• Global DHIS2 users join this vibrant community of practice

    “A wise man learns from his mistakes. A wiser one learns from others mistakes. But the wisest of all learns from others’ successes.”

    I can certainly relate to this Zen proverb adapted by John C. Maxwell. It sums up my experience with the DHIS2 community of practice and my adventures with the DHIS2 open source platform for the collection, management, analysis and use of information.

    With the DHIS2 now in 67 countries, the number of ways to use DHIS2 is growing rapidly. Fortunately,  the number and proficiency of DHIS2 users is growing too. Sharing and learning from one another’s experiences and successes has become an invaluable part of creating sustainable, robust DHIS2 projects. It has led to the creation of this community of experienced DHIS2 practitioners who share a common goal; to use DHIS2 to implement information systems to better the health of all.

    As the lead of a large Data Science lead team at HISP South Africa, which works with a number of Africa partners, I am frequently responsible for conceptualising new and innovative ways of configuring DHIS2 to meet a wide variety of information management requirements. The community of fellow DHIS2 users is my first port of call when I have face challenges, need some additional assistance, or want to show off a new success.

    The global DHIS2 community is dynamic and highly productive. It has all three distinctive traits for a community of practice:

    Domain – what we care about: DHIS2Practice – our shared body of knowledge, experience, and techniques: decades of experience implementing DHIS2 and developing the DHIS2 platformCommunity – our self-selected group of individuals who care enough about DHIS2 to participate in regular interactions: implementers from Ministries of Health, Partners and NGOs who voluntarily subscribe to and interact in this community.

    If you are a DHIS2 user, join the community today and help us share, learn and explore DHIS2 together.


  • A treasure trove of global goods revealed at DHIS2 2019 conference in Oslo

    Midsummer in Oslo, Norway has become synonymous with the DHIS2 conference, an annual meeting of the global DHIS2 community. This week I have had the pleasure of being part of it, along with 267 other participants from 61 countries and 118 organisation, 17 to 20 June.

    I have seen big changes over the three years I’ve been attending this event. Technology, people and ideas are maturing and aligning to provide a formidable vehicle for positive change, all brought together around the DHIS2, a remarkable global good supporting health strengthening and Universal Health Coverage efforts around the world.

    Hot topics this year include the DHIS2 FHIR adaptor, usability enhancements for a new DHIS2 Android App, extended analytics and visualisation, promising UX/UI enhancements, and many success stories of country DHIS2 use cases.

    I led a team to present on the Human Resource Information System work we have been doing in South Africa. In particular, we showcased an open standards-based interoperability architecture we've developed. It integrates a wide range of primary systems using OpenHIM, HAPI-FHIR, custom NodeJS, IHE mediators and DHIS2 to create a highly responsive, integrated environment. Key products are a Human Resources for Health Registry and a Data Warehouse. They will put data in the hands of various users, including the public, and give decision makers what they need to plan and manage the health workforce.

    A conference highlight is the picnic on Hovedøya Island. Some say that this is where the real work gets done. We will head across this afternoon to swim, barbecue and forge new partnerships for health systems transformation around the world.

    If you are strengthening your country’s health information systems, and haven’t attended a DHIS2 conference yet, then put a placeholder in your calendar for next year.

    I look forward to seeing you in Oslo.

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  • webDHIS data experts for South Africa at eHealthAFRO 2017 pre-conference seminar

    A new seminar will help to develop data management experts for South Africa’s National Department of Health (NDoH) and provinces to expand use of the webDHIS and its data to support the best possible health strengthening decisions. The seminar is part of the extensive eHealthAFRO 2017 pre-conference programme.

    Health Information Systems Program – South Africa (HISP-SA) data specialists and NDoH partners, led by Chief Director Ms. Thulile Zondi and her team from the Health Information Research and M&E (HIRME) cluster will facilitate the five-day seminar. It is designed to give participants an understanding of data management principles and hot to get the most out of the webDHIS.

    Find out more about pre-conference seminars on the eHealthAFRO website. Tickets are available through the conference website or from Quicket. Don’t miss your opportunity to a part of this landmark event for the eHealth community in Southern Africa.

    HISP-SA develops and implements health information systems. Its vision is to do this sustainably to empower healthcare participants and improve the efficiency of health services, in partnership with ministries of health. HISP-SA is supporting webDHIS rollout across South Africa.

