Ethiopia Embarks on Standardizing Its Electronic Health Management Information System

By Benti Ejeta

Ethiopia is revolutionizing its current health management information system by adopting DHIS2—a tool with global acclaim for transforming the way health data is collected, validated, visualized, and analyzed.

Ethiopia is rolling out the eagerly awaited comprehensive health data management platform, commonly known as District Health Information Software 2 (DHIS2). By launching the software, Ethiopia joins a growing list of countries that have adopted and are using DHIS2—an open source software developed and maintained by the University of Oslo’s Health Information Systems Program.

After months of customizing and testing the software, the Federal Ministry of Health (FMOH) organized the Master Training of Trainers (TOT) in Adama on Nov 20–24, 2017. The TOT, which was financed and technically supported by the Data Use Partnership (DUP), a consortium project led by JSI Research and Training Institute, Inc., attracted more than 100 healthcare professionals from the FMOH, regional health bureaus, universities, and implementing partners.

Participants of the Master TOT, Adama Science & Technology University. Photo credit: Benti Ejeta, JSI.

The principal objective of the TOT was to raise awareness and build capacity on the effective application of DHIS2. The training also aimed to test the applicability of the design. Over the course of five days, participants not only learned the application but also contributed to further development of the software. True to this goal, key points which will be useful in bringing DHIS2 to the production instance level—the applicable version of the software—emerged from the week-long interactive training.

Participants noted that before DHIS2 fully goes operational, it should have features (full set of data validation rules) that will produce multiple analytical reports in any given period during implementation. They also pointed out the need to work on data migration from irreconcilable information systems. The trainers and trainees emphasized the importance of significant investment in infrastructure, particularly Internet connectivity and computers, to the rollout of DHIS2.

As DHIS2 is a web-based data capturing and analyzing platform, ensuring the implementation and functionality of the current HealthNet initiative is critical. HealthNet is a broadband Internet connectivity that links health institutions to their respective administrative health units. It thus provides an infrastructure that will be used by DHIS2 and other eHealth systems.  The installation of the network infrastructure and computer procurement are expected to happen in parallel with the DHIS2 cascading trainings.

Photo credit: Benti Ejeta, JSI.

Given that DHIS2 is capable of transforming the country’s health data management, trainees strongly recommended the creation of DHIS2 academies in local universities. Official representatives of the FMOH were in agreement. They stated that universities will have multifaceted roles ranging from teaching the experts to further customizing the software to serving as hubs for sharing experiences for new DHIS2 versions.

There are two teams, based in the FMOH, that are tasked with developing, customizing, and supporting the implementation of the software. These are the national DHIS2 development team, also known as DHIS2 Core Customization Team (CCT), and the National Implementation Team. In collaboration with DHIS2 regional focal persons, the national teams will work to collect and consolidate learnings from the implementation phase and use these to further improve the software.

DHIS2 has been positively received as a national electronic Health Management Information System. For people, such as Dr. Desalegn Tegabu, the director of the Policy and Planning Directorate at the FMOH, DHIS2 is not only a data collection software but also an engagement forum where data from other platforms converge; allowing data analysis, and use. As such, there is a need for stakeholders to work collaboratively to ensure its success. Dr. Desalegn called upon the TOT participants, whom he fondly referred to as ‘the army of the healthcare,’ to work diligently towards this.

At the moment, the CCT is incorporating the trainees’ inputs to ensure the deployment of a user-friendly version of the DHIS2 to the regions. In his closing remarks at the TOT, Eyob Kebede, the director of the Health Information Technology Directorate at the FMOH, said that the use of DHIS2 could move the health sector ‘one step forward.’ He also stated that regions are expected to actively engage in the development of the implementation plan, maintain the momentum, and roll out the software in an organized manner. The plan for the next couple of months is to finalize the cascading of the training and prepare the infrastructure for DHIS2 implementations.

Re-posted from JSI’s The Pump

*The Ethiopia Data Use Partnership (DUP) is a collaborative endeavor of the FMOH to advance the country’s healthcare. The DUP is a dynamic, responsive team of partners that is led by JSI and currently includes Regenstrief Institute, University of Gondar, and the Gobee Group. The DUP aims to improve the collection and use of high-quality routine information in the health sector, leading to better quality, efficiency, and availability of primary health and nutrition services at all levels of the health system. It is funded by the Bill & Melinda Gates Foundation.