Joseph January

A Constitutional and Policy Reflection on Executive Order No. 1 of 2026

Executive Order No. 1 of 2026, concerning health services in Malawi, addresses two significant matters within the public health sector. First, it prohibits the solicitation of payments from patients in public health facilities. Secondly, it restricts public health employees from owning, operating, or holding shares in private clinics, hospitals, pharmacies, or drug stores, requiring divestment within thirty days.

The intention to safeguard patients and restore integrity within the health system is both understandable and commendable. At the same time, it is important in a constitutional democracy to reflect carefully on the legal, human rights, labour, and economic implications of such policy measures. The following analysis is offered in that spirit, as a constructive contribution to public discourse.

1. The Prohibition of Soliciting
Payments

The prohibition against public health workers demanding or accepting payments as a condition for providing services aligns with constitutional principles and long-standing ethical standards within the medical profession.

The Constitution of Malawi guarantees access to essential services without discrimination. Informal payments undermine equality and disproportionately affect vulnerable citizens. Addressing such conduct strengthens public confidence, reinforces professional ethics, and protects the dignity of patients.

From a legal and human rights standpoint, this component of the Order appears consistent with:

a. The right to equality before the
law
b. The right to dignity
c. The protection of access to
public services

Measures aimed at preventing exploitation in public facilities are therefore defensible and grounded in legitimate public interest.

2. Restriction on Ownership of
Private Health Facilities

The second component of the Order, which prohibits public health employees from owning or holding shares in private health facilities or pharmacies, presents more complex constitutional and policy considerations.

(a) Constitutional and Property Rights Considerations

The Constitution protects the right to property and recognises the freedom to engage in lawful economic activity. Public servants, while subject to professional regulation, retain these rights unless lawfully and proportionately limited.

In constitutional jurisprudence, limitations on rights must generally meet the test of:

a Legality
b. Legitimate purpose
c. Proportionality
d. Reasonableness

While preventing conflicts of interest is unquestionably a legitimate objective, a blanket prohibition on ownership may raise questions as to whether it represents the least restrictive means of achieving that objective.

Alternative mechanisms often used in comparable jurisdictions include:

a. Mandatory disclosure of financial
interests
b. Regulation of dual practice hours
c. Clear separation of public duties
and private enterprise
d. Strict prohibition of self-referrals
e. Performance and attendance
monitoring

A total prohibition may therefore warrant further legal clarification to ensure consistency with constitutional protections.

(b) Labour and Administrative Law
Considerations

The requirement for divestment within thirty days introduces additional practical and legal concerns.

Public employment is governed by statutory frameworks and labour principles that typically require procedural fairness, clarity, and reasonable implementation timelines. Abrupt divestment requirements may create financial disruption, particularly where individuals have invested capital, secured loans, or entered into contractual obligations.

Should significant numbers of professionals elect to resign rather than divest, the public health system could experience workforce instability. While such outcomes may not be the intention of the Order, they represent foreseeable consequences that merit careful consideration.

3. Economic and Entrepreneurial
Implications

It is widely recognised that in many low- and middle-income countries, dual practice has emerged partly as a response to limited public sector remuneration and resource constraints.

Private health enterprises often:

a. Create employment
b. Expand service coverage
c. Contribute to tax revenue
a. Reduce patient pressure on
public facilities

If facilities owned by public servants are closed or rapidly divested, potential consequences may include:

a. Reduced corporate and
income tax contributions
b. Increased unemployment
among allied health workers
c. Greater patient load
within government hospitals
d Expansion of informal
or unregulated health services

These are economic and systemic considerations rather than ideological objections. Policymaking in this area requires a careful balance between preventing abuse and sustaining healthcare capacity.

4. Public Interest and System
Stability

The overarching goal of strengthening integrity within the health sector is widely shared. However, policy design must also consider health system resilience.

Malawi, like many countries, continues to face shortages of specialised personnel. Any regulatory framework that significantly alters income structures or investment rights may influence retention, morale, and long-term workforce planning.

A calibrated approach, one that manages conflicts of interest without eliminating lawful entrepreneurship, may better preserve both public trust and system stability.

5. A Constructive Way Forward

In light of these considerations, policymakers might consider:

a. Establishing comprehensive
conflict-of-interest disclosure
requirements
b. Prohibiting referrals from public
facilities to privately owned
facilities
c. Strengthening internal
disciplinary systems
d. Reviewing remuneration and
incentive structures
e. Introducing phased or
consultative implementation
mechanisms

Such measures could address ethical concerns while respecting constitutional guarantees and economic realities.

Summary

Executive Order No. 1 of 2026 addresses a genuine and pressing concern within the public health sector. The prohibition of soliciting payments in public facilities appears legally sound and ethically justified.

