Lessons Learned from Introducing a Village Health Registry in Malawi.

The Village Health Registry (VHR) was a community health data collection tool introduced in 1998. It was first introduced in Mwanza district of Malawi with the objectives of collecting community-based data, analysing and taking action in a local setting. The tool was collecting and updating data such as demography, immunization status for children under one year, growth monitoring for children under five, monitoring of all pregnant women, incidence of malaria, acute respiratory infections, diarrhoea cases, water and sanitation and deaths, by visiting households in every village every month. The tool was able to collect all targeted information as required. The data collected by the tool appeared to be more reliable than that obtained through a national information system used by the Ministry of Health (MoH) for the same district and the same year. It was easy for health centres to accurately order supplies based on actual requirements, to follow-up cases during disease outbreaks and to identify deficiencies in immunisation coverage rates. Despite promising results, the VHR registry fell into disuse following the establishment of a national register. The MoH's Health Information System (HIS) data used projections which normally did not represent the actual situation on the ground while the VHR registry gave real physical data which was representative and verifiable. The potential of the VHR outweighed that of the HIS. Although the HIS had been rolled out nationally, there were shortfalls which MoH could consider rectifying to reach its full potential. In conclusion, the VHR was worth adopting as it would give MoH realistic statistics to be effectively used at all levels.