Introduction
Most countries, supported by the African Leaders Malaria Alliance (ALMA), produce digital scorecard tools every three months. Some countries are now moving to monthly scorecard publishing. This change makes it possible to track performance almost in real time at national and local levels.
The move to monthly publishing allows countries to:
- identify emerging gaps more quickly
- check follow-up actions more often
- respond to upsurges in malaria cases more quickly
- check high-risk indicators more often
Benin, Guinea, Rwanda and Uganda now publish scorecard tools every month.
When scorecard tools connect with a country’s health management information system, such as DHIS2, moving to monthly publishing only needs a little extra work.
Benin: monthly data validation improves data quality and timeliness
The African Leaders Malaria Alliance helped Benin’s Ministry of Health develop their digital malaria scorecard tool in early 2018. Initially, routine malaria data validation was conducted solely by statisticians, on a quarterly basis. This data would then feed into the scorecard tool, but this process often caused delays.
Benin’s national malaria control programme, with support from the US President’s Malaria Initiative, wanted to improve the quality of routine malaria data. They started checking the malaria data every month with health facility staff, instead of just once every three months with only statisticians.
Staff validate the data every month in all 77 municipalities. These validation sessions bring together all public and private facilities and are led by the municipal chief medical officer. Previously, they did not always include data from private facilities.
They make corrections in the DHIS2 database before the 20th of the next month. This means they can use the validated data in the scorecard tool every month. Monthly checks have improved data completeness and quality. The data are then analysed every month by both the national and regional management teams, enabling more timely planning and implementation of corrective actions.
The government and partners, such as the Clinton Health Access Initiative and the US President’s Malaria Initiative, have allocated US$500,000 each year for these data validation reviews.
Since August 2025, Benin has published its malaria scorecard tool every month on the ALMA Scorecard Hub.
Guinea: monthly publishing for malaria and RMNCAH scorecard tools
In 2025, Guinea started using monthly scorecard tools for malaria and reproductive, maternal, newborn, child and adolescent health (RMNCAH).
This change helped teams find gaps sooner, check follow-up actions more often, and respond to changes in malaria cases more quickly and accurately.
They use the Scorecard Web Platform’s ability to connect with DHIS2 to support this. This connection lets them populate their scorecard tools by transferring data straight from DHIS2.
Monthly scorecards help with daily facility management
Guinea also used this monthly scorecard approach to deepen decentralisation of its RMNCAH scorecard tool. In 2025, Guinea’s ministry of health and the African Leaders Malaria Alliance trained health facility leaders to use the RMNCAH scorecard tool in five regions. Now, the scorecard tool helps staff with daily facility management. It means that decisions on tasks, community engagement, and supervision use up-to-date monthly RMNCAH data.
Sharing the scorecard tools with partners and other stakeholders
Guinea shares its scorecard tools widely. Sharing scorecard tools with partners and other groups increases their impact and helps teams use them in regular management meetings.
Each month, Guinea’s scorecard tools are produced centrally, and are then:
- shared electronically with national programmes, regions, districts and partners
- sent to relevant stakeholders by email distribution lists
- made available on the ALMA Scorecard Hub
- printed for use in national, regional and district review meetings
These monthly scorecard tools are now shared consistently. This helps partners track malaria and RMNCAH indicators in near real time and enables district and facility teams to follow up on issues more quickly.
Integrated use of Guinea’s malaria and RMNCAH scorecard tools
Guinea now uses malaria and RMNCAH scorecard tools together to solve common challenges in health services.
At district and regional levels, using both scorecard tools provides Guinea with the data needed for joint analysis meetings, shared action plans and coordinated follow-up.
At national level, Guinea reviews the RMNCAH and malaria scorecard tools together during monthly and three-monthly meetings. This lets leaders examine maternal, newborn, child, and nutrition outcomes alongside malaria trends.
Uganda: monthly malaria scorecard tools for stronger evidence-based programming
Uganda started monthly malaria scorecard tools in 2023 when the country was experiencing malaria outbreaks across several districts to reinforce tracking and managing outbreaks. The monthly scorecard tool gives up-to-date data and complements the weekly routine surveillance data. The scorecard is also used for routine programme management during monthly review forums.
Uganda uses two types of malaria scorecard tools to meet different needs
Uganda produces a monthly scorecard tool and a different quarterly scorecard tool to meet different needs and monitor malaria performance.
Uganda’s monthly and quarterly malaria scorecards are used complementarily. The monthly scorecard allows for more frequent progress reviews and actions. The quarterly scorecard is used in routine quarterly accountability forums to assess longer term performance including for ministry of health leaders and decision-makers who set overall strategy.
The monthly scorecard tool showed a drop in malaria testing rates in Budaka district, in eastern Uganda. The rate fell from over 90% before April to 81% in June.
An investigation found that 85% of facilities had run out of malaria rapid diagnostic tests. The shortage happened at the same time as a rise in malaria cases. The district health management team worked with the district medical stores to move supplies from a nearby district. These changes led to a 93% testing rate for malaria in November 2025.
The monthly scorecard trends helped the district malaria task force work with national medical stores to act quickly to change purchasing plans and prepare for upsurges.
Rwanda: monthly scorecard tools help community planning and minister engagement
Rwanda’s national malaria and other parasitic diseases programme now uses monthly scorecard tools at the district level, as well as quarterly scorecard tools for malaria and neglected tropical diseases (NTDs).
Health facility-level monthly scorecard tools guide the work of civil society organisations and help with discussions with local leaders and communities. The indicators on these monthly scorecard tools focus on what happens at the health centre and community levels from a behaviour change communication perspective.
The quarterly malaria and neglected tropical disease scorecard tool is reviewed and used in national and local meetings. It was the first integrated malaria and NTD scorecard tool in Africa and is also published on the ALMA Scorecard Hub.
Driving high-level, ministerial engagement
Promoting the monthly scorecard tool has led to more ministerial engagement, when malaria cases increase.
In 2025, following a review of the monthly scorecard tool, the minister of local government worked to mobilise communities against malaria. The minister asked for regular talks on malaria prevention and control, and on removing mosquito breeding sites, during monthly community service days (called Umuganda) and other community events. These actions were carried out in the most affected villages to remove breeding sites and encourage behaviour change. Malaria cases have dropped in these villages since then.
Conclusion
Experiences from Benin, Guinea, Rwanda, and Uganda show that moving from quarterly to monthly publication of scorecard tools can make them more useful for management and accountability.
Publishing scorecard tools monthly helps teams identify gaps sooner, follow up more effectively, and respond to issues more quickly and accurately.
Recommendations for countries
- Establish interoperability between the Scorecard Web Platform and DHIS2 to help move to monthly publishing: Guinea’s experience shows that linking with DHIS2 lets teams produce more frequent performance reports with minimal extra work, since the data is already in DHIS2.
- Invest in monthly data validation processes to ensure the quality of more frequently published data: Benin’s model of monthly peer-to-peer routine data validation sessions across all 77 municipalities shows how monthly publishing can drive improvements in data completeness and quality, not just timeliness.
- Share monthly scorecard tools with many different groups beyond the health sector: Rwanda shared monthly scorecard tools with leaders at all levels, from central to community level, and with civil society organisations to help them target support where malaria cases were rising.
- Publish the monthly scorecard tool on the Scorecard Hub to make it open and support peer learning: Public publishing helps other countries learn from the data and approach and improves accountability domestically.