When I consider the issue of ghost workers, I usually end up concluding that it is a simple problem that can be resolved easily. But the problem is that corruption is so entrenched in the system to the extent that the people that are entrusted with the task of averting it are the same people that are responsible for aggravating it.

Clement your analysis is very true. HR (compensation)Salary Planning and implementation is still centralized in Malawi for three main reasons: 1. To prevent other districts not to be sidelined in health personnel establishment fulfillment which sounds good ( to level the deployment field-opportunities regardless of other factors).
2. To guarantee job security ( to prevent unethical recruitments and dismissals which haunt tax payers money at courts).
3. To prevent abuse of staff authority at district level against line authority in decentralization dispensation.

So its the system not individuals. It needs an overhaul maintenance, I guess. It seems civil servants in Malawi accept low compensation for their sweat(salary)as an excuse for conducting corruption (guise). If you audit thoroughly, one could discover that its a tripartite syndicate of CHAM-MOH-Treasury! Even with bank accounts by all civil servants, they will still find fraudful solace and penetrate with "human face" corruption! Its a mind set which needs to be uprooted!