COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Malawi

COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Malawi

Policy Context

Global strategy on women and children/

commitment

National Health Sector Plan and

M&E Plan

M&E Platform

Situation Analysis

Malawi will strengthen human resources for health, including accelerating training and recruitment of health professionals to fill all available positions

in the health sector; expand infrastructures for maternal, newborn and child health; increase basic emergency obstetric and neonatal care coverage to

reach World Health Organization standards; and provide free care through partnerships with private institutions.

In addition to program monitoring and evaluation (M & E) data routinely collected using the Health Management Information System (HMIS), the

PoW also provided for Joint Annual Reviews (JAR) for the health sector, the mid-term review (MTR) and the final evaluation as ways of measuring

progress towards achieving the targets set in 2004. The PoW expired in June 2010 but was extended for one year partly to allow for the final

evaluation to be completed. The results from both the MTR and the final evaluation informed the development of the Health Sector Strategic Plan

(HSSP) 2011-2016. Over the period of the HSSP the MoH and stakeholders will ensure that monitoring and evaluation is strengthened including

making the HMIS functional.

Some of the key strategies to strengthen M&E are: 1) Strengthen the HIS policy and legislative environment; 2) Build the capacity of the health sector

to effectively generate, manage, disseminate and utilise health information at all levels of the sector for programme management and development;

3) Strengthen the monitoring and evaluation system for Malawi’s health sector. The development of a comprehensive M&E strategic plan is one of

the intervention to strengthen M&E.

The goal of Malawi's National Health Policy is to improve the health status of all the people of Malawi by reducing the risk of ill health and occurrence

of premature deaths. This overall goal will be achieved by implementing strategies and interventions that address critical areas in health services

delivery such as management, hospital reform, quality assurance, public private partnerships, human resources for health, drugs and medical supplies,

blood safety, infrastructure and health financing. The national health policy also redefines the essential health package (EHP) based on the burden of

disease study and the STEPS survey and it further puts emphasis on the need for an effective monitoring, evaluation and research system that will

address the data needs of the sector. The Sector Wide Approach (SWAp)

Program of Work (PoW) for Malawi covered the period 2004-2010 and it guided the implementation of interventions aimed at improving the health

status of the people of Malawi. The MoH, Health Development Partners (HDPs) and other stakeholders in the health sector were involved in the

development and implementation of the PoW.

* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. /20

Country team present at the National Accountability Workshop, 29-31 May 2012

MINISTRY OF HEALTH

Dr. Ann Maureen Phoya, Director

Email: [email protected]

Fannie Kachale, Reproductive Health Unit


Diana Khonje, Reproductive Health Unit


Dr. Chris Moyo


Clifford Dedza, IMCI Programme


Willie Kachaka, CMED


WHO

Dr. Felicitas Zawaira, WHO Representative


Ms Ellen Thom - PMTCT


Ms Harriet Chanza - Family Health Planning


Dr. Kambale Susan - Child and Adolescent Health & Nutrition


Dr. Leslie Mgalula - Maternal and Child Health


UNFPA

Gift Malunga, Deputy Rep - Email: [email protected]

Dr. Chris Oyeyipo, Reproductive Health - Email: [email protected]

Grace Hiwa - Email: [email protected]

CHAM

Grace Banda, Program Manager - Email: [email protected]

UNFPA

Jean Mwandira, Reproductive Health - Email: [email protected]

UNICEF

Ellubey Rachel Maganga, Health Specialist - Email:

[email protected]

Grace F. Mlava, Reproductive Health & Newborn specialist - Email:

[email protected]

Nyson Chizani - Email: [email protected]

NORWEGIAN EMBASSY

Georgina Chinula - Email: [email protected]

CIVIL SOCIETY (MHEN)

Martha Kwataine - Email: [email protected]

MEDICAL COUNCIL OF MALAWI

Kondwani Mkandawire - Email:[email protected]

CENTRE FOR REPRODUCTIVE HEALTH - COLLEGE OF MEDICINE

Dr F. Taulo - Email: [email protected]

FAMILY HEALTH INTERNATIONAL

Malla Mabona, Acting Country Director - Email: [email protected]