The restriction on ownership of private health enterprises, however, raises more complex constitutional, labour, and economic questions. In a constitutional democracy, robust public discussion of such matters is not opposition but participation.

A balanced approach, rooted in legality, proportionality, and practical implementation, may ultimately serve both patients and professionals more effectively.

We are experts in Emergency Medicine, General Surgery, Obstetrics and Gynaecology, Paediatrics, Clinical Counselling, Psychosocial Counselling

"How to Develop Teamwork in Marriage"
Marriage is not about two individuals living separate lives under one roof—it’s about becoming a team. True partnership requires effort, patience, and intentionality. Here’s how you can strengthen teamwork in your marriage:

1. Don’t Be Fixed in Your Ways
"Marriage is about two becoming one, not one person getting their way."
A successful team requires flexibility. Not everything has to be done your way, when you want, or how you want. Prioritize the strength of your marriage over personal preferences.

2. Be Appreciative
"Gratitude fuels love, while complaints drain it."
Your spouse is more likely to do more for you and with you when appreciation outweighs criticism. Make gratitude a daily habit.

3. Ask for Your Spouse’s Opinion
"A great team makes decisions together, not just for each other."
Involving your spouse in decision-making makes them feel valued and respected. When you both own the outcome—good or bad—you build trust and unity.

4. Choose Going Together Over Going Fast
"Marriage is not a race but a shared journey."
You’re no longer single; patience with each other is key. It’s not just about reaching your goals—it’s about reaching them together.

5. Foster Emotional Connection
"A strong marriage is built on friendship, not just responsibility."
Without emotional closeness, even the most well-intended efforts feel mechanical. Have fun, be vulnerable, flirt, joke, and enjoy each other’s presence.

6. Check Your Tone
"It’s not just what you say, but how you say it."
A sharp tone can push your spouse away even when your words are right. Speak with warmth, kindness, and love.

7. Notice Effort
"Familiarity should not lead to forgetfulness."
After years together, it’s easy to overlook your spouse’s efforts. But when people feel unseen by the one they love, their motivation fades. Acknowledge and appreciate their contributions.

8. Have a Joint Vision
"Without direction, even love can feel lost."
What are you building together? What’s your shared purpose? A strong marriage has goals, dreams, and a sense of purpose beyond daily routines.

9. Evaluate the Vision Together
"Goals are not just set—they are assessed."
Check in with each other regularly to track progress, adjust plans, and stay aligned as a team.

10. Avoid External Influence
"The strongest marriages resist outside forces."
Be cautious of external voices—whether it’s unsolicited advice, toxic social media narratives, or negative influences that create division. Protect your marriage.

11. Be a Peacemaker
"Peace strengthens teamwork; animosity destroys it."
Learn to de-escalate tension. Resolve conflicts quickly. Choose to heal rather than hurt. A peaceful partner is easier to work with.

12. Find Activities to Do Together
"Love grows through shared experiences."
Discover and engage in activities you both enjoy. Love is built through quality time and shared adventures.

13. Cover Each Other
"When one is weak, the other provides strength."
On bad days, when mistakes happen, or when one of you is struggling, extend grace instead of judgment. Marriage is about supporting, not condemning.

14. Ask for Help Even If You Can Do It Alone
"Independence is good, but interdependence is better in marriage."
Your spouse wants to feel needed. Don’t be so self-sufficient that you shut them out. Ask for their help—even in small ways.

15. Don’t Force Your Spouse to Be Like You
"Love thrives in acceptance, not control."
Trying to mold your spouse into your version of “better” only creates pressure. Embrace their uniqueness and let your differences complement each other.

16. Don’t Let Your Spouse Be the Only One to Initiate Effort
"A one-sided effort is exhausting."
Teamwork requires two active participants. Don’t just respond—initiate. Be present, engaged, and willing to put in the effort.

17. Speak Highly of the Team
"Words shape reality—speak life into your marriage."
Celebrate your relationship. Say things like:
✅ "We make a great team!"
✅ "Nothing can stop us!"
✅ "We did it, love!"
Your words will reinforce your unity and strength.

If you need help contact
Florence Medical Consultants which is a subsidiary of Florence Group of Companies on:

Emails
[email protected]
[email protected]

Phone Numbers +265993857560
+254774829610
+254115901071

Social Media Handles
Tik tok: Dr. Joseph January EM Consult
Facebook: Profile and Page
Joseph January
YouTube: Joseph January
Twitter: Joseph January

Contributions for charity Works
M pesa: +254115901071
Airtel Money: +265993857560
Mpamba: 0884 28 81 86
NBM Account: 1396137
ECOBANK: 5460000007018