DHIS 2 in action

After 1 year of country-wide use the national reporting rates for the major monthly forms are stable above 90 percent. Approximately 2000 users are entering data and using the data analytics features in DHIS 2 to improve management of health districts and other administrative areas.

Kenya has through the DHIS 2 Tracker customised the WHO SARA tool to conduct an extensive facility survey directly in DHIS 2. Having a full inventory of availability and readiness of services for all health facilities, public and private, will be a big boost for the data analysis in the national Kenyan DHIS 2 system.

To foster data use and simplify access to the data in DHIS 2 (and other systems in the HIS architecture) a web portal is under development. This Drupal-based portal makes full use of the DHIS 2 Web-API accessing pre-defined data analysis outputs like tables, charts and maps, as well as plugins to embed the Data Visualizer and GIS modules or to display favourite charts in a dynamic carrousel.

The Kenyan DHIS 2 system is seeing an increase in the use of the collaborative tools. District officers from different sides of the country are using Interpretations to share charts and discuss possible interventions to improve health care, and daily many users are sending feedback messages or requests for support to the national team iusing the Messages feature.

In addition to HMIS aggregate data, Uganda is at the forefront of the use of the new patient tracking capabilities in DHIS 2. A pilot implementation to track mothers and children to improve the continuum of care is under way and different client platforms are being explored to reach out to the local health workers and the pregnant mothers, such as laptops, smart phones, feature phones, and SMS messaging.

In the four Saving Mothers and Giving Life (SMGL) pilot districts in Western Uganda key indicators on maternal health are being collected in the community using mobile phones. Village Health Teams (VHT) are submitting data directly to the online national DHIS 2 system using SMS. This data is then immidiately available for data analysis by all online users at all levels across the the country.

In addition to the routine aggregate data collected every month, the district hospitals are using the DHIS 2 Tracker module to capture case-based data from inpatient admissions and deaths with ICD-10 coded diagnosis, enabling more accurate morbidity and mortality statistics. More than 200 hospitals across the country register totally about 1000 new amissions every day using DHIS Tracker.

The online national DHIS 2 system played an active role in the recent regional annual performance reviews and by policy only data from the DHIS 2 is to be used in these reviews.  

About the same time, a workshop was held in Oslo together with a research network based in Latin America and Spain called EHAS*, to explore possibilities of implementation research throughout the region. Following this workshop, pilot studies were conducted in Colombia, Mexico, and Paraguay, by researchers and students affiliated with EHAS.

The first implementation of DHIS 2 in Latin America started later that year in Cauca province, Colombia, where both the local university and the secretary of health are involved.

Due to wide interest, the first edition of the DHIS 2 Academy in Spanish were held in Cauca in 2013, with participants from several of the Latin American countries and regional health organizations.

At the time of the Academy, and as DHIS 2 was rolled out as the provincial HMIS in Cauca, there are plans for implementation in other provinces as well as the federal level in Colombia. Read more about the Cauca implementation at PAHO. Chiapas region of Mexico has made a decision to use DHIS 2, as has a national level health program in Paraguay. Communication about implementation is going on also with Ecuador, Nicaragua, Costa Rica, and Cuba. DHIS 2, the website DHIS 2.org, and all documentation has been translated to Spanish.

* Enlace Hispano Americano de Salud, www.ehas.org