Design and implementation of a health management information system in Malawi: issues, innovations and results

As in many developing countries, lack of reliable data and grossly inadequate appreciation and use of available information in planning and management of health services were two main weaknesses of the health information systems in Malawi. Malawi began strengthening its health management information...

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Bibliographic Details
Published in:	Health policy and planning Vol. 20; no. 6; pp. 375 - 384
Main Authors:	Chaulagai, Chet N, Moyo, Christon M, Koot, Jaap, Moyo, Humphrey BM, Sambakunsi, Thokozani C, Khunga, Ferdinand M, Naphini, Patrick D
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 01-11-2005 Oxford Publishing Limited (England)
Subjects:	Births Data collection Developing countries Development studies Diffusion of Innovation Government policy Health administration Health care policy Health facilities health information management Health information services Health management health management information system Health policy Health services Hospitals Information management Information systems Innovation LDCs Malawi Management information systems Maternal mortality Medical Informatics - organization & administration Medical personnel Original article Planning Program Development Studies Malawi
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Summary:	As in many developing countries, lack of reliable data and grossly inadequate appreciation and use of available information in planning and management of health services were two main weaknesses of the health information systems in Malawi. Malawi began strengthening its health management information system with an analysis of the strengths and weaknesses of existing information systems, sharing findings with all stakeholders. All were agreed on the need for reformation of various, vertical programme-specific information systems into a comprehensive, integrated, decentralized and action-oriented simple system. As a first step towards conceptualization and design of the system, a minimum set of indicators was identified and a strategy was formulated for establishing a system in the country. The design focused only on the use of information in planning, management and the improvement of quality and coverage of services. All health and support personnel were trained, employing a training of trainers cascade approach. Information management and use was incorporated into the pre-service training curriculum and the job description of all health workers and support personnel. Quarterly feedback, supportive supervision visits and annual reviews were institutionalized. Civil society organizations were involved in monitoring coverage of health services at local levels. A mid-term review of the achievements of the health information system judged it to be one of the best in Africa. For the first time in Malawi, the health sector has information by facility by month. Yet very little improvement has been noted in use of information in rationalizing decisions. The conclusion is that, no matter how good the design of an information system, it will not be effective unless there is internal desire, dedication and commitment of leadership to have an effective and efficient health service management system.
Bibliography:	istex:DCCF5CD5DBE986AB1C51FBE43471747D24375FF1 ark:/67375/HXZ-5CPCP1Z2-D local:czi044 Correspondence: Chet Nath Chaulagai, Kapan-1, GPO Box 12159, Kathmandu, Nepal. Tel: +977 1 481 0504; Fax: +977 1 481 0740; E-mail: chaulagaichet@yahoo.com or chaulagai@info.com.np ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0268-1080 1460-2237
DOI:	10.1093/heapol/czi044