GLOBVAC: Integrated Health Information Systems. Network of action: Capacity building in HIS in West Africa
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1 GLOBVAC: Integrated Health Information Systems Network of action: Capacity building in HIS in West Africa Johan Sæbø, Edem Kossi & Jørn Braa University of Oslo
2 GLOBVAC project: Integrated Health Information Systems - Collaborating Network of Countries and Institutions Health Information Architecture Integration, standards, interoperability Use of information for action HIS /HMIS /M&E, management Free & Open Source Software Sharing across the world Distributed development knowledge & support South Africa Norway Malawi Vietnam Togo Botswana Tanzania Burkina Faso Bangladesh India Uganda Kenya Gambia Capacity Building Training, Education, Research Training of health workers Graduate courses, Masters, PhD others Nigeria Liberia Bissau Sri Lanka Ghana Sierra Leone Côte d Ivoir Network of Action in West Africa: HIS Centre of excellence
3 The Context of HIS in West Africa
4 The context Limitation of old ways of doing things: fragmentation, poor quality, less use Lack of qualified human resource Resource limitation More attention given to HIS globally and locally Opportunities of new technologies New approach to HIS: data warehousing, integration, interoperability Increased complexity
5 Old system: Fragmentation of information National: Fragmented info Difficult access District: Fragmented data management Paper-based transcription and transmission Not fully disaggregated TB TB All programs own systems IDSR IDSR HIV HIV EPI EPI RH/FP RH/ FP District reports compiled by hand Directorate of Planning & Information HMIS Outpatient services & morbidity National Statistics Office Surveys Census Facility: Many reports Little feedback Little use at facility No hospital reports TB IDSR HIV EPI RH/ FP Outpatient services & morbidity Hospital
6 The proposed solution
7 Following HMN Framework for HIS
8 Recommended HIS: Integrated architecture (design) of interoperable systems An integrative umbrella across programs, sub-systems & infrastructures (paper, computers, Internet, mobile telephones) Replicated at each Administrative Level: National State/Province District Data warehouse Import Electronic data standard SDMX-HD Export electronic summary data Use of data Reports, GIS, Pivot, graphs, etc, DHIS2/HealthMapper DHIS2/ NBIT Data from / to Mobile telephones(idsr ) Data capture from paper reports Household Tracking Monthly summary reports Logistic MIS OpenLMIS Human Resource records ihris Medical Records OpenMRS Register pregnant women & children for immunization
9 SDMX-HD Statistical Data and Metadata Exchange for the Health Domain SDMX-HD: Metadata order From DHIS to OpenMRS, e.g.: centre X for month of May DHIS : Data warehouse Statistical data DHIS is calculating: Deliveries per midwife SDMX-HD: Metadata order From DHIS to ihris, e.g.: centre X for month of May OpenMRS : Medical records SDMX-HD: Developed and piloted in Sierra Leone ihris: Human Resource records
10 DHIS 2: Web & Fully Open Source Development of DHIS2 in Java started 2004 First implementation Kerala India 2006 With HMN /WHO & Sierra Leone from 2007 develop DHIS to HMN & African requirements The Gambia, Liberia, Ghana, Burkina Faso from 2009; now more West African countries (8+3 in pipeline, of 15) In India: implemented in 25 states Kenya: countrywide by 9 September 2011 GIS developed with WHO: Open Health Mapper 2010: Full Health Information Architecture: - SDMX-HD Interoperability Standard launched in Accra
11 Sustainability and further development: HIS Centre of Excellence in West Africa
12 Capacity building strategies in West Africa Continuous training in countries Build regional team /capacity Regional workshops with WAHO Master program: HIS, open source software development PhD program: HIS Collaboration with and between - Universities in West Africa to co-develop HIS curricula HIS Centre of excellence with WAHO
13 HIS Centre of Excellence Joint effort: West African Health Organisation (WAHO), UEMOA (French part of ECOWAS) & University of Oslo Training on integrated information architecture for Health & Open Source Software implementation strategies &system development Data analysis & use Certification Data warehouse for the region (key data) and thereby easier to support on data management Support countries on standards for interoperability Support activities in countries Networking universities and countries
14 Current situation Joint development of HIS policies for West Africa Joint regional capacity building workshops Shared regional pool of local experts Shared training material and best-practices Next steps Shared regional list of essential indicators - standards Further interoperability between software Continuous capacity building less dependent on outside experts HIS for community services mobile technology
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