50,000 Monte Carlo simulations for each facility using triangular distributions for all assumptions. For these simulations, potential permutations of the activity times (+/- 25% difference) and assumptions made to calculate the number of surgeries, clients in the HIV program, and the number of ANC follow-up visits (since no data existed in the HMIS for these variables (+/- 10% difference) were calculated repeatedly by randomly drawing variables from distributions around each assumption. The minimum and maximum outputs for each HCW cadre demanded at each facility type are provided in Annex 8. National HCWs by facility type. Figure 7. HMIS data validation

Indicator

Totals Extracted from HMIS Database per Activity Categories Used in Optimization Model

Alternate Source % Difference

Antenatal First Visits 603,184 603,200 0% Antenatal Total Visits 1,583,564 1,498,000 6% Normal Deliveries 409,998 405,700 1% Complicated Deliveries 59,376 32,770 81% Caesarean Sections 27,792 26,700 4% Family Planning Total Visits 1,660,256 1,683,800 1% Persons Receiving HCT results 1,110,551 1,040,400 7% TB Cases Evaluated 14,743 3,820 286% Fully Immunized Children <1 486,891 449,200 8% STI Cases 238,360 188,700 26% Outpatient Admissions 17,389,287 18,553,400 6%

Source: HMIS Bulletin Annual Report, July 2009 - June 2010

3.6 Limitations

This approach has several limitations. The purpose of this analysis was to prepare workload-based staffing targets for public health facilities throughout Malawi. However, the facility-level targets should be interpreted with some caution since demand-based indicators may be imprecise.


This analysis relied on clinical experts to provide work activity measurements needed by different HCW cadres to manage essential health issues. Since patient management is not an exact science, these approximations are subjective. Time requirements are not adjusted to reflect prevalence patterns in certain areas. Further, HMIS data was not available for 45 facilities (See Annex 7. Missing Data), and some facilities did not report a full year of data. The facilities without any data were removed from the analysis, and averages were used to represent missing values when monthly facility data was not available. Facility-level service utilization rates and catchment areas were unknown at the time of the analysis. Without a solid understanding of how much of the population is accessing services at each of the facilities, how much of the population lives in the vicinity and might someday visit the facilities, and how much the future population will grow and eventually utilize the facilities, it is not possible to estimate the future demand for health services at the facility-level. Finally, it must be emphasized that the optimal prototypes for each facility output by the optimization model are meant to reflect the HCW staffing requirements to meet health demands of an average patient in an average district in one year. For this reason, the model does not incorporate extraneous variables such as the physical distance to the nearest health center, service utilization, age distribution, or disease incidence by district. To adjust for future changes to health demands in Malawi, the optimization model was designed as a hand-over tool that can easily be updated with new HMIS data and staffing information on a regular basis.

A significant limitation is the completeness and timeliness of MOH HRMIS data available at the time this analysis was conducted. The MOH HRMIS was current as of July 2010. Several health facilities known to be staffed with HCWs are recorded as not having any HCWs, and current MOH processes cannot track “ghost workers” meaning staff may be posted at a health facility per the HRMIS but are not in fact working there. Recognizing limitations of current staffing figures, the workload analysis tool was designed to enable MOH HR and Planning staff to enter current figures into the model easily so as to determine vacancies based on the results of this study once more accurate current staffing figures are available.


4. Results

Below are the topline results of the optimization analysis. Please refer to Annexes 8 – 9 for the complete findings for staffing levels demanded by facility type and district.

4.1 National summary Figure 8. National HCWs by cadre

Note: The error bars represent the minimum and maximum optimal workforce numbers that were calculated in the model sensitivity analysis, as explained in Section 3.5 above. Further results from the sensitivity analysis can be found in Annex 8.

95

362

0

50

100

150

200

250

300

350

400

450

Medical Officer

Current Staff Optimal Staff

697

2,548

0

500

1,000

1,500

2,000

2,500

Clinical Officer


622

1,678

0

500

1,000

1,500

2,000

Nursing Officer


2,494

5,177

0

1,000

2,000

3,000

4,000

5,000

6,000

Nurse Midwife Technician


688

2,495

0

500

1,000

1,500

2,000

2,500

3,000

Medical Assistant


9,443

22,043

0

5,000

10,000

15,000

20,000

25,000

Health Surveillance Assistant



Figure 9. National HCWs by facility type

Note: Health Surveillance Assistants are not included in the charts above.

8102,155

83 93 2812,217 2,860

899 656

3,167

02,0004,0006,0008,000

10,00012,00014,00016,00018,000

Central Hospital District Hospital Community Rural Hospital

Urban Health Center

Rural Health Center

MINISTRY OF HEALTH NATIONAL HEALTH WORKFORCE

Ministry of Health Current Staff Ministry of Health Optimal Staff

864

16

294

1,555

30

876

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

Community Rural Hospital Urban Health Center Rural Health Center

CHAM NATIONAL HEALTH WORKFORCE

CHAM Current Staff CHAM Optimal Staff


4.2 Medical officer

Figure 10. Current, funded, and optimal levels of medical officers

Figure 11. Optimal staffing levels for medical officers by facility type

95

187 282

80362

0

50

100

150

200

250

300

350

400




Optimal Staff

Vacancy rate between current and funded health staff is 34% [1 - (187/282)]

Vacancy rate between current and optimal staff is 26% [1 - (187 + 80)/362]

MEDICAL OFFICERS

142172

20

0255075

100125150175200


MINISTRY OF HEALTH : MEDICAL OFFICERS

28

0

10

20

30

Community Rural Hospital

CHAM : MEDICAL OFFICERS


Figure 12.Optimal staffing for medical officers by district

RegionMedical Officer :

Ministry of Health Medical Officer :

CHAM Medical Officer: TotalBalaka 0 0 0Blantyre 81 1 82Chikwawa 21 1 22Chiradzulu 8 1 9Chitipa 9 1 10Dedza 7 1 8Dowa 6 2 8Karonga 7 1 8Kasungu 10 1 11Lilongwe 37 4 41Machinga 16 0 16Mangochi 2 1 3Mchinji 7 0 7Mulanje 7 1 8Mwanza 5 0 5Mzimba 11 5 16Mzimba N 0 0 0Neno 2 0 2Nkhata Bay 4 1 5Nkhotakota 5 2 7Nsanje 4 1 5Ntcheu 12 0 12Ntchisi 8 0 8Phalombe 0 1 1Rumphi 9 1 10Salima 12 0 12Thyolo 15 1 16Zomba 29 1 30TOTAL 334 28 362


4.3 Clinical officer

Figure 13. Current, funded, and optimal levels of clinical officers

Figure 14. Optimal staffing levels for clinical officers by facility type

697

2,150 2,847

-299

2,548

-1,000

-500

0

500

1,000

1,500

2,000

2,500

3,000




Optimal Staff

Vacancy rate between current and funded health staff is 24% ([1 - (2,150/2,847)]

Vacancy rate between current and optimal staff is 27% [1 - (2,150 - 299)/2,548]

CLINICAL OFFICERS

494

917

278 232

0100200300400500600700800


Urban Health Center

MINISTRY OF HEALTH : CLINICAL OFFICERS615

120

50100150200250300350400

Community Rural Hospital Urban Health Center

CHAM: CLINICAL OFFICERS


Figure 15. Optimal staffing for clinical officers by district

RegionClinical Officer :

Ministry of Health Clinical Officer :

CHAM Clinical Officer: TotalBalaka 0 0 0Blantyre 328 34 362Chikwawa 58 10 68Chiradzulu 31 12 43Chitipa 27 4 31Dedza 42 40 82Dowa 54 40 94Karonga 34 3 37Kasungu 69 36 105Lilongwe 343 190 533Machinga 52 0 52Mangochi 66 5 71Mchinji 39 0 39Mulanje 44 88 132Mwanza 33 0 33Mzimba 66 53 119Mzimba N 0 0 0Neno 16 0 16Nkhata Bay 33 4 37Nkhotakota 41 13 54Nsanje 25 15 40Ntcheu 49 0 49Ntchisi 36 0 36Phalombe 0 20 20Rumphi 172 33 205Salima 48 0 48Thyolo 80 16 96Zomba 135 11 146TOTAL 1,921 627 2,548


4.4 Nursing officer

Figure 16. Current, funded, and optimal levels of nursing officers

Figure 17. Optimal staffing levels for nursing officers by facility type

622

573 1,195

483 1,678

0

500

1,000

1,500

2,000




Optimal Staff

Vacancy rate between current and funded health staff is 52% [1 - (573/1,195)]

Vacancy rate between current and optimal staff is 37% [(1 - (573 + 483)/1,678]

NURSING OFFICERS

863

627

61

0

300

600

900


MINISTRY OF HEALTH : NURSING OFFICERS

127

0

50

100

150

200

250


CHAM : NURSING OFFICERS


Figure 18. Optimal staffing for nursing officers by district

RegionNursing Officer :

Ministry of Health Nursing Officer :

CHAM Nursing Officer: TotalBalaka 0 0 0Blantyre 383 7 390Chikwawa 62 4 66Chiradzulu 28 4 32Chitipa 30 1 31Dedza 29 6 35Dowa 23 15 38Karonga 23 1 24Kasungu 49 3 52Lilongwe 314 31 345Machinga 52 0 52Mangochi 20 1 21Mchinji 26 0 26Mulanje 30 7 37Mwanza 22 0 22Mzimba 34 21 55Mzimba N 0 0 0Neno 7 0 7Nkhata Bay 17 1 18Nkhotakota 17 3 20Nsanje 15 6 21Ntcheu 40 0 40Ntchisi 29 0 29Phalombe 0 5 5Rumphi 26 3 29Salima 39 0 39Thyolo 53 4 57Zomba 183 4 187TOTAL 1,551 127 1,678


4.5 Nurse midwife technician

Figure 19. Current, funded, and optimal levels of nurse midwife technicians

Figure 20. Optimal staffing for nurse midwife technicians by facility type

2,494

7,922 10,416

-5,239

5,177

-8,000

-6,000

-4,000

-2,000

0

2,000

4,000

6,000

8,000

10,000




Optimal Staff

Vacancy rate between current and funded health staff is 24% [1 - (7.922/10,416]

Vacancy rate between current and optimal staff is 48% [1 - (7,922 - 5,239)/5,177]

NURSE MIDWIFE TECHNICIANS

718868

382262

1,782

0

400

800

1,200

1,600

Central Hospital

District Hospital


Urban Health Center

Rural Health Center

MINISTRY OF HEALTH : NURSE MIDWIFE TECHNICIANS628

10

527

0

100

200

300

400

500

600


Urban Health Center Rural Health Center

CHAM : NURSE MIDWIFE TECHNICIANS


Figure 21. Optimal staffing for nurse midwife technicians by district

Region

Nurse Midwife Technician : Ministry

of Health Nurse Midwife

Technician : CHAMNurse Midwife

Technician: TotalBalaka 35 19 54Blantyre 541 43 584Chikwawa 133 34 167Chiradzulu 95 21 116Chitipa 70 8 78Dedza 162 64 226Dowa 131 77 208Karonga 66 10 76Kasungu 138 25 163Lilongwe 636 198 834Machinga 136 31 167Mangochi 191 56 247Mchinji 116 40 156Mulanje 162 58 220Mwanza 47 0 47Mzimba 164 92 256Mzimba N 40 6 46Neno 30 17 47Nkhata Bay 66 13 79Nkhotakota 71 22 93Nsanje 74 31 105Ntcheu 118 45 163Ntchisi 90 1 91Phalombe 66 53 119Rumphi 92 27 119Salima 103 17 120Thyolo 173 60 233Zomba 266 97 363TOTAL 4,012 1,165 5,177


4.6 Medical assistant

Figure 22. Current, funded, and optimal levels of medical assistants

Figure 23. Optimal staffing for medical assistants by facility type

688

357 1,045

1,450 2,495

0

500

1,000

1,500

2,000

2,500




Optimal Staff

Vacancy rate between current and funded health staff is 66% [1 - (357/1,045)]

Vacancy rate between current and optimal staff is 28% [(1 - 357 + 1,450)/2,495]

MEDICALASSISTANTS

276158 162

1,385

0

250

500

750

1,000

1,250

1,500

District Hospital Community Rural Hospital

Urban Health Center

Rural Health Center

MINISTRY OF HEALTH : MEDICAL ASSISTANTS

157

8

349

0

50

100

150

200

250

300


Urban Health Center Rural Health Center

CHAM : MEDICAL ASSISTANTS


Figure 24. Optimal staffing for medical assistants by district

RegionMedical Assistant : Ministry of Health

Medical Assistant : CHAM

Medical Assistant: Total

Balaka 31 9 40Blantyre 131 15 146Chikwawa 63 20 83Chiradzulu 55 6 61Chitipa 29 5 34Dedza 98 41 139Dowa 80 15 95Karonga 35 4 39Kasungu 89 16 105Lilongwe 220 52 272Machinga 75 18 93Mangochi 105 35 140Mchinji 64 20 84Mulanje 108 29 137Mwanza 24 0 24Mzimba 81 25 106Mzimba N 34 1 35Neno 26 13 39Nkhata Bay 51 10 61Nkhotakota 56 13 69Nsanje 46 12 58Ntcheu 64 28 92Ntchisi 50 1 51Phalombe 45 8 53Rumphi 61 12 73Salima 57 9 66Thyolo 107 25 132Zomba 96 72 168TOTAL 1,981 514 2,495


4.7 Health surveillance assistant

Figure 25. Current, funded, and optimal levels of health surveillance assistants

9,443

3,307 12,750

9,293 22,043

0

5,000

10,000

15,000

20,000




Optimal Staff

Vacancy rate between current and funded health staff is 74% [1 - (3,307/12,750)]

Vacancy rate between current and optimal staff is 43% [1 - (3,307 +9,293)/22,043]

HEALTH SURVEILLANCE ASSISTANTS


Figure 26. Optimal staffing for health surveillance assistants by district

Region

Health Surveillance Assistant : Ministry of

Health Health Surveillance

Assistant : CHAMHealth Surveillance

Assistant: TotalBalaka 303 82 385Blantyre 1,503 93 1,596Chikwawa 614 230 844Chiradzulu 503 26 529Chitipa 253 31 284Dedza 1,023 359 1,382Dowa 724 79 803Karonga 281 21 302Kasungu 810 93 903Lilongwe 2,269 209 2,478Machinga 747 145 892Mangochi 962 280 1,242Mchinji 660 167 827Mulanje 1,029 86 1,115Mwanza 205 0 205Mzimba 820 124 944Mzimba N 342 13 355Neno 252 140 392Nkhata Bay 425 70 495Nkhotakota 546 80 626Nsanje 503 67 570Ntcheu 586 196 782Ntchisi 485 8 493Phalombe 446 48 494Rumphi 486 42 528Salima 576 79 655Thyolo 733 237 970Zomba 703 249 952TOTAL 18,789 3,254 22,043


5. Recommendations

5.1 Increase funded establishment to meet demand

The Government of Malawi will need to increase its health workforce of medical officers, clinical officers, nursing officers, nurse midwife technicians, medical assistants, and health surveillance assistants by a total of 19,033 staff to meet the existing demand for health services from the population. Again, these staffing numbers are meant to meet existing demand – not need – as service utilization (% of those ill seeking health services) in Malawi is 39% at MOH and CHAM facilities and a large percentage of the population is not reflected in the HMIS data.5

Also, since this optimization analysis only focused on the priority cadres listed above, there may be a need to increase the levels of other HCW cadres not included in this analysis.

5.2 Scale-up training enrollment for critical cadres

A quantitative analysis of Malawi-specific root causes determined pre-service training as the leading driver of the country’s nurse and midwife shortfall, and thus the best focus area for an intervention. Increasing the number of first-year students enrolling in BSCN, DN, and NMT training programs to 400, 100, and 1,230 respectively will result in a 194% increase the available nursing workforce by 2021 (see Figure 27). Figure 27. 10-year national pipeline forecast for nursing officers and nurse midwife technicians

Source: CHAI 2010 Pipeline Forecast for nursing officers and nurse midwife technicians

Supplemental interventions targeting graduation rates and public sector entry rates can also help close the gap over the next decade (see Figure 28).

