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. Page 1/20
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
Email: [email protected]
Diana Khonje, Reproductive Health Unit
Email: [email protected]
Dr. Chris Moyo
Email: [email protected]
Clifford Dedza, IMCI Programme
Email: [email protected]
Willie Kachaka, CMED
Email: [email protected]
WHO
Dr. Felicitas Zawaira, WHO Representative
Email: [email protected]
Ms Ellen Thom - PMTCT
Email: [email protected]
Ms Harriet Chanza - Family Health Planning
Email: [email protected]
Dr. Kambale Susan - Child and Adolescent Health & Nutrition
Email: [email protected]
Dr. Leslie Mgalula - Maternal and Child Health
Email: [email protected]
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:
Grace F. Mlava, Reproductive Health & Newborn specialist - Email:
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
Email: [email protected]
Stanley Midzi - MPN (Zimbabwe, HARARE)
Email: [email protected]
Ishmael Nyasulu - INCO – (TB/HIV NPO)
Email: [email protected]
Dag Roll-Hansen - Headquarters (Health Statistics)
Email: [email protected]
Bernadette Daelmans - Headquarters (Maternal, Newborn, Child and
Adolescent Health)
Email: [email protected]
E4A
Gibson Masache, Chief Executive. Officer - Email: g-
Jimmy Innes, Options Consultancy - Email:
UNIVERSITY COLLEGE OF LONDON
Dr. Bejoy Nambiar, Research Associate - Email:
PARENT AND CHILD HEALTH INITIATIVE (PACHI)
Charles Makwenda, Head of Programmes - Email: c-
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 2/20
Context Possible actions
Assessment 1Plan 1Coordinating Mechanism 1.5Commitment 2Hospital reporting 1.5Community reporting 1Vital statistics 1.5Local studies 3.00
Context Possible actions
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. Page 3/20
COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Malawi
Context Possible actions
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
* This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 4/20
COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Malawi
Context Possible actions
Policy
Infrastructure
Services
Standards 3Governance 2Protection 1
Context Possible actions
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
* This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 5/20
COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Malawi
Context Possible actions
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
* This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 6/20
COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Malawi
Context Possible actions
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.
* This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 7/20
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
($$)
Other
funding
sources
Gap
1. Engage the National Registration
Bureau in OPC to identify the
existing gaps (e.g. vital statistics)
and find out how the health sector
can collaborate/contribute to the
process
Rapid Assessment of National CRVS
using the WHO Quick CRVS
assessment tool
MOH -Planning Dept., NRB,
NSO
Partners: USG, WHO,UNICEF
Oct-12 Dec-12 USAID, CDC,
UNICEF
Establish a National CRVS
Coordinating unit
NRB, MoH, MoLGRD,and
Partner- USG, WHO, UNICEF,
UNFPA, Baobab, Pachi, NSO,
Plan International
Sep-12
Review the current CRVS strategic
plan (2011- 2016)
NRB, MoH, MoLGRD,and
Partner- USG, WHO, UNICEF,
UNFPA, Baobab, Pachi, NSO,
Plan International
Jan-13
2. Enforce of the National
Registration Act of Jan 2010
Formulate regulations to support
the National Registration Act of
2010
MoJ, MoH, NRB, MoLGRD 2013
Sensitize all stakeholders e.g. chiefs,
civil society and religious bodies,
general population, government
NRB, Ministry of Information,
Civil Society, media and all
applicable stakeholders
2013
3. Roll out and strengthen hospital
reporting of births across Malawi
Implement a phased approach in
rolling out of birth reporting (start
with Lilongwe- 52 MW by December
2012).
NRB, Ministry of Health and
partners
Dec-12
Review the pilot project on birth
reporting ( paper based and
electronic based systems) before
national roll out
NRB, MoH, and
partners:UNFPA,UNICEF, NGOs-
Plan International, Baobab
Health Trust
Jan-13
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 8/20
Priority areas/activities Approach/actions Prime responsibility
(government & partners)
Activity
start date
Activity
finalized
2012 2013 2014 2015 Funding
needs
(est.)
