Problems associated with the health management information system at district level in southern Malawi

Kasambara, Ansley and Kumwenda, Save and Kalulu, Khumbo and Lungu, Kingsley and Morse, Tracy and Beattie, Tara and Masangwi, Salule and Ferguson, Neil (2016) Problems associated with the health management information system at district level in southern Malawi. Malawi Medical Journal : the Journal of Medical Association of Malawi. pp. 1-20. ISSN 1995-7262 (Unpublished)

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Abstract

Introduction: Malawi implemented a Health Management Information System (HMIS) in 1999 whose aim was to improve health data management. However, there still exists a deficiency of accurate, reliable and timely health data to inform effective planning and resource management. Methods: A cross sectional survey was conducted where qualitative and quantitative data was collected through in-depth interviews, documentation review and focus group discussions. Study participants comprised of 10 HMIS Officers and 10 District Health Managers, from 10 districts in the southern region of Malawi. The study was conducted from March to April 2012 and the data collected was transcribed to identify theme and key points. Results: The study established that 1 out of 10 HMIS Officers was qualified for the post using Ministry of Health HMIS minimum requirements. The HMIS Officers stated that data collectors for HMIS from the district hospital, health facilities and the community included Medical Assistants, Nurses/Midwives, Statistical Clerks and Health Surveillance Assistants. Challenges with the system included inadequate resources, knowledge gaps, inadequacy of staff and lack of training and refresher courses which lead to information provided not being reliable. The HMIS Officers further commented that missing values arose from incomplete registers and data gaps. Furthermore, improper comprehension of some terms by Health Surveillance Assistants (HSAs) and Statistical Clerks led to incorrectly recorded data. The study suggests that collection of data by a wide range of health workers and use of different tools leads to inaccuracy of the data being reported. Nevertheless, data users reported that they find the system useful for development of District Implementation Plans (DIPs). Conclusion: There is need for the review of HMIS indicators and harmonization of data collection tools feeding into the HMIS to reduce data inconsistencies. We suggest that Ministry of Health should consider employing HMIS Officers with suitable qualification as stated under the job requirement, and quarterly refresher courses should be organized to increase the competence of staff involved in data management at all levels.

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