Development and Implementation of the new

Mozambique National Health Information System

for M&E (SIS-MA), a systemic implementation using

DHIS2 platform

Ivan Pinto

Program Manager Jembi Health System NPC / MOASIS,

Mozambique

Alessandro Campione

Program Director Jembi Health Systems NPC / MOASIS,

Mozambique

Christopher Seebregts

CEO, Jembi Health Systems NPC

Hon Assoc Prof, Discipline of Computer Science, UKZN

Funded by

MOASIS is a non-profit organization of University Eduardo Mondlane,

Living Lab created and supported entirely by JEMBI with support of

IDRC, CDC, WHO, Rockefeller and others ORG. We aim to:

– Strengthen HIS local capabilities involving the public, private and

academic sectors

– reference and link between the MOH and public/private

partners

– Set up a South-South cooperation model

JEMBI/MOASIS model

MOASIS/JEMBI – MISAU (MOH)Funded by

PROJECT PROPOSAL

MISAU APPROVAL

REQUIREMENTSSPECIFICATIONS

RESPONSIBILITIES ATTRIBUTION

JOINT OPERATIONSFOR DEPLOYMENT

PARTICIPATORY SYSTEMDEVELOPMENT

DOCUMENTATION AND HAND OVER

5 years

Memorandum of Understanding renewed till 2020

Physical presence in the MISAU

Agenda DIS

AgendaMOASIS

Quarteror

Annual

results

Constant physical

presence in the MISAU of

MOASIS team

HIS strategic plan

DIS annual planMOASIS annual plan = projects

OVERALL STRATEGY

IT PROBLEM & TECHNOLOGY

MANY FOCUS HERE

NEED ASSESSMENT REQUIREMENTS

TRAINING DATA QUALITYPUBLICATION

AND USE

MAINTENANCESUPPORT AND

SUSTAINABILITY

CLINIC/PUBLIC HEALTH PROBLEM

PROJECT, AGREEMENTSFUNDRISING

COMMITMENTDEPLOYMENTINTEGRATION

Funded by

SIS-MA DEVELOPMENT PHASES:1- STUDY2- PROPOSAL SOFTWARE DEVELOPMENT3- SOFTWARE DESIGN4- DEVELOPMENT5- TEST PILOT INSTALLATION6- FINAL DELIVERY

SYSTEMATIC APPROACH TO SIS-MAFunded by

EVALUATION OF MODULO BASICO

REQUIREMENTS FOR A NEW

SYSTEM

DEVELOPMENT SCENARIOS &

METHODOLOGY

TENDER, MIXED OR IN-HOUSE

DEVELOPMENT CONTRACT (in phases) JEMBI-WINNING ORG

DHIS 2 PLATFORM SOLUTION

POOR QUALITY MB DATA

IMPLEMENTATION, INTEGRATION OF OTHER SYSTEM AND MAINTENANCE

BETTER & SUSTAINABLE QUALITY OF M&E DATA

MOH’s OWNED PROJECT

• Jembi/Moasis is providing support throughout the SIS-MA project (MoH

project) in systematic way by facilitating all steps:

i. Assessment MB

ii. Requirement for the new system SIS-MA

iii. Scenario analysis, methodology and costing

iv. Tender management activities (6 phases), contract tracking, technical

activities, quality assurance and transfer of historical data.

v. Implementation, integration of other systems and maintenance

• The project belongs in its entirety to the MoH and any relevant decision was

made by the same.

• Jembi/Moasis ensures the specialized management of the project, resources

(human and financial), monitoring and quality review and ensure compliance

according to laws and rules of the MoH.

SIS-MA PROJECT STRATEGYFunded by

MODULO BASICO

First M&E in Mozambique, developed by an external Consultant whose contract ran out in 2009.From that point there was no agreed sustainability plan, system support, maintenance, development of

new features.

Modulo Basico SIS-MA

Outdated and discontinued technology Open Source platforms and possible local development => SUSTAINABILITY

Difficulties in development of new functionalities and inclusion/modification of modules

Possibility to add new features and modules without highly skilled developers => EASIER ACCEPTANCE AND EXPANSION

Difficulties in creation of reports, graphs,geographical and other data representations

Introduction of Data warehousing, GIS and other simplified mechanism => MORE INFORMATION AVAILABLE

Lack of mechanisms for data validation Simpler and integrated rules for validation => BETTER QUALITY OF DATA

System not interoperable Interoperability standards and possibility to communicate with other systems => GREATER HIS COVERAGE

Funded by

STEP OF THE SYSTEMATIC APPROACH:

FROM MODULO BASICO TO SIS-MA

2009: EVALUATION OF MODULO BASICO2010: DEFINE THE REQUIREMENTS FOR THE

NEW M&E SYSTEM (SIS-MA)

Funded by

2010: DEFINE THE REQUIREMENTS FOR THE NEW M&E SYSTEM (SIS-MA)

USE CASES

SYSTEM PLATFORM

SYSTEM INDICATORS

Funded by

STEP OF THE SYSTEMATIC APPROACH:

FROM MODULO BASICO TO SIS-MA

2011: ANALYSIS OF SCENARIOS, METHODOLOGY AND COSTING, TIME, ETC.

