session 6 a dhis2 : overview and implementation in west africa
TRANSCRIPT
DHIS2 Overview and Implementation in
West AfricaRegional Workshop
From Health Information System to collective Intelligence Refocusing the health district on population using ICT16-18 December 2015
Hôtel du Lac, Cotonou-Bénin
Dapo Adejumo & Jerry Aziawa HISP
Outline• Introduction• Historical Perspective• DHIS2 and HIS• DHIS2 Core Features• DHIS2 Implementations in West Africa
• Anglophone WA , Nigeria, Ghana, SL , Liberia• Francophone
• Development Philosophy and Plan• Conclusion
Introduction• District Health Information Software• A web-based software package built with free and open source
frameworks • A tool for collection, validation, analysis, and presentation of
aggregate statistical data, tailored (but not limited) to integrated health information management activities.
• A generic tool rather than a pre-configured database application, with an open meta-data model and a flexible user interface that allows the user to design the contents of a specific information system without the need for programming
Health Indicators
Maternal Health
Population Data
Diseases
Child Health
Semi-Perm Data
Integrated Monthly Report
RHIS for local management
0
204060
80100
1s tQtr
2ndQ tr
3r dQtr
4thQtr
E as t
Wes t
Nor th
Other Systems
•Quality Control•Aggregation•Analysis
•Graph •Maps•Reports
•Self Assessment•Monitoring•Decisions
•Minimum Data Set
Surveys
HMIS
Priority Programs
FEEDBACK
Core Functionality• Online Application with offline capabilities• Capture, analysis and dissemination of data
• Handles Routine aggregate data, events (individual records) and surveys
• Can server as an Integrated warehouse for essential data
• Self-service analysis and communication
Information For Action – Power to the User!!!• Efficient Access Control to make information available
to all levels of information systems with emphasis on districts
• Interactive platform to to ensure peer review of information ( District to District
Data
DHIS 2
LMIS
HR EMR
(Measles d o s e s gi ve n to children < 1 ye ar / total populat ion < 1 year)
8 9 .59 4 .4 9 3 . 6 9 3. 81 0 0 .0
9 0 .0
8 0 .0
7 0 .0
6 0 .0
5 0 .0
4 0 .0
3 0 .0
2 0 .0
1 0 .0
0 .0
s t
r ic t
74
81
. 7 . 3 7 9 .0 8 0 .7 80.0 7 9 .9
Chake
Chake
Distric t
Michew eni
Dis t ric t
Pemba
Mkoani
Dis trict
Z o n e
Wete
Distric t
Cent ral
District
North A
District
North B
Distric t
Unguja
South
Distric t
Z o n e
Urban
Distric t
We
Dist
D istric t
Ann
ual m
easl
es c
over
age
%
Data from Mobile devises
-Data mart-Meta data-
Visualising tools
Dashboard
Graphs
Maps
Getting data in - Data warehousing
Getting data out - Decision support systems – ‘Business intelligence (BI)
Web Portal
Mobile
DataWarehouse
Paper based systems: OPD, EPI, RCH,other programs
Users of primary data & data providers
Electronic Medical Records HR
Management
Logistics & drugs
Mobile reportingFinanc
e
Users ofprimary data& data providers
Users of processed & integrated data
Integration of technologies, systems, data & health programs
Integrated Health Information Architecture (“Horizontal integration”)- integrating sub-systems, technologies, health services & programs
Performance Based financing reporting
SDMX -HD
Paperreports
Aggregate & indicator data
National Health Management Information System - Nigeria• Routine data from 34000 health facilities across the country• DHIS2 implemented in 2012 for the National Health Management
Information System• Proved to be a highly scalable solution for the country• Current National reporting of 70% for National Minimum Dataset• Long-term vision of DHIS2 as National Datawarehouse
Implementation Design• Centralized System with leadership from the Federal Ministry of
Health – A single National instance• Paper forms transmit data from the health facility to the District• District officers capture data to the online DHIS2 via laptop computers
and internet modems• A growing number of health facilities capture routine data directly to
the database using mobile devices• All levels with access to relevant information
Challenges• Last Vestiges of parallel reporting systems by various donors and
institutions• Human resource constraints at district level – staff are often saddled
with multiple responsibilities aside information systems• Low Funding from National , Regional and Local Governments with
heavy dependence on external donors – problems of sustenability• Challenges with quality of data stemming from weak data systems at
lower levels• Low use of information at lower levels…
Tracker and Events – Ghana Health Service• Registration of Outpatient Cases• Registration and Tracking of Antenatal Clients• Registration and Tracking of Children within Immunization program
Full CIF
Minimal case line list (Name, Sex, Age, Status, Location)
Lab result (for diagnosis)
Burial data
Contacts
WWW
WWW
WWW
WWW
WWW
Case Import
WWW
Case Investigation Form
Liberia : IntegratedEbolaInformation System
Sierra Leone• Distributed installation: Due to poor internet connectivity, the idea
was to have many local instances in order to collect and aggregate data without relying on internet.
• Few setbacks: human resource issues as the entire HMIS team was sacked.
Burkina Faso• System used nationwide• Few setbacks: Big data collection tools designed to satisfy everybody
but does not in practice and human resource issue as they difficulties in keeping the team.