In terms of skills transfer and capacity development, technical assistance (TA) in the first SWAp in Malawi was a failure. This was partly due to lack of Malawian counterparts with quality staff leaving the service. The TAs were required to do the jobs themselves. It was also partly due to strained professional relationships between staff and TAs often caused by differential salaries and poor selection, management and supervision of TAs. The management arrangements have been improved so that TAs are better selected, appointed, and managed with clear cut supervision and performance appraisal. However, senior and middle management staff can not benefit from TA skills transfer unless there is continuity of staff linked to an approach which allows personal professional development. The scheme to strengthen policy implementation capacity in the Ministry of Health is designed to allow this to take place.
The VSO health programme 2008-2011 is the second of two phases to assist the Ministry of Health address the human resources for health crisis in Malawi. The first phase concentrated on filling vacancies in key professional positions both in the health service and in training institutions. Phase two continued to fill key vacancies but expanded its purpose to include what were considered more sustainable activities. The programme was recently reviewed and reported in January 2011 and an end of programme evaluation has recently been commissioned by VSO and completed with a preliminary draft of the evaluation available for use in this Project Completion Report (PCR).