dhis2-users team mailing list archive

[Knut Staring <knutst@xxxxxxxxx>]

---------- Videresendt e-post ----------
Fra: "Dagmar Timler" <diggitydugs@xxxxxxxxx>
Dato: 18. nov. 2013 07:42
Emne: [ict4chw] HCT project in South Africa using DHIS2 and OpenXdata (as
"Capture")
Til: <ict4chw@xxxxxxxxxxxxxxxx>
Kopi:

Hi, my name is Dagmar Timler and I am part of a team at *Cell-Life
<http://www.cell-life.org/>* in South Africa.

It's my pleasure to tell you today about a project initiated by the South
African National Department of Health.

*Background*

The *South African National Department of Health
<http://www.doh.gov.za/>*(NDOH) identified that mobile technology
could play an important role in
improving both the speed and the quality of data for informed decision
making and improved service delivery in the Public health sector. The
Department Tendered for a supplier to design and implement a Mobile
Monitoring and Reporting System for the HIV Counseling and Testing and
Antiretroviral Treatment data collection programs, the Ward-Based Primary
Health Care Workers Community Outreach Teams mobile support initiative and
other rapid data submission programmes as may be required.

Through funding from the Department of International Development, under the
SARRAH Programme a consortium of *HISP <http://www.hisp.org/>* and *Cell-Life
<http://www.cell-life.org/>* were appointed to implement the Project, and
used the *OpenXdata <http://www.openxdata.org/>* software (under the brand
name “Capture”) and the DHIS2 to implement the Mobile Monitoring and
Reporting System.

*Pilot Phase*

The pilot phase included all nine provinces in South Africa, selecting one
pilot district per province.

This meant, that the project pilot consisted of 937 users and facilities (1
user per facility). The project pilot phase launched in May 2012 and ran
successfully until July 2013. The pilot phase started with the reporting
data on HIV Testing And Counselling (HCT) which included the number of
persons pre-test counseled and also tested for HIV, and also
Anti-retroviral Treatment (ART) which collects information on people
started and remaining on ART.

The initial data elements collected reports on the HIV Counselling and
Testing (HCT) programme of the NDOH. The success of the pilot phase was
such, that the program is now being implemented in all 52 districts with
more than 4000 facilities reporting their HCT and ART data monthly via
mobile phones.

*Technology*

HISP-SA and Cell-Life presented a solution that responds to NDOH
requirements by integrating OpenXdata (under the brand name “Capture”)
and *DHIS2
<http://dhis2.org/>*.

OpenXdata (under the brand name “Capture”) is used as the Mobile component
for data collection, which enables users to capture, validate their data at
the time of capturing and upload data to the DHIS2

DHIS2 is used to store the data submitted via the mobile component and
provides flexible analysis and reporting tools in the form of dashboards on
user’s desktop - where the page contents are automatically updated from the
database – and is fully integrated with reporting tools (iReports, Jasper)
and third party analysis tools - Excel Pivot tables and GIS .

This solution will provide facility managers, sub district managers,
district managers, provincial mangers and NDOH with instant access of the
data collected at facility level and allows it to respond quickly and
effectively should it be required.

The technical solution consisted of the following elements:

   -

   OpenXdata (under the brand name “Capture”): Mobile data collection
   -

   DHIS2: web based central database
   -

   APN: Access Point Name with 10 Gig monthly data
   -

   Data SIM Cards: Vodacom SIM cards linked only to the APN
   -

   Server: Hosting Capture and DHIS
   -

   Cell-Phones: Nokia 5230
   -

   Please Call Me line (PCM): Used to send the download link to the users.
   -

   Implementation – set-up (distributing 1000 phones)

Each user was given a Cellphone, SIM card, username and password. The
Cellphones were issued by the National Department of Health and the SIM
cards are paid for by the National Department of Health. SIM cards were
configured to link only to the APN and would not have any access to the
internet or make and receive voice calls in order to control costs and
limit abuse.

Users send a Please Call Me (PCM) on receiving their phones, that triggers
a response SMS directing them to download the mobile phone application
which sits on the server and only accessible via the APN.

A PCM is free service provided by South African mobile networks which sends
an SMS to a specified number requesting the sender is called back. The PCM
was used as it would have been logistically challenging setting up each
phone and then having them distributed to the users, and since it was
unknown when the users would be receiving the phones, an SMS sent too early
could be deleted without being read.

*Implementation*

Users were instructed by the NDOH to submit the required data on a monthly
basis. Once data is submitted from the mobile phone to the openXdata server
(under the brand name “Capture”) the data is automatically exported to
DHIS2 in an XML format. The form data elements are linked using DHIS
specific bindings.

Managers can then access the data and generate the required reports in
DHIS2 via the web interface.

*Training*

The method used in training users on the application was a train the
trainers model. 20 master trainers were selected per district and were
responsible for cascading the training sessions to the rest of the district.

Each user was provided a comprehensive user guide detailing every step of
the process, which mainly included screen shots and explanations on what
was required.

*Progress to-date*

On the whole the feedback from users has continually been very positive.
Users like the simple interface and the ease with which data can be
inputted and submitted.

It is vital that there is “buy-in” to the solution to ensure that it is
accepted and used as specified. This should be incorporated into training
sessions to overcome any potential user resistance to change.

To-date, over 900 facilities have been trained and the project team is in
the process of planning the roll-out of the balance of approximately 3200
mobiles required to complete the project. Funding is provided jointly by
the National Ministry of Health plus DFID who are assisting in the early
phases.

The Project Pilot evaluation report together with the project close out
report was extremely positive resulting in the recommendation to commence
with the full roll-out to the remaining 43 districts.

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