UNICEF

Clemens Gros, M&E Officer - Email: [email protected]

USAID

Chimwemwe Chitsulo, Monitoring, Learning &Evaluation - Email: [email protected]

BAOBAB HEALTH TRUST

Patricia Khomani, Senior Project Coordinator - Email: [email protected]

NURSES AND MIDWIVES COUNCIL OF MALAWI

Thokozire Lipato - Email: [email protected]

LUKE INTERNATIONAL NORWAY (LIN)

Francis J. Mafupa, Deployment Officer - Email: [email protected]

CIDA

Julita Manda Nkhwazi, Nutrition Advisor - Email: [email protected]

KAMUZU COLLEGE OF NURSING

Martha Kamanga - Email: [email protected]

NATIONAL REGISTRATION BUREAU

Peter Chitedze, Director - Email: [email protected]

Dr. Francis Magombo - MPN


Stanley Midzi - MPN (Zimbabwe, HARARE)


Ishmael Nyasulu - INCO – (TB/HIV NPO)


Dag Roll-Hansen - Headquarters (Health Statistics)


Bernadette Daelmans - Headquarters (Maternal, Newborn, Child and

Adolescent Health)


E4A

Gibson Masache, Chief Executive. Officer - Email: g-

[email protected]

Jimmy Innes, Options Consultancy - Email:

[email protected]

UNIVERSITY COLLEGE OF LONDON

Dr. Bejoy Nambiar, Research Associate - Email:

[email protected]

PARENT AND CHILD HEALTH INITIATIVE (PACHI)

Charles Makwenda, Head of Programmes - Email: c-

[email protected]


Context Possible actions

Assessment 1Plan 1Coordinating Mechanism 1.5Commitment 2Hospital reporting 1.5Community reporting 1Vital statistics 1.5Local studies 3.00


National M&E Plan 3M&E Coordination 1.5Health Surveys 1.5Facility data (HMIS) 0.666666667Data sharing 1Analytical capacity 3Equity 2MNCH indicators

There is a national monitoring and evaluation (M&E) plan and coordinating committee.

Greater involvement of academia is needed. Discussions are underway to conduct an

endline survey in 2013 with the purpose of reporting on the MDG in 2015. HMIS has

problems of completeness and data quality. There is a District Health Information

System 2 (DHIS-2) pilot in 2 districts. Analytical capacity is limited and there is no

specific focus on maternal, neonatal and child health (MNCH). Equity data are

presented but can be done more effectively. Limited capacity of data consolidation and

storage at district level.

1. Participate in the design of the MDG end-line survey

2. Strengthen analytical capacity of MOH at district and central

3. Ensure functional district databanks and establish a central data repository

4. Review and revise the M&E plan for the Malawi Health Sector Strategic Plan

(HSSP) to ensure the 11 RMNCH core indicators are included

5. Conduct data quality analysis, with verification of key indicators

COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Malawi

Civil registration & vital

statistics systems

Monitoring of results

The Government of Malawi is committed to civil registration and vital statistics (CRVS)

strengthening. Legal Framework in place,several Acts( Constitution of R.of Malawi,

Refugee Act, Local Government Act, Presidential and Parliamentary Act, National

Registration Act), CRVS Strategic plan (2011-2016), registration is mandatory, roll out

hospital reporting within 24 months, roll out - Mass registration using mobile community

vans, community reporting through current system and Village Registers, pilot electronic

reporting within Lilongwe through Baobab health Trust( 2012). Hospital reporting is not

complete, verbal autopsy protocal and ICD under discussion. Community reporting

systems are in pilot stage. There are 2 health and demographic surveillance (HDSS) site

in Karonga and Mangochi,one proposed additional site in Central region - 10yrs project -

then establish 1 HDSS site( under LSTM ), Mai Mwana( since 2005, 10yrs project)-

Mchinji. Coordination of CRVS through NRB.

1. NRB conducted an assessment on civil registration but Vital statistics issues not

done.National CRVS Coordinating body (MoH and NRB) to conduct quick

assessment, Review the current strategic plan if necessary to improve it.

