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

Area of Science:

• Public Health
• Health Systems Strengthening
• Evidence-Based Decision Making

Background:

• Malawi has reduced child mortality but faces high maternal and newborn mortality rates.
• The Reproductive, Maternal, Newborn and Child Health (RMNCH) Trust Fund provided catalytic financing from 2013-2016 to support RMNCH initiatives.
• Addressing persistent maternal and newborn mortality requires strategic investment and improved health systems.

Purpose of the Study:

• To document Malawi's use of evidence in RMNCH decision-making and investments.
• To identify barriers to utilizing evidence in national and sub-national RMNCH planning.
• To assess the utility of the RMNCH Landscape Synthesis for reviewing RMNCH commodities and services.

Main Methods:

• Qualitative case study employing a Rapid Appraisal (RA) approach.
• Semi-structured interviews conducted with Ministry of Health (MoH), UN agencies, and development partners.
• Framework approach used for manual qualitative content analysis of collected data.

Main Results:

• The RMNCH Trust Fund utilized an evidence-based, equity-focused process for investment prioritization, led by the MoH.
• Data-informed decision-making is present in commodity-focused working groups, yet common health information system (HIS) weaknesses persist, especially at the district level.
• The RMNCH Landscape Synthesis proved to be a useful and sustainable tool for evidence collation and planning support.

Conclusions:

• The RMNCH Trust Fund's evidence-based approach offers a model for inter-agency investment prioritization.
• Strengthening data-informed decision-making necessitates financial and political commitment to HIS and capacity building for data utilization, particularly at district levels.
• Emerging initiatives like the Health Data Collaborative and QED Network present opportunities to enhance evidence-informed decision-making in RMNCH.