Catalytic
funding
request
12/13
Other
funding
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
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
MoH- Clinical and Planning
department
2013
Produce and distribute adapted ICD
manual
MoH- Clinical and Planning
department and partners- USG
and Health training institutions
2013
Roll out ICD to hospitals then
Health Centres
MoH- Clinical and Planning
department and partners- USG
2013
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 9/20
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
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)5. Community reporting of birth
and deaths (with cause): learn from
pilots, roll out
Pilot a system of complementing
the Village Health Register with a
Civil Village Register, using uniform
codes
National CRVS Coordinating
body (MoH and NRB)
National CRVS Coordinating unit to
analyse the complementation of
Village Health register and Civil
Village Register at community level
and recommend way forward
National CRVS Coordinating
body (MoH and NRB) to
conduct
Roll out verbal autopsy at
community level
MoH- Clinical and Planning
department and partners- USG
2013
6. Establish the analytical capacity
of vital statistics office
Build analytical capacity through
training within NRB and MoH
NRB, MoH- Planning(CMED) Jan-13 Dec-15 150,000 32,000 118,000
7. Collaborate and strengthen HDSS
sites
Collaborate with NCST( National
Commission for Science and
Technology) on Health Research
Capacity Strengthening Initiative
and establishment of an additional
HDSS site.
NRB, MoH- Malawi Public
Health Institute(MPHI)
Partners: NCST
Jul-12 Dec-15
Assess existing HDSS systems (in
Karonga, Mangochi-College of
Medicine and Mchinji- Mai Mwana
project) to enhance collaboration.
MoH- Planning Department
Partners: College of Medicine,
Karonga Prevention Study.
Jul-12 Dec-12 5,000 5,000
For sustainability, integrate current
HDSS with government systems
through piloting and eventual roll
out of VS, ICD.
MoH- Planning Department. Jan-13 Dec-15 10,000 5,000 5,000
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 10/20
Priority areas/activities Approach/actions Prime responsibility
(government & partners)
Activity
start date
Activity
finalized
2012 2013 2014 2015 Funding
needs
(est.)
Catalytic
funding
request
12/13
Other
funding
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)
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
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 11/20
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
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)5. Conduct data quality analysis,
with verification of the 11 RMNCH
core indicators
Conduct an assessment of RMNCH
reporting mechanisms with the
intent to inform
integration/streamlining of data
collection and reporting
MOH-RHU and Planning Dept.
Conduct data quality assessment,
with a focus on RMNCH indicators MOH-RHU and Planning Dept.
10,000
Train zonal supervisors in data
quality assessmentsMOH-RHU and Planning Dept.
Establish a mechanism for zonal
supervisors to implement routine
data quality assessments
MOH-RHU and Planning Dept.
6. Conduct 2012 Service Provision AssessmentTechnical Assistance and financial
resources in support
MOH-Planning Dept., NSO
Partners: USAID, ICF Macro
Feb-12 Jul-13
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 12/20
Priority areas/activities Approach/actions Prime responsibility
(government & partners)
Activity
start date
Activity
finalized
2012 2013 2014 2015 Funding
needs
(est.)
Catalytic
funding
request
12/13
Other
funding
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)
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
MOH -RHU Partners: UNFPA;
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
MOH -RHU Partners: UNFPA;
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
MOH -RHU Partners: UNFPA;
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
MOH -RHU Partners: UNFPA;
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
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 13/20
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
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Integrate MDSR initiative in
preservice and inservice training
curriculum for health profesionnals
Work with Medical and Nursing
Councils to update the curriculum.
The councils will work on the
syllabuas while training institutions
will work on the curricula, so
include training institutions, CHAM,
KCN & College of Medicine, Malawi
College of Health sceinces and
Mzuzu University
MoH RHU with Medical and
Nursing Council, partners:
UNFPA, CDC
Jan-13 MoH RHU
with
Medical and
Nusring
Council
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 14/20
Priority areas/activities Approach/actions Prime responsibility
(government & partners)
Activity
start date
Activity
finalized
2012 2013 2014 2015 Funding
needs
(est.)
