dhis2-devs-core team mailing list archive

[Jim Grace <jimgrace@xxxxxxxxx>]

Hi All,

I'll be representing DHIS this Thursday and Friday at the "Tools Developer
Summit" of PATH's "Better Immunization Data" (BID) initiative (Gates
funded), in Washington D.C. I think I'm fine preparing for the event, but I
would welcome suggestions in two areas:

1. On Thursday morning I'll give a "lightning talk" about DHIS -- 5
minutes, with 20 slides auto-advancing every 15 seconds. Based on the
"challenges" below, it looks like the tracker module is of special
interest, as it can be used in all three areas: beneficiary campaigns
(e.g., sending texts to patients), identifying patients, and stocks
management. So my basic idea is give a brief overview of DHIS in general,
and then talk some about tracker. As far as ideas for slides, I see the
slide repository on dhis.org, and I also stumbled on Kristin's very nice
set of slides "Innovative Mobile Technologies improving health in
developing countries" from http://www.slideshare.net/dhis2/global-citizen2.

Are there any other slide resources I should know about? A lightning talk
especially benefits from more pictures and fewer words (even more than a
usual presentation.)

2. They're talking about using standard tools like DHIS as part of their
solution to get better immunization data, with the possibility of using
some of the grant funding to pay for software enhancements if necessary.
After looking at the "challenges" below, what features could we add to DHIS
for these areas, if we had more funding? (Don't worry, I won't make any new
commitments, but I'd like to have some ideas in mind for brainstorming.)

Connectivity is a big problem, and I wonder if one thing we might do is
more powerful off-line data entry. I've seen talk of efforts to integrate
ODK with DHIS. Where do these stand now? Is this the best way to get more
flexible off-line data entry, or are there other approaches we should
consider?

What are the various things we know people are currently using tracker for?
Here's what I've heard of:

- Tracking patients in programs: (where?)
- Tracking drugs stocks: South Africa(?)
- Tracking lab test samples: CDC Global Health Security project in Uganda

Thanks.

The workshop "challenges" are:

*Challenge A: Beneficiary campaigns*

*Discuss challenges in health messaging to beneficiaries in the context of
health education, alerts, and adherence.*

Messages may need to be broadcast to a village or to a specific to an
individual.  For example, there may need to be an alert for a village about
an upcoming immunization campaign, notification that new vaccines are in
stock after a period of shortage, or warning of a disease outbreak and
anticipated symptoms.  If there is an ability to uniquely identify a mother
and child, perhaps a targeted message can be sent to provide the mother
with a relevant health tip based on an upcoming immunization or a reminder
that it is time for the next vaccine, a follow-up, etc.  This may also
include tools to improve social mobilization and awareness.

*Challenge B: Patient identification*

*Discuss challenges in relation to identification, tracking, and
longitudinal records.*

While a country may have unique identification of adults, this type of
tracking seldom extends to children.  A caregiver is often given a child
health card to track the child’s growth and vaccine history.  Whether the
card accompanies a child to an immunization session varies.  It is
difficult, if not impossible to determine the identity of the child who is
brought for immunization and match it to health facility records.  At a
health facility, there may be an individual record of a child’s vaccination
history within a register that could be cross-referenced.  Yet this process
can be time consuming when there is a large lineup of children waiting for
services.  Further, if the family moves outside of the district, it is near
impossible to see the longitudinal record of care.  Who is this particular
child?  Did the child receive the full regimen of DTP?  Of the polio
vaccine?  Which children are expected at the clinic this month?

*Challenge C: Supply chain*

*Discuss challenges in relation to stock on hand, cold chain, and stock
management.*

Beyond the district level of the health system, there is limited visibility
into the interdependencies of the cold chain necessary for viable
vaccines.  Often, vaccines are pushed to the outlying facilities, tracked
on paper registers, resupplied through inefficient processes in the event
of a stock-out, with a seeming data disconnect between what vaccines have
been administered and what has been supplied.  Unfortunately, immunization
officers often do not have the data to help guide efficient flow of
vaccines when there are overstocks, when vaccines are nearing their expiry
dates, when growing population trends predict near future shortages in
supply, or when problems with the refrigeration foretell a need for
immediate maintenance.

Cheers,
Jim