2. Formulation of Regulations to support the acts by NRB

3. Roll out and Strengthen hospital reporting of births across Malawi ( phased

apporach start with Lilongwe( 52 MW by December2012). Capacity building and

training , 4.Innitiate use of ICD

for causes of death for hospital reporting ( Build capacity through- In service and

pre service Training, on- line ICDtraining, ICDmanual provision, Look at possibilities

of use of ICD. Phased approach - start Central Hospital

5. Community reporting of birth and deaths (with cause): learn from pilots, roll

out,use innovative approaches, verbal autopsy, Village Health register to

compliment Civil Village Register at community level. Pilot use of key informants to

ID births and deaths - use interVA for verbal autopsy.

6. Strengthen analytical capacity of vital statistics office

7. Establish and strengthen 1 additional HDSS sites in Central Region and the 2

existing sites (Karonga, Mangochi) and ensure good reporting. Intergrate existing

system into government systems for sustainability ( use project and program

approach - eg. Mai- Mwana Project)

* This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. /20



Notification 1Capacity to review and act 1.5Hospitals / facilities 2Quality of care 2Community reporting & feedback 0.5Review of the system 3

The national level committee is not functional and has not produced any report since it

was constituted. While reviews take place and most of the districts report on maternal

deaths, there is no reporting at the national level. The capacity to do maternal death

surveillance and response (MDSR) is limited. Reporting is timely but ICD is just being

piloted. The private clinics sometimes are not willing to provide data/information. The

competence of those doing the maternal death audits is not at the desired level in some

cases. An emergency obstetric and neonatal care (EmONC) assessment was done in

2010.

1. Conduct a qualitative assessment of the current status of maternal deaths review

and notification in selected districts to identify strengths and weaknesses, as well as

opportunities for strengthening the system.

2. Build capacity of district health managers and health staff to conduct maternal

deaths surveillance and response using new WHO/CDC/University of Aberdeen

guidance.

3. Adapt the existing guidelines, forms and classifications based on standards

recommended by WHO.

4. Review legislation and ensure that there is a national policy recommending

notification of maternal deaths within 24 hours, as well as protection of health

professionals engaged in maternity services.

5. Develop a plan for introducing MDSR, phasing in the various components. A first

priority will be to strengthen reporting in public health facilities. This can be

followed by strengthening community-based reporting and verbal autopsy. A

blended approach might be considered for selected districts.

6. Build capacity for implementation of MDSR

7. Introduce new components in MDSR as the system is getting stronger, e.g. for

perinatal deaths or near miss events, confidential enquiry.

8. Strengthen the national committee and support the preparation of periodic

reports.

9. Integrate MDSR in the Integrated Disease Surveillance and Response system

10. Collaborate with the HMIS unit on the introduction of the ICD classification

system.

Maternal death

surveillance & response




Policy

Infrastructure

Services

Standards 3Governance 2Protection 1


National health accounts 2Compact and coordination 2Production capacities 0Data use 1

Health management information system (HMIS) strategy is available and the e-health is

part of the HMIS strategy. Draft national ICT policy at national level( Housed by Min. of

Information- process since 2003, ehealth strategy at MoH being complied- by task force-

draft by end 2012, All systems at aggregate level to be linked to DHIS 2.0( currently in 2

districts- Sallima and Lilongwe), to roll out national wide-UNFPA- 5 districts, UNICEF- 6

districts, USAID- 12 districts, MoH to introduce in remaining districts-5, Norway has

resources for this,Plan for roll out available, Cover equipment, Training, follow ups.

Piloted Electronic medical records system and roll out to all sites. Start with High burden

sites, start with District Hospital then Health Centres. ICT being used for Reproduction,

maternal, neonatal and child health (RMNCH). Baobab for MoH has developed ANC,

Maternity Modules, Pilot in Bwaila and roll out to 7 sites . Birth Reports to be

intergrated into the Maternity system. Various organisations working on mhealth and

ehealth - coordinated through mhealth and data standards sub group- landsacpe

available to define area of operation. Cell phones are available but internet needs to be

upgraded, costs for SMSing an issue . The availability of electricity in all facilities also

needs to be upgraded. There are issues with compatibility of data from different

systems.

