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2016 Infokes Guest Lecture Jogja Jorn UGM Based On Colombo HISP Network
2016 Infokes Guest Lecture Jogja Jorn UGM Based On Colombo HISP Network
Background:
• HISP started 1994 in “New” post apartheid South Africa
• Development DHIS started 1997 & 2002 National Standard
• DHIS v1 & HISP to India from 2000
• DHIS v1 spread to many countries in Africa from 2000
• 2000-2013 - Develop Masters Programs in Mozambique,
South Africa, Malawi, Tanzania, Ethiopia & Sri Lanka
• PhD program, 40 students from Asia and Africa
…… who are later running the Masters programs
Background in ‘NEW’ post apartheid South Africa 1994-2000
Data:
• Where?
• What?
• When?
Analysis
& decisions:
• Why?
• How to?
‘When, What, Where’:
Basis for DHIS2 data model
–‘
Example South Africa, Atlantis District 1994:
First Architecture approach: From fragmentation to integration;
Health Higher
programs levels
Cape Town DNHPD
RSC Western Cape
Cape Town
PAWC Family Planning
Clinic Clinic
RSC RSC Malmesbury Clinic Clinic
PAWC
Clinic
PAWC
Hospital Mother Clinic
Private PAWC Child Database
Info. office
School NGO
Health MOU School Hospital
PAWC Health
Private
A NGO
Private
B
A) Post-apartheid centralised, vertical and B) Decentralised integrated district model
fragmented structure in Atlantis (simplified). As according to the ANC Health Plan
Countries/ Indicators
Health Programs National /program
Indicators district
District
management
Facility
Facility
management
Patient records,
Patient
tracking & care
More data
Hierarchy of data standards:
• Balancing national need for standards with local need for
flexibility to include additional indicators
• All levels – province, district, facility – can define their own
standards as long as they adhere to the standards of the level above
Facility
Sub-National Level
Sub National
National
Health Facility Level
Regional -
ECOWAS
Patient – individual client Level
3 components of the HISP ‘Network of Action’
Mozambique
South Africa Building Capacity,
Vietnam Academies, Education, Research
Uganda Training of health workers
Norway
Nigeria Graduate courses, Masters, PhD
India Sharing teaching /courses
Kenya Sri Lanka
Rwanda Bangladesh
Ghana Phillipines
Indonesia
others Laos
Regional approach:
Implementing DHIS2 through HISP nodes
Early phase / pilots / preparation
Under implementation / many states in India
Nation-wide
PEPFAR
HISP
Kenya
Tanzania
HISP Uganda
West Africa Rwanda HISP India & Vietnam
Nigeria,
& HISP Sri Lanka!
Ghana, ..
HISP South Africa
HISP – DHIS2 Community: principles
• Free and Open Source Software &
training / educational materials, etc.
• Development and implementation of
sustainable & integrated Health
Information Systems
• Empower communities, healthcare
workers and decision makers to
improve the coverage, quality and
efficiency of health services
• Developmental approach to capacity
building & research
– Research based development
– Engage HISP groups and health
workers in action research!
WHY SUCH EXPANSION ?
And how to continue to
build the network and open source
platform
Mobile subscribers per 100 persons, Africa
Source: AFRINIC
DHIS2 implementations /initial projects
correlated with increase in bandwidth
DHIS 2
implementations
DHIS = 1/1000
2014 2015
Source: AFRINIC
Improved Internet & mobile network – ‘cloud’ infrastructure
Rapid scaling – from ‘hundreds’ of installations to 1
Online system – one server
Easier to integrate / interoperability with other systems
which are also online: web API
& central server
Interoperability
with Other systems
Improved Internet and mobile network: Rapid scaling
Implementation Using central server & “cloud” infrastructure
90.0
Measles under 1 year coverage by district 2006
(Measles doses given to children < 1 year / total population < 1 year)
89.5
94.4 93.6 93.8
DHIS2
81.3 80.7 80.0 79.9
79.0
80.0 74.7
70.0
Annual measles coverage %
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Chake Micheweni Mkoani Wete Central North A North B South Urban West
Chake District District District Dis trict District Distric t District District District
Dis trict
District
Data
from capture
form paper
s
-Visualising
(Measles doses given to children < 1 year / total population < 1 year)
tools
70.0
60.0
50.0
40.0
DHIS 2
30.0
20.0
10.0
0.0
Chake Michew eni Mkoani Wete Central North A North B South Urban West
Chake District District District District District District District District District
District
act rm
Pemba Zone Unguja Zone
District
LMIS tr
Ex nsfo Graphs
Tra ad
Lo
HR EMR
Mobile Maps
Getting data in - Data warehousing Getting data out - Decision support systems –