5 Mangham, L. Who benefits from public spending on health care in Malawi? An application of Benefit Incidence Analysis to the Health Sector. Malawi Medical Journal. 2006; 18(2):60-65.

3,000

6,000

9,000

12,000

15,000

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

National Baseline National Intervention National Target

Optimization Target : 11,611


Figure 28. Impact of 10-year intervention to increase the number of nursing officers and nurse midwife technicians

Source: CHAI 2010 Pipeline Forecast for nursing officers and nurse midwife technicians

Severe staffing shortages observed among clinical officers and medical assistants call for a strategic increase in health school training enrollment to meet the minimum need for HCWs in Malawi. The optimization model can help MOH policy-makers determine the relative priority and level of investment needed to expand Malawi’s workforce to optimal staffing levels.

5.3 Prioritize HCW deployment according to demand In order to expedite the provision of health services across Malawi to meet current demand, it is critical that the MOH has the data needed to identify the districts across the country most in need of additional HCWs. For this reason, the results of the optimization model have been incorporated into a deployment prioritization analysis designed to organize districts by demand (determined by vacancy rates, which was calculated as 1 – current/optimal staff) for additional HCWs. The advantage of the prioritization scheme is that when a certain type of HCW comes up for staffing (i.e. new graduates), it is clear which districts are in greatest need of that specific cadre. Figure 29 below ranks districts by their vacancy rates (100% vacant = no staff available to meet demand) and are therefore the most in need of HCWs based on the deployment prioritization analysis. The districts highlighted in blue are the ten districts identified as having the greatest need for additional HCWs based on current vacancy rates.

3,544 +10

+13,089 -1,309

-2,241

-1,300

-151 -502 11,132513 11,611

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

Total Workforce in 2011

Total Hired from Abroad

Total Students Total Did Not Graduate

Total Graduated, But Not Entering

Workforce

Total Retiring Total Involuntary Attrition

Total Voluntary Attrition

Total Workforce in 2021

Remaining Gap Target Workforce in

2021


Figure 29. Health care worker deployment prioritization

MEDICAL OFFICERS

RegionCurrent

StaffOptimal

StaffVacancy

RateChiradzulu 0 9 100.0%Karonga 0 8 100.0%Mangochi 0 3 100.0%Mwanza 0 5 100.0%Neno 0 2 100.0%Ntcheu 0 12 100.0%Ntchisi 0 8 100.0%Phalombe 0 1 100.0%Rumphi 0 10 100.0%Salima 0 12 100.0%Machinga 1 16 93.8%Kasungu 1 11 90.9%Chitipa 1 10 90.0%Zomba 3 30 90.0%Mulanje 1 8 87.5%Nkhotakota 1 7 85.7%Chikwawa 4 22 81.8%Blantyre 16 82 80.5%Nkhata Bay 1 5 80.0%Dedza 2 8 75.0%Dowa 2 8 75.0%Thyolo 4 16 75.0%Nsanje 2 5 60.0%Mchinji 3 7 57.1%Mzimba 8 16 50.0%Lilongwe 44 41 -7.3%Balaka 1 0 N/AMzimba N 0 0 N/ATOTAL 95 362 73.8%

CLINICAL OFFICERS

RegionCurrent

StaffOptimal

StaffVacancy

RateRumphi 13 205 93.7%Blantyre 38 362 89.5%Phalombe 3 20 85.0%Kasungu 18 105 82.9%Mulanje 27 132 79.5%Dowa 21 94 77.7%Machinga 13 52 75.0%Lilongwe 144 533 73.0%Thyolo 27 96 71.9%Mwanza 10 33 69.7%Chitipa 10 31 67.7%Chikwawa 22 68 67.6%Chiradzulu 15 43 65.1%Nsanje 14 40 65.0%Mangochi 25 71 64.8%Ntcheu 18 49 63.3%Mzimba 44 119 63.0%Ntchisi 14 36 61.1%Zomba 57 146 61.0%Salima 20 48 58.3%Karonga 16 37 56.8%Nkhata Bay 17 37 54.1%Dedza 39 82 52.4%Mchinji 20 39 48.7%Nkhotakota 29 54 46.3%Neno 9 16 43.8%Balaka 13 0 N/AMzimba N 1 0 N/ATOTAL 697 2,548 72.6%

NURSING OFFICERS

RegionCurrent

StaffOptimal

StaffVacancy

RateBlantyre 31 390 92.1%Machinga 7 52 86.5%Mwanza 3 22 86.4%Zomba 36 187 80.7%Rumphi 7 29 75.9%Salima 10 39 74.4%Kasungu 14 52 73.1%Ntcheu 12 40 70.0%Chikwawa 20 66 69.7%Ntchisi 9 29 69.0%Chiradzulu 11 32 65.6%Lilongwe 119 345 65.5%Karonga 9 24 62.5%Chitipa 12 31 61.3%Mchinji 14 26 46.2%Nkhata Bay 10 18 44.4%Thyolo 32 57 43.9%Dowa 25 38 34.2%Mangochi 16 21 23.8%Mulanje 32 37 13.5%Nsanje 20 21 4.8%Dedza 35 35 0.0%Neno 7 7 0.0%Phalombe 5 5 0.0%Mzimba 78 55 -41.8%Nkhotakota 33 20 -65.0%Balaka 14 0 N/AMzimba N 1 0 N/ATOTAL 622 1,678 62.9%

NURSE MIDWIFE TECHNICIANS

RegionCurrent

StaffOptimal

StaffVacancy

RateMzimba N 3 46 93.5%Blantyre 162 584 72.3%Kasungu 47 163 71.2%Chiradzulu 37 116 68.1%Phalombe 38 119 68.1%Dedza 83 226 63.3%Rumphi 44 119 63.0%Mchinji 59 156 62.2%Mwanza 19 47 59.6%Chitipa 32 78 59.0%Thyolo 99 233 57.5%Machinga 72 167 56.9%Ntcheu 71 163 56.4%Dowa 91 208 56.3%Mulanje 99 220 55.0%Ntchisi 43 91 52.7%Chikwawa 80 167 52.1%Mangochi 120 247 51.4%Neno 23 47 51.1%Mzimba 126 256 50.8%Nsanje 56 105 46.7%Zomba 215 363 40.8%Salima 73 120 39.2%Lilongwe 533 834 36.1%Karonga 54 76 28.9%Nkhata Bay 62 79 21.5%Balaka 52 54 3.7%Nkhotakota 101 93 -8.6%TOTAL 2,494 5,177 51.8%

MEDICAL ASSISTANTS

RegionCurrent

StaffOptimal

StaffVacancy

RateMzimba N 1 35 97.1%Thyolo 18 132 86.4%Machinga 14 93 84.9%Kasungu 17 105 83.8%Mangochi 25 140 82.1%Zomba 31 168 81.5%Dedza 26 139 81.3%Neno 8 39 79.5%Mulanje 32 137 76.6%Lilongwe 64 272 76.5%Blantyre 35 146 76.0%Chiradzulu 15 61 75.4%Phalombe 15 53 71.7%Dowa 28 95 70.5%Mchinji 25 84 70.2%Rumphi 22 73 69.9%Ntcheu 29 92 68.5%Salima 24 66 63.6%Balaka 15 40 62.5%Chikwawa 32 83 61.4%Karonga 16 39 59.0%Ntchisi 21 51 58.8%Nkhata Bay 28 61 54.1%Chitipa 16 34 52.9%Nsanje 28 58 51.7%Mzimba 53 106 50.0%Nkhotakota 36 69 47.8%Mwanza 14 24 41.7%TOTAL 688 2,495 72.4%

HEALTH SURVEILLANCE ASSISTANTS

RegionCurrent

StaffOptimal

StaffVacancy

RateMzimba N 0 355 100.0%Mangochi 206 1,242 83.4%Nkhotakota 110 626 82.4%Mulanje 214 1,115 80.8%Neno 77 392 80.4%Phalombe 140 494 71.7%Rumphi 164 528 68.9%Chitipa 96 284 66.2%Nsanje 196 570 65.6%Nkhata Bay 181 495 63.4%Dedza 520 1,382 62.4%Blantyre 605 1,596 62.1%Machinga 354 892 60.3%Ntchisi 198 493 59.8%Chikwawa 339 844 59.8%Lilongwe 1,119 2,478 54.8%Chiradzulu 254 529 52.0%Salima 336 655 48.7%Ntcheu 414 782 47.1%Thyolo 528 970 45.6%Dowa 443 803 44.8%Mchinji 485 827 41.4%Kasungu 548 903 39.3%Karonga 195 302 35.4%Mwanza 136 205 33.7%Mzimba 650 944 31.1%Zomba 658 952 30.9%Balaka 277 385 28.1%TOTAL 9,443 22,043 57.2%


5.4 Assess impact of formally task-shifting ART care from COs to NMTs

If Malawi adopts the 2009 WHO recommendations for earlier initiation of ART, the proportion of the adult population on ART is expected to triple in the next decade, which will require significant additional health staff for the country as a whole. Building on this optimization work and the costing data gathered during the pre-service training analysis, it would be beneficial to examine the impact of a) shifting ART care to nurses and scaling up the number of nurses trained to close the existing nursing workforce shortage versus b) using the same funds to scale-up a more skilled group of clinical officers to continue with the current model of care. This forthcoming analysis will allow Malawi’s decision-makers to compare the potential cost and personnel savings of applying task-shifting to meet the needs of the country’s increasing demand for ART.


Annex 1. Health activity times for central hospitals

Medical Officer

Clinical Officer

Nursing Officer


Medical Assistant


Inpatient Inpatient Admissions

30.33 7.65 7.65 0.00 0.00

Inpatient Admissions (Ongoing Monitoring)

2.50 2.50 20.50 15.67 0.00 0.00

Normal Deliveries 0.00 0.00 0.00 115.00 0.00 0.00

Complicated Deliveries 0.00 0.00 195.00 0.00 0.00 0.00

Caesarean Sections 18.50 87.00 0.00 117.50 0.00 0.00

Surgical Procedures 82.50 0.00 60.00 108.50 0.00 0.00

Outpatient Under 5 Outpatient Admissions 0.00 7.00 13.00 19.25 0.00 0.00

Over 5 Outpatient Admissions 12.50 7.50 0.00 15.00 0.00 0.00

Accidents and Emergencies 9.00 10.00 0.00 5.00 0.00 0.00

ANC Visit 1 0.00 0.00 0.00 27.00 0.00 0.00

ANC Visit 2 0.00 0.00 0.00 21.00 0.00 0.00

ANC Visit 3 0.00 0.00 0.00 21.00 0.00 0.00

ANC Visit 4 0.00 0.00 0.00 21.00 0.00 0.00

Nutrition Program 0.00 0.00 0.00 58.50 0.00 0.00

EPI 0.00 0.00 3.00 3.00 0.00 0.00


0.00 0.00 0.00 23.00 0.00 0.00

HIV/AIDS Program (New Patient) 0.00 35.00

4.50 0.00 0.00

HIV/AIDS Program (Follow-up Patient)

0.00 27.00 0.00 0.00 0.00 0.00

TB Program (New Patient) 0.00 25.00 0.00 0.00 0.00 0.00

TB Program (Follow-up Patient) 0.00 7.00 0.00 0.00 0.00 0.00

STI Clinic 0.00 20.00 0.00 0.00 0.00 0.00

Family Planning 0.00 0.00 0.00 60.00 0.00 0.00


Annex 2. Health activity times for community hospitals

Medical Officer

Clinical Officer

Nursing Officer


Medical Assistant


Inpatient Inpatient Admissions 0.00 30.33 10.00 7.65 0.00 5.00


0.00 5.33 0.00 30.00 0.00 0.00








ANC Visit 1 0.00 0.00 0.00 27.00 0.00 1.50

ANC Visit 2 0.00 0.00 0.00 21.00 0.00 5.00

ANC Visit 3 0.00 0.00 0.00 21.00 0.00 5.00

ANC Visit 4 0.00 0.00 0.00 21.00 0.00 5.00


EPI 0.00 0.00 0.00 0.00 0.00 9.00


0.00 13.20 0.00 18.81 0.00 12.87

HIV/AIDS Program (New Patient) 0.00 35.00 0.00 7.00 6.00 0.00


0.00 15.67 0.00 5.00 5.00 0.00



STI Clinic 0.00 8.81 0.00 4.79 4.62 0.00

Family Planning 0.00 0.00 0.00 30.65 0.00 5.00


Annex 3. Health activity times for district hospitals

Medical Officer

Clinical Officer

Nursing Officer


Medical Assistant


Inpatient Inpatient Admissions 0.00 30.33 10.00 7.65 0.00 5.00


5.00 3.50 11.75 15.67 0.00 0.00








ANC Visit 1 0.00 0.00 0.00 27.00 0.00 15.00

ANC Visit 2 0.00 0.00 0.00 21.00 0.00 5.00

ANC Visit 3 0.00 0.00 0.00 21.00 0.00 5.00

ANC Visit 4 0.00 0.00 0.00 21.00 0.00 5.00


EPI 0.00 0.00 0.00 0.00 0.00 12.00


0.00 0.00 0.00 0.00 0.00 55.20



0.00 27.00 0.00 2.00 0.00 2.00



STI Clinic 0.00 6.60 2.31 9.24 0.00 0.00

Family Planning 0.00 0.00 8.00 27.00 0.00 0.00


Annex 4. Health activity times for urban health centers

Medical Officer

Clinical Officer

Nursing Officer


Medical Assistant


Inpatient Inpatient Admissions 0.00 9.00 0.00 12.50

0.00


0.00 2.00 0.00 12.50 0.00 0.00





ANC Visit 1 0.00 0.00 0.00 17.00 0.00 3.50

ANC Visit 2 0.00 0.00 0.00 12.00 0.00 3.50

ANC Visit 3 0.00 0.00 0.00 12.00 0.00 3.50

ANC Visit 4 0.00 0.00 0.00 12.00 0.00 3.50


EPI 0.00 0.00 0.00 0.00 0.00 3.00


0.00 0.00 0.00 0.00 8.50 41.15



0.00 0.00 0.00 0.00 15.00 1.00



STI Clinic 0.00 0.00 0.00 13.80 9.12 0.00

Family Planning 0.00 0.00 0.00 33.33 0.00 2.50


Annex 5. Health activity times for rural health centers

Medical Officer

Clinical Officer

Nursing Officer


Medical Assistant


Inpatient Inpatient Admissions 0.00 0.00 12.50 8.67 0.00

Inpatient Admissions (Ongoing Monitoring) 0.00 0.00

12.50 0.00 0.00

Normal Deliveries 0.00 0.00 0.00 115.00 0.00 2.00 Complicated Deliveries 0.00 0.00 115.00 0.00 0.00

Outpatient Under 5 Outpatient Admissions 0.00 0.00 2.50 3.00 18.88

Over 5 Outpatient Admissions 0.00 0.00 2.50 4.00 10.25

ANC Visit 1 0.00 0.00 0.00 17.00 0.00 3.50

ANC Visit 2

0.00 0.00 0.00

12.00 0.00 3.50

ANC Visit 3 0.00 0.00 0.00 12.00 0.00 3.50 ANC Visit 4 0.00 0.00 0.00 12.00 0.00 3.50 Nutrition Program 0.00 0.00 0.00 18.00 1.58 19.00 EPI 0.00 0.00 0.00 0.00 0.00 3.00

Voluntary Counseling and Testing Program 0.00 0.00 0.00

0.00 8.50 41.15


HIV/AIDS Program (Follow-up Patient) 0.00 0.00 0.00

0.00 15.00 1.00

TB Program (New Patient) 0.00 0.00 0.00 21.83 8.00


STI Clinic 0.00 0.00 0.00 13.80 9.12 0.00

Family Planning 0.00 0.00 0.00 33.33 0.00 2.50


Annex 6. HCW productivity

HCW

Gen

der

Male (%)

Female (%)

% Pregnant

HCWs Source

Medical Officer 74% 26% 17.3% Used M/F breakdown from titles: Medical Officers and Medical Doctors (MOH HRMIS)

