With a population of 17 million,[1] Malawi is a high disease burden country. The adult HIV prevalence is estimated at 12%, and an an estimated 85,000 new infections occur each year. Of the 28,000 tuberculosis cases reported annually, 70% also test positive for HIV. Malaria is the major cause of hospital visits in children under the age of five and of adult deaths.[2]
SIAPS supported the Ministry of Health (MoH) Malawi to undertake assessments and implement activities to strengthen pharmaceutical management.
Project Highlights
A patient and a health worker at a clinic in Malawi. [Click to enlarge]SIAPS supported the National TB Control Program (NTP) to conduct a more accurate estimate of TB cases and quantify TB medicines needed to ensure the uninterrupted availability of TB treatment.
The NTP introduced QuanTB for the quantification and forecasting of TB medicines. The medicine management staff of the NTP and partners received training on QuanTB from SIAPS.
A rapid situational analysis of TB data and commodity management showed that while the country has a strong foundation for TB data and commodity management, improvements are needed in areas such as use of data for decision making, specific tools for quantification, and commodity management.
To standardize and optimize patient care, SIAPS supported the MoH in revising, disseminating, implementing, training on, and monitoring their standard treatment guidelines in close collaboration with end users and through a consultative and consensus-building process.
An assessment on data management challenges faced by the health system in Malawi and quantification of the level and causes of data burden at the service delivery point were conducted. The assessment on data burden showed that there is duplication in data recording because of the concurrent use of old and new forms. It was observed that duplication may have been purposefully introduced for data validation; however, the reality is that these checks and balances add to the workload. It was also noted that the data are managed by the same individual at the service delivery level but managed by different departments at the central level.
In collaboration with the Ecumenical Pharmaceutical Network and the Christian Health Association of Malawi, regional-level capacity for antimicrobial stewardship and the prevention of antimicrobial resistance were strengthened through a baseline assessment of hand hygiene practices at Likuni and Daeyang Luke Hospitals. A hand washing committee was established and conducted trainings on proper hand hygiene guidelines.
SIAPS supported the regular collection of data on the stock status of malaria medicines.
Results
The routinely collected data on the stock status of malaria medicines were sent to USAID|DELIVER for collation and sharing with the USAID/PMI team to guide procurement decisions. In addition, QuanTB is being used in country for quantification.
Project Legacy
The recommendations from the assessment of data burden suggest simplifying forms; defining and prioritizing key data; and determining the value added by correctly collecting the particular information, based on internet connectively. It was recommended that the Ministry should consider introducing electronic data capturing and recording.
The NTP may look into the option of expanding training and use of QuanTB to ensure accurate quantification and forecasting and expanding hand washing training to other hospitals and facilities.
