The main objective of this study was to determine technical efficiency of CHAM facilities and some of its determinants in Malawi. This study used input and output variables from 26 CHAM facilities in Malawi using a two- stage analysis involving data envelopment analysis and to bit regression. The study finds that most CHAM facilities(69%) are technically efficient in Malawi and that only 31% of CHAM facilities are operating at optimal scale size having a scale efficient score of 100%. The study further finds that increase in average length of stay; bed turnover ratio and regional location of a facility in the north decreases technical inefficiency in CHAM facilities. The results of this study showed that 31% of CHAM facilities are operating at less than optimal level. This finding implies that the inefficient hospitals could significantly improve their efficiency by better resource management. The study concludes that decision makers and administrators of the inefficient facilities could identify causes of inefficiencies and take appropriate actions and in some cases consider downsizing both the services provided and staff compositions of inefficient facilities to increase efficiency.