dhis2-devs team mailing list archive

[Abyot Gizaw <abyota@xxxxxxxxx>]

On Sun, Apr 5, 2009 at 3:32 PM, Ola Hodne Titlestad <olati@xxxxxxxxxx>wrote:

> Hi Abyot
>
> Thanks for writing this up on the list. As you say it should be moved to
> launchpad and the blueprint is a good place for such specification and
> design discussions.
> This link will create a new blueprint for DHIS 2 and in the field
> Specification URL you can link to your pdf:
> https://blueprints.launchpad.net/dhis2/+addspec
>

Yes I can do that. But this will again appear as an idependent blueprint.
Right now we have 3 different postings about CBS on the launchpad (one by
you, one by Bob and another one by Saptarshi, I wanted to append it to any
one of these ... otherwise it will be difficult to keep coherence) - I don't
know this is my impression with a little interaction I have with launchpad


>
> To all of you:
>
> I have a few questions about this system, mostly related to use cases.


Good!


>
>
> I assume that the community health worker will collect the data, either on
> a paper form or on a mobile phone acting as a client. The same end user will
> also receive updated work plans, visit lists and feedback reports if I have
> understood correctly. These users are visiting their clients in their homes,
> although some of these users have their base at the health facility (ANMs)
> while others (ASHAs) work only in the community with looser links to the
> health facilities. Is this correct?


Not sure on the feedback report ... haven't seen such a usecase from my
visits. But this doesn't mean that it will not be considerd. And again from
my observation and the discussion I have with Sundeep, ASHAs are not in the
proper MoH structure and they are not eligible to do any reporting or data
collection ... our focus is only ANMs or JPHNs in the case of Kerala. And
ANMs are doing the house-to-house visits followed by service delivery and
data collection, recording these on primary registers and finally data entry
in DHIS2 (after manually tallying specific services from their primary
registers)


>
>
> My main question is: where do you see the backbone (main) system installed?
> I mean the system where the forms are generated, data is collected/imported
> and work plans and feedback reports generated. If the end users has a mobile
> phone for data entry etc. then the mobile phone and this backbone system
> would act as a server-client setup. If data is collected on paper, then this
> system would be the first level of computerisation, meaning where data is
> entered into the computer, similar to how it works for routine data
> collection in DHIS.


The main system will be installed in either a subcenter/facility or PHC -
not sure on the similarity or differnce between facility and subcenter,
somebody can correct me. This system is a first level computerization, as
you pointed out. I have tried to make it clear in my earlier mails that the
mobile is something which is going to come in the final stage. So generating
an activity plan on the paper followed by automation of the backend is the
first target ... then mobile will follow.


>
>
> If I understood correctly the DHIS is installed (or planned to be rolled
> out) at block PHC ("subdistrict") level all over in India and that
> computerisation of lower levels than block (PHC and subcenters (=facility?)
> ) is not likely due to the enormous scale. I assume that the orgunit level
> for computerisation (where you have computerised data entry, either via
> internet accessing a server or directly on a standalone installation) will
> be the same for DHIS and for the CBS, as both systems would benefit from
> being installed as low as possible within the limits of infrastructure and
> capacty for maintanance.


True. I think I have tried to address this, in the attaced PDF file,  by
extending the orgunit structure of DHIS2 so that it includes village, then
house then family and then individual.


>
>
> As a result of the gap between the community health workers and the lowest
> orgunit level of computerisation, from community to block, the mobile phone
> is introduced as a possible bridge that can collect data during house visits
> and send to the block PHC using SMS or other mobile transport. Without the
> mobile phone clients the patient level forms would have to be sent on paper
> all the way up to the block which doesn't make sense, and in I guess in
> stead it would be aggregated at the facility and sent up only as monthly
> aggregated reports (which is the current and usual scenario). Only with
> either a computer system installed locally at the facility (subscenter) or
> with mobile clients in the community it would be possible to deal with
> patient/individual level data. Are these assumptions correct? And if you
> have a computer at the facility then I also assume that you would have DHIS
> installed there as well to improve data collection and feedback report
> possibilities also for aggregated data.
>
> Sorry for dragging this out, but I guess my main comment here is that
> wouldn't DHIS and CBC always be installed (or accessed via internet) from
> the same orgunit level?
> If not, what makes the CBC different from DHIS when it comes to where it
> should be installed and how it can be maintained?


