2017 was an exciting year for DHIS2 at PSI, and Global Business Systems (GBS) is continuing to work closely with Evidence teams, technical departments, and PSI country offices to build systems that are meant for data use.
The number of countries using DHIS2 increased to 32, up from 25 in 2016. We added over 1,000 new PSI DHIS2 users, and the Help Desk fielded 500+ tickets, more than any previous years.
New DHIS2 configurations in Honduras, Lesotho, Liberia, Mozambique, Myanmar, Panama, and Vietnam reflected innovative ways to better track our clients and understand their behaviors.
Veteran PSI DHIS2 users not only continued using the system (there are now more than 19 million data values in there!), but we’re also able to see how teams are using DHIS2 to unlock their data and use it to make better decisions to serve Sara.
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In 2017, PSI/Lesotho launched DHIS2 to improve data use for their HIV programming, and specifically to use data to better target HIV testing and improve the linkage rate of HIV positive clients to treatment.
PSI Lesotho’s HIV Testing Services (HTS) counselors use the New Start web app on their tablets to electronically enter in client HIV results. Key data, like test results, geographic location, and demographic data, is immediately pushed into DHIS2 for analysis. Thanks to real time data, the PSI/Lesotho team is able to focus on improving targeted case finding.
In addition to seeing HIV testing trends and performance in real time, counselors are now able to better manage how they link clients to care and treatment, thanks to the introduction of DHIS2 and the New Start app. The New Start app immediately identifies clients who have tested positive and need to be connected to care and treatment at a public health facility. Data is automatically uploaded to DHIS2, where supervisors, team leaders, HIV program managers, and the M&E Manager are able to analyze PSI/Lesotho’s HIV testing and linkage information and performance in real-time. Thanks to dashboards that connect to a data to action framework, DHIS2 makes it easier to identify and address trends, team performance, and to take action based on the data.
Prior to DHIS2, HTS counselors collected data by hand on paper records. This costly process consumed counselors’ valuable time and a faster process to link clients to treatment was impeded by a lengthy, paper-dependent process. Given the delay of information being collected on paper, then recorded by hand into Excel, the time delay limited the HIV program team’s ability to quickly pivot strategy and react immediately to client data. By digitizing the process in the web app and in DHIS2 for analysis, Lesotho’s is able to make better, data-driven decisions.
HIV testing information is now collected and uploaded in real time at the point of care. Mobile data collection enables counselors to spend more time with patients and track follow-up reminders, rather than transcribing paper forms. At the headquarters level, the data in DHIS2 empowers managers with the real-time data so they can target program resources where they will have the most impact.
In sub-Saharan Africa, girls and young women account for over 70% of new HIV infections among adolescents.1 In 2017, PSI Zimbabwe created the DREAMS Database to effectively track individual women through a cascade of HIV services across multiple partners in the country. Under USAID’s DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) Initiative, this database measures client-level layering of services across multiple partners and will inform global efforts to develop DHIS2 capabilities for capturing and visualizing this kind of “layered service” data. This is the first of its kind in DHIS2 and offers new ways to understand the different services that each client receives.
The DREAMS Database enables PSI Zimbabwe and its partners to better combat HIV rates by ensuring each young woman gets the care she needs and deserves. Current efforts are focused on facilitating a data-to-action plan for identifying the central and district level visualization required for partners to monitor performance as defined by successful layering of the right services for each DREAMS girl.
In the fall of 2017, GBS went to Haiti to begin the implementation of DHIS2 with PSI’s local partner Organisation Haïtienne de Marketing Social pour la Santé (OHMaSS). The new DHIS2 system will support OHMaSS’ work with The Global Fund (GF) across three health areas – HIV, malaria, and tuberculosis. The system will also support the work of 21 GF sub-recipients across Haiti. DHIS2 will improve the reporting processes, data quality and use, and the overall management of the GF program.
GBS will work directly with the Haiti Ministry of Health (MoH) to harmonize the system data requirements and structure. GBS will support and share best practices for DHIS2 configuration and maintenance with the unit at the MoH in charge of the country’s health management information system (HMIS).
The work in 2017 included the early planning stages of the DHIS2 implementation, including a broad needs assessment. A pilot of the system is expected in early 2018.
Strong malaria surveillance systems enable countries to design more effective, data driven health interventions. By sharing and integrating malaria surveillance systems between the public and private health sectors, program implementers have greater access to key data and are better equipped to make decisions aimed to reduce, and ultimately eliminate, malaria. PSI uses DHIS2 to harmonize the data life cycle for malaria surveillance by:
- 1. Collecting data in real-time from the public and private sectors
- 2. Creating mechanisms for timely reporting of validated data
- 3. Analyzing dashboards to evaluate and improve the effectiveness of program interventions
To transmit data from the field to DHIS2, the Malaria Case Surveillance (MCS) app was created by PSI in 2017. This simple and user-centric Android app was built to replace paper-based reporting forms used by health workers. The MCS app is presented in the local language and its clear visuals and intuitive interface guide the health worker through an eight-step data collection process: Data is transmitted in real-time into DHIS2 to support project managers and public health offcers who use surveillance data for planning case surveillance activities. The MCS App is an open source, “plug and play” tool that is available to stakeholders in burden reduction and elimination settings. It is also easily adaptable to other health contexts.
This application is intended to be used by healthcare providers in the field after they have conducted an mRDT test. Once the application is downloaded, no internet connection is needed to access or enter data. A healthcare provider can open the application, complete a simple and highly visual 7 question survey and upload data to DHIS2, PSI’s MIS platform, once an internet connection is established.
Once this data is pushed to DHIS2, the Surveillance team is able to immediately identify hot spots, liaising with the National Malaria Control Program and Provincial Health Departments to determine the appropriate course of action. In addition to reducing the time taken to move data through the system, the app also alleviates some of the room for error. With a simple interface, pictorial prompts and clear response options, the app should improve the quality of data received. The data collected will be validated by comparing each individual entry with used Rapid Diagnostic Test cassettes, allowing supervisors to ensure that providers are reporting accurately.
The MCS app is now being used by nearly 1,000 private sector providers in Cambodia and Laos. 50,000+ surveys were submitted through the MCS app in 2017, with 13,000 positive malaria cases pushed in real-time to DHIS2 through MCS. Save the Children has adapted the app for Myanmar and is currently rolling it out across a large network of village malaria workers.
For more information about these programs or with any DHIS2 question, email the Global Business Systems (GBS) team at email@example.com.