    The webDHIS is the South African deployment of the web-based District Health Information System 2 (DHIS2). NDoH first adopted the DHIS in early 2000. The primary objective of DHIS is to generate, analyze and disseminate health information. This facilitates effective policy development, formulate and implement health programmes, direct and budget health resources effectively, and monitor and evaluate healthcare in South Africa.

  • eHealth takes a step forward in Namibia

    Namibia has officially launched the second version of the District Health Information System (DHIS2). This is in line with the government’s priorities of implementing an efficient and effective eHealth system to streamline and strengthen data-driven healthcare.


    Speaking at the launch on Friday July 7, the Minister of Health and Social Welfare, Dr Bernard Haufiku, said his ministry is moving in the right direction towards a paperless healthcare system that is web-based and more efficient.  


    The country has been using the first iteration of the DHIS since 2005 as a routine health information monitoring system. This initial version was a desktop application using Microsoft Access installed on individual computers. The application was useful in supporting the capturing, analysis and use of data. However, other data quality components, such as timeliness in reporting for decision making, remained a challenge.


    DHIS2 brings a host of new features and possibilities that enable vastly improved routine health monitoring through a single platform that can capture and aggregate all health data. It also maintains the free and open source philosophy of the previous version.


    It offers the ability to collect aggregated data across all primary healthcare programmes, from expanded programmes on immunisation, family planning, HIV and AIDS services, etc., to bringing in data from other sectors.


    As a web-based solution, DHIS2 provides data in real-time and enables expanded access. The system also offers more user-friendly presentation and visualisation of data, so decision-makers no longer have to wait to get hold of the data they need, in the format they need it, to inform planning and take action.  


    The DHIS2 was fully deployed across the country by December 2016, with funding support from the President’s Emergency Plan for AIDS Relief (PEPFAR), technical assistance and capacity development support from Health Information Systems Program (HISP) Namibia, and additional technical support from the University of California at San Francisco.


    A crucial factor in any health information system is ensuring that data is not only timely, but that it is of the highest quality. As Dr Haufiku stated at the launch, “We know that if you put garbage in you will get garbage out, therefore training must emphasise data quality”.


    For this reason, not only does the DHIS2 have strong built-in data quality functionalities, HISP Namibia also provides extensive support to the ministry to strengthen national and regional health information management.


    This includes training and mentoring ministry and healthcare facility staff and partners on the use of the DHIS2 system, data quality and information use, as well as supporting the health information technical working group and the successful implementation of Namibia’s health information systems strategy.


    “We have a good platform and we want to use this platform for further expansion”, said Dr Haufiku, with the ministry looking at using DHIS2 as a surveillance system for disease outbreaks, to improve efficiency in response rates, and to improve overall quality of health service delivery.

    As the routine health information system in use in over 50 countries worldwide, the DHIS2 is certainly contributing to the eHealth revolution. Hopefully the benefits to healthcare will soon be felt by all. 

  • Protecting our children from HPV

    One in every eight women in South Africa die from complications of  cervical cancer. Each year, 5,743 new cases of cervical cancer are reported. Almost half of these, 3,027 cases are fatal.

    About 80% of cervical cancers are caused by the Human Papilloma Virus (HPV). It infects the genital area and causes anything from a small genital wart to cervical and other cancers. Vaccination can prevent the virus infection developing on the cervix. 

    In 2014, the South African National Departments of Health (NdoH) and Basic Education launched a national vaccination campaign to prevent cervical cancer by vaccinating girls aged over nine against HPV. The vaccination was aimed at 500 000 girls from 17 000 public and special schools to provide them with protection before they can be exposed to HPV infection. 

    In co-ordination with the government’s Integrated School Health Programme (IHSP), school health nurses visit schools twice a year to vaccinate the girls. None of them are vaccinated without parental consent.

    As the vaccination campaign grew, collecting data became more complex and challenging. NDoH approached the Health Information Systems Program South Africa (HISP-SA) to lead implementation of a mobile data capturing application. It supports data capture during the campaigns. 

    The app’s part of the NDoH's routine health information system, DHIS2, sometimes referred to as webDHIS. It was customised for the campaign by HISP-SA’s Lusanda Ntoni and piloted in three provinces. Then, it was developed further using findings from field visits, and implemented during the 2016 campaign. 