Clinical Officer 92% 8% 17.3% Used M/F breakdown from title: Clinical Officer (MOH HRMIS) Nursing Officer 26% 74% 17.3% Used M/F breakdown from title: Nursing Officer (MOH HRMIS) Nurse Midwife Technician 11% 89% 17.3% Used M/F breakdown from title: Nurse Technician (MOH HRMIS) Medical Assistant 76% 24% 17.3% Used M/F breakdown from title: Medical Assistant (MOH HRMIS) Health Surveillance Assistant 38% 62% 17.3% Used M/F breakdown from title: Laboratory Technician (MOH HRMIS)

Number of children born 516,629 Number of women of child-bearing age (15-49) 2,980,103 % of female HCWs who are estimated to be pregnant in one year 17.3%

Data from Malawi National Statistics Office 2008 Housing and Population Census http://www.nso.malawi.net/data_on_line/demography/census_2008/Main%20Report/Census%20Main%20Report.pdf

Notes Malawi has 11 public holidays, but HCWs will work on these days and then those days will be compensated for personal use later on

In hospital setting, only the medical officer has 30 days of vacation while the other cadres have 24 Malawi does not have a policy for sick days so - based on data collected from Zambia's HR policies - it was assumed that staff will take 20 days of sick leave per year Mothers received 90 days of maternity leave in Malawi Malawi just started a CPD program for Nurses and Clinicians, no prelim data on days taken for seminars, using Zambia data here but fairly similar to Malawi policy At hospitals, MO spends 1 hour per day training and 1 hour per day on other routine activities, which was deducted from their patient-facing hours per day At hospitals, CO spends 1 hour per day on other routine activities, which was deducted from their patient-facing hours per day At hospitals, NO spends 2 hours per day supervising, which was deducted from their patient-facing hours per day At hospitals, HSA is spending 1 day per week on outreach and health education services outside of the hospital, which was deducted from the number of days available at the hospital for patient-facing activities At hospitals, EHO is spending 15 hours per week outside of hospital conducting outreach and health education, which was deducted from the number of days available for patient-facing activities at the hospital At health centers, CO is spending 45 minutes per week on healthy living education and 2 hours per month on health education training for patients, which would be 1 hour per week or 8.7 days per year (which was calculated from 52 hours/6 hour workdays) . CO spends 1 hour per day on other routine activities, which was deducted from their patient-facing hours per day. At health centers, NO has a 4 hour work day because NO spends 2 hour per day on management and supervisory tasks such as human resources allocation, checking for problems in the facility, and supplying the clinic with drugs. At health centers, MA spends 1 day a week outreach in the community which was removed from their available hours for patient-facing activities recorded on the summary times tab At health centers, HSAs spends 2 days conducting outreach in the community (i.e. under-5 screening clinics, sanitation inspections, distribution of chlorine, home visits) and 2 hours per day conducting group counseling sessions at the HC clinics

Medical Officer

Clinical Officer

Nursing Officer


Medical Assistant

Health Surveillance

AssistantWorkdays / Year 260 260 260 260 260 260Public Holidays 11 11 11 11 11 11Vacation Days 30 24 24 24 24 24Sick Days 20 20 20 20 20 20Maternity Leave 90 90 90 90 90 90Days on Seminar / Training 30 30 30 15 15 15Days conducting community outreach outside of health facility 0 0 0 0 0 52Productive hours per day (Time spent on patient-facing activities) 4.0 5.0 4.0 6.0 6.0 6.0Total Available Minutes per Year 39,597 52,123 39,232 63,376 67,027 46,193

Cent

ral,

Dis

tric

t, a

nd C

omm

unit

y H

ospi

tal P

rodu

ctiv

ity

Medical Officer

Clinical Officer

Nursing Officer


Medical Assistant

Health Surveillance

AssistantWorkdays / Year 260 260 260 260 260 260Public Holidays 11 11 11 11 11 11Vacation Days 30 30 30 30 30 30Sick Days 20 20 20 20 20 20Maternity Leave 90 90 90 90 90 90Days on Seminar / Training 15 15 15 15 15 15Days conducting community outreach outside of health facility 0 8.7 0 0 52 104Productive hours per day (Time spent on patient-facing activities) 4.0 5.0 4.0 6.0 6.0 4.0Total Available Minutes per Year 43,197 52,213 41,392 61,216 46,147 16,875

Hea

lth

Cent

er P

rodu

ctiv

ity


Annex 7. Missing data Facilities where no HMIS data was available to estimate demand were removed from the analysis, as were dispensaries and facilities that are not managed by the MOH.

Facilities Removed from Analysis MOH/CHAM Reason Not Included in Analysis

African Bible College - ABC Clinic CHAM Not in HMIS data Chamba Rural Health Center MOH Listed as dispensary in HMIS Chamwamvi Rural Health Center Unknown Not in HMIS data Chezi -St. Mary’s Rehabilitation Centre CHAM Listed as dispensary in HMIS Chimwala Health Center CHAM Not in HMIS data Chiole Health Center CHAM Listed as dispensary in HMIS Comfort Clinic CHAM Not in HMIS data Daeyang Lukes Hospital CHAM Not in HMIS data David Gordon Memorial Hosp CHAM Not in HMIS data Dziwe Rural Health Center MOH Listed as dispensary in HMIS H Parker Sharp Health Centre CHAM Listed as dispensary in HMIS Holy Family-Phalombe Mission Hospital CHAM Not in HMIS data Kandeu Health Centre CHAM Listed as dispensary in HMIS Kukalanga Rural Health Center MOH Listed as dispensary in HMIS Lumbila Health Centre CHAM Not in HMIS data Lupembe HC Local Govt No matching HRMIS data/Not considered MOH Lusubilo Rehabilitation Centre CHAM Not in HMIS data Lutheran Mobile Clinic CHAM Not in HMIS data Lwezga HC Local Govt No matching HRMIS data/Not considered MOH Malabada CHAM Not in HMIS data Malabada Health Centre CHAM Not in HMIS data Maureen Murray - Nyenyezi Health Centre CHAM Not in HMIS data Mbonechera Rural Health Center MOH Listed as dispensary in HMIS Mharaunda Health Centre CHAM Not in HMIS data Mikondo Health Centre CHAM Listed as dispensary in HMIS Mkope Health Centre CHAM Not in HMIS data Mlobza CHAM Not in HMIS data Mlodza Health Centre CHAM Not in HMIS data Mpherere Health Centre CHAM Not in HMIS data Mulibwanji Community Hospital CHAM Not in HMIS data Mziza Health Centre CHAM Not in HMIS data Nancholi Rural Health Center MOH Listed as dispensary in HMIS Nthenje Health Centre CHAM Listed as dispensary in HMIS Police Hospital National Govt No matching HRMIS data/Not considered MOH Senga-bay Baptist Medicals CHAM Not in HMIS data St. Andrews Rural hospital CHAM Not in HMIS data St. Faith Clinic CHAM Not in HMIS data St. Vincent CHAM Not in HMIS data St. Vincent Health Centre CHAM Not in HMIS data Tcharo Health Centre CHAM Listed as dispensary in HMIS Thembe Health Centre CHAM Listed as dispensary in HMIS Thondwe Pastoral Clinic CHAM Listed as dispensary in HMIS Tsangano Health Centre CHAM Listed as dispensary in HMIS Zomba Mental Hospital MOH Not in HMIS data Zunga Health Centre CHAM Not in HMIS data


Annex 8. Sensitivity analysis (NOTE: to be updated when figures finalized) Since uncertainty exists around some of the inputs used in this analysis, it is important to assess whether the use of different, but still realistic, assumptions would result in quantitative changes to the findings.6

For example, if the activity times that were reported by HCWs were higher or lower than reality, it could inflate or deflate the number of HCWs demanded by the health facilities or the optimal staffing targets. Therefore, it is important to conduct a sensitivity analysis on the variables around which uncertainty exists in order to qualify statements made about the model’s outputs.

Variables for which uncertainty existed included: - Reported HCW activity times - HMIS demand volume for surgical procedures for Community Hospital and District Hospitals - HMIS demand volume for ANC Visit 2, 3, and 4 for all facilities - HMIS demand volume for HIV/AIDS Program (New Patients)

The activity times recorded during interviews with HCWs are prone to measurement bias, where the responses recorded during the interviews may have been skewed up or down for a number of reasons. Further, the missing data for the HMIS variables was estimated based on assumptions around available data and could be prone to over- or under-estimation. For each variable under consideration, a triangular distribution was described, meaning that a minimum, maximum, and most likely value was selected. An assumption was made that in all cases the HCW activity times may have been over- or under-estimated at most likely rate of 0% with a minimum of the times being discounted by 25% versus a maximum of 25%. It was also assumed that the HMIS variables in question may have been over- or under-estimated at a most likely rate of 10% with a minimum of 0% and a maximum of 20%. All sensitivity analyses were run in Excel 2007 by drawing values for each variable from its assigned distribution. It is unlikely that all the variables would be simultaneously at either extreme of their range so 50,000 Monte Carlo simulations were run for each facility using Oracle Crystal Ball. In each iteration, random values for each variable were drawn from the assigned distributions and the resulting outcome variable – the number of HCWs by cadre for each facility type – was recorded. The range of values in which 95% of the outcomes occurred were reported as most likely. The most likely values, minimums, and maximum ranges for the key outcomes are depicted in the tables below as follows: most likely (minimum – maximum).

6 Doubilet P, Begg CB, Weinstein MC, Braun P, McNeil BJ. Probabilistic sensitivity analysis using Monte Carlo simulation. Med Decis Making 1985; 5:157-77.

Type Current Optimal Difference % Vacancy

Central Hospital 47 142 (127 - 157) -95 66.9%

District Hospital 22 172 (146 - 203) -150 87.2%

Community Rural Hospital 26 48 (48 - 49) -22 45.8%

Urban Health Center 0 0 N/A N/A

Rural Health Center 0 0 N/A N/A

95 362 (321 - 409) -267 73.8%

Medical Officer : National Summary



Central Hospital 177 353 (318 - 390) -176 49.9%

District Hospital 378 744 (677 - 824) -366 49.2%

Community Rural Hospital 115 597 (562 - 655) -482 80.7%

Urban Health Center 9 244 (209 - 282) -235 96.3%

Rural Health Center 18 0 18+ 18 EXCESS

697 1,938 (1,766 - 2,151) -1,259 64.0%

Clinical Officer : National Summary


Central Hospital 100 863 (760 - 966) -763 1

District Hospital 246 627 (562 - 706) -381 1

Community Rural Hospital 245 188 (173 - 212) 57+ 57 EXCESS

Urban Health Center 2 0 2+ 2 EXCESS

Rural Health Center 29 0 29+ 29 EXCESS

622 1,678 (1,495 - 1,884) -1,144 62.9%

Nursing Officer : National Summary


Central Hospital 477 711 (640 - 788) -234 0

District Hospital 1,100 855 (790 - 942) 245+ 245 EXCESS

Community Rural Hospital 465 949 (874 - 1,056) -484 1

Urban Health Center 74 255 (235 - 282) -181 1

Rural Health Center 378 2,211 (2,078 - 2,408) -1,833 1

2,494 4,981 (4,617 - 5,476) -2,732 49.9%



Central Hospital 9 0 9+ 9 EXCESS

District Hospital 409 276 (233 - 314) 133+ 133 EXCESS

Community Rural Hospital 96 260 (229 - 296) -164 1

Urban Health Center 24 140 (122 - 157) -116 1


688 2,236 (1,988 - 2,497) -1,690 69.2%

Medical Assistant : National Summary


Central Hospital 0 0 N/A N/A

District Hospital 40 1,955 (1,659 - 2,251) -1,915 1

Community Rural Hospital 0 890 (794 - 1,004) -890 1

Urban Health Center 0 1,865 (1,577 - 2,155) -1,865 1


Unassigned 9,387

Total 9,443 21,877 (18,979 - 24,582) -21,821 56.8%

Health Surveillance Assistant : National Summary


Annex 9. HCW vacancy rates by facility

Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyKamuzu Central Hosp Central West Lilongwe Central Hospital MOH 33 21 12 EXCESS 61 105 41.9% 35 188 81.4%Mzuzu Central Hosp North Lilongwe Central Hospital MOH 1 13 92.3% 44 67 34.3% 23 112 79.5%Queen Elizabeth Hosp South West Blantyre Central Hospital MOH 12 81 85.2% 32 218 85.3% 29 383 92.4%Zomba Central Hosp South East Zomba Central Hospital MOH 1 27 96.3% 40 104 61.5% 13 180 92.8%Alinafe Hosp Central East Nkhotakota Community Rural Hospital CHAM 0 1 100.0% 1 8 87.5% 1 2 50.0%Atupele CH North Karonga Community Rural Hospital CHAM 0 1 100.0% 0 3 100.0% 0 1 100.0%Bwaila Hosp Central West Lilongwe Community Rural Hospital MOH 0 1 100.0% 0 51 100.0% 0 5 100.0%Chilumba Hosp North Karonga Community Rural Hospital MOH 0 1 100.0% 0 7 100.0% 0 2 100.0%Chintheche Hosp North Nkhata Bay Community Rural Hospital MOH 0 1 100.0% 0 11 100.0% 0 3 100.0%Cobbe Hosp South East Zomba Community Rural Hospital MOH 0 1 100.0% 0 3 100.0% 0 1 100.0%DGM Livingstonia Hsp North Rumphi Community Rural Hospital CHAM 0 1 100.0% 0 33 100.0% 0 3 100.0%Domasi Hosp South East Zomba Community Rural Hospital MOH 0 1 100.0% 0 15 100.0% 0 2 100.0%Dwambazi RH Central East Nkhotakota Community Rural Hospital MOH 0 1 100.0% 0 5 100.0% 0 1 100.0%Edingeni Hosp North Mzimba Community Rural Hospital MOH 0 1 100.0% 0 3 100.0% 0 1 100.0%Ekwendeni Hosp North Mzimba Community Rural Hospital CHAM 2 1 1 EXCESS 7 20 65.0% 15 6 9 EXCESSEmbangweni Hosp North Mzimba Community Rural Hospital CHAM 3 1 2 EXCESS 8 11 27.3% 32 7 25 EXCESSEuthini Hosp North Mzimba Community Rural Hospital MOH 0 1 100.0% 0 7 100.0% 0 1 100.0%Kabudula Hosp Central West Lilongwe Community Rural Hospital MOH 0 1 100.0% 2 13 84.6% 0 4 100.0%Kaluluma Hosp Central East Kasungu Community Rural Hospital MOH 0 1 100.0% 0 6 100.0% 0 2 100.0%Kaporo Hosp North Karonga Community Rural Hospital MOH 0 1 100.0% 1 6 83.3% 0 2 100.0%Kaseye Hosp North Chitipa Community Rural Hospital CHAM 0 1 100.0% 0 4 100.0% 0 1 100.0%Katete Hosp North Mzimba Community Rural Hospital CHAM 0 1 100.0% 1 6 83.3% 6 2 4 EXCESSKatowo Hosp North Rumphi Community Rural Hospital MOH 0 1 100.0% 0 15 100.0% 0 1 100.0%Kochil ira Hosp Central West Mchinji Community Rural Hospital MOH 0 1 100.0% 0 8 100.0% 0 2 100.0%Likuni Hosp Central West Lilongwe Community Rural Hospital CHAM 3 1 2 EXCESS 4 23 82.6% 10 7 3 EXCESSMadisi Hosp Central East Dowa Community Rural Hospital CHAM 1 1 0.0% 8 17 52.9% 9 7 2 EXCESSMalamulo Hosp South West Thyolo Community Rural Hospital CHAM 2 1 1 EXCESS 5 16 68.8% 14 4 10 EXCESSMangochi Hosp South East Mangochi Community Rural Hospital MOH 0 1 100.0% 0 50 100.0% 0 16 100.0%Mhuju Hosp North Rumphi Community Rural Hospital MOH 0 1 100.0% 0 5 100.0% 0 1 100.0%Mitundu Hosp Central West Lilongwe Community Rural Hospital MOH 0 1 100.0% 3 19 84.2% 0 5 100.0%Mlale Hosp Central West Lilongwe Community Rural Hospital CHAM 0 1 100.0% 3 19 84.2% 8 3 5 EXCESSMlambe Hosp South West Blantyre Community Rural Hospital CHAM 0 1 100.0% 0 27 100.0% 0 7 100.0%Monkey-Bay HC South East Mangochi Community Rural Hospital MOH 0 1 100.0% 0 16 100.0% 0 4 100.0%Mponela Hosp Central East Dowa Community Rural Hospital MOH 0 1 100.0% 1 21 95.2% 0 5 100.0%Mtengowanthenga Hosp Central East Dowa Community Rural Hospital CHAM 1 1 0.0% 3 23 87.0% 8 8 0.0%Mua Hosp Central West Dedza Community Rural Hospital CHAM 1 1 0.0% 9 40 77.5% 15 6 9 EXCESSMulanje Mission Hosp South East Mulanje Community Rural Hospital CHAM 1 1 0.0% 0 88 100.0% 18 7 11 EXCESSMzambazi Hosp North Mzimba Community Rural Hospital CHAM 0 1 100.0% 1 6 83.3% 3 3 0.0%Ngabu Hosp South West Chikwawa Community Rural Hospital MOH 0 1 100.0% 0 9 100.0% 0 2 100.0%Nguludi Hosp South West Chiradzulu Community Rural Hospital CHAM 0 1 100.0% 0 12 100.0% 0 4 100.0%Nkhamenya Hosp Central East Kasungu Community Rural Hospital CHAM 1 1 0.0% 3 36 91.7% 6 3 3 EXCESSNkhoma Hosp Central West Lilongwe Community Rural Hospital CHAM 0 1 100.0% 7 80 91.3% 17 10 7 EXCESSPhalombe Mission Hsp South East Phalombe Community Rural Hospital CHAM 0 1 100.0% 0 20 100.0% 0 5 100.0%St Annes Hosp Central East Nkhotakota Community Rural Hospital CHAM 1 1 0.0% 13 5 8 EXCESS 21 1 20 EXCESSSt Gabriels Hosp Central West Lilongwe Community Rural Hospital CHAM 4 1 3 EXCESS 4 63 93.7% 11 11 0.0%

