By Dapo Adejumo Jerry Aziawa

1. DHIS2 Overview and
Implementation in West Africa
Regional Workshop
From Health Information System to collective Intelligence Refocusing the health district on population using
ICT
16-18 December 2015
Hôtel du Lac, Cotonou-Bénin
Dapo Adejumo & Jerry Aziawa
HISP

2. 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

3. 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

4. DHIS2 and HIS….Answers to Multiple
Questions….

5. H
e
a
l
t
h
I
n
d
i
c
a
t
o
r
s
Maternal
Health
Population
Data
Diseases
Child
Health
Semi-Perm
Data
Integrated
Monthly
Report
RHIS for local management
Other
Systems
•Quality Control
•Aggregation
•Analysis
•Graph
•Maps
•Reports
•Self
Assessment
•Monitoring
•Decisions
•Minimum Data Set
Surveys
HMIS
Priority
Programs
FEEDBACK

6. Hierarchy of Standards
Client
Data
System
Data
Facility
Data
MDG
Data
Strat Plan
Data

7. 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

8. Core Features / Applications

9. Data Mining – Aggregate, Individual and
Tracker

10. Powerful Analytic Tools

11. Interactive Dashboards

12. 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

13. Interoperability – Robust WEB API

14. DHIS2 as a datawarehouse

15. Data
DHIS 2
LMIS
HR EMR
(Measles dos e s giv en to children < 1 ye a r / total population < 1 year)
8 9 .5
9 4 .4 93. 6 93. 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
ric t
74
81
. 7
. 3
7 9 . 0 8 0 . 7 80. 0 7 9 . 9
Chake
Chake
District
Michew eni
District
Pemba
Mkoani
District
Z o n e
Wete
District
Central
District
North A
District
North B
District
Unguja
South
District
Z o n e
Urban
District
We
Dist
D is tric t
Annualmeaslescoverage
%
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

16. Data
Warehouse
Paperbasedsystems:
OPD,EPI, RCH,
other programs
Usersof primarydata
& dataproviders
Electronic
Medical
Records
HR
Management
Logistics
& drugs
Mobile
reporting
Finance
Usersof
primarydata
& dataproviders
Usersof processed& integrateddata
Integration of technologies,
systems,data & health programs
IntegratedHealth Information Architecture (“Horizontal integration”)
- integrating sub-systems,technologies,health services& programs
Performance
Basedfinancing
reporting
SDMX -HD
Paper
reports
Aggregate&
indicator data

17. DHIS 2 Implementation

18. Global Reach
Partners Pilot/early phase Scaling up Nation-wide rollout

19. West Africa Implementation use cases

20. 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

21. 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

22. 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…

24. Tracker and Events – Ghana Health Service
• Registration of Outpatient Cases
• Registration and Tracking of Antenatal Clients
• Registration and Tracking of Children within Immunization program

25. FullCIF
Minimal caseline list
(Name,Sex,Age,Status,
Location)
Labresult (for
diagnosis)
Burial
data
Contacts
WWW
WWW
WWW
WWW
WWW
Case
Import
WWW
CaseInvestigation
Form
Liberia : Integrated
Ebola

26. 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.

27. 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.

28. WAHO(WestAfrica) Dashboard

29. Thank you