District Health Performance Improvement


The District Health Performance Improvement (DHPI) project focused on equitable programming and real-time monitoring, strengthening Malawi’s district health system. DHPI helped districts plan more effectively and efficiently, prioritize, and focus resources where they are needed most.

DHPI is Malawi’s adaptation of UNICEF’s systematic and outcome-based DIVA (Diagnose, Intervene, Verify, Adjust) approach. MSH contributed to the development of this approach, as well as resource materials.

Funded by UNICEF, the partnership with MSH and Malawi’s Ministry of Health provided technical and programmatic support to districts in the process of applying DHPI and introduced additional districts to the process. Assistance was focused on improving reproductive, maternal, newborn, child, and adolescent health in 12 priority districts: Lilongwe, Mzimba, Kasungu, Dedza, Ntcheu, Dowa, Mangochi, Blantyre, Zomba, Mulanje, Thyolo, and Mchinji.

The project aimed to increase the proportion of districts that fully implement DHPI, informing strategic use of limited resources. DHPI sought to achieve this by:

  • Increasing accountability for and transparency of district planning
  • Increasing capacity for applying DHPI and monitoring for results
  • Sharing best practices and lessons learned more widely to maximize DHPI application

Sixty indicators for ten key interventions were identified and refined and new tools were developed to support data collection. A cadre of Ministry of Health staff, called DHPI champions, assisted in implementing DHPI, identified solutions to challenges, and further adapted the approach to suit the Malawian context.

Since 2012, the country’s ministry of health has supported DHPI in 14 districts with UNICEF support. District plans align with national priorities with the goal of increasing coverage of critical interventions. Preliminary results indicated that strengthened planning resolves bottlenecks and improves coverage of services, leading to greater health outcomes and impact.

Donors & Partners


​​United Nations Children’s Fund