Financing of Trauma and Burn Prevention and Care in Malawi: A Scoping Review.

BACKGROUND AND AIMS: Trauma and burns constitute major public health concerns in Malawi, disproportionately affecting children, young adults, and low-income populations. Despite free care policies at public facilities, the financial implications of trauma and burn care are profound and understudied. This scoping review examined the evidence on financing of trauma and burn prevention and care in Malawi.

METHODS

This scoping review was conducted following Arksey and O'Malley's framework and reported using the PRISMA-ScR guidelines. A systematic search of ten bibliographic databases, Google Scholar and Google was conducted up to April 2025. Relevant literature were included in the scoping review if they investigated the financing of trauma or burns prevention and care in Malawi. Included peer-reviewed literature were appraised using the Mixed Methods Appraisal Tool (MMAT, 2018 version), while grey literature was appraised using the AACODS checklist. Data were extracted, charted, and synthesized thematically.

RESULTS

Of the 16 included literature (6 peer-reviewed, 10 grey literature), all peer-reviewed studies used quantitative methods, mostly descriptive. Four focused on inpatient cost analyses. The mean burn admission cost was US$559.85; and orthopaedic treatment ranged from US$195-$711. Personnel (up to 48%), medications, and facility resources were the main cost drivers. Indirect costs included transportation (US$2.87 per visit), income loss, and food insecurity. Annual trauma registry maintenance cost US$33,361.64. All the peer-reviewed literature reported exclusive government funding with no donor or private sector financing. Grey literature confirmed no dedicated trauma/burn financing lines, relying instead on general health allocations and non-financial support like training and donated supplies.