Contents Background Connected Woreda Data Governance eHealth Architecture eRIS Lesson Learned Future Priorities

FIVE YEAR PROGRESS REPORT

FIVE YEAR PROGRESS REPORT

I
REVOLUTION
INFORMATION
 FIVE YEAR PROGRESS REPORT

CONTENTS

Contents
BACKGROUND INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

CONNECTED WOREDA STRATEGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Background
DATA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

DATA QUALITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Connected Woreda
GOVERNANCE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

HEALTH INFORMATION TECHNOLOGY SYSTEMS & SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . 5

eHEALTH ARCHITECTURE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

HEALTH INFORMATION TECHNOLOGY SYSTEM STANDARDS & INTEROPERABILITY . . . . . . . . . . . . . . . . . . 6

Data
ELECTRONIC REGULATORY INFORMATION SYSTEM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

HEALTH MANAGEMENT INFORMATION SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

ELECTRONIC COMMUNITY HEALTH INFORMATION SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Governance
MASTER FACILITY REGISTRY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ELECTRONIC MEDICAL RECORDS SYSTEM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

eHealth Architecture
HUMAN RESOURCE INFORMATION SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

PUBLIC HEALTH EMERGENCY MANAGEMENT SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Ethiopia’s Digital Health Response to COVID-19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

HEALTHNET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 eRIS

SUPPLY CHAIN SYSTEMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

GUIDELINES AND PROTOCOLS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Lesson Learned

CAPACITY BUILDING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

LESSONS LEARNED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

FUTURE PRIORITIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Future Priorities

II
 FIVE YEAR PROGRESS REPORT

BACKGROUND INFORMATION

Contents
The Information Revolution (IR) led by Ethiopia’s Ministry of IR Roadmap (2016-2020) identifying two pillars of focus
with actionable and measurable interventions: (1) enhance

Health (MOH) was one of four key transformation agendas in the
first Health Sector Transformation Plan (HSTP). The IR agenda
was launched in response to increasing demands for health
information and opportunities to leverage advancements
in information and communications technology (ICT). To
advance the IR objectives, the MOH developed a national
Background
the culture of information use for decision making, and (2)
implementation and scale-up of prioritized health information
systems (HIS) and tools The IR agenda continues to be a major
priority in HSTP-2 to bring fundamental cultural changes and
accelerate the process of data use within the health sector.

Connected Woreda
Ethiopia IR
IR PILLARS

Data
Enhance the culture PILLAR PILLAR
of information use for
decision making. 1 2 Implementation and scale-up of
prioritized HIS and tools.

Governance
HIS Governance

eHealth Architecture
Improving performance of
the health system Enable equitable access to high
quality health care services
eRIS
Lesson Learned

Improve patient and

population health outcomes
IR Goals

This is a summary of the IR Roadmap Booklet highlighting key accomplishments and learnings from the last five years, as well as recommendations
Future Priorities

for the next five years. More detailed information is available in the IR Roadmap Booklet. Information provided in the IR Roadmap Booklet and this
summary IR Progress Report is intended to be used by the federal government, donors, partners and other stakeholders supporting the health
sector.

1
 FIVE YEAR PROGRESS REPORT

CONNECTED WOREDA STRATEGY

Contents
The Connected Woreda Strategy is Ethiopia’s program to support and implement the IR agenda
and HTSP priorities at the woreda level. The program aims to:
• Improve the quality and transformation of health information at all levels.
• Improve the culture of using health information for decision at all levels.

Background
• Strengthen HIS infrastructure through improved connectivity and digitization of health
information system tools.
• Strengthen IR implementation and expansion to all regions.
A woreda that has established a data use culture and is taking advantage of digital tools at 90% of

Connected Woreda
the facilities within the woreda are credited as Model Facilities.