Medical Officer Clinical Officer Nursing Officer


Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancySt Johns Mzuzu Hosp North Mzimba Community Rural Hospital CHAM 2 1 1 EXCESS 6 10 40.0% 17 3 14 EXCESSSt Lukes Hosp South East Zomba Community Rural Hospital CHAM 1 1 0.0% 10 11 9.1% 8 4 4 EXCESSSt Martin Hosp South East Mangochi Community Rural Hospital CHAM 0 1 100.0% 2 5 60.0% 1 1 0.0%St Montfort Hosp South West Chikwawa Community Rural Hospital CHAM 1 1 0.0% 5 10 50.0% 13 4 9 EXCESSSt Peters Hosp North Nkhata Bay Community Rural Hospital CHAM 0 1 100.0% 2 4 50.0% 0 1 100.0%Thekerani Hosp South West Thyolo Community Rural Hospital MOH 0 1 100.0% 0 8 100.0% 0 1 100.0%Trinity - Fatima Hos South West Nsanje Community Rural Hospital CHAM 2 1 1 EXCESS 6 15 60.0% 12 6 6 EXCESSChikwawa Hosp South West Chikwawa District Hospital MOH 0 20 100.0% 0 49 100.0% 0 60 100.0%Chiradzulu Hosp South West Chiradzulu District Hospital MOH 0 8 100.0% 0 31 100.0% 0 28 100.0%Chitipa Hosp North Chitipa District Hospital MOH 0 9 100.0% 0 27 100.0% 0 30 100.0%Dedza Hosp Central West Dedza District Hospital MOH 0 7 100.0% 0 42 100.0% 0 29 100.0%Dowa Hosp Central East Dowa District Hospital MOH 0 5 100.0% 0 33 100.0% 0 18 100.0%Karonga Hosp North Karonga District Hospital MOH 0 5 100.0% 0 21 100.0% 0 19 100.0%Kasungu Hosp Central East Kasungu District Hospital MOH 0 9 100.0% 0 63 100.0% 0 47 100.0%Machinga Hosp South East Machinga District Hospital MOH 0 16 100.0% 0 52 100.0% 0 52 100.0%Mchinji Hosp Central West Mchinji District Hospital MOH 0 6 100.0% 0 31 100.0% 0 24 100.0%Mulanje Hosp South East Mulanje District Hospital MOH 0 7 100.0% 9 44 79.5% 1 30 96.7%Mwanza Hosp South West Mwanza District Hospital MOH 0 5 100.0% 0 33 100.0% 0 22 100.0%Mzimba Hosp North Mzimba District Hospital MOH 0 9 100.0% 0 35 100.0% 0 32 100.0%Neno Hosp South West Neno District Hospital MOH 0 2 100.0% 0 16 100.0% 0 7 100.0%Nkhata Bay Hosp North Nkhata Bay District Hospital MOH 0 3 100.0% 0 22 100.0% 0 14 100.0%Nkhotakota Hosp Central East Nkhotakota District Hospital MOH 0 4 100.0% 0 36 100.0% 0 16 100.0%Nsanje Hosp South West Nsanje District Hospital MOH 0 4 100.0% 0 25 100.0% 0 15 100.0%Ntcheu Hosp Central West Ntcheu District Hospital MOH 0 12 100.0% 0 49 100.0% 0 40 100.0%Ntchisi Hosp Central East Ntchisi District Hospital MOH 0 8 100.0% 0 36 100.0% 0 29 100.0%Rumphi Hosp North Rumphi District Hospital MOH 0 7 100.0% 0 152 100.0% 0 24 100.0%Salima Hosp Central East Salima District Hospital MOH 0 12 100.0% 0 48 100.0% 0 39 100.0%Thyolo Hosp South West Thyolo District Hospital MOH 0 14 100.0% 0 72 100.0% 0 52 100.0%Balaka District Health Office South East Balaka District Hospital_NA MOH 1 12 11Blantyre District Health Office South West Blantyre District Hospital_NA MOH 4 1 2Chikwawa District Health Office South West Chikwawa District Hospital_NA MOH 3 17 6Chiradzulu District Health Office South West Chiradzulu District Hospital_NA MOH 0 15 11Chitipa District Health Office North Chitipa District Hospital_NA MOH 1 10 12Dedza District Health Office Central West Dedza District Hospital_NA MOH 1 26 15Dowa District Health Office Central East Dowa District Hospital_NA MOH 0 9 8Global Fund HSAs Central West Mchinji District Hospital_NA MOH 0 0 0Karonga District Health Office North Karonga District Hospital_NA MOH 0 15 9Kasungu District Health Office Central East Kasungu District Hospital_NA MOH 0 15 8Lilongwe District Health Office Central West Lilongwe District Hospital_NA MOH 3 11 10Machinga District Health Office South East Machinga District Hospital_NA MOH 1 12 7Mangochi District Health Office South East Mangochi District Hospital_NA MOH 0 22 13Mchinji District Health Office Central West Mchinji District Hospital_NA MOH 3 20 13Mulanje District Health Office South East Mulanje District Hospital_NA MOH 0 17 12Mwanza District Health Office South West Mwanza District Hospital_NA MOH 0 10 3Mzimba District Health Office North Mzimba District Hospital_NA MOH 1 21 5



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyNeno District Health Office South West Neno District Hospital_NA MOH 0 8 7Nkhata Bay District Health Office North Nkhata Bay District Hospital_NA MOH 1 15 10Nkhotakota District Health Office Central East Nkhotakota District Hospital_NA MOH 0 15 11Nsanje District Health Office South West Nsanje District Hospital_NA MOH 0 8 8Ntcheu District Health Office Central West Ntcheu District Hospital_NA MOH 0 17 12Ntchisi District Health Office Central East Ntchisi District Hospital_NA MOH 0 14 9Phalombe District Health Office South East Phalombe District Hospital_NA MOH 0 3 4Rumphi District Health Office North Rumphi District Hospital_NA MOH 0 12 6Salima District Health Office Central East Salima District Hospital_NA MOH 0 20 10Thyolo District Health Office South West Thyolo District Hospital_NA MOH 2 19 14Zomba District Health Office South East Zomba District Hospital_NA MOH 1 5 9Bembeke HC Central West Dedza Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ABenga HC Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABilira HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABimbi HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABiriwiri HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABolero HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABondo HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABowe HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABua HC (Kasungu) Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABula HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABulala HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABvumbwe Research HC South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABvumbwe-Makungwa HC South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABwanje HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ABwengu HC Central West Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChabvala HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChadza HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChakhaza HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChambe HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChambo HC North Chitipa Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChang'Ambika HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChangata HC South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChankhungu HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChapananga HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChesamu HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChididi HC (Nkhota) Central East Nkhotakota Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChididi HC (Nsanje) South West Nsanje Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChifunga HC South West Neno Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChigodi HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChikande HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChikowa HC (Blant) South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChikowa HC (Lilong) Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChikuse HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChikweo HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyChikwina HC North Nkhata Bay Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChilambwe HC North Nkhata Bay Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChileka HC (Lilong) Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChileka HC HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChileka Sda HC South West Blantyre Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChilipa HC (Mango) South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChilipa HC (Zomba) South East Zomba Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSChilobwe Majiga HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChimaliro HC South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChimbalanga HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChimembe HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChimoto HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChimvu HC South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChingale HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChingazi HC South West Thyolo Health Center CHAM 0 0 N/A 2 0 2 EXCESS 1 0 1 EXCESSChinguluwe HC (Ntch) Central East Ntchisi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChinguluwe HC (Sali) Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChinkhwiri HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChinthembwe HC Central East Ntchisi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChinyama HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChioshya HC Central West Mchinji Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChipho HC South West Thyolo Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSChipini HC South East Zomba Health Center CHAM 0 0 N/A 1 0 1 EXCESS 2 0 2 EXCESSChipoka HC Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChiponde HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChipumi HC Central West Mchinji Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChipwaila HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChipwanya HC Central West Dedza Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChisala HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChisepo HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChisinga HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChisitu HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChitala HC Central East Salima Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AChitedze HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChitekesa HC South East Phalombe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChitera HC South West Chiradzulu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChitheka HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChitimba HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChitowo HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChitsimuka HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChiumbangame HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChiunda Health Cent South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChiunjiza HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChiwamba HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChiwe HC Central West Lilongwe Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyChiyendausiku HC South East Balaka Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChizolowondo HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChoma HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChonde HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChulu HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ADiamphwe HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ADolo HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ADwangwa Clinic Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ADwangwa HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ADzeleka Ref Camp HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ADzindevu HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ADzoole HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AEmfeni HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AEmsizini HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AEndindeni HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AEnukweni HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AFulirwa HC North Karonga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AGaga HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AGawanani HC South East Machinga Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/Agogo South East Phalombe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AGogode HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AGolomoti HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AGowa HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AGuilleme HC Central West Mchinji Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AHallena Oakely HC South West Thyolo Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AHoho HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AIba Health Cent South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AIfumbo HC North Chitipa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AIponga HC North Karonga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AJalasi HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AJalawe HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AJenda HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKabuwa HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKabwafu HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKachale HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKachere HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKadango Health Cent South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKafele HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKafukule HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKaigwazanga HC Central West Mchinji Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKakoma HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKalemba HC South West Nsanje Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKalikumbi HC North Mzimba Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKalulu HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKambenje HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyKamboni HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKameme HC North Chitipa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKamsonga HC Central East Ntchisi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKamteteka HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKamwe HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKande HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKangolwa HC Central East Ntchisi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKang'Oma HC Central West Lilongwe Health Center MOH 0 0 N/A 1 0 1 EXCESS 0 0 N/AKankao HC South East Balaka Health Center CHAM 0 0 N/A 0 0 N/A 2 0 2 EXCESSKanyama HC Central West Dedza Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSKanyezi HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKapanga HC Central West Mchinji Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKapelula HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKapenda HC North Chitipa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKapeni HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKaphatenga HC Central East Salima Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKaphuka HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKapichila HC South West Chikwawa Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKapili HC Central East Nkhotakota Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKapire HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKapiri HC Central West Mchinji Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSKasina HC Central West Dedza Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSKasinje HC Central West Ntcheu Health Center MOH 0 0 N/A 1 0 1 EXCESS 0 0 N/AKasoba HC North Karonga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKatema HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKatimbila HC Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKatsekera HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKatuli HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKaundu HC Central West Dedza Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSKawamba HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKayembe HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKhola HC Central East Kasungu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKhombedza HC Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKhondowe HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKhongoni HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKhonjeni HC South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKhosolo HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKhuwi HC Central East Ntchisi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKoche HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSKTFT HC Central East Kasungu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AKunenekude HC South West Mwanza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AKwitanda HC South East Balaka Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALakeview HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALambulira HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALemwe HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyLifuwu HC Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALikangala HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALinyangwa HC Central East Kasungu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALirangwe HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALisungwi HC South West Neno Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALiuzi HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALiwaladzi HC Central East Nkhotakota Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALizulu HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALobi HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALudzi St Josephs HC Central West Mchinji Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALugola HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALujeri HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALulanga HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALulwe HC South West Nsanje Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALumbadzi HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALundu HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALungwena HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALunjika HC North Mzimba Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALura HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALuwalika HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ALuwani HC South West Neno Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALuwawa HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALuwerezi HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ALuwuchi HC North Rumphi Health Center CHAM 0 0 N/A 1 0 1 EXCESS 1 0 1 EXCESSLuzi HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMabili HC North Mzimba Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMachinga HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMachinjiri HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMadede HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMadziabango HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMaganga HC Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMagareta HC South West Neno Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMagomero HC South East Zomba Health Center CHAM 0 0 N/A 0 0 N/A 2 0 2 EXCESSMakanjira HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMakapwa HC South West Thyolo Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMakhanga HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMakhwira HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMakiyoni HC Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMakwapala HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMalembo HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMalidadi HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMalingunde HC Central West Lilongwe Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSMalombe Health Cent South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMalomo HC Central East Ntchisi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMangamba HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyMangunda HC South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AManyamula HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMaonde HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMaperera HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMase HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMasenjere HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMatanda HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMatandani HC South West Neno Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMatiki HC Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMatiya HC South East Zomba Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMatope HC South West Neno Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMatumba HC Central West Dedza Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMauwa HC South West Chiradzulu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMayaka HC South East Zomba Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMayani HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbabvi HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbalachanda HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbang'ombe 1 HC Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbang'ombe 2 HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbenje HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbera HC South East Balaka Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbingwa HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbiza HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMbwatalika HC Central West Lilongwe Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMchoka HC Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMdeka HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMfera HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMhalaunda HC North Mzimba Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMidzemba HC South West Neno Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMigowi HC South East Phalombe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMikolongwe HC South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMikundi HC Central West Mchinji Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMilepa HC South West Chiradzulu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMilonde HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMing'Ongo HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMisomali HC South West Chikwawa Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSMisuku HC North Chitipa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMkanda HC Central West Mchinji Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMkepere HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMkhota R Growth HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMkhuzi HC Central East Ntchisi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMkhwayi HC South East Phalombe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMkoma HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMkomaula HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMkumaniza HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyMkumba HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMlanda HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMlangeni HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMlowe HC North Rumphi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AM'mambo HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMpala HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMpamba HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMpasa HC South East Phalombe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMpata HC North Karonga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMpemba HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMphathi HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMpherembe HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMphopha HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMphunzi HC Central West Dedza Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMpiri HC South East Machinga Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMpondas HC South East Mangochi Health Center CHAM 0 0 N/A 1 0 1 EXCESS 0 0 N/AMposa HC South East Machinga Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMsakambewa HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMsenjere HC Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMsese HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMtakataka HC Central West Dedza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMtakataka Police Central East Salima Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMtende HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMtendere HC Central West Dedza Health Center CHAM 0 0 N/A 4 0 4 EXCESS 2 0 2 EXCESSMtenthera HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMtimabii Health Cent South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMtonda HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMtosa HC Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMtunthama HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMtwalo HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMulomba HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMuloza HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMvera Mission HC Central East Dowa Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AMwanga HC South East Phalombe Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSMwansambo HC Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMwazisi HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMzalangwe HC North Mzimba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMzandu HC Central East Ntchisi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMzenga HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AMzokoto HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANaisi HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANakalanzi HC Central West Dedza Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANamadzi HC South West Chiradzulu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANamalaka HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANamandanje HC South East Machinga Health Center CHAM 0 0 N/A 1 0 1 EXCESS 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyNamanja HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANamanolo HC South East Balaka Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANamasalima HC (Mula) South East Mulanje Health Center CHAM 0 0 N/A 1 0 1 EXCESS 0 0 N/ANamasalima HC (Zom) South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 1 0 1 EXCESSNambazo HC South East Phalombe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANambuma HC Central West Lilongwe Health Center CHAM 0 0 N/A 0 0 N/A 2 0 2 EXCESSNamikango HC South East Zomba Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANamitambo HC South West Chiradzulu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANamphungo HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANamulenga HC South East Mulanje Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSNamwera HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANangalamu HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANankhwali HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANankumba HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANaphimba Hc South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANasawa HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANathenje HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANayinunje HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANayuchi HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANdakwela HC South West Chikwawa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANdamera HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANdaula HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANdunde HC South West Chiradzulu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANeno Parish HC South West Neno Health Center CHAM 0 0 N/A 1 0 1 EXCESS 0 0 N/ANewa / Mpasazi HC Central East Kasungu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANgala HC Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANgana HC North Karonga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANgapani Health Cent South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANgodzi HC Central East Salima Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANgokwe HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANg'onga HC North Rumphi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANgwelero HC South East Zomba Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANjuyu HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANkalo HC South West Chiradzulu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANkasala HC South East Zomba Health Center CHAM 0 0 N/A 1 0 1 EXCESS 0 0 N/ANkhorongo HC North Mzimba N Health Center CHAM 0 0 N/A 1 0 1 EXCESS 1 0 1 EXCESSNkhulambe HC South East Phalombe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANkhunga HC Central East Nkhotakota Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANkhuyukuyu HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANkhwazi HC Central West Mchinji Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANkope HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSNkula HC South West Neno Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANsambe Sda HC South West Neno Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANsanama HC South East Machinga Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANsaru HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyNsipe HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANsiyaludzu HC Central West Ntcheu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANtaja HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANthalire HC North Chitipa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANtholowa HC North Machinga Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ANthondo HC (Lilong) South East Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANthondo HC (Ntchisi) Central East Ntchisi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANthungwa HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANyambi HC South East Machinga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANyamithuthu HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANyungwe HC North Karonga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ANzama HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AOfesi HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AOld Maula Court HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/APhalula HC South East Balaka Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/APhimbi HC South East Balaka Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/APhiri longwe HC South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/APhokera HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/APim HC South West Chiradzulu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/APirimiti HC South East Zomba Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASangilo HC North Karonga Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASankhulani HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ASanthe HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ASenzani HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASimlemba HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ASinyala Health Cent South East Mangochi Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ASister Teleza HC Central West Ntcheu Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASorgin HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ASouth Lunzu HC HC South West Blantyre Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ASt Annes HC North Karonga Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASt Josephs HC South West Thyolo Health Center CHAM 0 0 N/A 1 0 1 EXCESS 0 0 N/ASt Marthas HC South East Mangochi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASt Martins Molere HC South West Thyolo Health Center CHAM 0 0 N/A 0 0 N/A 2 0 2 EXCESSSt Marys HC North Nkhata Bay Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASt Patricks HC North Rumphi Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASucoma HC South West Chikwawa Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ASukasanje HC South East Phalombe Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/ATembwe HC Central West Mchinji Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ATengani HC South West Nsanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AThambani HC South West Mwanza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AThavite HC Central East Salima Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AThomas HC South West Thyolo Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AThonje HC Central East Dowa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AThuchila HC South East Mulanje Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AThumbwe HC South West Chiradzulu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current Optimal % VacancyThunduwike HC North Mzimba N Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/ATulonkhondo HC South West Mwanza Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AUkwe HC Central West Lilongwe Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AUlongwe HC South East Balaka Health Center CHAM 0 0 N/A 0 0 N/A 1 0 1 EXCESSUsisya HC North Nkhata Bay Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AUtale 1 HC South East Balaka Health Center CHAM 0 0 N/A 0 0 N/A 0 0 N/AUtale 2 HC South West Balaka Health Center CHAM 0 0 N/A 1 0 1 EXCESS 0 0 N/AWenya HC North Chitipa Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AWiliro HC North Karonga Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AWimbe HC Central East Kasungu Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AZoa Health Centre South West Thyolo Health Center MOH 0 0 N/A 0 0 N/A 0 0 N/AChiringa Mat Mat South East Phalombe Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/AChithumba Mat South West Chikwawa Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/ADzenje Mat South East Mulanje Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/AGanya Mat Central West Ntcheu Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/AGombe Mat North Rumphi Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/AKampanje Mat Central West Ntcheu Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/AManjawira Mat Central East Dowa Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/AMapanga Mat Central East Nkhotakota Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/AMganja Mat Central West Dedza Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/ANkhataombere Mat North Nkhata Bay Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/ASharpevale Mat Central West Ntcheu Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/ATsoyo Mat Central West Lilongwe Maternity CHAM 0 0 N/A 0 0 N/A 0 0 N/AArea 18 HC Central West Lilongwe Urban Health Center MOH 0 0 N/A 2 39 94.9% 0 0 N/AArea 25 HC Central West Lilongwe Urban Health Center MOH 0 0 N/A 0 25 100.0% 0 0 N/ABangwe HC South West Blantyre Urban Health Center MOH 0 0 N/A 0 20 100.0% 0 0 N/AChilomoni HC South West Blantyre Urban Health Center MOH 0 0 N/A 2 18 88.9% 0 0 N/ADzenza HC Central West Lilongwe Urban Health Center CHAM 0 0 N/A 0 5 100.0% 2 0 2 EXCESSKawale HC Central West Lilongwe Urban Health Center MOH 0 0 N/A 2 24 91.7% 0 0 N/ALimbe HC South West Blantyre Urban Health Center MOH 0 0 N/A 0 20 100.0% 0 0 N/AMatawale HC South East Zomba Urban Health Center MOH 0 0 N/A 0 13 100.0% 0 0 N/AMzuzu Urban HC North Mzimba Urban Health Center MOH 0 0 N/A 0 21 100.0% 0 0 N/ANdirande HC South West Blantyre Urban Health Center MOH 0 0 N/A 2 30 93.3% 0 0 N/ASoche Mat Mat South West Blantyre Urban Health Center CHAM 0 0 N/A 0 7 100.0% 0 0 N/AZingwangwa HC South West Blantyre Urban Health Center MOH 0 0 N/A 1 22 95.5% 0 0 N/A