    A Standard Operating Procedure (SOP) document helps vaccinators and data capturers to transfer HPV data from registers into the tracker capture app. There’s also a guideline for programme managers and information officers on accessing dashboards with information from the campaign on  webDHIS. These were updated as the app was implemented. 

    To date, the app’s been implemented in all nine provinces in South Africa, a task co-ordinated by HISP SA’s HPV project manager, Margaret Modise. It’s simplified HPV dashboards for monitoring and reporting and shows how a simple mHealth initiative can enhance the productivity of vaccination campaigns. Will this way of capturing data lead to more large-scale campaigns in South Africa?   

  • HISP-SA at the DHIS2 Academy in Goa, India

    Surveillance of priority diseases and events is a core part of the Global Health Security Agenda. Success depends on access to, and using, reliable information systems for prevention, detection and response.

    In most developing countries, public and Community Health Workers (CHWs) are challenged with collecting, disseminating, analysing and presenting  surveillance data. It’s a task hampered by a lack functional structures to support them in their response to public health events.

    Health Information Systems Program South Africa (HIPS-SA), with financial support from the Center for Disease Control and Prevention (CDC), in Atlanta, is part of the global District Health Information System 2 (DHIS2) community working closely with global, regional and national partners to improve diseases surveillance systems. In support of this, a DHIS2 Academy, hosted by HISP India in collaboration with University of Oslo and HISP teams from ten countries, met in Goa, India.

    Participants came from Asia and East, West and Southern Africa representing Ministries of Health, CDC Atlanta and country offices, WHO, Population Services International (PSI), eHealth Africa, University of Oslo and HISP teams from India, Vietnam, Uganda, Bangladesh, Tanzania, South Africa and Namibia to identify ways to strengthen capacity for implementers to use DHIS2’s tracker application as a customised system to support disease surveillance.

    The workshop’s main aim was exploring key components of a DHIS2 Surveillance template. Based on the DHIS2 tracker module, it’ll provide countries with an easy-to-use, integrated surveillance system they can customise for their use locally. It won’t take them long to refine it.

    A surveillance system developed by HISP-SA for use in South Africa  was developed into a template and shared with Sierra Leone. It took the team there only a month to customised and deployed it. Sharing this experiences at the Goa Academy aims to shorten customisation and deployment time.

    DHIS2’s current surveillance functionality shows great promise in its ability to address 90% of reporting requirements. This could increase as further releases of the tracker module addresses the remaining requirements.

    A challenge the 32 participants reviewed was the off-line data capture functionality of the mobile android app that feeds data into the surveillance database. During the Ebola epidemic, offline data capture was a huge challenge. A range of solutions were explored during the academy, and will inform the development of the DHIS2 android app. Other technologies will benefit too.

    HISP-SA will be working closely with the South African and Namibian governments, and supporting countries is East and West Africa, to implement and build their  disease surveillance capacity. Dr Vincent Shaw, CEO of HISP-SA, said “The potential of this work is that it can help to establish systems that will respond quickly to an epidemic threat, and prevent the kind of spread, and damage, that was seen during the Ebola epidemic.“

  • DHIS2 expands in Nigeria

    Nigeria, Africa’s most popolous country, has one of the largest and most complex health systems on the continent with over 34,000 health facilities spread across 774 Local Government Areas, Nigeria’s Districts.

    Nigeria’s Health Information System (HIS) is a core pillar of the health system and a crucial base for the survival of the other components needed to delver healthcare in the country. Like many developing countries, Nigeria has over the years struggled to implement and sustain a robust and efficient HIS. It’s particlulary challenging given the size and complexity of the health system.

    The District Health Information Software (DHIS) developed by the Health Information Systems Program (HISP) has been used in several countries since the early 2000s. It’s an electronic platform to support HIS. The DHIS was introduced to Nigeria in the early 2000s and DHIS 1.3 in a few pilot implementations with donor agencies. DHIS 1.4 replaced it as a National system in 2006.

    National scale-up of the DHIS 1.4 proved a massive task in the midst of poorly efficient National Health Management Information Systems and resource constraints. In 2012, HISP Nigeria encouraged and supported the Federal Ministry of Health (MOH) to migrate the National system to the DHIS2 , a web based version of the DHIS using a multipronged and practical approach. This has resulted in the development of a single instance of the DHIS2 for routine health data in the country.

