How health scorecards are strengthening delivery of healthcare in Malawi
The Scorecard has significantly enhanced our ability to interpret data
In the remote village of Emfeni, approximately 90 kilometres from Mzimba District in the north of Malawi, health service delivery is undergoing a quiet but significant transformation.
Petros Kamanga, District Implementation Plan (DIP) Coordinator for Mzimba South, recalls a recent visit to the area where he observed first-hand how communities and health officials were using the Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) Scorecard to improve local health services. Through this scorecard, health workers are able to monitor key indicators, track progress, and implement timely interventions to improve service delivery.
“Through a recent discussion on the Scorecard results, community members evaluated the health facility’s performance and raised concerns about the lack of privacy for clients receiving Antiretroviral Therapy (ART),” Kamanga explains. “At the time, the facility had designated a single day for all ART clients, which made many feel exposed. While some encouraged acceptance of one’s status, others stressed the need for more discretion.”
Kamanga recalls that one of the district health coordinators openly shared that he was also on ART and could access his medication at any time, helping to reduce stigma. However, the discussion also revealed concerns about the limited follow-up on defaulters.
“We explained that our resources are constrained,” Kamanga says. “We encouraged the involvement of volunteers from support groups to assist with community follow-ups.”
In both Kasungu and Mzimba South districts, UNICEF has trained health officials and community members on how to use the Scorecard.
The RMNCAH Scorecard is aligned with Pillar 6 of the Malawi Health Sector Strategic Plan III (2023–2030), which focuses on digital health. This pillar aims to develop a sustainable, harmonized, and country-led digital health system that enhances service delivery at all levels.
Now integrated into the Ministry of Health’s District Health Information System (DHIS2), the Scorecard enables users to analyse specific indicators, identify underperforming areas, and develop solutions to address them.
According to Lydia Lipende, Deputy Safe Motherhood Coordinator for Mzimba South, the Scorecard has filled a long-standing gap. “Previously, health facilities simply entered data into the information system (DHIS2) without reviewing or analysing it. Now, they can evaluate their performance and develop data-driven plans,” she explains. “The Scorecard helps communities and health workers identify priority areas, discuss and agree on solutions before problems escalate.” To date, approximately 220 health workers have been trained in Mzimba and Kasungu districts.
Allan Chilima, a Nurse Midwife Officer at Kasungu District Hospital, finds the Scorecard particularly useful in maternity care. “It allows us to track specific indicators such as the number of women starting antenatal care in the first trimester or those beginning ferrous folic acid supplementation,” he explains. “If the numbers are low, the Scorecard prompts us to ask critical questions: Is it a supply issue? A cultural barrier? What can we do to improve?”
Bwanali Mphoka, Medical Laboratory Coordinator and Integrated Health Systems Strengthening Coordinator at the hospital, echoes this sentiment. “The Scorecard has significantly enhanced our ability to interpret data. Previously, we would just input figures. Now, we assess our performance and, if needed, launch Quality Improvement Projects to address gaps.”
To strengthen data utilisation across the health sector, UNICEF worked in collaboration with the Ministry of Health’s Department of Planning, Policy and Development, the Reproductive Health Department, and the Quality Management Department to revitalise the RMNCAH Scorecard.
What began as a digital data tool has become a powerful platform for community engagement, accountability, and improved health outcomes. By placing data into the hands of both health workers and communities, the RMNCAH Scorecard is helping districts like Kasungu and Mzimba ensure that health services are not only available but also responsive, effective, and people-centred.
