HMIS in Malawi: Achievements, Challenges and the Way Forward

1. HMIS in Malawi: Achievements, Challenges and the Way Forward Presented by A. Muyepa At the First International DHIS Workshop, Mpekweni South Africa, 9-12th Oct. 2006

2. Introduction MOH established an integrated, comprehensive and decentralized HMIS nationwide in January 2002 Covers both public and private facilities Developed through a process of collaboration and consultations with stakeholders ownership of the process, motivation and promotion consensus building Collects minimum data elements for calculating core indicators 110 health sector indicators have been developed and agreed upon Sub sets used for monitoring MDG, MGDS, SWAp, and EHP

3. TRAINING AND CAPACITY BUILDING IN HMIS

4. Training in HMIS Three prolonged approach to capacity development/ strengthening in HMIS In service training On the job training and supervision Pre service training Training in DHIS software DHIS a tool for data processing and report generation

5. In service Training in HMIS Training a major component of HMIS development Developed training and reference manual Trained health workers in data collection, analysis and use Cascade approach used in training health workers Trained Trainers in each district and central hospital TOT trained DHMT and 2 from each health facility On the job training at facility level Over 9000 health workers were training in 2001

6. In service Training in HMIS With BEANISH/HISP funding HMIS module introduced in MPH students in College of Medicine since 2003 HISP Mozambique has assisted in setting up HMIS module in COM More than 15 students train in HMIS every year HMIS training in Tanzania 2 last year and 5 this year BEANISH workshop between Malawi and Mozambique in December 2005

7. In Service Training in DHIS software DHIS software introduced in 2002 for data processing and report generation at Headquarters, districts and central hospitals Trained the following in DHIS software Assistant Statisticians- data processing, presentation HMIS focal persons DHMT members Programme Managers

8. Pre Service Training in HMIS HMIS introduced in health training institutions Curriculum developed and introduced in training institutions for clinicians and nurses in 2002 Examinable subject

9. HMIS IMPLEMENTATION CHALLENGES

10. Human Resource crisis in the health sector Inadequate HR for data collection, analysis and dissemination due to high turn over Capacity inadequacies in data collection, analysis and dissemination especially at facility and district levels Lack of systematic use of data for decision making Inadequate institutional framework at all levels for HMIS/M&E activities Limited support supervision to districts and central hospitals Challenges/Issues

11. Unavailability of people with prerequisite skills Inadequate/aged,computers at hospital and health center level for data entry All these challenges result in low data quality Completeness of data Not all health facilities are submitting reports to district health office Not all data elements are reported by those facilities that report Timeliness of reporting Facilities send Quarterly Reports to DHO late DHOs send reports to Headquarters late HMIS has been unable to provide data timely Challenges/Issues

12. LESSONS LEARNT

16. CURRENT AND FUTURE ACTIVITIES

17. Activities for Strengthening Health Information System Strengthening planning and coordination mechanisms at all levels Restructuring the MOH- Creation of M&E officers positions at Zonal and district levels to provide support supervision Institutionalization of HMIS quarterly review meetings at facility, district and central hospital levels Increase capacity to analyse, present and use data Improve completeness, accuracy and consistency of data Validate data and provide feedback to districts Share experiences and lessons learnt

18. Activities for Strengthening Health Information System Strengthen collaborative efforts between MOH and training institutions- COM Malawi and neighbouring countries With BEANISH/ HISP funding Development of a Training Plan training with emphasis on practical skills and competencies Assistant Statisticians Health workers Policy makers

19. THANKS