WEBDHIS TRANSITION STRATEGY Mbulelo Cabuko Department of Health

WEB-DHIS TRANSITION STRATEGY Mbulelo Cabuko Department of Health Presentation to NHISSA 6 -7 July 2016

Outline • Background • DHIS in South Africa – March 2016 • Transition to web. DHIS – Benefits – Legislation, Policies, Strategies, Norms & Standards – Transition phases and provincial plans – Resource impacts – Transition risks and mitigation – Hosting and backups – National Data Dictionary – Training, Mentoring and Support (TMS)

Background • The District Health Information System (DHIS) was adopted by NDo. H in 2000 • Development of web based DHIS 2 was lead by the University of Oslo and India • More than 40 Countries use DHIS

Background q One of the primary objectives of DHIS implementation in South Africa is to be able to generate, analyze and disseminate health information to facilitate effective policy formulation, management, planning, budgeting, implementation, monitoring and evaluation of health services and program interventions in the health sector (DHMIS Policy, 2011).

DHIS Status in South Africa 1. Web-DHIS implementation in Free State commenced in Nov 2013 2. Rest of South Africa is still using DHIS 1. 4 a) Distributed system, Microsoft Access – size limitations b) Different versions of Office in provinces - all not supported c) Affects on Data Quality 1) 2) 3) 4) Human error during importing and exporting of data affects Reporting discrepancies at different levels Org. Unit standardisation and maintenance challenges QR time lines, dataflow 45 days to NDo. H – NDo. H manager access 50 -60 days 5) Updates e. g. NIDS to each facility

Benefits for Web-DHIS • The introduction of Web-DHIS in Free State has resulted in improvement in data quality compared to the period where DHIS 1. 4 version was used. – There is no import and export of data required; which results in reduced human error. – Web-DHIS has enhanced Data Quality features. – Direct online capturing at the lowest level allows data validation to take place. – Reporting discrepancies are eliminated as same data/reports are accessed at all levels.

Benefits for Web-DHIS – Org. Unit management and metadata updates are enhanced through the use of National Data Dictionary. – The Data Flow period is reduced to 24 hours for nonvalidated data and allows immediate validation and feedback as well as online sign-off by appropriate responsible managers. – Online sign-off of data by the Facility Manager/CEO enhances accountability. – There is no need for recombination of data files as is the case with DHIS 1. 4

Legislation, Policies, Strategies, Norms & Standards

Legislation, Policies, Strategies, Norms & Standards NHI e. Health interventions (700 Facility and e. PHC)

5 web. DHIS Transition Phases Preparation Main/monthly Transition Consolidation Facility Daily Data Capturing (DDC) Interoperability Oct 15 – Mar 16 April – Dec 2016 Jan – 2016 Mar – 2017 June Mar 2020……………

Facility Transition Phase (based on available resources: connectivity, computers and data capturers) No computer Connectivi and/or data ty capturer At least one computer and data capturer Consulting room computers and data capturer e. Tick register daily e. Summary daily saved offline and uploaded at nearest Monthly facility weekly or at least summaries are facility weekly/monthly Not captured at the connected Monthly summary on lowest Monthly summary on connected level paper to nearest connected facility by 5 th for capturing e. Tick register daily Monthly web. DDC daily posted to web. DHIS summaries are capturing when saved Connected captured at the

Resource Impact of Transition • All levels • Skills gains – Training = mostly current in-service training adapted • more efficient use HIS staff time – more time for DQI & TMS • Integrate with 700 facility / e. PHC projects • Facility level – minimal, DDC on different system • Sub-district level – minimal, capture on different system • District & Provincial levels – no import and export • NDOH level – none until transition complete – data will be provided in 1. 4 and web. DHIS. – No recombination = Reduced partner support time

Training, Mentoring and Support (TMS) • Training material mostly developed: in-service training, UNISA courses, e. Learning material • SOPs for all levels are being adapted • Training of Trainers, mentoring and support by partners – HISP TMS to NDo. H and PDo. H – PDo. H TMS to Districts (with backstopping by HISP and other experienced partners) – District TMS to Sub-districts (with backstopping by HISP and other experienced partners) – Sub-districts TMS to Facilities (with backstopping by HISP and other experienced partners)

Training, Mentoring and Support • Data Capturers and Info Officers – DHIS foundation – 5 days • Information Officers – DHIS intermediate – 5 days • Program Managers – M&E and Data Use • Database Managers – modules to complete over extended period of time and prove competency before provided access on production to perform those functions

National Data Dictionary • Datafiles: http: //dd. dhmis. org/ – NIDS integrated – ISHP – WBOT • Updates to NDD content is done but problematic from DHIS 14. NDD should be implemented ASAP as Master Metadata dictionary • Allow Orgunit recommendations to be captured in the NDD with registration of users • Email sent from NDD to user making submission and moderator – relayed via helpdesk so creates a ticket with expected response time • NDD metadata sync app which keeps web. DHIS instances aligned with NDD • NDD exports in different formats which allows other systems to synchronise. Used by Tier. net, HPRS and others.

Rapid Web-DHIS Transition Strategy and Implementation Plan q The Director-General has approved the Web-DHIS Strategy and a high level Implementation Plan. q The Web-DHIS Strategy was subsequently tabled at the last NHC-Technical Advisory Committee held in Kimberly, 28 -29 April 2016 and was approved. q The strategy outlines a coordinated national implementation of Web-DHIS.

Transition Plan per province Initiation workshops were held with the following provinces: North West, Gauteng, KZN, Eastern Cape, Limpopo, and Mpumalanga – Workshops to discuss provincial transition and to complete province specific transition plans

Main Transition Plan

Main Transition Plan • June to December 2016 - eliminate DHIS 1. 4 DDC by implementing the new tools, for example e. Tick register and e. Summary tools, based on maturity models and available resources • June 2016 to March 2020 staggered transition in all nine provinces to facility data capturing into Web-DHIS, using various approaches based on the maturity level and dedicated health information staff available in each health facility

Thank you