CONNECTED WOREDA – IMPLEMENTATION PHASES

EMERGING FACILITY CANDIDATE FACILITY MODEL FACILITY CONNECTED FACILITY

Data
Typical Profile
• Facilities working to • Facilities have basic M&E • Highest-performing • Model Facilities
improve core Measure infrastructure in place, facilities • Can access and share data
& Evaluation (M&E) but have room to improve • Score over 90% on
infrastructure and in data quality, and

practices across the board administration and clinic
data use.
• Score less than 65% on
assessment criteria • Score between 65% and
90% on assessment
criteria
Governance
assessment criteria
• Can access and share data
offline (e.g., paper, flash
drive)

Interventions Focus by Assessment Category

M&E Systems & • Capacity building
Capacity to strengthen HIS
infrastructure and
supportive supervisions
• Capacity building for
Data Quality data completeness
and timeliness, and
performance of Lot
Quality Assurance
eHealth Architecture
• Targeted support for • Document Model Facility • Same as Model Facility
lower-performing best practices • May demonstrate
facilities. (Assumes • Provide a site to test, how digital tools
M&E infrastructure is demonstrate and diffuse complement processes
mostly in place at this data-use best practices at Model Facility levels
level.)
• May demonstrates how • May include
• Targeted support for digital tools complement demonstrations of
lower-performing processes at Model Facility tools such as Electronic
facilities. (Assumes levels, such as: Medical Records (EMR)
most facilities are • Fully functional
»»IVR/SMS for monthly/
meeting data quality HealthNet
PHEM reporting
eRIS

Sampling (LQAS) standards at this level.)

»»HMIS dashboards
Administrative Adds: »»eCHIS and DHIS2 data
• Capacity building for
Data Use • Capacity assessments exchanges
PMT processes and
information products • Tailored training
presentation and materials (job aids)
dissemination Digitalization
Lesson Learned

• Other support (e.g.,

person-to-person
Clinic Data Use • Data monitoring tools sharing, support for • Range: Intermittent data connectivity and electricity →
such as charts/reports to data analytics) full connectivity across the woreda
support service delivery • Testing data use
performance incentives • Health Extension Workers (HEW) basic literacy and
numeracy
DHIS2 District Health Information Software 2 • Woreda Health Office (WoHO) has digital reporting
eCHIS Electronic Community Health Information System capabilities to replace paper submissions
Future Priorities

HMIS Health Management Information System • HEWs use standard processes (i.e., non-standard
Graphic acronyms processes may not function correctly with eCHIS)
IVR Interactive Voice Response
PHEM Public Health Emergency Management • Minimum training requirements met by relevant health
SMS Short Message Service workers and administrators

2
 FIVE YEAR PROGRESS REPORT

DATA

Contents
Health and health-related data in Ethiopia are gathered through different institutions and
processes, including surveys and surveillance systems to improve evidence-based decisions
making at all levels. Over the last five years, updated and new survey and surveillance data

Background
were collected in alignment with the IR agenda.

2016

Connected Woreda
Emergency Obstetric and
Newborn Care Survey
conducted on maternal and
newborn services in the
country 2016 - 2017

National health account

Data
2016 - 2018

Service Availability and

Readiness Assessment (SARA)

Governance
facility-based surveys
2017 - 2018

Ethiopia Population Based

HIV impact assessment

eHealth Architecture
2017 - 2018

National household survey to

measure urban HIV epidemic
2018
eRIS

Antenatal care (ANC)

surveillance survey
2018-2019

Performance Monitoring and

Lesson Learned

Accountability survey on population

dynamics, family planning,
reproductive health service delivery,
and water, sanitation, and hygiene 2019
Ethiopia Mini Demographic and
Health Survey conducted to
update key health indicators
Future Priorities

and measure progress on health

sector goals

3
 FIVE YEAR PROGRESS REPORT

DATA QUALITY

Contents
Improving data quality and promoting the culture of information use are the center of the IR
agenda. The following graphic provides information on the quality assurance.