Funded bySTEP OF THE SYSTEMATIC APPROACH:

FROM MODULO BASICO TO SIS-MA

2011: DEVELOPMENT PLAN AND RESOURCE MOBILIZATION

WITH THE REQUIREMENTS

DOC, DEVELOPMENT PLAN

AND COSTING JEMBI/MOASIS

WAS ABLE TO APPROACH

POTENTIAL FUNDERS

Funded bySTEP OF THE SYSTEMATIC APPROACH:

FROM MODULO BASICO TO SIS-MA

STEP: SIS-MA DEVELOPMENT

(INTERNATIONAL TENDER)

INTERNATIONAL RECRUITMENT

FOR THE SIS-MA PRODUCT

MANAGER

Funded by

SIS-MA INTERNATIONAL TENDER

Funded by

1. TENDER PREPARATION & ANNOUNCEMENT

2. REQUEST FOR EXPRESSION OF INTEREST & EVALUATION

3. TENDER EVALUATION

4. ORGANIZATIONAL

5. STRUCTURE & COMMUNICATION

6. CONTRACT MANAGEMENT AND QUALITY CONTROL

COST OF THE CONTRACT: 820.000 USD

TIME: 24 MONTHS

ORGANIZATIONAL STRUCTURE AND

COMMUNICATION

MOHOwner of the product

and decision maker

Critical SoftwareDeveloping the

system

Jembi/MoasisFacilitating

organization

Frequent interaction and

quality assurance

Formal approval at the end of each phase

CDCProvide financial

resources

Formal approval of resources and

workplan

Funded by

Phase 1 – Study

Phase 2 – Software

development proposal

Phase 3 – Software

design

Phase 4 – Development

Phase 5 – Test and pilot

installation

Phase 6 – Training and

implementation

• Team Contextualization.

• Analysis and requirements specification, HIS architecture,

data elements, flow, reports, forms etc..

• Alignment of expectations.

• Design the system architecture.

• Definition of the proposal and development methodology.

• Review of project plan for the next stages.

• Production of detailed design of the system

• Definition of test plan and acceptance criteria

• Setting the migration of historical data model.

• Develop the SIS-MA according to the requirements set out above.

• Iterative validation with Jembi, Moasis and MOH.

• Validate the developed system in a limited environment

• Tests in three districts of a province.

• Definition of training and materials plan.

• Implementation of the system at central, provincial and district levels.

• Training for system users.

SIS-MA TECHNICAL DEVELOPMENTFunded by

SIS-MA PROJECT - CURRENT STATUS

OBJECTIVE Support collection, analysis, interpretation and dissemination of health

data used to plan public health services across Mozambique

APPROACH 6 Phases:1) Study2) Proposal of software development and methodology3) Design of the application 4) Software Development 5) Installation and testing 6) Training and Implementation

KEY ACCOMPL. • System fully developed with translated manuals and training material • Migration of historic data from MB to SIS-MA • Development of additional modules: HIV, Nutrition, BES, SMI • Maputo City Implementation in 7 sites: Data available for HIV-PAV• Plan of National expansion according to MoH priorities ready and operational

2015 (Next

Steps)• Evaluate implementation• Identify corrective actions in coordination with the MOH• Further expansion to other provinces• Expand functionality

Funded by

SIS-MA TECHNICAL DEVELOPMENT

CURRENT STATUS

Complete analysis of HIS architecture and structure, data flow, forms, reports, mapping of all data elements, systematization and protocol ready for systems development phase

Conclusion of phase 5 (system development): SIS-MA inDHIS 2 completed with all MB modules, manuals and all training materials in Portuguese

Complete analysis of health sector structure and SIS-MA – Facility list ready for implementation phase

Migration of MB data from previous years to specific SIS-MA server for ready-to-go analysis and statistics comparisons.

Infrastructure ready and functional

All training materials, manuals and modules ready

Development of additional MODULES: NUTRITION, BES, HIV.

Funded by

SIS-MA NATIONAL IMPLEMENTATION

CURRENT STATUS

Development of all logistic for phase 6 (IMPLEMENTATION)

Support the MoH in the provincial training and implementation

Implementation of SIS-MA with the DHIS2 WEB based version completed in Maputo city (11) and Maputo Province (10)

National implementation ongoing: Gaza (9) and Niassa(1) are ongoing

Use of innovation technology developed by Jembi/Moasis to ensure connectivity, security, distance

support and dedicated tools: SIS COMPACT STATION

COMPLETED

COMPLETED

ONGOING

ONGOING

Funded by

SIS-MA CONNECTIVITY

AND SECURITYKIOSK HARDWARE (SIS COMPACT

STATION)

• Secure (all hardware is embedded including 3G card)

• WiFi/cable or 3G connected• Dedicated, no virus• Standard hardware (South Africa

MoH standard)

KIOSK SOFTWARE• Allow only HMIS systems• Dedicated internet connection• Distance support

Funded by

CHALLENGES & WAY FORWARD

Online only scenario adopted making the operation extremely difficult at

district and provincial level.

Continue support after installation in all districts and provinces with reduced

human and financial resources

MB data and operation transition to SIS-MA difficulties

Training, maintenance and capacity building

Funded by

Include offline mode were no other option available

Include all subsystems (national health programs)

Integrate and interoperate other national health systems

Expand functionalities

Expand to health facilities

Create a strong Mozambican DHIS community

Support in the data quality control, extraction, publication and use of the SIS-

MA information

KANIMAMBO!

MUITO OBRIGADO!

(Thank you)