Catalytic
funding
request
12/13
Other
funding
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)
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
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 15/20
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
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)3. Strengthen the use of eHealth
services to improve information
sharing
Conduct quarterly Coordination
meetings - M&E TWG under SWAP
governance structure, Use Data
standards working group and
mhealth forum sub groups
MOH - Planning Dept., Ministry
of Information, e-government,
Universities in Malawi
(UNIMA,MZUNI) Partners: USG,
UNICEF, WHO,UNFPA,Norway,
NGOs
Jan-13 Dec-15 24,000 8,000
Develop / strengthen a system of
coordination of standards to ensure
interoperability ( DHIS 2- defacto)
MOH - Planning Dept., Ministry
of Information, e-government,
Universities in Malawi
(UNIMA,MZUNI) Partners: USG,
UNICEF, WHO,UNFPA,Norway,
NGOs
Develop data protection, legislation
and regulatory framework for
sharing health and protecting
information.- through M&E TWG
MOH - Planning Dept., Ministry
of Information, e-government,
Universities in Malawi
(UNIMA,MZUNI) Partners: USG,
UNICEF, WHO,UNFPA,Norway,
NGOs
4 Advocate for upgrading of the
infrastructure for electronic
communication-
Conduct negotiation meetings with
Private sector ICT and telecom
providers
MoH, Ministry of Information,
Partners:
Sep-12 Dec-15 3,000
5. Facilitate functional review of
CMED.
Conduct functional reviews of
CMED to establish additional
positions including ICT positions
Dec-15
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 16/20
Priority areas/activities Approach/actions Prime responsibility
(government & partners)
Activity
start date
Activity
finalized
2012 2013 2014 2015 Funding
needs
(est.)
Catalytic
funding
request
12/13
Other
funding
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)
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
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 17/20
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
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)
Strengthen the RMNCH component
in health sector reviews
Conduct zonal and district reviews
in preparation of the sector reviews
MOH ' RHU, IMCI Sep-12 Mar-13 25,000 MoH RHU
and IMCI
with UN and
other
partners
10,000 15,000
Conduct a national MNCH
programme review and develop
consolidated report to feed into the
annual sector reviews
Jan-13 Mar-13 20,000 10,000 MoH
Planning,
RHU, IMCI
and
partners
10,000 0
Develop a progress and
performance report to feed into the
annual sector review, level to be
decided
MOH ' Planning, RHU IMCI Sep-12 Aug-13 50,000 16,000 MoH RHU
and IMCI,
WHO, other
partners
34,000
Create M/E officer position in RHU MoH RHU and Planning Sep-13 staff salary UNDP MDG
acceleration
framework
Advocate for a RHU-specific budget
line
Dec-12 MoH RHU
with UN
partnersStrengthen collaboration and
coordination with civil society
organizations
Do a mapping of the women’ s and
civil society organisations
MOH - Planning Partners:
MHEN, CONGOMA, Ministry of
Gender, Children and
Community Development, Civil
Society, NONM, AMAMI
Dec-12 MoH RHU
and IMCI,
partners
Engage civil society on the MDSR at
the community level and in
preparation of the SWAP reviews
MOH - Planning ,RHU Partners:
Civil Society; CONGOMA
Jan-13 Dec-15 MoH RHU,
partners
ACCOUNTABILITY PROCESSES
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 18/20
Priority areas/activities Approach/actions Prime responsibility
(government & partners)
Activity
start date
Activity
finalized
2012 2013 2014 2015 Funding
needs
(est.)
Catalytic
funding
request
12/13
Other
funding
($$)
Other
funding
sources
Gap
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)
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
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 19/20
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
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Malawi
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
Oct-12 Dec-15 MoH RHU,
IMCI and
partners
Build the capacity of key media
institutions (print and electronic) on
RMNCH
MOH-HEU Partners:
MHEN, civil society
Oct-12 Dec-13 MoH RHU,
IMCI and
partners
Conduct media
briefings/sensitisation on the
importance of RMNCH and
accountability
MOH-HEU Partners:
MHEN, civil society
Oct-12 Dec-15 MoH RHU,
IMCI and
partners
Build capacity of community and
faith based leaders on RMNCH
MOH-HEU Partners:
MHEN, civil society
Oct-12 Dec-13 MoH RHU,
IMCI and
partners
TOTALS 600,000 250,000 60,000 202,000
* This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 20/20