Just to make things STRAIGHT and VERY CLEAR .... because I think we are
making a big out of it which I couldn't really understand.

It is me who first got a hands on experience on OpenMRS and then decided not
to put any effort on OpenMRS for the task I planned in my PhD proposal. And
it is me who first implemented line-listing in DHIS2, and again it is me who
wanted to extend individual data collection using mobile phone for rural
settings ....... but for all this efforts of mine in extending DHIS2 for
individual (non-EPR) data collection - I got criticised for trying to do the
"most difficult task in HISP........ trying to break the whole philosphy of
DHIS2 [from aggregate to individual] .......... not willing to work in
OpenMRS ....."

I don't really understand what we are talking right now .... you only are
trying to tell me what I belived and wanted to do long time back. If people
don't have trust in what I am doing - then I think better to just leave it
for me. Honestly, I couldn't really point out any meaningful discussion from
this whole week - it is just talk, confusion, talk ... no meaningful
contribution.


Thank you
Abyot.



>
> I guess we should paste all this into a blueprint when it is ready.
>
> best regards,
> Ola Hodne Titlestad
> HISP
> University of Oslo
>
>
> On Sun, Apr 5, 2009 at 9:14 AM, Abyot Gizaw <abyota@xxxxxxxxx> wrote:
>
>> Hi All,
>>
>> Please find the attached presentation I made last time in our Delhi
>> Workshop - I feel there is a lot in that document to shape the
>> design-development process of our community-based system. And I would be
>> happy if someone can post this presentation on launchapd -- sorry couldn't
>> get a link on launchpad for uploading a file.
>>
>> As per the discussion we made we are now on the way to start development
>> and would appreciate any input you might have. To recall the discussion, the
>> focus is on house-to-house service delivery for an individual and its
>> subsequent followup with a final goal of generating aggregate figure for
>> DHIS2.
>>
>> And five points are visible in here - individual, house, service, followup
>> and aggregation - which I think our datamodel should base upon. Individual's
>> grouped together and forming a family, a family with/with-out a house and a
>> number of houses in a village belonging to a subcenter/facility is a context
>> we will be facing out in the community. A health-worker should therefore
>> plan ahead where to go, which house and which individual to meet, and what
>> kind of service to provide. This requires for a strict planning of activity
>> with inputs from standard health services and procedures (for example FP,
>> ANC, Birth, Immunization, ...) and current where about of individuals
>> (making issues of migration another critical factor). In the end, the ground
>> realtity (health status) of a particular village should be reflected in the
>> overall country's HMIS - aggregation and DHIS2.
>>
>> To break things in pieces/objects
>>
>>
>>    - Individual
>>    - family
>>    - house
>>    - village
>>    - service
>>       - procedure
>>       - cycle
>>    - migration
>>       - hierarchy
>>    - activity plan
>>    - aggregation
>>       - search
>>       - query
>>    - export
>>
>> Let's just put these pieces on the wall and trace their relationships or
>> even break them further.
>>
>>
>> *Saptarshi*: I hope you have got some input for revising your datamodel.
>>
>> *Vivek*: Can you arrange one visit, for Saptarshi, to any ANM Subcenter?
>>
>> *Ola*: I know that I haven't said anything about line-listing.... but I
>> feel that there will not be any major line-listing design issue to be
>> considered in here. Things will get shaped in this design-development
>> process (which is very much iterative).**
>>
>>
>>
>> Thank you.
>> Abyot.
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>
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