Background
Data Quality Assurance – Timeline

Year 1 Year 2 Year 3 Year 4 Year 5

Connected Woreda
2016 2017 2018 2019 2020

Five Years HSTP

Basline & endline assessments PRISM PRISM

Woreda Based Planning and Annual Health Sector Review Meetings

Data
Annual assessment (MOH/RHB) Annual DQR Annual DQR Annual DQR

Quarterly assessment by RHBs Routine DQA Routine DQA Routine DQA Routine DQA Routine DQA

Supportive Supportive Supportive Supportive Supportive

Monthly supervision by WoHO Supervision Supervision Supervision Supervision Supervision

Governance
Monthly self assessment by LQAS LQAS LQAS LQAS LQAS
health facilities

Graphic acronyms • Annual Data Quality review (DQR) • Performance of Routine Information System Management (PRISM)
• Data Quality Assessment (DQA) • Regional Health Bureaus(RHBs)

eHealth Architecture
• Lot Quality Assurance Sampling (LQAS) • Woreda Health Office (WoHO)

GOVERNANCE

HIS governance encompasses national-level coordination of investments and strategic planning

activities. The MOH endorsed a HIS governance framework two years ago to further define and
eRIS

document HIS governance functions, principles, and structures in a consultative process with
stakeholders.

LAUNCHED
HIS governance framework approved an HIS Steering Committee led by the Minister
Lesson Learned

and national technical working groups (TWGs)

established

PROMOTING DEVELOPING Digitalization TWGs Data Use Cultural Transformation TWGs

HIS Accountability HIS Legislation and Designed to support the Designed to support the data use cultural
and Transparency Regulation digitalization pillar of the IR transformation pillar of the IR
Future Priorities

DEVELOPING FOSTERING HIS Governance TWGs

HIS Policy and HIS Coordination and Follow up, monitoring and flagging of the existence of
Partnerships the various HIS governance functions
Strategy

4
 FIVE YEAR PROGRESS REPORT

HEALTH INFORMATION TECHNOLOGY SYSTEMS & SERVICES

Contents
eHEALTH ARCHITECTURE

The eHealth Architecture is a blueprint for Ethiopia’s health information needs, software and hardware
requirements to coordinate IT choices, ensuring appropriate resource utilization, and facilitating access
and integration of data. The MOH made progress over the last five years developing and refining the

Background
eHealth Architecture blueprint and making investments in the components.

National Health ICT Infrastructure

Shared Services Institution-Based HIS & Data Sources Population-Based Analytics &
Acronyms

Connected Woreda
HIS & Data Sources Business Intelligence

Shared Health Record

LEGEND:
Facility Surveys Analytics and BI
Client Registry (EMPI) (SPA+)
Development not started

Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS Under Development

Master Facility Registry eLMIS/HCMIS eRIS Surveys Data Warehouse Functional Application

Data
Health Data Dictionary eHMIS/DHIS 2 HGIS Census EHDAP

External Systems

Interoperability Service
Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation IFMIS

Governance
Agriculture

Point of Service HIS

Metrology

Nutrition eLIS Surveillance IVR EMR Patient Portal

Education
eCHIS

eHealth Architecture
eHealth Architecture Governance, Principles, Processes and Standards

Shared Services
• MFR system customization completed
• Data about health facilities collected from different sources and being reconciled
• A plan to generate an authoritative list of all health facilities by the end of the current fiscal year
eRIS

• National Health Data Dictionary (NHDD) is up and running and National Classification of Diseases
(NCoD) is loaded; indicators are loaded into NHDD.
• A mobile app to access the data dictionary
• Develop client registry and shared health records in the later years of the project
Lesson Learned

Interoperability Services
• Data exchange between different systems being demonstrated
• Additional priority use cases have been identified and planned to be implemented
• eHealth Architecture (eHA) and interoperability academy established at Mekelle University

eHealth Architecture
Future Priorities

• Conduct eHA maturity assessment

• Develop a roadmap for national eHA implementation
• Strengthen development and adoption of national data and interoperability standards

5
 FIVE YEAR PROGRESS REPORT

Contents
Deployed the Ethiopia Digital Health Projects Inventory System to
register and conduct inventory registry digital health projects

Established eHealth Architecture and interoperability academic

center of excellence opened at Mekelle University

Background
Tested data exchange between the MFR and DHIS2

Accomplishments

Connected Woreda
Leveraged DHIS2 for case-based COVID-19 surveillance and data
exchange with the lab information system on lab orders and results

