his implementation in ethiopia case studies from aahb l.
Skip this Video
Loading SlideShow in 5 Seconds..
HIS implementation in Ethiopia: case studies from AAHB PowerPoint Presentation
Download Presentation
HIS implementation in Ethiopia: case studies from AAHB

Loading in 2 Seconds...

play fullscreen
1 / 23

HIS implementation in Ethiopia: case studies from AAHB - PowerPoint PPT Presentation

  • Uploaded on

HIS implementation in Ethiopia: case studies from AAHB. Woinshet Abdella PhD Student Department of Informatcs University of Oslo. CONTENTS. Background Ethiopia / Health Care System HISP Ethiopia DHIS Implementation in Addis & Oromia Challenges. Ethiopia. Population - 72+ million

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

HIS implementation in Ethiopia: case studies from AAHB

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
his implementation in ethiopia case studies from aahb

HIS implementation in Ethiopia: case studies from AAHB

Woinshet Abdella

PhD Student

Department of Informatcs

University of Oslo

  • Background
    • Ethiopia / Health Care System
  • HISP Ethiopia
  • DHIS Implementation in Addis & Oromia
  • Challenges
  • Population - 72+ million
  • Area – 1.1 million km2
  • Decentralized administrative structure
    • 9 regional states & two city administrations
      • 580 weredas (districts)
  • Regional sates are autonomous
  • Poor literacy, education, health status
health care system
Health Care System
  • MOH, Regional health bureaus, Zonal health departments, Wereda/Sub-city health offices, Health Facilities
  • Under developed
  • Health service coverage – 61%
  • MMR – 871/100,000, U5MR – 140/1000
  • High Infectious & communicable diseases
  • HIS is primarily manual & under developed
hisp ethiopia
  • Project Initiation
    • Through a collaboration of the Department of Information Science, Addis Ababa University (AAU) and the University of Oslo in February 2003.
  • Partners
    • AAU; regional health bureaus of Ethiopia; global HISP
hisp ethiopia6
  • Objective
    • Introducing computer based HMIS in Ethiopia in view of supportinglocal analysis and use of data
hisp ethiopia7
  • HISP Members
    • 4 PhD students / 7 Masters students (one Norwegian)
    • 5 DHIS facilitators hired by HISP
  • Research Sites for HISP Ethiopia
    • Addis Ababa, Oromia, Tigray, Amhara, Benishangul-Gumuz
      • DHIS implementation is being carried out
        • Addis & Oromia – since Jan 04
        • Others – since June 04
      • Different stages of implementation
case studies from addis
Case Studies from Addis
  • Research Objective
    • key research objective is to broadly understand the challenges and opportunities with respect to the integration of existing paper-based HIS with computer-based systems in Ethiopia.
  • Theoretical Perspective
    • ANT
  • Research Approach & context
    • PAR
  • AR intervention:
      • HIS implementation Intervention into health organizations (AAHB & OHB)
      • One DHIS facilitator for each region
research approach context
Research Approach & context
  • Research Site
    • Addis Ababa health bureau (AAHB) ,
    • 10 sub-cities (districts)
    • 500 public & private health facilities,
    • located in Addis Ababa city Administration (Province).
    • Addis Ababa is the capital city of Ethiopia (540 km2 )
    • Population is 3 millions.
research approach context10
Research Approach & context
  • Researcher Role.
    • The role assumed was an involved researcher through action research.
    • Qualitative data collection method was employed including
      • photography, observations, interviews, discussions, meetings, workshops, training, action experiments, document analysis, telephone calls, visit related institutions, informal lunch/tea meetings.
research approach context11
Research Approach & context
  • Research subjects
    • managers and planners at different levels of the health structure, the health workers responsible in data collections and analysis.
dhis implementation in addis
DHIS Implementation in Addis
  • Negotiate research access (KK)
  • Situation analysis (Mar 03 – Aug 03)
    • Visits to Health bureaus & HFs
  • Initiating the Design / implementation process with AAHB/OHB (Dec 03) (Bureau)
  • EPR was just introduced then
  • Prototype system was developed and populated with 9 months own data
dhis implementation in addis ababa
DHIS Implementation in Addis Ababa
  • Demonstration of the prototype DHIS Addis (Jan 04)
    • The experiences gained revealed the problems with the existing HMIS
      • Data duplication, fragmentation, …
    • Local requirement (Morbidity/Mortality data handling) identified that DHIS does not support efficiently
  • Developing minimum health data set & health indicators was proposed
dhis implementation in addis ababa14
DHIS Implementation in Addis Ababa
  • Major decisions
    • The proposal for standardizing data set/health indicators accepted
    • Adapting DHIS based on new dataset and reporting requirement
    • Adding module to accommodate M/M data handling
    • Implementing DHIS to ALL Sub-cities.
  • Team formed
The research team was composed of
  • Bureau level,
    • Bureau head;
    • health service head (leader of the project on the part of the bureau), team leader, and senior expert;
    • family health head, team leader and expert;
    • Disease Prevention and Control head; IDSR team leader, TB / Leprosy and HIV/Aids program team leader and senior expert;
    • IEC expert;
    • Network administrator;
  • Sub-city Level
    • two family health experts
  • Facility Level
    • two health facility managers;
  • And the researcher.
dhis implementation in addis ababa16
DHIS Implementation in Addis Ababa
  • Two Parallel activities performed
    • Standardized data set, health indicators, data collection & reporting instruments & procedures (data flow, …) development
      • Draft prepared by the group presented for workshops, comments incorporated, the draft was further developed in a series of long meetings,
    • Development of Morbidity & Mortality module
      • Iterative / incremental (involved one major revision)
dhis implementation in addis ababa17
DHIS Implementation in Addis Ababa
  • Use of DHIS as a prototyping tool
      • to better understand user requirements for producing an improved & useful system – which potentially increases data use
  • The standardized data set is implemented in all facilities
  • DHIS adapted, the new module incorporated
    • (Input Form, DHIS Data Flow, Data Entry (next slide), Pivot Table Report, Standard Report )

Monthly Routine Data Entry/Edit Form

Monthly Morbidity and Mortality Data Entry/Edit Form

dhis implementation in addis19
DHIS Implementation in Addis
  • DHIS is implemented
    • All districts (10 sub-cities) and AAHB initially
    • Scaled to health facility levels
      • 18/23-Health centers & 5/5-Hospitals (when resource / situation allowed)
  • Training (DHIS/computer basics) was given to sub-city/bureau/HF health staff / managers / data clerk / DHIS facilitators (with own data)
  • Technical support is being provided by the facilitator
  • Participatory design
  • July 2005, Workshop for evaluating one year experience of the use DHIS
Observations …
  • DHIS Software is well-tested & supports
    • Data aggregation; data sharing; health structure implementation; easily adaptable for new needs, which is inevitable; rapid set-up of DHIS application for a new setting
  • Complaints from different actors (use of MS Access in DHIS – DHIS 2 is a response)
dhis implementation in oromia
DHIS Implementation in Oromia
  • Collection/reporting instruments and software prepared for Addis is shared by Oromia & other regions
  • Followed similar approach
    • Some of the differences
      • The process was slower when compared to Addis
      • The minimum data set prepared for Oromia not yet adopted by the region
      • DHIS implementation status
        • Some Weredas of East Shewa zone (based on computer availability)
        • Is being rolled out to the remaining zones (at the zone level only)
  • Improving data quality, data analysis and use
  • Reduce / Improve dataset
  • Achieving partnership with MOH
  • Scaling & Sustainability
  • Over burdened health worker
  • Limited resource
  • Negotiating with multiple actors
  • Parallel systems