This community innovation has been accepted at the 2025 DHIS2 Annual Conference
Neonatal Dataset Integration with DHIS2 in Malawi
Introduction: Neonatal mortality remains a critical global health issue, with 2.3 million deaths annually, disproportionately affecting Sub-Saharan Africa (SSA), where the rate is 27 deaths per 1,000 live births. Malawi, like many SSA countries, relies on aggregate data from the District Health Information System 2 (DHIS2) to monitor service coverage, but this approach lacks granularity, hindering efforts to improve care quality. Fragmented data systems and excessive registers further complicate neonatal health advancements. Methods: To address this, Malawi’s Ministry of Health (MoH) and the NEST360 Alliance co-designed the Neonatal Inpatient Dataset (NID) to capture individual-level data for small and sick newborns. Initially implemented via REDCap across 37 neonatal units, the NID was later integrated into DHIS2 through a process involving situational analysis, stakeholder engagement, system design, and testing. Data elements were aligned with newborn health indicators, and custom forms with validation rules ensured accuracy. Results: The NID has captured 250,000 admissions, enabling national and subnational tracking of intervention coverage, care quality, and mortality. This has strengthened Quality Improvement (QI) systems, reduced median data entry delays from 49 to 6 days, and facilitated timely, data-driven interventions. The system’s integration into DHIS2 ensures interoperability, with APIs enabling seamless data exchange. Despite challenges like server space and internet connectivity, DHIS2’s web-based and offline platforms maintain continuous data flow. Conclusion: The integration represents a significant step forward in neonatal care, enabling real-time monitoring through ward-level dashboard, reducing fragmentation, and enhancing sustainability. By providing a comprehensive view of factors influencing newborn care, the system supports data-driven decision-making to address neonatal mortality in Malawi and beyond.
Primary Author: Samuel K. Ngwala
Keywords:
Neonatal mortality, Sub-Saharan Africa, Malawi, District Health Information System 2 (DHIS2), individual-level data, Neonatal Inpatient Dataset (NID), NEST360 Alliance, Ministry of Health (MoH), REDCap, data integration, quality improvement (QI), real-time monitoring, data-driven decision-making, interoperability, small and sick newborns, service delivery, health indicators, validation rules, data entry delays, APIs, internet connectivity, sustainability, newborn care, mortality tracking, stakeholder engagement, system design, situational analysis, intervention coverage, care quality, health outcomes