Presented by Joy Kamunyori at a meeting for MEASURE Evaluation staff in March 2016.

1. Building Fundamentals
in South Africa through the
SIFSA Associate Award
Joy Kamunyori
Health Informatics Advisor
MEASURE Evaluation SIFSA
March 2, 2016
MEASURE Evaluation Webinar
UNC-Chapel Hill
eHealth/mHealth:

2. We help identify data needs, collect, and analyze good-
quality routine data, and use information for health
decision making, focusing on sustainable capacity
enhancement of government officials (DOH & DPME), and
the PEPFAR implementers that support them.
What is MEASURE Evaluation
SIFSA(Strategic Information for
South Africa)?

3. Consortium of PEPFAR-funded implementers
Period of Performance: July 2013 – June 2018
What is MEASURE Evaluation
SIFSA?
Expertise offered
JSI Capacity building, HIS, M&E (lead implementer)
ICF International eHealth, mHealth, sustainability framework
Palladium Data demand and use
MSH Organizational development
UNC Specialized studies (Cooperative Agreement prime)
Tulane eLearning and health systems strengthening
University of Pretoria M&E courses

4. eHealth eLearning
Geographic
information
systems
Operations
research
RHIS
support
mHealth
Data demand
& use
Data quality
assurance
Capacity
enhancement
MEval-SIFSA Project:
Focus Areas
Priority 1: Implementation of
strategies and policies that
enhance HIV strategic
information (SI)
Priority 2: Building SI capacity
for data quality and use
Priority 3: Building capacity
to strengthen health
information systems

5. eHealth Perspective:
Basis for Implementation

6. MA4Health 2015:
5-point Call to Action
1. Increase the level and efficiency of investments by governments and development
partners to strengthen the country health information systems in line with
international standards and commitments;
2. Strengthen country institutional capacity to collect, compile, share, disaggregate,
analyze, disseminate, and use data at all levels of the health system;
3. Ensure that countries have well-functioning sources for generating population health
data, including civil registration and vital statistics systems, censuses, and health
surveys tailored to country needs, in line with international standards;
4. Maximize effective use of the data revolution, based on open standards, to improve
health facility and community information systems including disease and risk
surveillance and financial and health workforce accounts, empowering decision makers
at all levels with real-time access to information;
5. Promote country and global governance with citizens’ and community’s participation
for accountability through monitoring and regular, inclusive transparent reviews of
progress and performance at the facility, subnational, national, regional, and global
levels, linked to the health-related SDGs

7. eHealth & mHealth in South Africa
SouthAfrica’s eHealth Strategy was published in 2012
• It adopted WHO’s definition of eHealth:
“the use of information and communication
technologies (ICTs) for health to, for example, treat
patients, pursue research, educate students, track
diseases and monitor public health.”
mHealth Strategy published in 2015
• mHealth is “a subset of eHealth referring to the delivery of health
related services via mobile communications technology”
• mHealth solutions are “designed expressly to employ elements of
mobile communications technology as a means of providing remote
health care services”

8. MEval-SIFSAaims
to help the South
African National
Department of
Health implement the
eHealth Strategy
using a technical
assistance and
capacity-building
approach

9. Challenges in South Africa
• Limited capacity to implement eHealth at all levels
• Slow progress on eHealth Strategy implementation
o eHealth important, but no motivation
o Lack of defined responsibilities
• Moratorium on new eHealth projects since 2010
o Some projects have gone ahead anyway
o Provinces are semi-autonomous
• Limited broadband connectivity at facilities
• No coordination of mHealth projects
• Approx. 116 different projects
• No localization of patient-based data standards or creation of a
shared health record

10. eHealth architecture (ideal)

11. South Africa Associate
Award:
eHealth/mHealth
Contributions

12. Facility coding
• Facility codes required for MomConnect
• Patient-based data standards published in 2014; however
NDoH still used facility names as key index
• MEval-SIFSAproduced concept document and
presentation for adoption of coding system for facilities
• Six- or seven-digit code based on international standards
• Presented to Health Information Systems Task Team
• Recommendations adopted and new facility coding
structure implemented throughout the country

13. Support for mHealth
Strategy development
• Provided significant input
• Helped in finalization of
mHealth Strategy
Published in June 2015

14. Support for ePHC project
• Reference implementation project for eHealth Strategy
• National project being rolled out to more than 3,500 facilities
over the next two years
• Centerpiece is infrastructure improvements
• Computers with patient administration software
• Will form the basis of the Master Patient Index in SouthAfrica
• MEval-SIFSAproviding technical assistance with rollout
• Strategy for roll-out, developing capacity, and helping to establish
support systems−e.g., business helpdesks integrated into existing IT
helpdesks

15. Linking helpdesk systems
Assisting NDoH to establish
DHMIS helpdesks
• International standards and
helpdesk management SOPs
• Strengthen RHIS reporting
• Contribute to better health policy
and improved services
• Focus ison provinces;
supporting training and capacity
building
Also working to make sure
ePHC and DHMIS helpdesks
are linked and interoperable

16. Technical briefs
Developed technical briefs to support the
e/mHealth activities in SouthAfrica including:
• Overview of Security Considerations for eHealth
• Moving from Paper-Based Systems to Electronic
Systems in SouthAfrica
• Good Practices for the Implementation and
Management of a National Master Patient Index
• mHealth for Behavior Change Communication
Brief: Why mHealth messaging?
These briefs are available on the
MEval-SIFSAwebsite

17. Support for mHealth
Strategy implementation
• Supporting NDoH in establishing an open
and transparent repository of mHealth
projects
• Using common framework to describe
projects
• Willbe hosted within NDoH and managed
by Health Information Systems Directorate
• Willhelp with overall coordination of
mHealth activities
• mHealth technical briefs all based around supporting NDoH to create
guidelines defined in mHealth Strategy

18. Systems and projects:
Enabling links
• Ever increasing number of eHealth/mHealth
projects and initiatives in SouthAfrica
• MEval-SIFSAwill work with DoHs and
individual projects to help improve the links
between all systems through interoperability
and standardization of processes
• MEval-SIFSAwill also support more national
rollouts and provide technical assistance on
scaling initiatives
• Particularly those that can help achieve 90-
90-90 goals

19. This presentation has been supported by the United States
Agency for International Development (USAID) under the terms
of MEASURE Evaluation–Strategic Information for South Africa
associate award AID-674-LA-13-00005. Views expressed are not
necessarily those of USAID or the United States government.
MEASURE Evaluation SIFSA is implemented by the Carolina
Population Center at the University of North Carolina at Chapel
Hill in partnership with John Snow, Inc.; Palladium; ICF
International; Tulane University; and Management Sciences for
Health.
www.measureevaluation.org/sifsa