The supply and distribution of essential medicines in Malawi

This paper summarises the findings of a brief political economy analysis of the procurement, supply and distribution of essential medicines in Malawi.

It uses a sectoral political economy framework that provides a more structured form of analysis, working through various stages, including identifying the nature of the problem to be addressed; diagnosing systemic features and key dynamics and incentives; and pinpointing policy options and feasible theories of change.

Key issues identified in the paper include: (1) the role of political patronage in staff appointments and award of supply contracts, (2) the institutional vacuum caused by incoherent and poorly implemented decentralisation policy, (3) ineffective bottom-up monitoring by service users, and (4) donors funding parallel supply systems adds to incoherence. The recommendations of the study centre on strengthening policy coherence and performance monitoring.