There is a national health account (NHA) framework and in 2004 and in 2010 MNCH

subaccounts were done. There is no compact but resource mapping is done and there is

a joint funding agreement for sector-wide approach (SWAp). However, the coordinating

mechanism for NHAs and resource tracking is not functioning properly. NHA production

capacity needs considerable strengthening. Capacity to monitor and track resources at

subnational level, including zones and districts, is very limited.

1. Evaluate the RMNCH project and then scale up ICT for MNCH

2. Advocate for upgrading of the infrastructure for electronic communication- by

MoH, Ministry of Information

3. Connect electricity in all health facilities and staff houses that dont have power

and also look at altanative power sources such as solar and wind energy.

4. Strengthen the use of eHealth services to improve information sharing through M

and E technical working group under SWAP governance structure. Use Data

standards working group and mhealth forum sub groups to feed into M and E TWG-

MoH

5. Develop / strengthen a system of coordination of standards to ensure

interoperability ( DHIS 2- defacto)

6. Use existing Data Standards Subgroup on data security, archtecture, data to

develop data protection, legislation and regulatory framework for sharing health

and protecting information.

7. HIS strategic plan - conducting functional reviews by 2016 with view to establish

ICT positions in MoH.

1. Build capacity of MOH Planning Unit to routinely conduct NHA

2. Set up a steering committee, officially approved, with institutional support, and

functioning using results-based management methods

3. Support institutionalization of NHA at MOH Planning department

4. Use subaccounts for RMNCH for budgeting

Monitoring of resources

Innovation and eHealth




Annual reviews 2Synthesis informs reviews 1.5From review to planning 2.5Compacts or equivalent 3

Annual multi-sector reviews and joint annual reviews (JAR) are conducted mid-year and

annually. While key stakeholders are involved, follow-up of agreed upon action points is

not done adequately. Civil society are involved but women’s organizations are not

adequately involved. M&E framework is available in the HSSP and is used for the

reviews; however, the M&E plan is understood differently by different partners and

there is a multiplicity of tools used to measure this. Data collection for the millennium

development goals (MDG) monitoring is weak. Reproductive health (RH) indicators are

not included in the Welfare Monitoring Surveys. While survey data are good, there is

weakness in the way HMIS data is collected. More work is needed in data utilization.

There are multiple reporting channels by different stakeholders that do not involve the

MOH. Maternal death audits are conducted (by civil society) but it is not systematically

done and it is not discussed at the national level. A maternal death audit committee

was put in place but is not active. Mechanisms for M&E exist e.g. the new

HSSP has been developed based on the review of the previous strategic plan (sector

wide approach (SWAp) programme of work). While stakeholders are involved through

technical working groups (TWG), in the zonal and district review meetings, challenges

remain on how to translate the review milestones at the district level. No full compact

exists - only those partners in the SWAp pool are involved. SWAp is midway to achieving

this. While typically not the case, reprogramming can occur within an organization

when an activity has already been done using other funds. Sector reviews do take place

but not all partners are engaged and not all partners buy in. Synthesis of information is

done but does not make full use of data available.

1. Conduct district and zonal reviews biannually in order to assess the situation and

collect relevant information for discussion in the technical working groups and for

input in the mid-term and annual health sector review meetings.

2. Conduct an annual review of progress of MNCH at the national level, and prepare

a consolidated report for input in the annual health sector review meeting.

3. Establish the position of a monitoring and evaluation office in the RHU

4. Build capacity for conducting a full a progress and performance review of the

health sector as a key preparation for a sector review, with technical assistance

from WHO.

5. Strengthen collaboration of the MoH with civil society organizations, to

contribute in the management and review of programs and progress.

Accountability processes




Parliament active in RMNCH 1.5Active RMNCH civil society 1.67RMNCH progress report/review 2.6Media role 0.75National Countdown meeting 0

KEY: Needs to be developed/done

Needs a lot of strengthening

Needs some strengthening

Already present/no action needed

1. Develop an engagement strategy to define approaches and working mechanisms

to collaborate with multiple partners.

2. Establish strong links with the Presidential Initiative on MDG5.

3. Organize a national Countdown to 2015 event to discuss actual progress data by

district, and stimulate action of a broad range of constituencies including high level

decision makers and parliamentarians on the most pressing issues regarding the

health of women and children. Time it prior to the annual sector review.