    With strong leadership from the MOH andcoordinated collaborative efforts of various development partners, Nigeria has seen a turnaround of the HIS over the last few years, with a potential for further exponential growth. With national data completeness for routine health Information from public and private health facilities of less than 5% in 2011, completeness has now reached over 60% of all Nigeria’s health facilities. It’s significantly improved the availability of information for decision making at different levels of health systems. The challenge now is to extend completeness.

  • DHIS conference was wide-ranging and a success

    On the 21st of April, 55 speakers and 120 people arrived in Bloemfontein, South Africa for the District Health Information System (DHIS) Conference. The four-day event provided a platform to explore new developments, innovations and possibilities around health information systems development and information use. It was a joint event by Health Information Systems Program (HISP) and South African National Department of Health. Over the last 20 years, DHIS in many Sub-Saharan African countries and Asian countries has evolved from spreadsheets supporting paper based records to a sophisticated web based system.

    The goal of the conference was to explore and share best practices and lessons learned. These are derived from a wide range of experience and stakeholdres, such as health information users, systems developers, health leaders, programme managers, district managers, provincial managers and health planners.  Participants were from eight countries: Democratic Republic of Congo, South Sudan, Nigeria, Lesotho, Mozambique, Zimbabwe, Namibia and South Africa.

    South Africa’s National Department of Health presented its innovative work computerising health facilities and developing electronic data capture in health clinics. Its 700 Facilities initiative brings 21st century technology to health facilities with the aim of decreasing patients’ waiting times and improving service quality.

    Three round table groups reviewed:

    Implementing EHRs in resource-constrained contexts Innovations and best practices for hosting large databases in the cloud, including security issues, back-up and recovery procedures and data access Achievements from South Africa’s eHealth Normative Standards Framework for Interoperability.

    Keynote speakers included:

    HISP’s Dr Vincent Shaw on the ways that health information systems are developing in Africa Milani Wolmarans dealt with the South African government perspective of eHealth for better Systems for better health Dr Lynn Hanmer from the MRC examined partnerships as a significant factor in Health Information Systems Strengthening Ms Ineke Buskens explored gender issues in her presentation on a woman-friendly health information system Dr Peter Benjamin from HealthEnabled described recent developments using mHealth to eliminate mother  to child transmission of HIV/AIDS Dr Theo Lippeveld covered strengthening global systems Prof Jørn Braa from Oslo gave his perspectives on DHIS past, present and future The African Centre for eHealth Excellence (Acfee) chairperson, Dr Sean Broomhead, updated the conference on the Centre’s initiatives across the continent, including an update on the need for expanded capacity and capability on several eHealth themes, including regulation for better eHealth investment.

    The range of themes was considerable. It’s indicative of DHIS’s progress over 20 years.

  • What has a DHIS database to offer?

    If health workers and managers have data, the District Health Information Software (DHIS) can help them to manage it. With DHIS2, health workers can collect, manage and analyse transactional data from case records and store and use it to track patients over time. It also helps to configure SMS reminders, track missed appointments and produce visit schedules. DHIS and DHIS2 are provided by the Health Information Systems Program South Africa (HISP-SA).

    DHIS 2 is supported by the Research Council of Norway (Norad), President’s Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund. There are two main services. One is a free, open-source Health Management Information System (HMIS). The other is a data warehouse. DHIS is supplied for desktops using MS Access® or Windows®, and there’s a web-based version using Java™ or HTML5. HISP recommends that DHIS is used with an Ubuntu Server.

    HISP has several DHIS and DHIS2 projects in Africa. They include:

    South Africa National Health Information Repository and Data Warehouse Project (NHIRD) Support to the Health Information Management Monitoring and Evaluation (HIMME) Cluster Support HIS Development in South Africa National Data Capturers Integrated Access to Care and Treatment (IACT) Project in Eastern Cape Province Nigeria DHIS Support to the Partnership for Reviving Routine Immunisation in Northern Nigeria; Maternal and Newborn Child Health Initiative (PRRINN-MNCH) Program Botswana Convert DHIS14 to DHIS2 Southern Sudan DHIS Support to Southern Sudan

    As African countries expand their eHealth investment, DHIS provides a way of collecting and managing some of their health data. Clarity on how the data’s used is vital for realising benefits.