Session 6 a DHIS2 : Overview and Implementation in West Africa

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

DHIS2 and HIS….Answers to Multiple Questions….

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

Hierarchy of Standards

Client Data

System Data

Facility Data

MDG Data

Strat Plan Data

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

Core Features / Applications

Data Mining – Aggregate, Individual and Tracker

Powerful Analytic Tools

Interactive Dashboards

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

Interoperability – Robust WEB API

DHIS2 as a datawarehouse

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

DHIS 2 Implementation

Global Reach

Partners Pilot/early phase Scaling up Nation-wide rollout

West Africa Implementation use cases

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.

WAHO (West Africa) Dashboard

Thank you