Effects of climate change on health system, policy response, and factors hindering policy formulation in Malawi: A qualitative study

Background: Evidence shows that both developed and developing countries are refining and establishing regulatory frameworks to address climate change in health policies. However, progress in sub-Saharan African countries, including Malawi, is slower than other regions, despite their vulnerability to multiple factors induced by climate change. This study explores the effects of climate change on the health system, policy responses, and factors hindering policy formulation in Malawi. Methods: A descriptive qualitative study was conducted through key informant interviews with policymakers, including health planning officials and some members of academics. Purposive and snowballing sampling techniques were used to identify study participants. Data was analysed using thematic analysis. Findings: Twelve in-depth interviews were conducted with policymakers and two with academicians. The results were grouped into three main themes, including the effects of climate change on the health system, health system policy responses, and barriers to policy formulation. Our informants reported several factors under each of the three themes. Conclusions: The study concludes that the effects of climate change on the health system require a policy response. Generating enough evidence to inform policy is one of the key elements towards the formulation of climate change-specific health policy. The study recommends continuous sensitization and advocacy to gain political support and commitment from relevant stakeholders.