Supported eHealth Architecture technical workgroup meetings and

governance processes established

Data
HEALTH INFORMATION TECHNOLOGY SYSTEM
STANDARDS & INTEROPERABILITY

Governance
HIS and ICT standards promote collection, exchange, use and reuse of health data across
unaffiliated organizations and technologies, reducing fragmentation. The MOH advanced
guidelines and protocols supporting HIS standards over the past five years to advance
interoperability of health data.

eHealth Architecture
eRIS
Lesson Learned

DEVELOPED LAUNCHED DEVELOPED ESTABLISHED TWGs

Future Priorities

the NHDD as the authoritative NHDD Pocket, a mobile app of National data to develop EMR standards (i.e., minimum
source for indicators and HIS the NHDD to enable access to dictionary data sets, functionalities, technical
standards practitioners requirements)

6
 FIVE YEAR PROGRESS REPORT

ELECTRONIC REGULATORY INFORMATION SYSTEM

Contents
National Health ICT Infrastructure

Services Institution-Based HIS & Data Sources Population-Based Analytics &

HIS & Data Sources Business Intelligence

alth Record

Background
LEGEND:
Facility Surveys Analytics and BI
stry (EMPI) (SPA+)
Planned Activities: Development not started

CRVS • Upgrade eRIS to address new requirements and new modules

Health Insurance /
IDSR / ePHEM
eHNIIS Under Development
• Implement i-Import integration with electronic single window
y Registry eLMIS/HCMIS eRIS
eRIS Surveys • Finalize the Data
development
Warehouse and deployment inspection module in eRIS with
Functional Application

Connected Woreda
automatic synchronization to i-License and i-Register
Dictionary eHMIS/DHIS 2 HGIS Census EHDAP
• Implement i-License (health facilities ) in 100 woreda level offices to register all
public and private facilities
External Systems
eRIS is the umbrella system at Ethiopia Food and Drug Administration (EFDA) comprised of multiple
Interoperability Service
sub-systems
Authentication • Encryption •which
Routing •work together:
Transformation • Queuing • Validation • Translation IFMIS

i-Register
Agriculture is used to manage the
i-License enables entities to apply food, medicines and medical devices
Point of Service HIS
for a certificate of competence to

Data
registration
Metrology processes when an
eLIS register and
Surveillance IVRimportEMR
products. Patient Portal applicant seeks to register those
products
Education
in Ethiopia for later import.

eHealth Architecture Governance, Principles, Processes and Standards

Governance
eHealth Architecture
i-Verify is used to verify and check
i-Import is used to manage the
the authorization status of medicines
import process, once registered in
by EFDA and monitor the movement
Ethiopia.
of medicines from manufacturer to
the point of issue.
eRIS

SCA
N
Lesson Learned

SCAN
Future Priorities

7
 FIVE YEAR PROGRESS REPORT

HEALTH MANAGEMENT INFORMATION SYSTEM (HMIS)

Contents
An HMIS supports routine collection, aggregation, analysis, presentation and utilization of health and

Background
health related data for evidence-based decisions by health workers, managers, policy makers and
others. Since launching the IR Roadmap, Ethiopia deployed the electronic DHIS2 to support HMIS
activities.

National Health ICT Infrastructure

Connected Woreda
Shared Services Standardized indicator
Institution-Based HIS & Data Sources Populatio
HIS & Data
definitions
Shared Health Record

Facility Surveys
Client Registry (EMPI) (SPA+)

Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS
Accomplishments

Data
Master Facility Registry eLMIS/HCMIS eRIS Surveys

Health Data Dictionary eHMIS/DHIS2

eHMIS/DHIS 2 HGIS Census

Governance
Interoperability Service
Authentication • Encryption • Routing • Transformation • Queuing • Validati
DEPLOYED DHIS2
3,605 1,600 7,000 4,000
system consolidating two
ONLINE OFFLINE DATA WORKERS DATA WORKERS
systems into one for HMIS
trained on Point ofon
trained Service
DHIS2 HIS
data
data collection, analysis
DHIS2 access sites DHIS2 use analytics tools
and reporting

eHealth Architecture
Nutrition eLIS Surveillance IVR EMR

eCHIS

eHealth Architecture Governance, Principles, Processes an

131 IMPROVED QUALITY OF

HMIS DATA
DHIS2 ACADEMIC CENTER OF
EXCELLENCE
CORE HMIS (i.e., DHIS2) completeness
and timeliness of data opened at Gondar University
INDICATORS
Established collected
eRIS
Lesson Learned

