BETTER EVALUATION MEANS BETTER HEALTH
Accelerating national progress on women’s and children’s health and nutrition—in a way that is equitable, sustainable, and accountable—requires that Malawi scale up interventions proven to work in local contexts. The National Evaluation Platform equips the Government of Malawi with tools and skills to evaluate health and nutrition programs by identifying, systematically compiling, and rigorously analysing data from diverse sources. Empowered with evidence, national and district leaders can make strategic decisions that will achieve maximum health and nutrition impact for the women and children of Malawi.
From 2014 through 2017, Malawi is building the National Evaluation Platform, with technical guidance from the Johns Hopkins University Institute for International Programs (IIP) and funding support from the Government of Canada. As NEP’s “home” institution, the National Statistics Office (NSO) conducts analyses and leads hands-on capacity-building workshops with teams of other public sector NEP stakeholders. Public-sector institutions focused on MNCH&N and data use—including the Ministry of Health, Central Monitoring and Evaluation Division (CMED), and the Department of Nutrition, HIV and AIDS (DNHA)—have pledged their support for NEP and are leading actors in every aspect of NEP’s development and use.
The High Level Advisory Committee (HLAC)—chaired by the Chief of Health Services within MOH—is composed of senior levels from MOH and NSO. HLAC identifies priority MNCH&N evaluation themes. The Technical Task Team (TTT) is composed of representatives form NEP stakeholder institutions who support national MNCH&N program management, M&E, and survey data collection and analysis. The TTT participates in NEP workshops and develop statistical and data collection skills to answer evaluation priorities set by HLAC. NEP has a special collaboration with the CMED within the MOH. CMED provides oversight of M&E within Malawi’s health sector and the national District Health Information System 2 (DHIS 2). CMED is active in all NEP analyses and—in collaboration with NEP—is leading the upcoming national routine Data Quality Assessment (DQA).
In 2015, NEP conducted Cycle 1 analyses in collaboration with the NSO-led Countdown to 2015’s case study. The case study determined factors enabling Malawi’s achievement of Millennium Development Goal 4 and concluded that Malawi rapidly reduced under-5 mortality through early and successful adoption of key child health interventions and policies. Increased coverage of interventions to treat and prevent pneumonia and nutrition-related interventions contributed to a high proportion of under-5 lives saved. The results from the case study generated interest from stakeholders in pursuing follow-up questions and district-level analyses.
During Cycle 1, the TTT used the Lives Saved Tool to model the impact of key reproductive, maternal, newborn, child health, and nutrition and water, sanitation, and hygiene interventions coverage targets on stunting prevalence in Malawi. The team developed two models. Model A suggests that if Malawi achieved the intervention coverage targets in the National Nutrition M&E Framework, Malawi would not reach the Government’s stunting prevalence target of 38% by 2020. Model B suggests that if Malawi reached 100% coverage of key interventions, Malawi would be able to reach the Government’s 2020 target, but would fall short from reaching the World Health Assembly 2025 stunting prevalence target of 22%. In response to the findings, nutrition policymakers in Malawi amended the national plan to include more high-impact nutrition interventions and advocated for multi-sectoral support to reduce national stunting. Cycle 2 currently focuses on expanding the nutrition analysis, exploring the overall reduction in pneumonia-specific mortality among children under-5, assessing the accessibility and implementation of youth-friendly family planning services, and determining the quality of routine data at facility, district, and central-levels.
NEP IS MALAWI-OWNED AND MALAWI-LED
WITH NEP, MALAWI CAN BUILD PLANS ON A FOUNDATION OF EVIDENCE
NEP helps stakeholders in Malawi leverage existing health sector data and collect new data to promote evidence-based MNCH&N policy and program planning. Malawi is one of four African countries that are building NEPs. Successful development of the platform in Malawi can provide a model for replication and development of the NEP approach in other countries with substantial health and nutrition challenges. The NEP Malawi team is currently working on planning for sustainability beyond the funding period.