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalKamuzu Central Hosp Central West Lilongwe Central Hospital MOH 193 150 43 EXCESS 1 0 1 EXCESS 0 0Mzuzu Central Hosp North Lilongwe Central Hospital MOH 81 91 11.0% 1 0 1 EXCESS 0 0Queen Elizabeth Hosp South West Blantyre Central Hospital MOH 95 326 70.9% 6 0 6 EXCESS 0 0Zomba Central Hosp South East Zomba Central Hospital MOH 108 151 28.5% 1 0 1 EXCESS 0 0Alinafe Hosp Central East Nkhotakota Community Rural Hospital CHAM 10 8 2 EXCESS 4 4 0.0% 0 14Atupele CH North Karonga Community Rural Hospital CHAM 0 4 100.0% 0 1 100.0% 0 2Bwaila Hosp Central West Lilongwe Community Rural Hospital MOH 0 89 100.0% 0 24 100.0% 0 101Chilumba Hosp North Karonga Community Rural Hospital MOH 8 8 0.0% 1 4 75.0% 0 11Chintheche Hosp North Nkhata Bay Community Rural Hospital MOH 0 12 100.0% 0 8 100.0% 0 24Cobbe Hosp South East Zomba Community Rural Hospital MOH 0 2 100.0% 0 3 100.0% 0 8DGM Livingstonia Hsp North Rumphi Community Rural Hospital CHAM 0 21 100.0% 0 7 100.0% 0 8Domasi Hosp South East Zomba Community Rural Hospital MOH 0 9 100.0% 0 8 100.0% 0 20Dwambazi RH Central East Nkhotakota Community Rural Hospital MOH 0 6 100.0% 0 4 100.0% 0 11Edingeni Hosp North Mzimba Community Rural Hospital MOH 0 4 100.0% 0 2 100.0% 0 7Ekwendeni Hosp North Mzimba Community Rural Hospital CHAM 39 33 6 EXCESS 3 5 40.0% 0 20Embangweni Hosp North Mzimba Community Rural Hospital CHAM 8 16 50.0% 7 4 3 EXCESS 0 11Euthini Hosp North Mzimba Community Rural Hospital MOH 0 6 100.0% 0 4 100.0% 0 11Kabudula Hosp Central West Lilongwe Community Rural Hospital MOH 13 21 38.1% 4 5 20.0% 0 18Kaluluma Hosp Central East Kasungu Community Rural Hospital MOH 2 9 77.8% 1 6 83.3% 0 18Kaporo Hosp North Karonga Community Rural Hospital MOH 1 8 87.5% 0 6 100.0% 0 19Kaseye Hosp North Chitipa Community Rural Hospital CHAM 5 4 1 EXCESS 0 3 100.0% 0 7Katete Hosp North Mzimba Community Rural Hospital CHAM 2 6 66.7% 2 2 0.0% 0 7Katowo Hosp North Rumphi Community Rural Hospital MOH 0 8 100.0% 0 5 100.0% 0 10Kochil ira Hosp Central West Mchinji Community Rural Hospital MOH 0 10 100.0% 0 7 100.0% 0 22Likuni Hosp Central West Lilongwe Community Rural Hospital CHAM 39 41 4.9% 4 5 20.0% 0 21Madisi Hosp Central East Dowa Community Rural Hospital CHAM 16 30 46.7% 8 5 3 EXCESS 0 16Malamulo Hosp South West Thyolo Community Rural Hospital CHAM 28 32 12.5% 3 3 0.0% 0 13Mangochi Hosp South East Mangochi Community Rural Hospital MOH 0 77 100.0% 0 22 100.0% 0 75Mhuju Hosp North Rumphi Community Rural Hospital MOH 0 5 100.0% 0 4 100.0% 0 12Mitundu Hosp Central West Lilongwe Community Rural Hospital MOH 16 36 55.6% 4 9 55.6% 0 33Mlale Hosp Central West Lilongwe Community Rural Hospital CHAM 7 15 53.3% 2 6 66.7% 0 13Mlambe Hosp South West Blantyre Community Rural Hospital CHAM 0 35 100.0% 0 9 100.0% 0 28Monkey-Bay HC South East Mangochi Community Rural Hospital MOH 2 16 87.5% 0 10 100.0% 0 32Mponela Hosp Central East Dowa Community Rural Hospital MOH 18 29 37.9% 2 15 86.7% 0 50Mtengowanthenga Hosp Central East Dowa Community Rural Hospital CHAM 11 39 71.8% 0 6 100.0% 0 22Mua Hosp Central West Dedza Community Rural Hospital CHAM 16 22 27.3% 8 9 11.1% 0 11Mulanje Mission Hosp South East Mulanje Community Rural Hospital CHAM 40 46 13.0% 5 20 75.0% 0 28Mzambazi Hosp North Mzimba Community Rural Hospital CHAM 7 10 30.0% 1 3 66.7% 0 8Ngabu Hosp South West Chikwawa Community Rural Hospital MOH 4 17 76.5% 0 6 100.0% 0 21Nguludi Hosp South West Chiradzulu Community Rural Hospital CHAM 0 18 100.0% 0 4 100.0% 0 12Nkhamenya Hosp Central East Kasungu Community Rural Hospital CHAM 4 15 73.3% 0 8 100.0% 0 9Nkhoma Hosp Central West Lilongwe Community Rural Hospital CHAM 23 60 61.7% 7 16 56.3% 0 22Phalombe Mission Hsp South East Phalombe Community Rural Hospital CHAM 5 34 85.3% 1 3 66.7% 0 8St Annes Hosp Central East Nkhotakota Community Rural Hospital CHAM 26 6 20 EXCESS 4 2 2 EXCESS 0 5St Gabriels Hosp Central West Lilongwe Community Rural Hospital CHAM 15 53 71.7% 3 11 72.7% 0 16

Nurse Midwife Technician Medical Assistant Health Surveillance As


Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalSt Johns Mzuzu Hosp North Mzimba Community Rural Hospital CHAM 20 14 6 EXCESS 3 3 0.0% 0 9St Lukes Hosp South East Zomba Community Rural Hospital CHAM 27 17 10 EXCESS 6 3 3 EXCESS 0 9St Martin Hosp South East Mangochi Community Rural Hospital CHAM 18 7 11 EXCESS 5 2 3 EXCESS 0 6St Montfort Hosp South West Chikwawa Community Rural Hospital CHAM 16 15 1 EXCESS 4 3 1 EXCESS 0 11St Peters Hosp North Nkhata Bay Community Rural Hospital CHAM 11 5 6 EXCESS 1 4 75.0% 0 13Thekerani Hosp South West Thyolo Community Rural Hospital MOH 0 10 100.0% 0 6 100.0% 0 19Trinity - Fatima Hos South West Nsanje Community Rural Hospital CHAM 8 22 63.6% 3 6 50.0% 0 19Chikwawa Hosp South West Chikwawa District Hospital MOH 0 61 100.0% 0 8 100.0% 0 69Chiradzulu Hosp South West Chiradzulu District Hospital MOH 0 35 100.0% 0 9 100.0% 0 57Chitipa Hosp North Chitipa District Hospital MOH 0 38 100.0% 0 9 100.0% 0 54Dedza Hosp Central West Dedza District Hospital MOH 0 68 100.0% 0 17 100.0% 0 100Dowa Hosp Central East Dowa District Hospital MOH 0 29 100.0% 0 15 100.0% 0 107Karonga Hosp North Karonga District Hospital MOH 0 26 100.0% 0 5 100.0% 0 43Kasungu Hosp Central East Kasungu District Hospital MOH 0 57 100.0% 0 25 100.0% 0 170Machinga Hosp South East Machinga District Hospital MOH 0 59 100.0% 0 14 100.0% 0 102Mchinji Hosp Central West Mchinji District Hospital MOH 0 37 100.0% 0 8 100.0% 0 58Mulanje Hosp South East Mulanje District Hospital MOH 0 42 100.0% 0 13 100.0% 0 84Mwanza Hosp South West Mwanza District Hospital MOH 6 32 81.3% 0 12 100.0% 39 79Mzimba Hosp North Mzimba District Hospital MOH 0 42 100.0% 0 13 100.0% 0 89Neno Hosp South West Neno District Hospital MOH 0 13 100.0% 0 7 100.0% 1 47Nkhata Bay Hosp North Nkhata Bay District Hospital MOH 0 19 100.0% 0 9 100.0% 0 55Nkhotakota Hosp Central East Nkhotakota District Hospital MOH 0 27 100.0% 0 16 100.0% 0 101Nsanje Hosp South West Nsanje District Hospital MOH 0 24 100.0% 0 9 100.0% 0 64Ntcheu Hosp Central West Ntcheu District Hospital MOH 0 51 100.0% 0 12 100.0% 0 91Ntchisi Hosp Central East Ntchisi District Hospital MOH 0 35 100.0% 0 13 100.0% 0 85Rumphi Hosp North Rumphi District Hospital MOH 0 47 100.0% 0 26 100.0% 0 207Salima Hosp Central East Salima District Hospital MOH 0 51 100.0% 0 16 100.0% 0 121Thyolo Hosp South West Thyolo District Hospital MOH 0 75 100.0% 0 20 100.0% 0 198Balaka District Health Office South East Balaka District Hospital_NA MOH 36 13 277Blantyre District Health Office South West Blantyre District Hospital_NA MOH 5 1 605Chikwawa District Health Office South West Chikwawa District Hospital_NA MOH 58 24 339Chiradzulu District Health Office South West Chiradzulu District Hospital_NA MOH 36 14 254Chitipa District Health Office North Chitipa District Hospital_NA MOH 21 10 96Dedza District Health Office Central West Dedza District Hospital_NA MOH 37 4 520Dowa District Health Office Central East Dowa District Hospital_NA MOH 34 12 443Global Fund HSAs Central West Mchinji District Hospital_NA MOH 0 0 139Karonga District Health Office North Karonga District Hospital_NA MOH 44 15 195Kasungu District Health Office Central East Kasungu District Hospital_NA MOH 31 7 548Lilongwe District Health Office Central West Lilongwe District Hospital_NA MOH 33 6 1119Machinga District Health Office South East Machinga District Hospital_NA MOH 46 6 354Mangochi District Health Office South East Mangochi District Hospital_NA MOH 65 8 206Mchinji District Health Office Central West Mchinji District Hospital_NA MOH 50 21 346Mulanje District Health Office South East Mulanje District Hospital_NA MOH 57 26 214Mwanza District Health Office South West Mwanza District Hospital_NA MOH 4 14 81Mzimba District Health Office North Mzimba District Hospital_NA MOH 48 34 650