DHIS2
Future Priorities

EVIDENCE-BASED
DECISIONS BY
HEALTH WORKERS

8
 Shared Health Record
Client Registry (EMPI)
FIVE YEAR PROGRESS REPORT
LEGEND:
Facility Surveys Analytics and BI
(SPA+)

ELECTRONIC COMMUNITY HEALTH INFORMATION

Development not started

Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS

SYSTEM (eCHIS)
Under Development

Contents
Master Facility Registry eLMIS/HCMIS eRIS Surveys Data Warehouse Functional Application

Health Data Dictionary eHMIS/DHIS 2 HGIS Census EHDAP

The eCHIS is a mobile platform that assists in the management of health extension programs through
the collection and use of demographic data, health services delivery information and service utilization. External Systems
Over the last five years, the MOH expanded eCHIS functionality and the number of implementation

Background
sites. Interoperability Service
Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation IFMIS

Agriculture

Point of Service HIS

Metrology

Connected Woreda
Nutrition eLIS Surveillance IVR EMR Patient Portal
Education
eCHIS
eCHIS

•eHealth
Development ofGovernance,
Architecture Principles,
eCHIS to support Processes
agrarian, and Standards
urban and pastoralist
communities
• Implementation of eCHIS in agrarian, urban, and pastoralist health posts
• Develop and implement eCHIS governance protocols and standard
operating procedures (SoPs )

Data
ACHIEVEMENTS: • Provide optimization and server side tech support

1,250

Governance
FAMILY FOLDER, RMNCH and COMMUNICABLE HEALTH POSTS
DISEASES (TB and MALARIA) health posts using eCHIS acoss 4
modules for eCHIS development completed agrarian regions

eHealth Architecture
eCHIS Components

FAMILY FOLDER
SERVICES

Household info, Household RMNCH, CDs, NCDs, NTDs, logistics

properties, Household supply and management
members
eRIS

SETTING

Data element list, data eCHIS

element to form mapping, user REPORTS
management, access to users, Electronic Community Health
Information System Demographic report, Service
organization units
Lesson Learned

coverage report, disease report,

HMIS reports, CHIS reports etc
DATA
SYNCHRONIZATION
DASHBOARD
Data sync between tablets
and to central server Charts, graphs, maps,
indicator analysis etc
Future Priorities

Graphic acronyms CDs Communicable Diseases NTDs Neglected Tropical Diseases

NCDs Non-Communicable Diseases RMNCH Reproductive, Maternal, Neonatal and Child Health

9
 FIVE YEAR PROGRESS REPORT

MASTER FACILITY REGISTRY (MFR)

Contents
The MFR is a platform for collecting, storing and sharing authoritative information on health
facilities in the country. The MFR data can be used by public and private sector stakeholders

Background
to align their systems and programs.

Connected Woreda
Deployed the MFR National Health ICT Infrastructure Developed MFR
with a public portal Institution-Based HIS & Data Sources HIS
Shared Services data accuracy
Population-Based Analytics & and

approval protocols
& Data Sources Business Intelligence

Data
Shared Health Record

LEGEND:
Facility Surveys Analytics and BI
Client Registry (EMPI) (SPA+)
Development not started

Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS Under Development

Governance
Master Facility Registry eLMIS/HCMIS eRIS Surveys Data Warehouse Functional Application

ELECTRONIC MEDICAL RECORDS

HGIS
(EMR) Census
SYSTEM
Health Data Dictionary eHMIS/DHIS 2 EHDAP

External Systems
An EMR is a digital version of a paper chart or register created and managed by health

eHealth Architecture
services providers at a health organization to capture Interoperability Service
and store patient health information.
Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation IFMIS

Agriculture

Point of Service HIS

Metrology

Nutrition eLIS Surveillance IVR EMR

EMR Patient Portal
Education
eCHIS eRIS

eHealth Architecture Governance, Principles, Processes and Standards

• Deploy EMR in selected learning hospitals and health centers
• Development of national EMR requirement and standards
• Develop and implement standard EMR in selected health facilities as per MOH requiremnts

470
Lesson Learned

ACHIEVEMENTS:

ANTIRETROVIRAL THERAPY (ART) SITES

DEPLOYED
Future Priorities

updated EMR software to maintain patient

records of People Living with HIV (PLHIV) taking
antiretroviral medications

10
 FIVE YEAR PROGRESS REPORT

HUMAN RESOURCE INFORMATION SYSTEM (HRIS)

Contents
An HRIS enables users to manage human capital and track the health workforce. In recognition of
the need to better track and manage the health workforce, the MOH made strides in planning for an
electronic HRIS.

