In Malawi, for the first time, palliative care indicators have been integrated into the District Health Information System (DHIS2). While another areas were already in the DHIS2, palliative acre reporting was being done manually.
Thanks to the PACAM STEP UP project which was funded through True Colours Trist since 2011. The Palliative care STEP Project started in 2011 in the Southern region of Malawi for four years. From 2015 to date, the Palliative Care STEP UP Project moved to the central and Northern Regions. However throughout the implementation period, one of the major challenges has been centralized reporting.
From 2017, PACAM through the STEP UP Project supported Ministry of Health to integrate palliative care indicators into the DHIS2. Palliative care indicators were developed by reviewing previous indicators and progress of implementation and other emerging issues. The development of indicators was highly consultative. It was done jointly with PACAM, MOH nursing, CMED, HTSS. Series of meetings were conducted and progress made at each level since April 2017. Our thanks also go to our donors TCT and adviser Evidence Centre.
The indicators were then imbedded into the DHIS2 ant tested. In February 2018, District Palliative care coordinators and HMIS officer from the 28 districts health offices of Malawi were trained in DHSI2. Two sessions of training were done, One session for the northern and central region was conducted at Linde Motel in Mponela from 13 to 15 February 2018. The second session was conducted at Malaria Alert Centre in Blantyre from 20 to 22 February 2018.
The Objectives of the training were to orient palliative care coordinators in DHSI2 and familiarize them on newly developed palliative care indicators and which data collection tools will be used
Before this development, data was personalized ie at district levels with the palliative care district coordinators at at national level with the palliative care desk office. This was almost a manual system and was a lot of work to produce periodic reports, eg monthly, quarterly and annual report.
DHIS2 training in progress at Linde Motel, Mponela. Picture by Glenda Winga
Previously when there was change in district palliative care coordinators, some of them could take the reports and data with them and there was no continuity. But from now, all data will be in the DHIS2 and available at national level anytime
Currently 90 sites are implementing palliative care while 20 are developing
The training was officially opened by the Director of Central Monitoring and Evaluation (CMED), Mr Isaac Dambula. He appreciated HMIS officers and palliative care coordinators for availing themselves for the training. He mentioned that the training would strengthen reporting and use of data in ministry of health
He reiterated the need for collaboration between various teams in taking care of palliative care patients. The director was happy that his team of HMIS officers were happy to be part of the team who provide palliative care services.
CMED director emphasized on the need for the palliative care coordinators to be able to enter data into the system by themselves. He said as program coordinators, they understand the indicators better and can easily verify and validate
The aim of the training was to strengthen reporting on selected palliative care indicators and this was possible through engaging the HMIS. This will help monitoring and reporting and in turn design better programs.
The training was able to equipping the district teams with skills to inputting into the DHIS2
Some data entry clerks who were not be part of the training but would be oriented by those who have come for the training so they can be able to capture the data well as this is the team work
The director said, ‘It has not been easy to come this far. There have a series of meetings of meetings to bring us this far.’
CMED appreciated efforts by PACAM to take MOH this far
Palliative care is in line with current focus of Health Sector Strategic Plan which is enhancing community level health system. The CMED Director said that the Issue of the reporting tools to the districts will be supported by the district health management team.
CMED reiterated the importance for coordinators to do data quality checks as the HMIS officers have so many data sets to look after. Hence the need for coordinators to do quality checks
The palliative care indicators are now going digital
Members pose for a group photo at Malaria Alert Centre in Blantyre on 22 February 2018