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalNeno District Health Office South West Neno District Hospital_NA MOH 15 8 76Nkhata Bay District Health Office North Nkhata Bay District Hospital_NA MOH 45 24 181Nkhotakota District Health Office Central East Nkhotakota District Hospital_NA MOH 62 23 110Nsanje District Health Office South West Nsanje District Hospital_NA MOH 47 20 196Ntcheu District Health Office Central West Ntcheu District Hospital_NA MOH 60 23 414Ntchisi District Health Office Central East Ntchisi District Hospital_NA MOH 41 20 198Phalombe District Health Office South East Phalombe District Hospital_NA MOH 27 14 140Rumphi District Health Office North Rumphi District Hospital_NA MOH 36 20 164Salima District Health Office Central East Salima District Hospital_NA MOH 43 11 336Thyolo District Health Office South West Thyolo District Hospital_NA MOH 55 9 528Zomba District Health Office South East Zomba District Hospital_NA MOH 58 22 658Bembeke HC Central West Dedza Health Center CHAM 5 5 0.0% 1 5 80.0% 0 59Benga HC Central East Nkhotakota Health Center MOH 0 3 100.0% 0 2 100.0% 0 25Bilira HC Central West Ntcheu Health Center MOH 0 8 100.0% 0 5 100.0% 0 55Bimbi HC South East Zomba Health Center MOH 0 7 100.0% 0 5 100.0% 0 54Biriwiri HC Central West Ntcheu Health Center MOH 0 6 100.0% 0 4 100.0% 0 44Bolero HC North Rumphi Health Center MOH 0 11 100.0% 0 8 100.0% 0 62Bondo HC South East Mulanje Health Center MOH 0 4 100.0% 0 4 100.0% 0 41Bowe HC Central East Dowa Health Center MOH 2 6 66.7% 1 4 75.0% 0 41Bua HC (Kasungu) Central East Kasungu Health Center MOH 1 4 75.0% 1 3 66.7% 0 29Bula HC North Nkhata Bay Health Center MOH 0 2 100.0% 0 2 100.0% 0 14Bulala HC North Mzimba Health Center MOH 0 4 100.0% 0 2 100.0% 0 26Bvumbwe Research HC South West Thyolo Health Center MOH 0 22 100.0% 0 26 100.0% 0 96Bvumbwe-Makungwa HC South West Thyolo Health Center MOH 0 8 100.0% 0 5 100.0% 0 56Bwanje HC Central West Ntcheu Health Center MOH 0 7 100.0% 0 4 100.0% 0 46Bwengu HC Central West Mzimba N Health Center MOH 0 3 100.0% 0 2 100.0% 0 26Chabvala HC South West Blantyre Health Center MOH 0 8 100.0% 0 3 100.0% 0 30Chadza HC Central West Lilongwe Health Center MOH 3 7 57.1% 1 5 80.0% 0 68Chakhaza HC Central East Dowa Health Center MOH 0 4 100.0% 0 3 100.0% 0 39Chambe HC South East Mulanje Health Center MOH 0 10 100.0% 0 5 100.0% 0 66Chambo HC North Chitipa Health Center CHAM 0 4 100.0% 0 2 100.0% 0 24Chang'Ambika HC South West Chikwawa Health Center MOH 0 1 100.0% 0 1 100.0% 0 9Changata HC South West Thyolo Health Center MOH 3 7 57.1% 1 5 80.0% 0 50Chankhungu HC Central East Dowa Health Center MOH 0 10 100.0% 0 7 100.0% 0 73Chapananga HC South West Chikwawa Health Center MOH 2 4 50.0% 2 3 33.3% 0 31Chesamu HC North Nkhata Bay Health Center MOH 0 1 100.0% 0 1 100.0% 0 6Chididi HC (Nkhota) Central East Nkhotakota Health Center CHAM 2 2 0.0% 3 1 2 EXCESS 0 9Chididi HC (Nsanje) South West Nsanje Health Center CHAM 1 2 50.0% 2 1 1 EXCESS 0 9Chifunga HC South West Neno Health Center MOH 0 4 100.0% 0 5 100.0% 0 55Chigodi HC Central West Ntcheu Health Center CHAM 1 2 50.0% 0 2 100.0% 0 12Chikande HC Central West Ntcheu Health Center MOH 0 5 100.0% 0 4 100.0% 0 43Chikowa HC (Blant) South West Blantyre Health Center MOH 0 6 100.0% 0 3 100.0% 0 36Chikowa HC (Lilong) Central West Lilongwe Health Center MOH 3 6 50.0% 2 5 60.0% 0 53Chikuse HC Central West Dedza Health Center MOH 1 8 87.5% 1 7 85.7% 0 83Chikweo HC South East Machinga Health Center MOH 2 12 83.3% 1 10 90.0% 0 91



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalChikwina HC North Nkhata Bay Health Center CHAM 0 2 100.0% 0 2 100.0% 0 23Chilambwe HC North Nkhata Bay Health Center CHAM 1 2 50.0% 1 1 0.0% 0 12Chileka HC (Lilong) Central West Lilongwe Health Center MOH 0 11 100.0% 0 7 100.0% 0 80Chileka HC HC South West Blantyre Health Center MOH 10 13 23.1% 5 13 61.5% 0 195Chileka Sda HC South West Blantyre Health Center CHAM 4 4 0.0% 1 2 50.0% 0 15Chilipa HC (Mango) South East Mangochi Health Center MOH 0 9 100.0% 0 7 100.0% 0 80Chilipa HC (Zomba) South East Zomba Health Center CHAM 1 4 75.0% 1 2 50.0% 0 14Chilobwe Majiga HC Central West Lilongwe Health Center MOH 0 4 100.0% 0 4 100.0% 0 60Chimaliro HC South West Thyolo Health Center MOH 0 9 100.0% 0 6 100.0% 0 60Chimbalanga HC Central West Lilongwe Health Center MOH 3 6 50.0% 0 3 100.0% 0 28Chimembe HC South West Blantyre Health Center MOH 2 4 50.0% 1 3 66.7% 0 31Chimoto HC Central West Dedza Health Center MOH 0 8 100.0% 2 6 66.7% 0 79Chimvu HC South West Thyolo Health Center MOH 0 6 100.0% 0 4 100.0% 0 39Chingale HC South East Zomba Health Center MOH 0 7 100.0% 0 7 100.0% 0 69Chingazi HC South West Thyolo Health Center CHAM 2 5 60.0% 1 3 66.7% 0 26Chinguluwe HC (Ntch) Central East Ntchisi Health Center MOH 1 6 83.3% 1 5 80.0% 0 50Chinguluwe HC (Sali) Central East Salima Health Center MOH 0 4 100.0% 0 3 100.0% 0 31Chinkhwiri HC Central East Dowa Health Center MOH 1 5 80.0% 1 3 66.7% 0 37Chinthembwe HC Central East Ntchisi Health Center CHAM 1 1 0.0% 0 1 100.0% 0 8Chinyama HC South East Mulanje Health Center MOH 0 5 100.0% 0 4 100.0% 0 42Chioshya HC Central West Mchinji Health Center MOH 0 6 100.0% 0 5 100.0% 0 56Chipho HC South West Thyolo Health Center CHAM 2 3 33.3% 0 2 100.0% 0 22Chipini HC South East Zomba Health Center CHAM 4 19 78.9% 0 23 100.0% 0 45Chipoka HC Central East Salima Health Center MOH 4 6 33.3% 1 5 80.0% 0 58Chiponde HC South East Mangochi Health Center MOH 0 3 100.0% 0 3 100.0% 0 34Chipumi HC Central West Mchinji Health Center MOH 0 7 100.0% 0 4 100.0% 0 49Chipwaila HC South West Chikwawa Health Center MOH 0 5 100.0% 0 4 100.0% 0 42Chipwanya HC Central West Dedza Health Center CHAM 0 3 100.0% 0 2 100.0% 0 23Chisala HC North Nkhata Bay Health Center MOH 0 2 100.0% 0 2 100.0% 0 28Chisepo HC Central East Dowa Health Center MOH 0 5 100.0% 0 4 100.0% 0 43Chisinga HC Central East Kasungu Health Center MOH 0 4 100.0% 0 3 100.0% 0 44Chisitu HC South East Mulanje Health Center MOH 0 5 100.0% 0 4 100.0% 0 55Chitala HC Central East Salima Health Center CHAM 3 4 25.0% 0 2 100.0% 0 13Chitedze HC Central West Lilongwe Health Center MOH 8 12 33.3% 1 7 85.7% 0 82Chitekesa HC South East Phalombe Health Center MOH 0 8 100.0% 0 7 100.0% 0 50Chitera HC South West Chiradzulu Health Center MOH 0 7 100.0% 0 8 100.0% 0 34Chitheka HC North Nkhata Bay Health Center MOH 0 2 100.0% 0 2 100.0% 0 15Chitimba HC North Rumphi Health Center MOH 0 2 100.0% 0 2 100.0% 0 19Chitowo HC Central West Dedza Health Center MOH 0 9 100.0% 0 6 100.0% 0 80Chitsimuka HC North Rumphi Health Center MOH 0 2 100.0% 0 1 100.0% 0 10Chiumbangame HC South East Mangochi Health Center MOH 0 2 100.0% 0 1 100.0% 0 12Chiunda Health Cent South East Mangochi Health Center MOH 0 4 100.0% 0 4 100.0% 0 47Chiunjiza HC Central West Lilongwe Health Center MOH 2 5 60.0% 0 3 100.0% 0 32Chiwamba HC Central West Lilongwe Health Center MOH 3 10 70.0% 2 8 75.0% 0 72Chiwe HC Central West Lilongwe Health Center CHAM 0 3 100.0% 0 2 100.0% 0 17



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalChiyendausiku HC South East Balaka Health Center MOH 0 3 100.0% 0 3 100.0% 0 34Chizolowondo HC Central East Dowa Health Center MOH 0 6 100.0% 0 3 100.0% 0 35Choma HC North Mzimba N Health Center MOH 0 3 100.0% 0 3 100.0% 0 36Chonde HC South East Mulanje Health Center MOH 0 15 100.0% 0 9 100.0% 0 117Chulu HC Central East Kasungu Health Center MOH 2 9 77.8% 1 7 85.7% 0 67Diamphwe HC Central West Lilongwe Health Center MOH 4 7 42.9% 1 5 80.0% 0 71Dolo HC South West Chikwawa Health Center MOH 0 5 100.0% 0 4 100.0% 0 42Dwangwa Clinic Central East Nkhotakota Health Center MOH 0 2 100.0% 1 3 66.7% 0 32Dwangwa HC Central East Kasungu Health Center MOH 0 5 100.0% 0 4 100.0% 0 44Dzeleka Ref Camp HC Central East Dowa Health Center MOH 0 10 100.0% 0 8 100.0% 0 101Dzindevu HC Central West Dedza Health Center MOH 0 5 100.0% 0 4 100.0% 0 38Dzoole HC Central East Dowa Health Center MOH 1 6 83.3% 1 4 75.0% 0 47Emfeni HC North Mzimba Health Center MOH 0 5 100.0% 0 3 100.0% 0 35Emsizini HC North Mzimba Health Center MOH 0 3 100.0% 0 2 100.0% 0 27Endindeni HC North Mzimba Health Center MOH 0 3 100.0% 0 3 100.0% 0 25Enukweni HC North Mzimba N Health Center MOH 1 2 50.0% 0 2 100.0% 0 16Fulirwa HC North Karonga Health Center MOH 0 3 100.0% 0 2 100.0% 0 24Gaga HC South West Chikwawa Health Center MOH 0 4 100.0% 1 4 75.0% 0 40Gawanani HC South East Machinga Health Center CHAM 1 3 66.7% 2 2 0.0% 0 12gogo South East Phalombe Health Center MOH 0 5 100.0% 0 4 100.0% 0 49Gogode HC Central East Kasungu Health Center MOH 0 3 100.0% 0 4 100.0% 0 51Golomoti HC Central West Dedza Health Center MOH 0 8 100.0% 0 5 100.0% 0 73Gowa HC Central West Ntcheu Health Center CHAM 4 3 1 EXCESS 0 2 100.0% 0 14Guilleme HC Central West Mchinji Health Center CHAM 0 11 100.0% 0 6 100.0% 0 57Hallena Oakely HC South West Thyolo Health Center CHAM 0 2 100.0% 0 2 100.0% 0 11Hoho HC North Mzimba Health Center MOH 0 3 100.0% 0 2 100.0% 0 24Iba Health Cent South East Mangochi Health Center MOH 0 2 100.0% 0 3 100.0% 0 26Ifumbo HC North Chitipa Health Center MOH 1 3 66.7% 1 2 50.0% 0 18Iponga HC North Karonga Health Center MOH 0 4 100.0% 0 5 100.0% 0 51Jalasi HC South East Mangochi Health Center MOH 0 5 100.0% 0 3 100.0% 0 40Jalawe HC North Rumphi Health Center MOH 0 1 100.0% 0 1 100.0% 0 16Jenda HC North Mzimba Health Center MOH 0 6 100.0% 0 3 100.0% 0 39Kabuwa HC North Mzimba Health Center MOH 0 3 100.0% 0 2 100.0% 0 22Kabwafu HC North Mzimba Health Center MOH 0 4 100.0% 0 3 100.0% 0 31Kachale HC Central West Lilongwe Health Center MOH 1 5 80.0% 1 4 75.0% 0 45Kachere HC North Nkhata Bay Health Center MOH 0 3 100.0% 0 3 100.0% 0 36Kadango Health Cent South East Mangochi Health Center MOH 0 2 100.0% 0 2 100.0% 0 25Kafele HC Central West Dedza Health Center MOH 1 6 83.3% 1 5 80.0% 0 64Kafukule HC North Mzimba N Health Center MOH 0 4 100.0% 0 4 100.0% 0 29Kaigwazanga HC Central West Mchinji Health Center MOH 0 8 100.0% 0 6 100.0% 0 63Kakoma HC South West Chikwawa Health Center MOH 0 4 100.0% 0 4 100.0% 0 40Kalemba HC South West Nsanje Health Center CHAM 0 6 100.0% 0 4 100.0% 0 34Kalikumbi HC North Mzimba Health Center CHAM 1 3 66.7% 1 2 50.0% 0 18Kalulu HC Central West Dedza Health Center MOH 0 4 100.0% 2 3 33.3% 0 38Kambenje HC South East Mulanje Health Center MOH 0 7 100.0% 0 5 100.0% 0 66



