TY - JOUR T1 - Allocating resources to support universal health coverage: policy processes and implementation in Malawi JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2020-002766 VL - 5 IS - 8 SP - e002766 AU - Pakwanja Twea AU - Gerald Manthalu AU - Sakshi Mohan Y1 - 2020/08/01 UR - http://gh.bmj.com/content/5/8/e002766.abstract N2 - Optimising the use of limited health resources in low-income and middle-income countries towards the maximisation of health outcomes requires efficient distribution of resources across health services and geographical areas. While technical research exists on how efficiencies can be achieved in resource allocation, there is limited guidance on the policy processes required to convert these technical inputs into practicable solutions. In this article, we discuss Malawi’s experience in 2019 of revising its resource allocation formula (RAF) for the geographical distribution of the government health sector budget to the decentralised units in-charge of delivering primary and secondary healthcare. The policy process to revise the RAF in Malawi was initiated by district assemblies seeking a more equitable distribution of government resources, with the Ministry of Health and Population (MOHP) leading the technical and deliberative work. This article discusses all the steps undertaken by MOHP, Malawi to date as well as the steps necessary looking forward to legally establish the newly developed RAF and to start implementing it. We highlight the practical and political considerations in ensuring the acceptability and implementation feasibility of a revised RAF. It is hoped that this discussion will serve as guidance to other countries undergoing a revision of their resource allocation frameworks. ER -