4. Build capacity of media and civil society organizations to communicate on MNCH

related issues.

5. Implement the engagement strategy and interact with parliamentarians, media,

community leaders and other relevant groups.

Advocacy & outreach

Parliament: Legislative support for MNCH issues is weak. Civil society not active in

RMNCH. While there is no coalition of civil society, there is strong engagement of

community leaders on maternal health. RMNCH progress report and reviews are not

prominent, but some reviews on the integrated management of childhood illness ( IMCI)

and MNCH acceleration plan review have been done

Media: There is a weekly column on RMNCH in newspapers and community radio

programmes on RMNCH issues. However, sustainability of these programmes could be a

problem as they ares a donor-funded initiative.


Priority areas/activities Approach/actions Prime responsibility

(government & partners)

Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap

1. Engage the National Registration

Bureau in OPC to identify the

existing gaps (e.g. vital statistics)

and find out how the health sector

can collaborate/contribute to the

process

Rapid Assessment of National CRVS

using the WHO Quick CRVS

assessment tool

MOH -Planning Dept., NRB,

NSO

Partners: USG, WHO,UNICEF

Oct-12 Dec-12 USAID, CDC,

UNICEF

Establish a National CRVS

Coordinating unit

NRB, MoH, MoLGRD,and

Partner- USG, WHO, UNICEF,

UNFPA, Baobab, Pachi, NSO,

Plan International

Sep-12

Review the current CRVS strategic

plan (2011- 2016)

NRB, MoH, MoLGRD,and

Partner- USG, WHO, UNICEF,

UNFPA, Baobab, Pachi, NSO,

Plan International

Jan-13

2. Enforce of the National

Registration Act of Jan 2010

Formulate regulations to support

the National Registration Act of

2010

MoJ, MoH, NRB, MoLGRD 2013

Sensitize all stakeholders e.g. chiefs,

civil society and religious bodies,

general population, government

NRB, Ministry of Information,

Civil Society, media and all

applicable stakeholders

2013

3. Roll out and strengthen hospital

reporting of births across Malawi

Implement a phased approach in

rolling out of birth reporting (start

with Lilongwe- 52 MW by December

2012).

NRB, Ministry of Health and

partners

Dec-12

Review the pilot project on birth

reporting ( paper based and

electronic based systems) before

national roll out

NRB, MoH, and

partners:UNFPA,UNICEF, NGOs-

Plan International, Baobab

Health Trust

Jan-13

COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi

CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Build capacity for hospital-based

reporting of birth through pre and

in-service training, targeting

training institutions e.g. College of

Medicine, Chanco, Health Sciences,

KCN, Christian Health Association

(CHAM) nursing schools

NRB + MoH in conjunction with

training institutions

2013

4. Strengthen hospital reporting

and use of ICD for causes of death

Conduct Sample Vital Registration

with Verbal Autopsy (SAVVY)

MOH - Planning Dept., USG Oct-12

Discuss ICD in M and E TWG in MoH MoH- Clinical and Planning

department

Jun-12

Conduct ICD Training (pre and in

service), targeting training

institutions e.g. College of

Medicine, Chanco, Health Sciences,

KCN and Christian Health

Association (CHAM) nursing schools

NRB + MoH in conjunction with

training institutions

Jan-13 Dec-13

Initiate use of ICD for causes of

death in hospital reporting

MoH- Clinical and Planning

department, Baobab Health

Trust

2013

Adapt the ICD Manual MoH- Clinical and Planning

department

2013

Do a phased implementation

starting with the Central Hospital


department

2013

Produce and distribute adapted ICD

manual


department and partners- USG

and Health training institutions

2013

Roll out ICD to hospitals then

Health Centres



2013




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)5. Community reporting of birth

and deaths (with cause): learn from

pilots, roll out

Pilot a system of complementing

the Village Health Register with a

Civil Village Register, using uniform

codes

National CRVS Coordinating

body (MoH and NRB)

National CRVS Coordinating unit to

analyse the complementation of

Village Health register and Civil

Village Register at community level

and recommend way forward

National CRVS Coordinating

body (MoH and NRB) to

conduct

Roll out verbal autopsy at

community level



2013

6. Establish the analytical capacity

of vital statistics office

Build analytical capacity through

training within NRB and MoH

NRB, MoH- Planning(CMED) Jan-13 Dec-15 150,000 32,000 118,000

7. Collaborate and strengthen HDSS

sites

Collaborate with NCST( National

Commission for Science and

Technology) on Health Research

Capacity Strengthening Initiative

and establishment of an additional

HDSS site.

