Dr. Rohitashva Agrawal conducted several assessments and analyses related to community health and the mortality data collection system in Malawi. This included directly observing verbal autopsies, analyzing mortality data, interviewing team members, and providing feedback. Some issues identified included ambiguous questions, delays in data collection, and incomplete community registers. Recommendations included periodic updates to questionnaires, better logistics for data collection and syncing, and addressing website issues.

1. -Dr. Rohitashva Agrawal
(Rohit)

4. Goals:
• Assess patterns of mortality using the
data.
• Asses the gaps in e health system.
• Assist e health specialist in CommCare
system .
• Verification of mortality data.

5. • Direct observation of verbal autopsies.
• Analysis of the mortality data.
• Interviews of the team member
responsible for VA.
• Edited questionnaires of the VA system.
• Provided feedback to the team members
on the importance of VA.

6. • Visited households.
• Interview of community members.
• Interview of community leaders.
• Observing data registers.

8. • Paper based to CommCare system.
• Issues with the CommCare system
(Syncing etc.).
• Issues with service provider (Airtel).
• Few questions in questionnaire were
ambiguous.
• Few questions were repetitive.
• Sometimes, there was a delay in conduct
of VA.

9. • CommCare system better than paper
system.
• Staff more comfortable with the digital
system.
• Staff comfortable with the data entry.
• Less chance of leak of information.

10. • Mortality analysis showed a spike in
the deaths during rainy season.
• Few cases of teenage pregnancies.
• Incomplete data entry in community
registers.
• Most of the deaths in Zomba Central
Hospital.

12. • Periodic update of the questionnaires.
• Better logistics for collection and
syncing of data.
• Efforts to reduce the website issues.
• Better level of access to data on
website.
• An additional trained staff on standby.

13. Goal:
To assess the operational gaps in the
CHW system through various methods
and to suggest feasible solutions.

14. • Interviews of CHW, CHW heads and
community members.
• Interviews of the health care
professionals.
• Presentation on M and E and
defaulter tracing with Dignitas.
• Periodic visits to the health centers.

15. • Observing evaluation of CHWs during
a household visit.
• Observing evaluation of CHW
supervisors.
• Observing CHW weekly meetings.

18. • Assisting under 5 clinic for HIV
exposed infants.
• Wrote a proposal for Monday
meetings.
• Observation and discussion with the
health team.

22. • Lack of availability of funds.
• Difficulties of logistics for CHWs
(Mobile chargers, bicycles etc).
• Confusion regarding future for CHWs
post 2015.

23. • Issues with the service provider and
syncing of data.
• Difficulties with the ComCare system
(e.g duplication of the data).
• Uneven distribution of the households
for CHWs.

24. • Better and timely allocation of funds.
• Better coordination with the service
provider (Airtel).
• Clarity for the CHWs for their future
post 2015.

25. • Better logistics for newly recruited
CHWs.
• Speeding up the process of
recruitment.
• Better coordination with the
CommCare system.

26. Goals :
To prepare documents for Diarrhea,
malnutrition and Family Planning.

27. • Visited DHO and collected essential
information.
• Visited health centers and observed
the system.
• Collected literature and guides to
make the documents.

28. • Competency assessment documents
for diarrhea, malnutrition and family
planning.
• Audit checklist documents for
malnutrition, family planning and
diarrhea.
• Supportive supervision document for
malnutrition, family planning and
diarrhea.

29. Goals:
• Assess community understanding of
the referral system.
• Identify gaps in the referral system.
• Interviews of the members involved in
the referral system.

30. • Interviews of the healthcare workers.
• Interview of the ambulance driver.
• Observed few live referrals.
• Interviews of the community
members.
• Wrote a proposal to speed up the
process.

31. • Only 1 ambulance & 1 driver available
for referrals.
• Problem of referrals from households
to health center.
• Delay in referral after 5 PM.

32. • Good condition of the ambulance.
• Well trained and experienced driver.
• Quick referral from health center to
Zomba Central Hospital.

33. • Need one more driver and an
ambulance on standby.
• Need oxygen cylinder in the
ambulance.
• Need to keep ambulance near
Mwnadama after 5PM.
• Need to reduce delay in transfers
from home to center.

34. Observation
• Great team to work with.
• Good dedication even with paucity of
resources.
• Qualified for the job.

35. • Access to internet is a big problem.
• Road construction made transport
difficult.
• Power outages.
• Lack of water in toilets.

36. • Internet needs to be the priority.
• Timely allotment of the funds.
• Power backup.
• Water and tissues for toilets.

41. and Malawi does not have
Ebola

42. Thank you MVP.