Abstract

The main objective of this study was to explore challenges and opportunities affecting information flow and feedback in health information systems (HIS) at district level in Malawi. The study employed qualitative research methods that included semi-structured interviews, observations in the health facilities settings, review of patient registers focusing on data collection tools and their contents and focus group discussions. The study was carried out at Health Facilities and District Health Offices in Blantyre, Zomba and Lilongwe. The results show that there is existing Health Management Information System (HMIS) data being used in health facilities and District Health Offices (DHOs) in Malawi. However, system of data collection and vertical data flow is rather complex; and there are a number of data collection tools in use: patient cards, registers, tally sheets and forms. Several challenges were identified, namely: lack of clear understanding of the purpose of data collection, information flows reflecting the requirements of higher levels without addressing the health facility and district level’s information needs, lack of appropriate transport to take data from community to health facilities and DHOs; inadequate HMIS materials and supplies (stationery, computers with internet connection, phones, etc), lack of adequate storage space and existence of parallel reporting systems in the health information systems. The research findings also indicated that the health data being reported is not sufficient to support informed decision-making and health planning. Furthermore, the study revealed that some of data collected is of low quality, incomplete, inaccurate; and there was untimely reporting. The following measures are recommended to mitigate the challenges in information flow and feedback at district level in Malawi: Promote local learning and discussion of essential HIS needs, and the role of routine data collection in meeting those needs; Establishing an information culture in HIS and health care organizations; Investing in health data collection, use and management of health information at local levels within the HIS; and provide enough resources (transport, computers with internet connection, cell phones).

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School	: School of Natural and Applied Sciences
Issued Date	: 2013

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