The Story
The Malawi Ministry of Health and Population (MoHP) set out to transform fragmented community health data systems into a national, integrated digital platform, the Integrated Community Health Information System (iCHIS). Building on the Phase I situational assessment, we aimed to define system requirements and workflows, ensuring that the next generation of Malawi’s community health services would be data-driven, interoperable, and user-centered.
The Challenge
Community health delivery in Malawi relied on paper-based, disjointed processes: more than a dozen separate service workflows, paper registers, and limited data analysis capacity. Health Surveillance Assistants (HSAs) and supervisors faced inefficient reporting, stock-outs, and gaps in disease surveillance, family planning, nutrition screening, and more. A digital system had to unify 12 service and cross-cutting workflows, be robust in low-connectivity settings, and meet diverse stakeholder needs, while earning the trust of frontline workers and national policymakers.
The Turning Point
The MoHP convened a National iCHIS Task Force, uniting the Community Health Services Section (CHSS), Quality Management and Digital Health Department (QMD), Central Monitoring and Evaluation Division (CMED), and partners. This multi-level coalition embraced Human-Centered Design (HCD) to keep frontline workers at the heart of design. The decision to co-create the system with HSAs, district officers, and NGOs marked a pivotal shift from top-down technology planning to inclusive, participatory design.
The Execution
Between October 2019 and January 2020, the project followed a full Human-Centered Design journey. It began with national consultative meetings that mapped existing workflows and identified high-level user needs. Field visits across four districts uncovered real practices through interviews, focus groups, and workflow sketches, revealing how data, actors, and systems interconnected. In the ideation phase, joint sketching and brainstorming sessions produced digital workflow concepts for twelve service areas such as immunization, TB, and maternal care and three cross-cutting domains namely: reporting, supply chain, and supervision. Teams drafted 120 user requirements and visualized how iCHIS could enhance daily routines. During testing, 58 users joined validation workshops to refine workflows and ensure alignment with Ministry of Health guidelines. Through persona creation, journey mapping, participatory diagramming, and iterative validation, the team grounded iCHIS in the lived realities of community health work, translating insights into actionable digital solutions.
Impact
This engagement demonstrates our ability to blend technical expertise with participatory design to achieve transformational public health outcomes. The consultancy not only defined a complex digital health system but also built capacity within the MoHP and community health workforce, ensuring that iCHIS will scale as a government-owned, user-approved platform capable of improving the health and well-being of all Malawians.
The Result
The project delivered a nationally endorsed roadmap for a scalable digital CHIS, grounded in real user experiences and validated workflows. It positioned Malawi to reduce reporting burdens, improve data accuracy, and enable real-time decision-making from village clinics to national offices. Anchored in government ownership and interoperability, the roadmap ensures sustainability through continuous learning and system evolution.