Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct;18(10):1231-9.
doi: 10.1111/tmi.12167. Epub 2013 Aug 1.

Monitoring child survival in 'real time' using routine health facility records: results from Malawi

Agbessi Amouzou  1 , Willie Kachaka, Benjamin Banda, Martina Chimzimu, Kenneth Hill, Jennifer Bryce
Affiliations
Free PMC article

Monitoring child survival in 'real time' using routine health facility records: results from Malawi

Agbessi Amouzou et al. Trop Med Int Health. 2013 Oct.
Free PMC article

Abstract

Objectives: Few developing countries have the accurate civil registration systems needed to track progress in child survival. However, the health information systems in most of these countries do record facility births and deaths, at least in principle. We used data from two districts of Malawi to test a method for monitoring child mortality based on adjusting health facility records for incomplete coverage.

Methods: Trained researchers collected reports of monthly births and deaths among children younger than 5 years from all health facilities in Balaka and Salima districts of Malawi in 2010-2011. We estimated the proportion of births and deaths occurring in health facilities, respectively, from the 2010 Demographic and Health Survey and a household mortality survey conducted between October 2011 and February 2012. We used these proportions to adjust the health facility data to estimate the actual numbers of births and deaths. The survey also provided 'gold-standard' measures of under-five mortality.

Results: Annual under-five mortality rates generated by adjusting health facility data were between 35% and 65% of those estimated by the gold-standard survey in Balaka, and 46% and 50% in Salima for four overlapping 12-month periods in 2010-2011. The ratios of adjusted health facility rates to gold-standard rates increased sharply over the four periods in Balaka, but remained relatively stable in Salima.

Conclusions: Even in Malawi, where high proportions of births and deaths occur in health facilities compared with other countries in sub-Saharan Africa, routine Health Management Information Systems data on births and deaths cannot be used at present to estimate annual trends in under-five mortality.

Keywords: Health Management Information Systems; Millennium Development Goal; child mortality; child mortality monitoring.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of health facility births by month and year in Balaka and Salima districts, Malawi, 2010 and 2011.
Figure 2
Figure 2
Distribution of health facility under-five deaths by month and year in Balaka and Salima districts, Malawi, 2010 and 2011.
See this image and copyright information in PMC

References

    1. AbouZahr C, Boerma T. Health information systems: the foundation of public health. Bulletin of the World Health Organization. 2005;83:578–583. - PMC - PubMed
    1. Braa J, Heywood A, Sahay S. Improving quality and use of data through data-use workshops: Zanzibar, United Republic of Tanzania. Bulletin of the World Health Organization. 2012;90:379–384. - PMC - PubMed
    1. Commission on Information and Accountability for Women's and Children's Health. Keeping Promises, Measuring Results. Geneva: WHO; 2011.
    1. Demographic and Health Surveys. 2012. http://www.measuredhs.com. (accessed 15 August 2012)
    1. Gething PW, Noor AM, Gikandi PW, et al. Improving imperfect data from health management information systems in Africa using space-time geostatistics. PLoS Medicine. 2006;3:e271. - PMC - PubMed

Publication types

LinkOut - more resources