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No matter which health system building block you are trying to improve, you need specific data, information, and knowledge to inform your decision-making process—this is where good knowledge management comes in handy.
“The Intersection of Knowledge Management and Health Systems Strengthening: Implications from the Malawi Knowledge for Health Demonstration Project” provides an interesting case study of the connection between improved knowledge management and health systems strengthening. Even though the K4Health Malawi project was focused on improving gaps in the FP/RH and HIV/AIDS information pathway (specifically links between information use and performance), we saw wider heath system improvements as a result of the KM improvements implemented. A happy turn of events!
The project’s evaluation (report forthcoming) highlights 10 ways that this project improved health system performance across five of the six building blocks: health information; health workforce; medicines, vaccines, and technology; service delivery; and leadership and governance. The 6th building block, health financing, was not directly affected, though we can see already ways that KM could improve health financing in other programs.
A sample of results from the project’s KM interventions:
- Reduced time for community health workers to report important events (stock-outs, transportation breakdowns, etc.) and receive feedback from their supervisor, from 19 hours using face-to-face meetings to 9 minutes using SMS
- Four-fold reduction in cost, from US$3.06 using public transport to reach supervisors at the district level to US$0.48 using SMS
- Detection and prevention of stock-outs, for example, averted stock-outs of Depo injectable contraceptives and male and female condoms
- Widened service coverage as the CHWs had more time available to visit new patients
We think the integration of KM approaches, tools, and processes into a holistic health systems strengthening program shows great potential for maximizing results. The Malawi example is compelling, and we strongly encourage designers of health systems strengthening projects to include knowledge management interventions.
To help guide KM efforts, K4Health has developed a conceptual framework for integrating a health systems performance improvement model with KM principles and processes based on the project's experience and expertise (see figure). Read more about the conceptual framework in the KM and HSS brief.