Background
National Health ICT Infrastructure

Shared Services Planned HIS

Institution-Based activities:
& Data Sources Population-Based Analytics &

Connected Woreda
HIS & Data Sources Business Intelligence
• Complete the
Shared Health Record
development of the
human resource LEGEND:
Facility Surveys Analytics and BI
Client Registry (EMPI) (SPA+) administration,
Development not started
development, and
Health Insurance /
eHIRIS
eHIRIS IDSR / ePHEM licensureeHNIIS
modules CRVS
Under Development

• Implement HRIS at MOH,

Master Facility Registry eLMIS/HCMIS
agencies,eRIS
RHBs, zonal Surveys Data Warehouse Functional Application

health departments

Data
Health Data Dictionary eHMIS/DHIS 2 HGIS
(ZHDs), WoHOs and HFs PLANNING
Census FOR DEPLOYMENT OF IHRIS SOFTWARE
EHDAP
AT THE NATIONAL AND SUB-NATIONAL LEVELS
External Systems

Interoperability Service
Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation IFMIS

Governance
Agriculture

Point of Service HIS

PUBLIC HEALTH EMERGENCY

Surveillance IVR MANAGEMENT
Metrology

Nutrition eLIS EMR Patient Portal

SYSTEM
eCHIS (PHEM) Education

eHealth Architecture
eHealth Architecture Governance, Principles, Processes and Standards
The MOH deployed the country’s PHEM in 2018 to capture and analyze public health
emergency data.

Deployed the electronic PHEM in 2018

eRIS

Developed PHEM data entry and PHEM Export to

facilitate process of mapping and translating data
between the Ethiopian Calendar in DHIS2 and
epidemiological weeks in PHEM
Lesson Learned

Developed a COVID-19 surveillance and tracking

system using DHIS2 with the opportunity to use
post-COVID-19 for other disease tracking activities.
The system includes a situation monitoring
dashboard, geospatial analysis and risk mapping,
Future Priorities

and key performance indicators.

11

Ethiopia’s Digital Health Response to COVID-19
Across the globe, digital health has been brought to the forefront as a crucial
tool to combat the COVID-19 pandemic. In Ethiopia, critical digital tools were
developed and implemented to mitigate the effects of the pandemic:
Critical Item Availability
Hand sanitizer quality control:
a system to enable the EFDA to monitor and
control hand sanitizer quality
Surveillance and Tracking
National COVID-19 surveillance and
tracking system:
supports the enrollment and tracking of
suspected cases; captures symptoms,
demographics, risk factors, and exposures;
creates lab requests; links confirmed cases
with contacts; and monitors patient outcomes
Surveillance follow-up app:
an application which builds on the case
surveillance and tracking system of COVID-19
and facilitates registration and follow-up of
suspects and contacts of confirmed cases who
will be followed for 14 days
Toll-free recording app:
an app which records and stores data
from individuals who call 8335 and 994
short codes to report their COVID-19
status and/or concerns
Data analytics and visualization:
a dashboard for EPHI and MOH to
monitor the COVID-19 situation in the
country
Health Communication and Education
WhatsApp helpline:
to support users on health queries or concerns and
direct them to accurate information sources
12
FIVE YEAR PROGRESS REPORT
Contents
Background
Expedited product registration:
Connected Woreda
Simplified process to expedite licensing
and registration of COVID-19 supplies
Data
Port-of-entry health declaration for
COVID-19 case surveillance program:
an application that travelers use
to record personal identification
information including phone number;
travel history; illness symptoms; and
Governance
their place of residence
Health facilities reporting app:
an application used by health workers
to report suspected cases at health
facilities to the rapid response teams
eHealth Architecture
Community house-to-house
screening app:
a mobile application for Health Extension
Workers that helps in data collection and
serves as job aid for nationwide door-to-
door COVID-19 screening campaigns
eRIS
Lesson Learned
Rumor and suspected cases reporting
and investigation application:
Future Priorities
developed for community members self-
reporting when they have COVID-19 symptoms
 FIVE YEAR PROGRESS REPORT

