{
  "abstract": "The Alma-Ata ‘Health for All’ Declaration of 1978 emphasised community participation in health systems and the need to ‘bring health care as close as possible to where people live and work’. Since then, decentralised approaches that leverage the proximity of local governments to their populations have emerged as the preferred model for health systems over fully centralised structures. The district health system, particularly in low- and middle-income countries, has evolved as a key framework to advance the Alma-Ata vision and strengthen health system governance in decentralised settings. However, implementation has often been hindered by limited local capacity, raising a persistent question: how can district health systems be strengthened to achieve decentralisation objectives? Using Malawi’s ongoing Blantyre Prevention Strategy (BPS), a systems-based project designed to build local capacity at district and city levels for HIV prevention, as a case study, this paper-reviews policies and frameworks guiding health sector decentralisation in Malawi and examines how BPS is contributing to strengthening the district health system and supporting broader decentralisation efforts in Malawi’s health sector.",
  "authors": [
    {
      "affiliations": [
        "Center for Innovation in Global Health, Georgetown University, Washington, District of Columbia, USA",
        "O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, District of Columbia, USA"
      ],
      "name": "Betha O Igbinosun"
    },
    {
      "affiliations": [
        "Blantyre District Health Office, Blantyre, Malawi"
      ],
      "name": "Gift Kawalazira"
    },
    {
      "affiliations": [
        "Ministry of Local Government, Unity and Culture, Lilongwe, Malawi"
      ],
      "name": "Darwin Pangani"
    },
    {
      "affiliations": [
        "Center for Innovation in Global Health, Georgetown University, Washington, District of Columbia, USA",
        "O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, District of Columbia, USA"
      ],
      "name": "Sara M Allinder"
    },
    {
      "affiliations": [
        "Center for Innovation in Global Health, Georgetown University, Washington, District of Columbia, USA",
        "Malawi National AIDS Commission, Lilongwe, Malawi"
      ],
      "name": "Yohane Kamgwira"
    },
    {
      "affiliations": [
        "Center for Innovation in Global Health, Georgetown University, Washington, District of Columbia, USA",
        "O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, District of Columbia, USA"
      ],
      "name": "Deborah Hoege"
    },
    {
      "affiliations": [
        "Department of Health and Social Services, Blantyre City Council, Blantyre, Malawi"
      ],
      "name": "Samden Seunda"
    },
    {
      "affiliations": [
        "Malawi National AIDS Commission, Lilongwe, Malawi"
      ],
      "name": "Chimwemwe Mablekisi"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Lilongwe, Malawi"
      ],
      "name": "Stephanie Heung"
    },
    {
      "affiliations": [
        "Clinton Health Access Initiative, Lilongwe, Malawi"
      ],
      "name": "Jacqueline Crowell"
    },
    {
      "affiliations": [
        "Center for Innovation in Global Health, Georgetown University, Washington, District of Columbia, USA",
        "O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, District of Columbia, USA"
      ],
      "name": "Charles B Holmes"
    },
    {
      "affiliations": [
        "Malawi National AIDS Commission, Lilongwe, Malawi"
      ],
      "name": "Beatrice Matanje"
    }
  ],
  "title": "Strengthening district health systems to achieve Malawi’s decentralisation objectives: lessons learnt from Malawi’s Blantyre Prevention Strategy",
  "uid": "131aa7fb-cbed-5471-ba3a-a91f5f4c37c2"
}