A Critical Intervention: Reviewing Medicine Policy in Malawi and East Africa

Access to essential medicines remains a significant challenge in sub-Saharan Africa, adversely affecting maternal and reproductive health outcomes. In Malawi and the wider East African region, despite ongoing policy reforms, systemic barriers to reliable medicine access persist. This intervention study aimed to critically review national medicine policies, using Malawi as a case study for East Africa. Its objectives were to analyse policy content, assess implementation challenges, and evaluate the perceived impact on healthcare delivery and medicine accessibility. A mixed-methods approach was employed. This involved a desk review of national policy documents, legislation, and strategic plans. The review was supplemented by key informant interviews with policymakers, healthcare providers, and pharmacy personnel. Thematic analysis was conducted on the qualitative data. Policy implementation was found to be consistently hindered by chronic underfunding and logistical constraints. A critical finding was the frequent stock-out of essential obstetric medicines in a substantial proportion of health facilities, despite policy commitments to ensure availability. Policy fragmentation across different government departments was also identified as a significant barrier. Although well-intentioned in design, medicine policies in the region have not fully translated into reliable access to essential medicines at the point of care. The persistent gap between policy aspiration and practical implementation continues to undermine service delivery in obstetrics and gynaecology. Future policy revisions must prioritise sustainable financing mechanisms and integrated supply chain management. It is essential to strengthen monitoring and accountability frameworks. Regional collaboration should be enhanced to improve medicine procurement and regulatory harmonisation. Essential medicines, Health policy, Maternal health, Drug access, Policy implementation, Malawi, East Africa This study provides a critical, contemporary analysis of medicine policy as an intervention, highlighting specific systemic failures that constrain access to essential maternal health commodities.