NRB, MoH- Malawi Public

Health Institute(MPHI)

Partners: NCST

Jul-12 Dec-15

Assess existing HDSS systems (in

Karonga, Mangochi-College of

Medicine and Mchinji- Mai Mwana

project) to enhance collaboration.

MoH- Planning Department

Partners: College of Medicine,

Karonga Prevention Study.

Jul-12 Dec-12 5,000 5,000

For sustainability, integrate current

HDSS with government systems

through piloting and eventual roll

out of VS, ICD.

MoH- Planning Department. Jan-13 Dec-15 10,000 5,000 5,000




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap



Establish consensus, among

stakeholders, on RMNCH indicators

to be included in the 2013 endline

survey (forum will be TWG)

MOH - Planning Dept., RHU,

NSO

Partners: UN; Kfw; USAID;

Norway

Jun-12 Planned and funded

Support data requirements for the

MNCH National Evaluation Platform

and measure implementation

strength

MOH IMCI, RHU; NSO; HMIS

Partners: UN, CIDA, JHU, PSI,

Save The Children

2. Strengthen analytical capacity of

MOH at district and central levels

Train health care workers (incl.

statistical clerks, HMIS officers and

assistant statisticians) in data

management, analysis and

reporting

MOH Planning Dept. Partners:

UN, CDC, Statistics Norway,

USAID, E4A

Jul-12 20,000

Provide ICT equipment to districts

health offices for use by HMIS MOH Planning Dept.

Jul-12

Establish a follow-up and support

mechanism to trained and equiped

district health offices

MOH Planning Dept. Partners:

UN, CDC, Statistics Norway,

USAID, E4A

3. Support the establishment of

district databanks and establish a

central data repository

Evaluate (internal) pilot of DHIS2 to

inform future roll-out

MOH -Planning

Partners: College of Medicine,

CDC, UN, USAID, Statistics

Norway

4. Review the M&E plan for the

Malawi Health Sector Strategic Plan

(HSSP) to ensure the 11 RMNCH

core indicators are included

Support TWG meetings to discuss

and resolve the few discrepancies in

the two RMNCH indicators included

in the HSSP

MOH-RHU and Planning Dept.

1. Participate in the design of the

2013 MDG end-line survey

MONITORING OF RESULTS




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)5. Conduct data quality analysis,

with verification of the 11 RMNCH

core indicators

Conduct an assessment of RMNCH

reporting mechanisms with the

intent to inform

integration/streamlining of data

collection and reporting


Conduct data quality assessment,

with a focus on RMNCH indicators MOH-RHU and Planning Dept.

10,000

Train zonal supervisors in data

quality assessmentsMOH-RHU and Planning Dept.

Establish a mechanism for zonal

supervisors to implement routine

data quality assessments


6. Conduct 2012 Service Provision AssessmentTechnical Assistance and financial

resources in support

MOH-Planning Dept., NSO

Partners: USAID, ICF Macro

Feb-12 Jul-13




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap



Strengthen the MDR system to

become MDSR at all levels:

recommendations to the SRH TWG

to form a task force to kick start the

MDSR processes are to be made.