HEALTHNET

Contents
The MOH has been working with Ethio Telecom to provide internet connection to all health
facilities and health administration units across the country via HealthNet, a Virtual Private
Network (VPN) service. HealthNet allows these sites to access digital tools such as DHIS2 to

Background
timely enter data and submit reports.

Connected Woreda
Internet

DHIS2 and LMIS are the two

Data
systems using HealthNet

3,605

Governance
HEALTH INSTITUTIONS
have been connected
to HeathNet

eHealth Architecture
Key benefits of HealthNet

Timely feedback to hospitals, health centers and

Improve timeliness of reports
eRIS

woreda offices and improved data quality and use

Improve accuracy and completeness Use by multiple systems

of health data
Lesson Learned

Data access during emergency Future uses of improved network connectivity

internet shut-down via HealthNet
Future Priorities

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 FIVE YEAR PROGRESS REPORT

SUPPLY CHAIN SYSTEMS

Contents
Ethiopia deployed and enhanced a suite of interoperable ICT systems for managing health
system supply chain information in support of the IR agenda.

Background
Vitas is an enterprise level mBrana is a Dagu is an inventory Fanos is a supply
procurement, inventory and mobile inventory management system chain dashboard for
warehouse management management system for health commodities decision making
technology system for vaccines at the facility level

Connected Woreda
Data
EXPANDING FUNCTIONALITY DAGU IS BEING REDESIGNED DEPLOYED mBrana
on Vitas to support Global Standards 1 to be interoperable with Vitas to track distribution of bed-nets in
(GS1) enabled tracking of select program and Fanos malaria risk areas
commodities and online ordering

Governance
Health SystemNational
Supply Health
Chain Information
ICT Infrastructure

Shared Services Institution-Based HIS & Data Sources Population-Based Analytics &
HIS & Data Sources Business Intelligence

Shared Health Record

Client Registry (EMPI)
eHealth Architecture
LEGEND:
Facility Surveys Analytics and BI
(SPA+)
Development not s

Health Insurance /
eHIRIS IDSR / ePHEM CRVS
eHNIIS Under Developmen

Master Facility Registry eLMIS/HCMIS

eLMIS/HCMIS eRIS Surveys Data Warehouse Functional Applica

Health Data Dictionary eHMIS/DHIS 2 HGIS Census EHDAP eRIS

External Syste

Interoperability Service Commodities

Authentication • Encryption • Routing • Transformation • Queuing • Validation • TranslationRequest/ Data IFMIS

Agriculture
Lesson Learned

Point of Service HIS

Metrology

Nutrition eLIS Surveillance IVR EMR WoredaPatient Portal

EFDA
Education
eCHIS

EPSA Center EPSA Hubs Service Delivery Point

eHealth Architecture Governance, Principles, Processes and Standards
Future Priorities

Suppliers
Hospital Clinic Health Posts

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 FIVE YEAR PROGRESS REPORT

GUIDELINES AND PROTOCOLS

Contents
Through additional supportive policies, laws, regulations, and guidelines, the MOH enhanced the
enabling environment for health information systems to operate.

Background
HIS governance Data access and
framework sharing directive

MFR management National HMIS

Connected Woreda
and governance mentorship
protocol guidelines

Woreda-based health
HMIS indicator sector planning
reference guide guidelines

Data
NHDD standard eHealth Architecture
operating procedures

Governance
CAPACITY BUILDING
Ethiopia launched several capacity building programs to enhance the knowledge and skills of

eHealth Architecture
the health workforce to increase use of health information for decision making.