‘Business intelligence (BI)
Integrated Health Information Architecture (“Horizontal integration”)
- integrating sub-systems, technologies, health services & programs
Users of processed & integrated data
Integration of technologies,
systems, data & health programs
Integration and interoperability
e
ix bl
fl e
e
or
M
SMS
PC/laptop
Lightweight
Browser
Android app
or browser Tablet
Enterprise architecture: 3 Levels (each serving the level above)
Level 1:
Information
Needs, Users, Usage
Across Organisations
Level 2:
Patient Data warehouse
Software applications records
DHIS Aggregate data
& Information
Systems iHRIS
Open
“Application level” MRS Applications supporting use
of information
E-Sismal
SITT (TB) SIHA (HIV) NCD NIHR&D Logistics
(Malaria)
Integrated National HTM Dashboard
National TB Dashboard
National Malaria Dashboard
TB + rate 2014
By Province
MAPPING
code
data Komdat
Diff /HMIS
cod erent
es Nutrition
Facility TB
Codes BPJS
Register
HIV/
AIDS
Human Resource
Dashboard records LMIS
Indonesia
Integration PROVINCE/NATIONAL:
DHIS2 Integrated data warehouse
- District system & dashboard used by all
TB AIDS
Vaccine DISTRICT:
IDSR MCH Integrated data
DHIS2
warehouse &
Malaria
dashboard
Others
Data access
TB AIDS
& use
Vaccine DISTRICT:
IDSR MCH Integrated data
DHIS2
warehouse &
Malaria
dashboard
Others
DHIS 2
HMIS
Community
Dashboard projects in Indonesia
Capacity building
•Train & develop national expert DHIS2 team –Pusdatin
&UGM
•Train all HSS staff
•Training of Trainers (TOT): Key people from provinces
& districts
•Training & data review and data use in districts
•Continuous hands-on training and support
Challenge:
Capture data from Puskesmas in Districts
Approved data by
DHIS2 : Data
E-SISMAL 2 Malaria department warehouse
DHIS2 Statistical
data
S t a n d a r d t o o l s a n d t e m p la t e s
W H O r e c o m m e n d e d i n d i c a t o r s fo r r o u t i n e fa c i l i t y d a t a .
R e f e r e n c e f a c ilit y
Learn m o re… Im p o rt
in d ic a t o r s
I n d ic a t o r s
A p p fo r b r o w s i n g o f D H I S 2 a g g r e g a t e m e t a d a t a , a s w e l l a s to a l i s t o f W H O r e fe r e n c e
D a t a d ic t io n a r y a p p in d ica t o r s. Learn m o re… In st a ll
M o d u l e fo r c o l l e c t i o n o f h o s p i t a l m o r t a l i t y d a t a u s i n g t h e I C D -1 0 s t a r t-u p m o r t a l i t y l i s t.
H o s p it a l m o r t a lit y
In clu d e s d a t a e n t r y t e m p la t e a n d b a s ic o u t p u t s . Learn m o re… Im p o rt
m o d u le
T h e d a t a c o l l e c t i o n fo r m fo r H I V , i n c l u d i n g d a t a e l e m e n t s (w i t h d i s a g g r e g a t i o n s ) a n d
H I V d a t a c o lle c t io n
d a t a v a lid a t io n r u le s .. Learn m o re… Im p o rt
f o rm s
D a t a c o lle c t io n
T h e d a t a c o l l e c t i o n fo r m fo r M a l a r i a , i n c l u d i n g d a t a e l e m e n t s (w i t h d i s a g g r e g a t io n s ) a n d
M a la r ia d a t a c o lle c t io n
d a t a v a lid a t io n r u le s. Learn m o re… Im p o rt
f o rm s
T h e d a t a c o l l e c t i o n fo r m fo r o t h e r p r o g r a m m e s / a r e a s , i n c l u d i n g d a t a e l e m e n t s ( w i t h
O t h e r d a t a c o lle c t io n
d i s a g g r e g a t i o n s ) a n d d a t a v a l i d a t i o n r u l e s , e . g . T B , E P I , M C H e tc . Learn m o re… Im p o rt
f o rm s
A p p fo r p e r fo r m i n g r o u t i n e a n d a n n u a l d a t a q u a l i t y c h e c k s o n a g g r e g a t e h e a l t h fa c i l i t y
D a t a q u a lit y W H O d a t a q u a lit y t o o l d a t a , a c c o r d i n g t o t h e W H O D a t a q u a l i t y r e v i e w t o o l k i t. Learn m o re… In st a ll
D a s h b o a r d s fo r u s e o f r o u t i n e fa c i l i t y -b a s e d H I V d a t a . I n c l u d e s d a s h b o a r d s , a n a l y t i c a l
H IV d a s h b o a rd s o u t p u t s a n d in d ica t o r s . Learn m o re… Im p o rt
D a s h b o a r d s fo r u s e o f r o u t i n e fa c i l i t y -b a s e d m a l a r i a d a t a . I n c l u d e s d a s h b o a r d s ,
D a s h b o a rd s M a la r ia d a s h b o a r d s a n a ly t ica l o u t p u t s a n d in d ica t o r s . Learn m o re… Im p o rt
D a s h b o a r d s a n d d a t a c o l l e c t i o n t e m p l a t e s fo r a d d i t i o n a l p r o g r a m m e s / a r e a s , e . g . T B ,
O th e r d a s h b o a rd s E P I, M C H e t c Learn m o re… Im p o rt
G u id a n c e o n e s t a b li s h i n g a n a t io n a l m a s t e r fa c i lit y lis t .
S y s te m M a s t e r F a c ilit y L is t Learn m o re… Im p o rt
Status WHO DHIS 2 standards/tools
2016Q1 2016Q2 2016Q3 2016Q4