Conduct a situational analysis in 6

districts yet to be identified

MOH -RHU Partners: UNFPA;

WHO; UNICEF, E4A, CDC, LATH,

others

Jul-12 Sep-12 20,000 10,000 RHU, E4A,

UN, other

partners

10,000

Conduct MDSR orientation and

capacity building workshop for all

stakeholders at national level '

following the approach used in

Tanzania


WHO; UNICEF, E4A, CDC, LATH,

others

Sep-12 30,000 20,000 RHU, UN,

E4A, other

partners

10,000 0

Work with the HMIS system to

adopt the ICD10 classifications - to

be discussed

RHU, Planning, CDC, others Jul-12

Review and update the national

guidelines and forms for MDSR

Conduct a workshop of national

experts to review and revise

existing forms /tools to reflect

MDSR


WHO; UNICEF, E4A, CDC, LSTM,

others

Oct-12 5000 RHU, UN,

other

partners

Integrate MDSR in the IDRS

approach

MoH Planning and RHU Oct-12 MoH RHU

Build capacity for implementation

of MDSR in districts

Develop a phased plan to roll out

components of the MDSR approach

in health facilities and communities


WHO; UNICEF, E4A, others

Oct-12 15,000 MoH RHU

and

partners

Implement the plan, focus on

strengthening capacity in health

facilities first, then strengthen

community surveillance and

response, implemented a blended

approach in selected districts


WHO; UNICEF, E4A, others

Oct-12 Dec-15 100,000 MoH RHU

and

partners

Add new components as capacity is

being strengthened, eg, perinatal

deaths review, near miss review

Jan-14 MoH RHU

and

partners

MATERNAL DEATH SURVEILLANCE AND RESPONSE




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Integrate MDSR initiative in

preservice and inservice training

curriculum for health profesionnals

Work with Medical and Nursing

Councils to update the curriculum.

The councils will work on the

syllabuas while training institutions

will work on the curricula, so

include training institutions, CHAM,

KCN & College of Medicine, Malawi

College of Health sceinces and

Mzuzu University

MoH RHU with Medical and

Nursing Council, partners:

UNFPA, CDC

Jan-13 MoH RHU

with

Medical and

Nusring

Council




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap



1. Identify best practices in e-health

for potential scale up

Conduct a consolidated situation

analysis on e-health

MOH - Planning Dept., Ministry

of Information, e-government,

Universities in Malawi

(UNIMA,MZUNI) Partners: USG,

UNICEF, WHO,UNFPA,Norway,

NGOs

Dec-12 7,000 7,000 0

Evaluate the RMNCH projects that

are using ICT for scale up

MoH- RHU, IMCI,

Planning(CMED), e-

government, Partners:

UNICEF, UNFPA, WHO, USG,

NGOs, Universities in Malawi

Dec-12

Conduct e-Health dissemination

workshop on best practices and

promote buy-in

MoH, Ministry of Information, Jan-13 4,000 4,000 0

Feed the findings into the ehealth

strategy

2. Computerisation of Integrated

Health Management Information

System(HMIS)

Provision of ICT equipment for

communication, EMRS,e reporting,

MoH- Planning, MoFinance,

RHU, IMCI, Information

Partners: USG, NGO

Ongoing activity

Training health care workers on ICT

systems

MoH- Planning, MoFinance,

RHU, IMCI, Information

Partners: USG, NGO

INNOVATION AND E-HEALTH




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)3. Strengthen the use of eHealth

services to improve information

sharing

Conduct quarterly Coordination

meetings - M&E TWG under SWAP

governance structure, Use Data

standards working group and

mhealth forum sub groups






NGOs

Jan-13 Dec-15 24,000 8,000

Develop / strengthen a system of

coordination of standards to ensure

interoperability ( DHIS 2- defacto)






NGOs

Develop data protection, legislation

and regulatory framework for

sharing health and protecting

information.- through M&E TWG






NGOs

4 Advocate for upgrading of the

infrastructure for electronic

communication-

Conduct negotiation meetings with

Private sector ICT and telecom

providers

MoH, Ministry of Information,

Partners:

Sep-12 Dec-15 3,000

5. Facilitate functional review of

CMED.

Conduct functional reviews of

CMED to establish additional

positions including ICT positions

Dec-15




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap



1. Build capacity of MOH Planning

Unit to routinely conduct NHA

Train MOH, MOF and NSO officials

in NHA and the use of the NHA

production tool

MOH - Planning

Partners: UN, USAID

50,000 50,000 0

2. Support institutionalization of

NHA at MOH

Set up a steering committee,

officially approved, with

institutional support, and

functioning using results-based

management methods

MOH-Planning Partners: UN,

USAID

3. Use subaccounts for RMNCH to

inform budgeting

Advocate for the inclusion of a

budget line specifically for RMNCH

MOH-RHU

Partners: UN, MHEN

4. Tracking RMNCH resources at

district level

Adopt and adapt NHA tool for

monitoring and tracking RMNCH

resources at district levelMOH-RHU, Planning Dept.

