HP+ in Malawi: Driving Decisions with Data
By: Anna Lisi, HP+
This blog was first published on Medium.
Data can be a powerful tool for change when it is collected, reviewed, and shared in a meaningful way. Part of what the Health Policy Plus project does is to help others collect and utilize data in order to provide evidence for advocacy and strengthen health systems. Below are a few examples of how this is being done in Malawi, offering a snapshot of the type of work we are doing in this area in countries around the globe.
Health Facility Data Capture and Review
At the Ministry of Health and Population, Jacob Kawonga is a senior monitoring and evaluation advisor, seconded by HP+ to support the Central Monitoring and Evaluation Division. He is helping to develop and implement strategies to ensure that data is being captured at health facilities and used to address gaps. As part of the strategy, training on data capture and review is being rolled out to facilities across the country. The review of health data often reveals information that can be used to improve services. For example, in one community, review of facility data indicated that when pregnancy tests were administered at the facility, there was an increase in the use of antenatal care—most likely because knowing when a woman is pregnant prompts a conversation about follow-up appointments for care. This follow-up care is important in Malawi to reduce the high rate of maternal and neonatal mortality. However, pregnancy tests are not always available and aren't included in the country's essential medicines list. Review of this data prompted advocacy by service providers in the district to address this service gap.
Tracking Condoms among Development Partners
Another example of addressing data gaps to strengthen the health system is our work on the country's condom program. After providing support to develop the national condom strategy, HP+ started working on the stock-out issue. While there is a national policy in place, many facilities simply don't have condoms to distribute (and most people don't have money to buy them). HP+ is piloting a simple Excel tool to track and monitor inventory coming from various development partners to predict and prevent stock-outs. The goal is that each district in Malawi will adopt the tool allowing data to flow up to the national level to be used for decision-making.
At the national level, HP+ played a role in the creation of the Malawi Growth and Development Strategy III, which establishes a roadmap for key multisectoral development goals and includes specific targets and indicators to track achievements from 2017–2022. Our support encouraged a multisectoral approach to addressing population and health issues, which link to other areas of development. This builds off of our work that models the effect that Malawi’s rapid population growth will have on the country’s ability to meet basic needs related to health, education, the economy, and agriculture. Adwell Zembele, Deputy Director at the Department of Economic Planning at the Ministry of Finance, Economic Planning and Development, highlighted that the support we provided was not based on “conditionalities”—instead it was driven by needs identified by the country, an important concept in country-led development.
At the district level, HP+ is helping people like Rueben Mayo, youth-friendly health services coordinator at Nkhata Bay District Hospital, incorporate family planning activities into district implementation plans. In a country with a high rate of teenage pregnancy, it is vital for district-level plans to include—and budget for—these activities in order for goals to be realized. HP+ worked with officials like Rueben on how to use local data (for example, the teenage pregnancy rate) as evidence for budget requests. HP+’s assistance led to a wider understanding at the district planning level of the need for family planning funding in order to reduce teenage pregnancy, keep girls in school, reduce HIV, and reduce maternal death.
These are just some examples of the work we are doing in Malawi—and around the globe—that puts data in the driver’s seat to drive advocacy for change.