Three years after its launch, the Malawi Government’s medical scheme has signed up 34 688 civil servants, representing barely 14 percent of the estimated 250 000 on the payroll. Mtonga further said that the government “had publicly expressed a desire to establish its own medical scheme, which will change this entire current situation. Minister of Local Government and Rural Development Ben Phiri, who announced the medical scheme for chiefs during meetings with council authorities and chiefs in Rumphi, Chitipa and Karonga districts last December, had said at the time that the scheme would start with Paramount Chiefs and Senior Chiefs from April 1 this year. He said: “A contributory medical scheme can provide valuable financial protection for civil servants, but the key question is whether it delivers better value for money than investing directly in the public health system. He said compulsory enrolment should only be considered if the scheme is affordable, transparent and delivers clear value to members.