# 7. Key Stakeholders

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">The Malawi LIMS is a multi-stakeholder national health information system. Its successful operation depends on collaboration between government, laboratories, technical teams, implementing partners and development partners.</span>

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">The current LIMS documentation identifies the following major stakeholder groups.</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.1 Ministry of Health</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">The Ministry of Health is a central stakeholder in the national LIMS ecosystem.</span>

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">The Ministry has an interest in:</span>

- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">National laboratory information</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Health system planning</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Laboratory performance</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Disease surveillance</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">National reporting</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Digital health interoperability</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">System sustainability</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Policy and strategic direction</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.2 National Reference Laboratories</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">National reference laboratories contribute to the implementation and use of LIMS for laboratory testing, quality management, specialized testing, national surveillance, and technical laboratory functions.</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.3 District Health Offices</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">District Health Offices are important stakeholders in the implementation and monitoring of laboratory services at district level.</span>

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">They benefit from information on:</span>

- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Laboratory performance</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Testing volumes</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Result availability</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Turnaround time</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Facility performance</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Reporting completeness</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.4 Laboratory Personnel</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Laboratory personnel are the primary operational users of facility-level LIMS functionality.</span>

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">This includes personnel involved in:</span>

- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Patient and sample processing</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Laboratory testing</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Result entry</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Result verification</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Result authorization</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Quality control</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Laboratory management</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.5 Software Developers</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Developers are responsible for designing, developing, maintaining, and enhancing the software components of the LIMS ecosystem.</span>

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Their responsibilities may include:</span>

- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Application development</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Database development</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">API development</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">System integration</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Analyzer interfaces</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Bug fixing</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Testing</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Deployment</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">System enhancements</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.6 Quality Assurance Teams</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Quality assurance teams contribute to ensuring that laboratory processes and the information system support appropriate quality standards.</span>

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Their involvement includes areas such as:</span>

- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Quality control</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Data quality</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Process monitoring</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">System validation</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Testing</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Performance monitoring</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.7 Implementing Partners</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Implementing partners contribute technical, operational, and program support to the national LIMS ecosystem.</span>

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Their role may include:</span>

- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">System implementation</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Technical assistance</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Training</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Infrastructure support</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Software development</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Integration</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Monitoring and evaluation</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.8 Donor Organizations</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Donor organizations provide financial and technical support that contributes to the implementation, expansion, and sustainability of laboratory information systems. CDC is the major donor for the LIMS</span>

**<span style="font-size: 18.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">7.9 System Administrators</span>**

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">System administrators maintain the operational configuration of LIMS.</span>

<span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">The current documentation identifies administrator functions, including management of:</span>

- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Users</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Roles</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Facilities</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Test catalogues</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Machines</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Printers</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Synchronization</span>
- <span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: #2000; mso-fareast-language: #2000;">Reference data</span>