A situational Analysis of the Legal Framework of Public Hospital Governance in Malawi

Abstract

Background: Sound organizational governance is critical to the health sector. The condition of the legal framework that is in place, plays a key role in institutionalizing sound governance. The present paper examines the condition of the legal framework that facilitates the implementation of robust public hospital governance in Malawi. Methods: The paper employed document analysis utilizing Clarke’s situational thinking to examine the legal framework pertaining to the governance of central and district hospitals. Results: The findings suggest that the current legal framework does not prescribe a specific organizational governance system for central and district hospitals. Governance of the hospitals relies on the governance framework of their parent entities, namely the Ministry of Health and District Councils respectively. This setup presents serious challenges that include undermining the uniqueness of the hospital governance system and obscuring the organizational visibility of public hospitals. Consequently, it has detrimental effects on the implementation of sound organizational governance principles including responsibility, transparency, and accountability. Conclusion: The paper demonstrates the need for policymakers to examine the condition of the specific elements of the legal framework in order to identify those areas that require attention toward reforming the state of organizational governance of the public hospitals under study.