ST. PETER’S COMPREHENSIVE HOSPITAL DHIS2 CAPACITY BUILDING

LAUNCHED A NATIONAL DIGITAL HEALTH
AND INNOVATION CENTER trainings at the national and
sub-national levels
eRIS

began offering pre-service health

30
across 6 universities participated
in an implementation research and
capacity building workshop in 2019, to
PARTICIPANTS identify priority learning questions.
8
informatics programs using the
nationally harmonized, Ministry of
Education approved bachelor’s level
UNIVERSITIES health informatics curriculum.
Lesson Learned

6 UNIVERSITY
GRANTEES
implemented the Capacity Building & Mentorship
Program to support woredas and health facilities

10 2,000 6PHD
43
MASTERS
Future Priorities

COMPUTER LABS INDIVIDUALS UPGRADED STUDENTS RECEIVED

established at to a bachelor’s degree in a research grant to document
teaching institution health informatics learnings from IR initiatives

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 FIVE YEAR PROGRESS REPORT

LESSONS LEARNED

Contents
The following key lessons were learned through the implementation of the IR agenda
between 2016-2020:

Background
Connected Woreda
Engaging stakeholders at different levels of the health
system increased buy-in for the IR agenda, and
mobilized resources to advance key priorities.

Data
Investing in capacity building programs to enhance
workforce knowledge and skills improved data use
practices.
LESSONS

Governance
Prioritizing data for decision making, maximized the
use of limited human and financial resources.

eHealth Architecture
Integrating the transformation agenda into the
health system improved the overall performance
and health outcomes.
eRIS

Enhancing data and ICT system governance and

national leadership improved coordination and
collaboration across stakeholders and led to more
Lesson Learned

effective implementation of the IR agenda.

Future Priorities

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 FIVE YEAR PROGRESS REPORT

FUTURE PRIORITIES

Contents
Accomplishments and lessons from the past five years

Background
have helped shape future priorities. Looking forward, the
IR strategic objectives outlined in HTSP 2 are as follows:

→→ Ensure existence and functionality of the HIS/digital health governance’s

Connected Woreda
structure
→→ Establish learning and knowledge management system at national and
subnational levels
→→ Improve confidence on the quality of the data generated through
routine sources by instituting sustained and comprehensive
implementation of data quality assurance techniques at all levels in the
health system

Data
→→ Create awareness and build capacity of health workers on data quality
and information use through continuous training. Mentorship, and
The MOH in
coaching
collaboration with
other health sector →→ Strengthen initiatives to improve the culture of use of data for action at
stakeholders will point of service delivery and administrative levels

Governance
work to coordinate, →→ Create model Woredas and hospitals on improved data quality and
collaborate, invest in information use
and advance these key →→ Advance data analytics approaches and practices from the routine
priorities. descriptive and exploratory analytics to big data, predictive data
modeling, data mining, and machine learning to respond to the

eHealth Architecture
growing demand to generate evidences to solve complex public health
problems
→→ Generation and translation of evidence to policy and action by
triangulating data from routine, survey, surveillance, and research
→→ Advance the eHealth Architecture and interoperability framework
→→ Develop standards and guidelines for selection, development and use
of digital health solutions
eRIS

→→ Strengthen digitization of routine and non-routine data collection,

management, analysis and use
→→ Develop digital solutions for health worker decision support on
prioritized health services
→→ Digitize digital health interventions for clients that improve client-
Lesson Learned

provider interaction and increase health literacy

→→ Establish eLearning systems for the health workforce on Continuing
Professionals Development (CPD) programme for pre-service and in-
service training and education
→→ Digitize and implement an individual level health data system
Future Priorities

→→ Strengthen ICT infrastructure at all levels of the health system

→→ Establish a national health data warehouse

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 FIVE YEAR PROGRESS REPORT

Contents
Background
Connected Woreda
Data
INFORMATION REVOLUTION
FIVE YEAR PROGRESS REPORT

Governance
eHealth Architecture
eRIS
Lesson Learned

Disclaimer:
Future Priorities

This Booklet is made possible by the support of the American people through the United States Agency for International Develop-
ment (USAID). The contents are the sole responsibility of the Ministry of Health of Ethiopia and do not necessarily reflect the views
of USAID or the United States Government.

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