Health Systems Strengthening with a focus on Maternal and New Born Health (MNH)

Health worker demonstrating the registration of a patient with the eRegister

Funder: Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH

Implementing Partner (s): Management4Health (m4h), Compelling Works (CW), Cooper/Smith (C/S)

Project period (Start-End Date): September 2021 - April 2024.

Country/(ies): Malawi

The Health Systems Strengthening with a focus on MNH project also referred to as the eRegister project is a  digital health initiative implemented by the Ministry of Health in Malawi through a consortium of  three organizations named above with funding from the Malawi German Health Program (MGHP) within GIZ. The project’s overall goal was to improve quality of health services through digital health interventions, in line with Malawi's Ministry of Health Focus on leveraging digital health for efficient and quality delivery of health services. The project therefore aligned and contributed to the MoH’s vision of digital health implementation as specified in the Health Sector Strategic Plan III (2023-2030) as well as the digital health strategy (2020-2025) which is “to develop a sustainable and harmonized country led digital health system that covers all areas of service provision and enables efficient delivery of health services at all levels of the health system.”

Objectives:

1. Enhancing the capacity of the Digital Health Division's capacity through strengthening governance structures, stakeholder coordination, and operationalizing selected Standard Operating Procedures (SOPs) for digital health initiatives.

2. Expansion and documentation of the eRegister platform/system to two more health facilities. The eRegister system is a Lightweight Electronic Medical Records (EMR) system with Antenatal Care (ANC), labour and delivery, Postnatal Care (PNC), Child Health modules and the Outpatient Department (OPD)

3. Support the MoH in the planning, coordination and development and implementation of the Malawi Health Care Information System (MaHIS), including the the operationalizing the Integrated Hospital Information System (IHIS) Blueprint

Key Activities:

Activities under Objective 1:

• eRegister project launch attended high-level delegation from MoH and other stakeholders presided over by the Deputy Minister of Health

• Supported the MOH with technical and financial support to conduct 7 Digital Health Technical Working Group (TWG), and 2 Sub Technical Working Group (SubTWG) meetings over a span of 3 years

• Provided technical support and participation in the formulation of the Malawi Digital Health Policy (2023-2028) compiled by the Ministry of Health

• Supported the Ministry of Health in the review and finalisation of key Standard operating procedures (SOPs) including:

• SOP on introduction and upgrading of digital health systems

• SOP on Data access and release

• SOP on digital health systems interoperability

Activities under Objective 2:

• Expanded the eRegister system to two more health facilities in addition to the first one which has been running since 2019. Total facilities with the system in operation being three.

• Compilation of training packages

• Training trainers and users

• Continuous technical support

• Infrastructure improvements in the eRegister sites through the installation of hybrid solar power and network infrastructure to the eRegister sites.

• Full hybrid solar power for the entire health facility with a life span of 10+ years

• High performance internet connectivity using space X starlink connection in all the facilities

• Provided technical support to users, routine supervision and Monitoring and evaluation mechanisms to the users of the eRegister system.

• Supported the transition of the eRegister system from third party host servers to the MoH locally hosted servers.

Activities under Objective 3:

• Completed the Integrated Hospital Information System (IHIS) blueprint which is a consolidation of all the required services and functions to be handled by a digital health system in the health care facilities at all levels and programs.

• Supported the Ministry with technical and financial support to conduct a comprehensive digital health systems landscape assessment, and a detailed technical platform assessment leading to the conceptualisation and implementation of the Malawi Health Care Information System (MaHIS).

• Supported the MoH with coordination of the development of MaHIS modules namely:

• Adult Emergency and trauma Centre (AETC) module for central hospitals

• Outpatient (OPD) Module for Primary Health Care

• Maternal and Newborn Health (MNH)

Results/Impact (Achieved /anticipated):

• Better coordination of stakeholders in the digital health landscape through the DH TWGs, and the implementation of the consolidated digital health One plan, one Budget and reporting mechanism.

• Satisfactory use of the eRegister system in the three eRegister facilities -over 45,000 clients seen using the eRegister application in the three sites in a space of 3 years.

• Infrastructure improvements leading to stable and reliable power and connectivity in the facilities.

• Significant progress in the development of the MaHIS in a coordinated multi stakeholder approach

Related links (resources):

• https://www.health.gov.mw/download/digital-health-strategy-2020-2025/

• https://www.health.gov.mw/download/hssp-iii/

• https://www.giz.de/en/downloads/GIZ2022_en_MGHP_HID%20factsheet.pdf

• https://health.bmz.de/videos/malawis-e-register-makes-life-easier-for-patients-and-health-workers/

• https://www.giz.de/en/aboutgiz/115897.html

• https://mwnation.com/e-registration-launched-at-bilira-health-centre/

• https://www.leymanck.com/hospital-e-register-project-launched-in-ntcheu/#google_vignette

• https://www.youtube.com/results?search_query=eRegister+project+Malawi

A short film by Healthy DEvelopments
Script: Ruth Evans
Director: Michael Hobeck
Camera: Falco Seliger
Editor and producer: Andreas Sawall