This article explores budget management in the public healthcare services delivery sector in the district hospitals of Malawi. The government
of Malawi continues to allocate finances to support public healthcare
services delivery; however, quality of services delivery remains poor. This
is attributed to among other factors, poor budget management practices.
The methodology entails a qualitative approach where data was collected
through a review of literature of documents on government budgeting
and individual semi-structured interviews. The study participants were
purposively selected key-informants who were deemed to have a deep
understanding of budget management in the district hospitals through their
various roles. It was found that budgeting in the public healthcare delivery
sector in Malawi is flawed and lacking; as such, the sector fails to achieve
its public health services delivery goals. Specifically, the study reveals that
budget management in the district hospitals lacks flexibility, faces limited
government funding allocations, encounters late government funding, has a
weak funding allocations formula and experiences ineffective budget evaluations. The study findings provide empirical evidence that explains budget
management gaps that exist in the public healthcare sector in Malawi, and
consequently, establishes a basis for recommendations to the government
on the need to improve budget management practices.