Partners: UN

10,000 10,000 0

MONITORING OF RESOURCES




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap



Strengthen the RMNCH component

in health sector reviews

Conduct zonal and district reviews

in preparation of the sector reviews

MOH ' RHU, IMCI Sep-12 Mar-13 25,000 MoH RHU

and IMCI

with UN and

other

partners

10,000 15,000

Conduct a national MNCH

programme review and develop

consolidated report to feed into the

annual sector reviews

Jan-13 Mar-13 20,000 10,000 MoH

Planning,

RHU, IMCI

and

partners

10,000 0

Develop a progress and

performance report to feed into the

annual sector review, level to be

decided

MOH ' Planning, RHU IMCI Sep-12 Aug-13 50,000 16,000 MoH RHU

and IMCI,

WHO, other

partners

34,000

Create M/E officer position in RHU MoH RHU and Planning Sep-13 staff salary UNDP MDG

acceleration

framework

Advocate for a RHU-specific budget

line

Dec-12 MoH RHU

with UN

partnersStrengthen collaboration and

coordination with civil society

organizations

Do a mapping of the women’ s and

civil society organisations

MOH - Planning Partners:

MHEN, CONGOMA, Ministry of

Gender, Children and

Community Development, Civil

Society, NONM, AMAMI

Dec-12 MoH RHU

and IMCI,

partners

Engage civil society on the MDSR at

the community level and in

preparation of the SWAP reviews

MOH - Planning ,RHU Partners:

Civil Society; CONGOMA

Jan-13 Dec-15 MoH RHU,

partners

ACCOUNTABILITY PROCESSES




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap



Conduct a National Countdown

2015 exercise

Establish an informal task force to

start planning

MOH - RHU and IMCI

Partners: UNFPA; UNICEF;

WHO, E4A, others

Jul-12 UNDP

(MAF), other

UN

agencies,

other

partners

20,000

Develop a plan and time frame for

conducting a country Countdown

Jul-12

Review data needs and availability,

create data profiles for district or

sub'national levels

Jul-12 Dec-12

Plan national meeting and media

events

Nov-12 Mar-13

Conduct a national Countdown

conference

Apr-13 50,000 30,000 20,000

ADVOCACY & ACCOUNTABILITY




Activity

start date

Activity

finalized

2012 2013 2014 2015 Funding

needs

(est.)

Catalytic

funding

request

12/13

Other

funding

($$)

Other

funding

sources

Gap


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Develop and implement an

engagement strategy

Engage with E4A experts to develop

a strategy for engagement with civil

society and other partners for

advocacy, transparency, and

accountability

MOH, RHU, IMCI Partners:

E4A, UNFPA; UNICEF; WHO,

others

Oct-12 Mar-13 20,000 10,000 E4A; UN

partners

10,000 0

Include RMNCH reports on MOH

webpage

Jan-13 Jun-13 5000 E4A, UN

partners

Brief the parliamentarians of

RMNCH

MOH - RHU and IMCI

Partners: UNFPA; UNICEF;

WHO, Women Caucus

Oct-12 Dec-15 MoH RHU,

IMCI and

partners

Support the presidential initiative

on maternal health and

safemotherhood

MOH, RHU, IMCI Partners:

E4A, UNFPA; UNICEF; WHO,

others


IMCI and

partners

Build the capacity of key media

institutions (print and electronic) on

RMNCH

MOH-HEU Partners:

MHEN, civil society


IMCI and

partners

Conduct media

briefings/sensitisation on the

importance of RMNCH and

accountability

MOH-HEU Partners:

MHEN, civil society


IMCI and

partners

Build capacity of community and

faith based leaders on RMNCH

MOH-HEU Partners:

MHEN, civil society


IMCI and

partners

TOTALS 600,000 250,000 60,000 202,000


COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Malawi

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