In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment EmONC services. The sample included 365 public and private health facilities, covering all 87 hospitals and a 60% random sample of the 468 health centres. Health facilities that did not offer maternal and newborn health (MNH) services were not included in the sampling frame.
Data were collected using a structured questionnaire comprised of 10 modules, adapted from the generic Averting Maternal Death and Disability Program (AMDD) modules, from 23 September – 17 October 2014 by 20 teams of three members, all of whom had a clinical background (nursing, midwifery or clinical medicine).
Data collectors received five days of training covering the survey tools, research ethics and interview techniques and including field visits and role plays for practice. Quality assurance of data collection was conducted by a supervisor assigned to each team supplemented with a core survey support team comprised of representatives from the MOH, AMDD, Save the Children International, University of Malawi College of Medicine, Medical and Nurses and Midwives Council of Malawi. Double data entry for EmONC data was conducted in CSPro 5.0 and cleaned data files were exported to Stata 12.1 for analysis.
Malawi has been using DHIS2 since 2013. The DHIS2 system has a field tested flexible data model with data entry forms for indicators and the ability to support data collection, management and analysis, including generation of reports to monitor indicator trends over time and production of maps to visualise subnational variations for identification of inequities. Currently, basic quality checks are built into the DHIS2 systems and DHIS2 has limited pre-developed indicator sets and reports.
In Malawi, all public and Christian Health Association Malawi (CHAM) facilities compile data from their registers into a paper monthly reporting form and submit to their district health office where they are entered into the DHIS2 system by data clerks and programme focal points.
The relevant reports that are being accessed as data sources are: a) the maternity monthly report; b) the monthly HMIS form.