What does it take to get to a unified system for monitoring and evaluation of health programs?  Cooper/Smith Co-Founder, Tyler Smith, explores this question in the Malawi context in a recent report commissioned by the Global Fund to Fight AIDS, Tuberculosis and Malaria

Most donors, including Global Fund, are looking to optimize their health investments in partner countries as needs increase and global health investments plateau.  Optimizing programs means employing high-quality and relevant data to plan programs that will have maximal returns on health benefits.  Having the best data means investing in monitoring and evaluation (M&E) systems that are efficient, well-coordinated, easily accessible, and promote a culture of data use at all levels.  Something much easier said than done, especially considering the ballooning reporting requirements piled on by donors.

Though tragically underfunded, improvements to health information systems (HIS) are gaining traction as the world embraces digital solutions (e.g., mobile tech) and as the tidal waves of data collected by health and development programs swell at break-neck speed.  Simply put, without better data management in health, countries won’t be able to effectively store or access the information collected, let alone use it for routine decision-making.  And if we aren’t going to use it, why are we distracting frontline workers from patient care to collect it? 

All that said, our staff have worked on the flip side for many years and understand the inherent dilemma.  Within PEPFAR, we pushed actively for more data from countries to increase accountability and allocate resources to better match disease burden.  Though effective for our program at the time, we know these increased requirements created strain on health workers and competition across programs for high-quality information. Aid earmarked for specific programs, tied to specific reporting requirements, isn’t likely to disappear anytime soon; it’s how we learn to manage and leverage these data streams that will ultimately determine if the data we collect are for show or truly used to improve health outcomes.

The Malawi report discusses gaps in performance and limitations of M&E systems in the country, barriers to data access and use, barriers to systems integration, and recommendations to address the principal gaps and barriers.  Further, a landscape analysis is included that can serve as a reference point or primer to those less familiar with the country context.  The analysis brings together findings from previous assessments (with hyperlinks to full text) and maps the flow of data for HIV, TB, and malaria programs in Malawi. 

We hope you find the report useful and would love your thoughts.  Please email us (contact@coopersmith.org) or post your comments below or on our twitter feed.   Don't forget to subscribe to our blog to get the latest as we disseminate interesting findings in the near future.  

Thanks for tuning in! - Tyler 

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