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalKamboni HC Central East Kasungu Health Center MOH 1 4 75.0% 1 4 75.0% 0 40Kameme HC North Chitipa Health Center MOH 1 5 80.0% 1 4 75.0% 0 39Kamsonga HC Central East Ntchisi Health Center MOH 0 5 100.0% 0 5 100.0% 0 53Kamteteka HC North Mzimba Health Center MOH 0 4 100.0% 0 4 100.0% 0 38Kamwe HC North Mzimba N Health Center MOH 0 4 100.0% 0 3 100.0% 0 29Kande HC North Nkhata Bay Health Center MOH 0 4 100.0% 0 4 100.0% 0 44Kangolwa HC Central East Ntchisi Health Center MOH 0 5 100.0% 0 4 100.0% 0 48Kang'Oma HC Central West Lilongwe Health Center MOH 2 7 71.4% 0 5 100.0% 0 78Kankao HC South East Balaka Health Center CHAM 5 8 37.5% 0 3 100.0% 0 24Kanyama HC Central West Dedza Health Center CHAM 2 5 60.0% 1 4 75.0% 0 47Kanyezi HC Central West Dedza Health Center MOH 0 4 100.0% 0 4 100.0% 0 51Kapanga HC Central West Mchinji Health Center MOH 1 7 85.7% 0 5 100.0% 0 54Kapelula HC Central East Kasungu Health Center MOH 1 6 83.3% 1 4 75.0% 0 48Kapenda HC North Chitipa Health Center MOH 1 4 75.0% 1 2 50.0% 0 23Kapeni HC Central West Ntcheu Health Center MOH 0 4 100.0% 0 4 100.0% 0 44Kaphatenga HC Central East Salima Health Center CHAM 4 4 0.0% 3 2 1 EXCESS 0 18Kaphuka HC Central West Dedza Health Center MOH 2 13 84.6% 2 16 87.5% 0 114Kapichila HC South West Chikwawa Health Center CHAM 0 1 100.0% 0 1 100.0% 0 9Kapili HC Central East Nkhotakota Health Center CHAM 0 2 100.0% 0 2 100.0% 0 22Kapire HC South East Mangochi Health Center CHAM 3 4 25.0% 1 2 50.0% 0 18Kapiri HC Central West Mchinji Health Center CHAM 1 19 94.7% 3 8 62.5% 0 60Kasina HC Central West Dedza Health Center CHAM 5 5 0.0% 0 4 100.0% 0 44Kasinje HC Central West Ntcheu Health Center MOH 0 9 100.0% 0 7 100.0% 0 67Kasoba HC North Karonga Health Center MOH 0 5 100.0% 0 4 100.0% 0 43Katema HC South East Mangochi Health Center CHAM 3 5 40.0% 0 2 100.0% 0 19Katimbila HC Central East Nkhotakota Health Center MOH 0 3 100.0% 0 3 100.0% 0 36Katsekera HC Central West Ntcheu Health Center MOH 0 6 100.0% 0 4 100.0% 0 43Katuli HC South East Mangochi Health Center MOH 2 6 66.7% 1 4 75.0% 0 46Kaundu HC Central West Dedza Health Center CHAM 2 4 50.0% 1 2 50.0% 0 24Kawamba HC Central East Kasungu Health Center MOH 0 6 100.0% 0 3 100.0% 0 31Kayembe HC Central East Dowa Health Center MOH 1 5 80.0% 1 4 75.0% 0 45Khola HC Central East Kasungu Health Center CHAM 0 2 100.0% 0 2 100.0% 0 22Khombedza HC Central East Salima Health Center MOH 2 10 80.0% 2 7 71.4% 0 74Khondowe HC North Nkhata Bay Health Center MOH 0 1 100.0% 0 1 100.0% 0 10Khongoni HC Central West Lilongwe Health Center MOH 1 8 87.5% 1 5 80.0% 0 43Khonjeni HC South West Thyolo Health Center MOH 0 17 100.0% 0 19 100.0% 0 75Khosolo HC North Mzimba Health Center MOH 0 3 100.0% 0 2 100.0% 0 23Khuwi HC Central East Ntchisi Health Center MOH 0 7 100.0% 0 5 100.0% 0 56Koche HC South East Mangochi Health Center CHAM 6 9 33.3% 2 6 66.7% 0 61KTFT HC Central East Kasungu Health Center CHAM 0 2 100.0% 0 2 100.0% 0 14Kunenekude HC South West Mwanza Health Center MOH 9 5 4 EXCESS 0 4 100.0% 5 37Kwitanda HC South East Balaka Health Center MOH 0 4 100.0% 0 3 100.0% 0 41Lakeview HC Central West Ntcheu Health Center CHAM 1 4 75.0% 1 2 50.0% 0 16Lambulira HC South East Zomba Health Center MOH 0 8 100.0% 0 7 100.0% 0 52Lemwe HC Central West Lilongwe Health Center MOH 0 1 100.0% 0 1 100.0% 0 6



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalLifuwu HC Central East Salima Health Center MOH 2 4 50.0% 2 4 50.0% 0 48Likangala HC South East Zomba Health Center MOH 0 14 100.0% 0 14 100.0% 0 61Linyangwa HC Central East Kasungu Health Center CHAM 0 5 100.0% 0 3 100.0% 0 38Lirangwe HC South West Blantyre Health Center MOH 4 7 42.9% 1 4 75.0% 0 44Lisungwi HC South West Neno Health Center MOH 0 7 100.0% 0 7 100.0% 0 80Liuzi HC North Nkhata Bay Health Center MOH 0 3 100.0% 0 3 100.0% 0 40Liwaladzi HC Central East Nkhotakota Health Center CHAM 1 2 50.0% 1 2 50.0% 0 21Lizulu HC Central West Ntcheu Health Center MOH 0 13 100.0% 0 13 100.0% 0 68Lobi HC Central West Dedza Health Center MOH 0 8 100.0% 0 7 100.0% 0 84Ludzi St Josephs HC Central West Mchinji Health Center CHAM 0 10 100.0% 0 6 100.0% 0 50Lugola HC South East Mangochi Health Center CHAM 0 3 100.0% 0 2 100.0% 0 16Lujeri HC South East Mulanje Health Center MOH 0 6 100.0% 0 7 100.0% 0 90Lulanga HC South East Mangochi Health Center CHAM 1 5 80.0% 1 6 83.3% 0 52Lulwe HC South West Nsanje Health Center CHAM 0 1 100.0% 3 1 2 EXCESS 0 5Lumbadzi HC Central West Lilongwe Health Center MOH 11 19 42.1% 2 13 84.6% 0 177Lundu HC South West Blantyre Health Center MOH 2 8 75.0% 1 6 83.3% 0 68Lungwena HC South East Mangochi Health Center MOH 1 8 87.5% 2 5 60.0% 0 69Lunjika HC North Mzimba Health Center CHAM 1 4 75.0% 2 2 0.0% 0 15Lura HC North Rumphi Health Center MOH 0 2 100.0% 0 2 100.0% 0 21Luwalika HC South East Mangochi Health Center CHAM 0 2 100.0% 0 1 100.0% 0 9Luwani HC South West Neno Health Center MOH 0 2 100.0% 0 2 100.0% 0 17Luwawa HC North Mzimba Health Center MOH 0 1 100.0% 0 1 100.0% 0 11Luwerezi HC North Mzimba Health Center MOH 0 7 100.0% 0 5 100.0% 0 53Luwuchi HC North Rumphi Health Center CHAM 0 2 100.0% 0 1 100.0% 0 10Luzi HC North Mzimba N Health Center MOH 0 3 100.0% 0 2 100.0% 0 23Mabili HC North Mzimba Health Center CHAM 0 4 100.0% 0 2 100.0% 0 23Machinga HC South East Machinga Health Center MOH 0 6 100.0% 0 7 100.0% 0 81Machinjiri HC South East Zomba Health Center MOH 0 5 100.0% 0 3 100.0% 0 36Madede HC North Mzimba Health Center MOH 0 8 100.0% 0 2 100.0% 0 23Madziabango HC South West Blantyre Health Center MOH 1 6 83.3% 1 4 75.0% 0 47Maganga HC Central East Salima Health Center MOH 2 7 71.4% 1 5 80.0% 0 60Magareta HC South West Neno Health Center MOH 0 3 100.0% 0 3 100.0% 0 29Magomero HC South East Zomba Health Center CHAM 2 6 66.7% 0 4 100.0% 0 25Makanjira HC South East Mangochi Health Center MOH 2 11 81.8% 0 7 100.0% 0 85Makapwa HC South West Thyolo Health Center CHAM 0 6 100.0% 1 6 83.3% 0 83Makhanga HC South West Nsanje Health Center MOH 0 6 100.0% 0 4 100.0% 0 48Makhwira HC South West Chikwawa Health Center MOH 0 10 100.0% 0 10 100.0% 0 107Makiyoni HC Central East Salima Health Center MOH 1 7 85.7% 1 6 83.3% 0 54Makwapala HC South East Zomba Health Center MOH 0 10 100.0% 0 7 100.0% 0 69Malembo HC South East Mangochi Health Center CHAM 2 4 50.0% 1 3 66.7% 0 25Malidadi HC North Mzimba N Health Center MOH 0 3 100.0% 0 2 100.0% 0 25Malingunde HC Central West Lilongwe Health Center CHAM 3 8 62.5% 1 3 66.7% 0 28Malombe Health Cent South East Mangochi Health Center MOH 0 4 100.0% 0 3 100.0% 0 43Malomo HC Central East Ntchisi Health Center MOH 0 13 100.0% 0 8 100.0% 0 84Mangamba HC South East Machinga Health Center MOH 0 6 100.0% 0 4 100.0% 0 47



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalMangunda HC South West Thyolo Health Center MOH 0 7 100.0% 0 8 100.0% 0 62Manyamula HC North Mzimba Health Center MOH 0 4 100.0% 0 3 100.0% 0 31Maonde HC Central West Dedza Health Center MOH 0 3 100.0% 0 3 100.0% 0 28Maperera HC South West Chikwawa Health Center MOH 0 6 100.0% 0 4 100.0% 0 42Mase HC South East Mangochi Health Center CHAM 0 3 100.0% 1 2 50.0% 0 12Masenjere HC South West Nsanje Health Center MOH 0 5 100.0% 0 4 100.0% 0 44Matanda HC Central West Ntcheu Health Center CHAM 0 3 100.0% 1 2 50.0% 0 12Matandani HC South West Neno Health Center CHAM 3 3 0.0% 0 2 100.0% 0 13Matiki HC Central East Nkhotakota Health Center MOH 0 9 100.0% 0 9 100.0% 0 117Matiya HC South East Zomba Health Center CHAM 4 7 42.9% 1 4 75.0% 0 32Matope HC South West Neno Health Center CHAM 2 6 66.7% 0 5 100.0% 0 70Matumba HC Central West Dedza Health Center CHAM 2 3 33.3% 0 3 100.0% 0 31Mauwa HC South West Chiradzulu Health Center MOH 0 6 100.0% 0 5 100.0% 0 57Mayaka HC South East Zomba Health Center CHAM 5 16 68.8% 0 16 100.0% 0 50Mayani HC Central West Dedza Health Center MOH 0 7 100.0% 0 7 100.0% 0 82Mbabvi HC Central West Lilongwe Health Center MOH 0 8 100.0% 0 5 100.0% 0 65Mbalachanda HC North Mzimba Health Center MOH 0 5 100.0% 0 3 100.0% 0 32Mbang'ombe 1 HC Central East Salima Health Center MOH 1 6 83.3% 0 4 100.0% 0 47Mbang'ombe 2 HC Central West Lilongwe Health Center MOH 0 4 100.0% 0 3 100.0% 0 36Mbenje HC South West Nsanje Health Center MOH 0 5 100.0% 0 3 100.0% 0 30Mbera HC South East Balaka Health Center MOH 0 12 100.0% 0 11 100.0% 0 92Mbingwa HC Central East Dowa Health Center MOH 1 7 85.7% 0 4 100.0% 0 33Mbiza HC South East Mulanje Health Center MOH 0 14 100.0% 0 18 100.0% 0 61Mbwatalika HC Central West Lilongwe Health Center CHAM 2 3 33.3% 1 1 0.0% 0 10Mchoka HC Central East Salima Health Center MOH 3 6 50.0% 1 5 80.0% 0 61Mdeka HC South West Blantyre Health Center MOH 4 7 42.9% 2 6 66.7% 0 56Mfera HC South West Chikwawa Health Center MOH 0 7 100.0% 0 7 100.0% 0 76Mhalaunda HC North Mzimba Health Center CHAM 0 2 100.0% 0 2 100.0% 0 13Midzemba HC South West Neno Health Center MOH 0 1 100.0% 0 2 100.0% 0 24Migowi HC South East Phalombe Health Center MOH 0 12 100.0% 0 7 100.0% 0 63Mikolongwe HC South West Thyolo Health Center MOH 0 10 100.0% 0 7 100.0% 0 77Mikundi HC Central West Mchinji Health Center MOH 1 11 90.9% 0 7 100.0% 0 89Milepa HC South West Chiradzulu Health Center MOH 0 8 100.0% 0 5 100.0% 0 51Milonde HC South East Mulanje Health Center MOH 0 6 100.0% 0 5 100.0% 0 59Ming'Ongo HC Central West Lilongwe Health Center MOH 2 5 60.0% 0 3 100.0% 0 37Misomali HC South West Chikwawa Health Center CHAM 0 2 100.0% 1 2 50.0% 0 19Misuku HC North Chitipa Health Center MOH 0 5 100.0% 0 4 100.0% 0 39Mkanda HC Central West Mchinji Health Center MOH 2 14 85.7% 1 10 90.0% 0 139Mkepere HC South East Machinga Health Center MOH 0 2 100.0% 0 2 100.0% 0 12Mkhota R Growth HC Central East Kasungu Health Center MOH 1 4 75.0% 1 3 66.7% 0 29Mkhuzi HC Central East Ntchisi Health Center MOH 0 6 100.0% 0 3 100.0% 0 32Mkhwayi HC South East Phalombe Health Center MOH 0 9 100.0% 0 6 100.0% 0 74Mkoma HC North Mzimba Health Center MOH 0 5 100.0% 0 3 100.0% 0 29Mkomaula HC South East Mulanje Health Center MOH 0 2 100.0% 0 2 100.0% 0 22Mkumaniza HC South West Chikwawa Health Center MOH 0 4 100.0% 0 3 100.0% 0 41



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalMkumba HC South East Mangochi Health Center MOH 0 5 100.0% 0 5 100.0% 0 47Mlanda HC Central West Ntcheu Health Center CHAM 1 3 66.7% 1 2 50.0% 0 14Mlangeni HC Central West Ntcheu Health Center MOH 0 3 100.0% 1 3 66.7% 0 37Mlowe HC North Rumphi Health Center CHAM 0 2 100.0% 0 2 100.0% 0 11M'mambo HC South East Zomba Health Center MOH 0 4 100.0% 0 2 100.0% 0 27Mpala HC South East Mulanje Health Center MOH 0 9 100.0% 0 5 100.0% 0 57Mpamba HC North Nkhata Bay Health Center MOH 4 4 0.0% 1 3 66.7% 0 33Mpasa HC South East Phalombe Health Center MOH 0 10 100.0% 0 6 100.0% 0 73Mpata HC North Karonga Health Center MOH 0 2 100.0% 0 2 100.0% 0 19Mpemba HC South West Blantyre Health Center MOH 0 11 100.0% 0 9 100.0% 0 42Mphathi HC Central West Dedza Health Center MOH 0 5 100.0% 1 4 75.0% 0 54Mpherembe HC North Mzimba N Health Center MOH 0 6 100.0% 0 6 100.0% 0 62Mphopha HC North Rumphi Health Center MOH 0 3 100.0% 0 2 100.0% 0 22Mphunzi HC Central West Dedza Health Center CHAM 1 4 75.0% 0 3 100.0% 0 29Mpiri HC South East Machinga Health Center CHAM 4 6 33.3% 0 2 100.0% 0 16Mpondas HC South East Mangochi Health Center CHAM 4 3 1 EXCESS 0 2 100.0% 0 13Mposa HC South East Machinga Health Center CHAM 2 6 66.7% 1 5 80.0% 0 35Msakambewa HC Central East Dowa Health Center MOH 2 5 60.0% 1 3 66.7% 0 35Msenjere HC Central East Nkhotakota Health Center MOH 0 4 100.0% 0 5 100.0% 0 54Msese HC North Mzimba Health Center MOH 0 2 100.0% 0 2 100.0% 0 19Mtakataka HC Central West Dedza Health Center MOH 0 6 100.0% 0 4 100.0% 0 55Mtakataka Police Central East Salima Health Center MOH 0 2 100.0% 0 2 100.0% 0 22Mtende HC North Mzimba Health Center MOH 0 3 100.0% 0 3 100.0% 0 28Mtendere HC Central West Dedza Health Center CHAM 6 8 25.0% 1 5 80.0% 0 54Mtenthera HC Central West Lilongwe Health Center MOH 7 12 41.7% 1 9 88.9% 0 112Mtimabii Health Cent South East Mangochi Health Center MOH 0 8 100.0% 0 7 100.0% 0 81Mtonda HC Central West Ntcheu Health Center CHAM 0 3 100.0% 0 2 100.0% 0 12Mtosa HC Central East Nkhotakota Health Center MOH 0 2 100.0% 0 2 100.0% 0 21Mtunthama HC Central East Kasungu Health Center MOH 1 6 83.3% 1 5 80.0% 0 52Mtwalo HC North Mzimba N Health Center MOH 0 2 100.0% 0 2 100.0% 0 17Mulomba HC South East Mulanje Health Center MOH 0 9 100.0% 0 7 100.0% 0 72Muloza HC South East Mulanje Health Center MOH 0 8 100.0% 0 5 100.0% 0 60Mvera Mission HC Central East Dowa Health Center CHAM 2 5 60.0% 0 2 100.0% 0 17Mwanga HC South East Phalombe Health Center CHAM 3 4 25.0% 0 2 100.0% 0 13Mwansambo HC Central East Nkhotakota Health Center MOH 0 4 100.0% 0 3 100.0% 0 34Mwazisi HC North Rumphi Health Center MOH 0 5 100.0% 0 4 100.0% 0 37Mzalangwe HC North Mzimba Health Center MOH 0 3 100.0% 0 2 100.0% 0 24Mzandu HC Central East Ntchisi Health Center MOH 0 8 100.0% 0 4 100.0% 0 38Mzenga HC North Nkhata Bay Health Center MOH 0 5 100.0% 1 5 80.0% 0 59Mzokoto HC North Rumphi Health Center MOH 0 3 100.0% 0 2 100.0% 0 25Naisi HC South East Zomba Health Center MOH 0 5 100.0% 0 4 100.0% 0 50Nakalanzi HC Central West Dedza Health Center CHAM 3 2 1 EXCESS 1 2 50.0% 0 12Namadzi HC South West Chiradzulu Health Center MOH 0 9 100.0% 0 6 100.0% 0 65Namalaka HC South East Mangochi Health Center CHAM 1 2 50.0% 0 1 100.0% 0 9Namandanje HC South East Machinga Health Center CHAM 5 5 0.0% 0 2 100.0% 0 21



