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Data-informed decision-making for life-saving commodities investments in Malawi: A qualitative case study

BACKGROUND: During the last 15 years, Malawi has made remarkable progress in reducing child mortality. However, maternal and newborn mortality remains persistently high. To help address these entrenched challenges, the Reproductive, Maternal, Newborn and Child Health (RMNCH) Trust Fund provided shor...

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Autores principales: Nemser, Bennett, Aung, Kyaw, Mushamba, Mildred, Chirwa, Samuel, Sera, Diana, Chikhwaza, Owen, Kachale, Fannie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Medical Association Of Malawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307067/
https://www.ncbi.nlm.nih.gov/pubmed/30627339
http://dx.doi.org/10.4314/mmj.v30i2.11
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author Nemser, Bennett
Aung, Kyaw
Mushamba, Mildred
Chirwa, Samuel
Sera, Diana
Chikhwaza, Owen
Kachale, Fannie
author_facet Nemser, Bennett
Aung, Kyaw
Mushamba, Mildred
Chirwa, Samuel
Sera, Diana
Chikhwaza, Owen
Kachale, Fannie
author_sort Nemser, Bennett
collection PubMed
description BACKGROUND: During the last 15 years, Malawi has made remarkable progress in reducing child mortality. However, maternal and newborn mortality remains persistently high. To help address these entrenched challenges, the Reproductive, Maternal, Newborn and Child Health (RMNCH) Trust Fund provided short-term catalytic financing of $11.5 million (2013–2016) to support country plans to advance the RMNCH and commodity agenda. OBJECTIVES: (1) To document how Malawi (ministries, partners, working groups) used evidence to inform decision-making and RMNCH investments, (2) To identify barriers to utilizing information and evidence in the planning and prioritization process at national and sub-national levels, and (3) To assess the utility of the RMNCH Landscape Synthesis, which uses existing information to review life-saving RMNCH commodities and services. METHODS: This was a qualitative case study utilizing a Rapid Appraisal (RA) approach, where semi-structured interviews were conducted with staff members from UN agencies, development partners and the Ministry of Health (MoH) at national and district level. The analysis enlists a framework approach for manual qualitative content analysis. RESULTS: Led by the MoH, the RMNCH Trust Fund grant proposal utilized an evidence-based and equity-focused process for prioritization of investments. Data-informed decision-making permeates similar commodity-focused working groups. However, common health information system (HIS) weaknesses, such as data quality and collection burden, persist and are more prevalent at district-level. The collation of evidence in the RMNCH Landscape Synthesis was a useful and sustainable tool to support planning. CONCLUSIONS: The evidence-based, equity-focused decision-making process for the RMNCH Trust Fund proposal provides an effective model for inter-agency investment prioritization. Strengthening data-informed decision-making will require financial and political commitments to HIS and capacity building for data use, particularly at the district-level. New initiatives (e.g. Health Data Collaborative and QED Network to Improve Quality of Care) provide opportunities to further improve evidence-informed decision-making.
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spelling pubmed-63070672019-01-09 Data-informed decision-making for life-saving commodities investments in Malawi: A qualitative case study Nemser, Bennett Aung, Kyaw Mushamba, Mildred Chirwa, Samuel Sera, Diana Chikhwaza, Owen Kachale, Fannie Malawi Med J Original Research BACKGROUND: During the last 15 years, Malawi has made remarkable progress in reducing child mortality. However, maternal and newborn mortality remains persistently high. To help address these entrenched challenges, the Reproductive, Maternal, Newborn and Child Health (RMNCH) Trust Fund provided short-term catalytic financing of $11.5 million (2013–2016) to support country plans to advance the RMNCH and commodity agenda. OBJECTIVES: (1) To document how Malawi (ministries, partners, working groups) used evidence to inform decision-making and RMNCH investments, (2) To identify barriers to utilizing information and evidence in the planning and prioritization process at national and sub-national levels, and (3) To assess the utility of the RMNCH Landscape Synthesis, which uses existing information to review life-saving RMNCH commodities and services. METHODS: This was a qualitative case study utilizing a Rapid Appraisal (RA) approach, where semi-structured interviews were conducted with staff members from UN agencies, development partners and the Ministry of Health (MoH) at national and district level. The analysis enlists a framework approach for manual qualitative content analysis. RESULTS: Led by the MoH, the RMNCH Trust Fund grant proposal utilized an evidence-based and equity-focused process for prioritization of investments. Data-informed decision-making permeates similar commodity-focused working groups. However, common health information system (HIS) weaknesses, such as data quality and collection burden, persist and are more prevalent at district-level. The collation of evidence in the RMNCH Landscape Synthesis was a useful and sustainable tool to support planning. CONCLUSIONS: The evidence-based, equity-focused decision-making process for the RMNCH Trust Fund proposal provides an effective model for inter-agency investment prioritization. Strengthening data-informed decision-making will require financial and political commitments to HIS and capacity building for data use, particularly at the district-level. New initiatives (e.g. Health Data Collaborative and QED Network to Improve Quality of Care) provide opportunities to further improve evidence-informed decision-making. The Medical Association Of Malawi 2018-06 /pmc/articles/PMC6307067/ /pubmed/30627339 http://dx.doi.org/10.4314/mmj.v30i2.11 Text en © 2018 The College of Medicine and the Medical Association of Malawi. This work is licensed under the Creative Commons Attribution 4.0 International License. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Research
Nemser, Bennett
Aung, Kyaw
Mushamba, Mildred
Chirwa, Samuel
Sera, Diana
Chikhwaza, Owen
Kachale, Fannie
Data-informed decision-making for life-saving commodities investments in Malawi: A qualitative case study
title Data-informed decision-making for life-saving commodities investments in Malawi: A qualitative case study
title_full Data-informed decision-making for life-saving commodities investments in Malawi: A qualitative case study
title_fullStr Data-informed decision-making for life-saving commodities investments in Malawi: A qualitative case study
title_full_unstemmed Data-informed decision-making for life-saving commodities investments in Malawi: A qualitative case study
title_short Data-informed decision-making for life-saving commodities investments in Malawi: A qualitative case study
title_sort data-informed decision-making for life-saving commodities investments in malawi: a qualitative case study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307067/
https://www.ncbi.nlm.nih.gov/pubmed/30627339
http://dx.doi.org/10.4314/mmj.v30i2.11
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