Monitoring Child Mortality through Community Health Worker Reporting of Births and Deaths: Case of Community Health Surveillance Assistants in Malawi

Benjamin Banda, National Statistical Office, Malawi
Willie Kachaka, National Statistical Office, Malawi
Agbessi Amouzou, Johns Hopkins Bloomberg School of Public Health
Jennifer Bryce, Johns Hopkins Bloomberg School of Public Health

Decline in child mortality in most low-income countries is too slow to achieve the Millennium Development Goals 4 of reducing under-five mortality by two-third between 1990 and 2015. Effective strategies to monitor child mortality on short term intervals are urgently needed to allow countries to assess their progress. We present results from a test of mortality monitoring approach based on community health workers (CHW) recording of births and deaths within their communities. Mortality data collected by randomly selected CHWs of Malawi are compared to those of a “gold-standard” mortality survey. Results indicate that CHWs data under-estimated child mortality from 24% to 49% and the level of under-estimation increased over-time. The approach appeared however promising because events reported were found to be accurate and reliable. Further investigations are being conducted to learn the patterns of errors and profile of events that are likely to be missed by the CHWs.