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalNamanja HC South East Machinga Health Center MOH 0 8 100.0% 0 8 100.0% 0 75Namanolo HC South East Balaka Health Center MOH 0 4 100.0% 0 5 100.0% 0 53Namasalima HC (Mula) South East Mulanje Health Center CHAM 0 7 100.0% 0 5 100.0% 0 31Namasalima HC (Zom) South East Zomba Health Center MOH 1 9 88.9% 0 7 100.0% 0 52Nambazo HC South East Phalombe Health Center MOH 0 10 100.0% 0 7 100.0% 0 75Nambuma HC Central West Lilongwe Health Center CHAM 4 7 42.9% 2 3 33.3% 0 30Namikango HC South East Zomba Health Center CHAM 4 5 20.0% 0 1 100.0% 0 10Namitambo HC South West Chiradzulu Health Center MOH 0 12 100.0% 0 8 100.0% 0 73Namphungo HC South East Mulanje Health Center MOH 0 8 100.0% 0 7 100.0% 0 46Namulenga HC South East Mulanje Health Center CHAM 2 3 33.3% 1 2 50.0% 0 19Namwera HC South East Mangochi Health Center MOH 0 6 100.0% 0 4 100.0% 0 48Nangalamu HC South East Mangochi Health Center MOH 2 5 60.0% 1 2 50.0% 0 22Nankhwali HC South East Mangochi Health Center CHAM 2 2 0.0% 0 1 100.0% 0 9Nankumba HC South East Mangochi Health Center MOH 2 9 77.8% 0 6 100.0% 0 74Naphimba Hc South East Mulanje Health Center MOH 0 3 100.0% 0 3 100.0% 0 33Nasawa HC South East Zomba Health Center MOH 0 7 100.0% 0 4 100.0% 0 42Nathenje HC Central West Lilongwe Health Center MOH 10 13 23.1% 6 9 33.3% 0 104Nayinunje HC South East Machinga Health Center MOH 0 7 100.0% 0 5 100.0% 0 63Nayuchi HC South East Machinga Health Center MOH 0 5 100.0% 0 4 100.0% 0 43Ndakwela HC South West Chikwawa Health Center MOH 0 5 100.0% 0 5 100.0% 0 54Ndamera HC South West Nsanje Health Center MOH 0 6 100.0% 0 4 100.0% 0 40Ndaula HC Central West Lilongwe Health Center MOH 0 6 100.0% 0 4 100.0% 0 39Ndunde HC South West Chiradzulu Health Center MOH 0 6 100.0% 0 4 100.0% 0 51Neno Parish HC South West Neno Health Center CHAM 3 2 1 EXCESS 0 2 100.0% 0 14Newa / Mpasazi HC Central East Kasungu Health Center CHAM 1 1 0.0% 1 1 0.0% 0 10Ngala HC Central East Nkhotakota Health Center MOH 0 4 100.0% 0 3 100.0% 0 40Ngana HC North Karonga Health Center MOH 0 1 100.0% 0 1 100.0% 0 10Ngapani Health Cent South East Mangochi Health Center MOH 0 2 100.0% 0 2 100.0% 0 21Ngodzi HC Central East Salima Health Center CHAM 4 4 0.0% 1 2 50.0% 0 17Ngokwe HC South East Machinga Health Center MOH 0 8 100.0% 1 6 83.3% 0 67Ng'onga HC North Rumphi Health Center MOH 0 3 100.0% 0 4 100.0% 0 45Ngwelero HC South East Zomba Health Center MOH 0 8 100.0% 0 5 100.0% 0 48Njuyu HC North Mzimba N Health Center MOH 0 3 100.0% 0 3 100.0% 0 25Nkalo HC South West Chiradzulu Health Center MOH 0 6 100.0% 0 5 100.0% 0 50Nkasala HC South East Zomba Health Center CHAM 1 5 80.0% 0 2 100.0% 0 18Nkhorongo HC North Mzimba N Health Center CHAM 2 6 66.7% 1 1 0.0% 0 13Nkhulambe HC South East Phalombe Health Center MOH 0 12 100.0% 0 8 100.0% 0 62Nkhunga HC Central East Nkhotakota Health Center MOH 0 7 100.0% 0 6 100.0% 0 75Nkhuyukuyu HC North Mzimba N Health Center MOH 0 3 100.0% 0 2 100.0% 0 27Nkhwazi HC Central West Mchinji Health Center MOH 2 8 75.0% 0 5 100.0% 0 49Nkope HC South East Mangochi Health Center CHAM 2 5 60.0% 1 3 66.7% 0 19Nkula HC South West Neno Health Center CHAM 0 1 100.0% 0 1 100.0% 0 15Nsambe Sda HC South West Neno Health Center CHAM 0 5 100.0% 0 3 100.0% 0 28Nsanama HC South East Machinga Health Center CHAM 3 9 66.7% 0 5 100.0% 0 47Nsaru HC Central West Lilongwe Health Center MOH 4 7 42.9% 2 5 60.0% 0 52



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalNsipe HC Central West Ntcheu Health Center CHAM 0 5 100.0% 0 3 100.0% 0 25Nsiyaludzu HC Central West Ntcheu Health Center MOH 0 6 100.0% 0 4 100.0% 0 48Ntaja HC South East Machinga Health Center MOH 6 14 57.1% 2 10 80.0% 0 113Nthalire HC North Chitipa Health Center MOH 2 11 81.8% 2 5 60.0% 0 49Ntholowa HC North Machinga Health Center CHAM 0 2 100.0% 0 2 100.0% 0 14Nthondo HC (Lilong) South East Lilongwe Health Center MOH 0 5 100.0% 0 3 100.0% 0 39Nthondo HC (Ntchisi) Central East Ntchisi Health Center MOH 0 5 100.0% 0 3 100.0% 0 39Nthungwa HC North Nkhata Bay Health Center MOH 0 1 100.0% 0 1 100.0% 0 10Nyambi HC South East Machinga Health Center MOH 3 9 66.7% 1 5 80.0% 0 53Nyamithuthu HC South West Nsanje Health Center MOH 0 3 100.0% 0 2 100.0% 0 23Nyungwe HC North Karonga Health Center MOH 1 7 85.7% 0 5 100.0% 0 49Nzama HC Central West Ntcheu Health Center CHAM 2 5 60.0% 0 3 100.0% 0 21Ofesi HC Central East Kasungu Health Center MOH 0 2 100.0% 0 2 100.0% 0 24Old Maula Court HC North Nkhata Bay Health Center MOH 0 3 100.0% 0 3 100.0% 0 29Phalula HC South East Balaka Health Center MOH 5 6 16.7% 1 4 75.0% 0 32Phimbi HC South East Balaka Health Center MOH 0 6 100.0% 0 5 100.0% 0 51Phiri longwe HC South East Mangochi Health Center MOH 2 4 50.0% 1 3 66.7% 0 36Phokera HC South West Nsanje Health Center MOH 0 4 100.0% 0 3 100.0% 0 28Pim HC South West Chiradzulu Health Center CHAM 1 3 66.7% 1 2 50.0% 0 14Pirimiti HC South East Zomba Health Center CHAM 0 18 100.0% 0 17 100.0% 0 46Sangilo HC North Karonga Health Center CHAM 0 3 100.0% 0 1 100.0% 0 8Sankhulani HC South West Nsanje Health Center MOH 0 4 100.0% 0 3 100.0% 0 30Santhe HC Central East Kasungu Health Center MOH 2 6 66.7% 1 6 83.3% 0 45Senzani HC Central West Ntcheu Health Center CHAM 0 4 100.0% 1 2 50.0% 0 15Simlemba HC Central East Kasungu Health Center MOH 0 7 100.0% 1 5 80.0% 0 58Sinyala Health Cent South East Mangochi Health Center MOH 0 3 100.0% 0 2 100.0% 0 19Sister Teleza HC Central West Ntcheu Health Center CHAM 0 4 100.0% 0 3 100.0% 0 19Sorgin HC South West Nsanje Health Center MOH 0 11 100.0% 0 10 100.0% 0 146South Lunzu HC HC South West Blantyre Health Center MOH 1 14 92.9% 0 11 100.0% 0 126St Annes HC North Karonga Health Center CHAM 0 3 100.0% 0 2 100.0% 0 11St Josephs HC South West Thyolo Health Center CHAM 4 3 1 EXCESS 1 2 50.0% 0 22St Marthas HC South East Mangochi Health Center CHAM 0 2 100.0% 0 2 100.0% 0 12St Martins Molere HC South West Thyolo Health Center CHAM 3 4 25.0% 1 3 66.7% 0 28St Marys HC North Nkhata Bay Health Center CHAM 1 2 50.0% 0 2 100.0% 0 16St Patricks HC North Rumphi Health Center CHAM 8 1 7 EXCESS 2 1 1 EXCESS 0 5Sucoma HC South West Chikwawa Health Center CHAM 0 13 100.0% 0 12 100.0% 0 176Sukasanje HC South East Phalombe Health Center CHAM 2 5 60.0% 0 2 100.0% 0 19Tembwe HC Central West Mchinji Health Center MOH 2 8 75.0% 0 7 100.0% 0 81Tengani HC South West Nsanje Health Center MOH 0 6 100.0% 0 4 100.0% 0 50Thambani HC South West Mwanza Health Center MOH 0 5 100.0% 0 4 100.0% 6 45Thavite HC Central East Salima Health Center CHAM 4 5 20.0% 1 3 66.7% 0 31Thomas HC South West Thyolo Health Center CHAM 2 5 60.0% 1 4 75.0% 0 32Thonje HC Central East Dowa Health Center MOH 2 4 50.0% 1 3 66.7% 0 38Thuchila HC South East Mulanje Health Center MOH 0 9 100.0% 0 5 100.0% 0 58Thumbwe HC South West Chiradzulu Health Center MOH 0 6 100.0% 0 5 100.0% 0 65



Facility Name Zone Region Type CHAM/MOH Current Optimal % Vacancy Current Optimal % Vacancy Current OptimalThunduwike HC North Mzimba N Health Center MOH 0 4 100.0% 0 3 100.0% 0 27Tulonkhondo HC South West Mwanza Health Center MOH 0 5 100.0% 0 4 100.0% 5 44Ukwe HC Central West Lilongwe Health Center MOH 0 6 100.0% 0 5 100.0% 0 58Ulongwe HC South East Balaka Health Center CHAM 4 4 0.0% 1 3 66.7% 0 27Usisya HC North Nkhata Bay Health Center MOH 0 4 100.0% 0 4 100.0% 0 22Utale 1 HC South East Balaka Health Center CHAM 0 3 100.0% 0 1 100.0% 0 8Utale 2 HC South West Balaka Health Center CHAM 2 4 50.0% 0 2 100.0% 0 23Wenya HC North Chitipa Health Center MOH 1 4 75.0% 1 3 66.7% 0 31Wiliro HC North Karonga Health Center MOH 0 2 100.0% 0 1 100.0% 0 12Wimbe HC Central East Kasungu Health Center MOH 0 6 100.0% 0 5 100.0% 0 60Zoa Health Centre South West Thyolo Health Center MOH 0 2 100.0% 0 1 100.0% 0 1Chiringa Mat Mat South East Phalombe Maternity CHAM 1 10 90.0% 0 1 100.0% 0 8Chithumba Mat South West Chikwawa Maternity CHAM 0 3 100.0% 0 2 100.0% 0 15Dzenje Mat South East Mulanje Maternity CHAM 0 2 100.0% 0 2 100.0% 0 8Ganya Mat Central West Ntcheu Maternity CHAM 2 4 50.0% 1 2 50.0% 0 10Gombe Mat North Rumphi Maternity CHAM 0 1 100.0% 0 1 100.0% 0 8Kampanje Mat Central West Ntcheu Maternity CHAM 0 1 100.0% 0 1 100.0% 0 5Manjawira Mat Central East Dowa Maternity CHAM 0 3 100.0% 0 2 100.0% 0 24Mapanga Mat Central East Nkhotakota Maternity CHAM 0 2 100.0% 0 2 100.0% 0 9Mganja Mat Central West Dedza Maternity CHAM 0 3 100.0% 0 2 100.0% 0 25Nkhataombere Mat North Nkhata Bay Maternity CHAM 0 2 100.0% 0 1 100.0% 0 6Sharpevale Mat Central West Ntcheu Maternity CHAM 0 4 100.0% 0 2 100.0% 0 21Tsoyo Mat Central West Lilongwe Maternity CHAM 0 2 100.0% 0 1 100.0% 0 12Area 18 HC Central West Lilongwe Urban Health Center MOH 13 23 43.5% 2 25 92.0% 0 310Area 25 HC Central West Lilongwe Urban Health Center MOH 0 28 100.0% 0 15 100.0% 0 170Bangwe HC South West Blantyre Urban Health Center MOH 0 25 100.0% 0 12 100.0% 0 153Chilomoni HC South West Blantyre Urban Health Center MOH 8 21 61.9% 2 12 83.3% 0 134Dzenza HC Central West Lilongwe Urban Health Center CHAM 9 6 3 EXCESS 3 4 25.0% 0 40Kawale HC Central West Lilongwe Urban Health Center MOH 18 24 25.0% 3 21 85.7% 0 200Limbe HC South West Blantyre Urban Health Center MOH 1 29 96.6% 0 16 100.0% 0 161Matawale HC South East Zomba Urban Health Center MOH 0 20 100.0% 0 20 100.0% 0 115Mzuzu Urban HC North Mzimba Urban Health Center MOH 0 36 100.0% 0 12 100.0% 0 173Ndirande HC South West Blantyre Urban Health Center MOH 11 36 69.4% 8 17 52.9% 0 206Soche Mat Mat South West Blantyre Urban Health Center CHAM 0 4 100.0% 2 4 50.0% 0 50Zingwangwa HC South West Blantyre Urban Health Center MOH 14 20 30.0% 4 12 66.7% 0 174


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