DHIS2: Concept and

Implementation Strategy

Guardian Y. Sanjaya

SIMKES Fakultas Kedokteran UGM

Learning Objective

• Understanding concept of DHIS2

• Understanding the use of DHIS2 as an integrated health information systems platform

• Knows how to customize DHIS2

DHIS2

• DHIS2 is a free and open source database and application for

collecting, processing, and analyzing health information

• Objective of DHIS2 implementation is to be able to generate, analyze

and disseminate health information to facilitate effective policy formulation, management, planning, budgeting, implementation,

monitoring and evaluation of health services and program

interventions in the health sector.

Karuri et al. 2014. DHIS2: The Tool to Improve Health Data Demand and Use in Kenya

Where is the role of DHIS2 mostly?

Essential Public Health management function

Concept of DHIS2

• Free and open source software (95% of cost is for capacity building, the rest infrastructure)

• Datawarehouse approach with data from various sources (regular reports, population data, map data)

• More likely to support health systems strengthening

• Improving data integration, rather than create new applications

• Promoting the use of data standards (data elements, indicators)

• The main benefit lies in the use of information for decision making

• Support the process flow of health data either vertically or horizontally

• Simplify scalability and sustainability of the information system

• DHIS2 is flexible according to local needs that can be controlled easily.

3 Dimension of DHIS2

• 3 dimension of DHIS 2 that describe data:

• where, related to the organisation unit

• when, related to periode of report

• what, related to data element which is collected

• All data values will at minimum have these 3 dimensions

Organization Unit Data Element Period Value

Mlati Health Center ANC Visit K4 Sept 2015 87.2%

Depok 1 Health Center ANC Visit K4 Sept 2015 91.4%

…. ….. …… ……

Data

warehouse

DHIS 2

LMIS

HR EMR

Measles under 1 year coverage by district 2006(Measles doses given to children < 1 year / total population < 1 year)

74.7

81.3 79.0 80.7

89.594.4

80.0 79.9

93.6 93.8

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Chake

Chake

District

Michew eni

District

Mkoani

District

Wete

District

Central

District

North A

District

North B

District

South

District

Urban

District

West

District

Pemba Zone Unguja Zone

District

Ann

ual m

easle

s c

overa

ge %

Data from

Mobile devises

-Data mart

-Meta data

-Visualising

tools

Dashboard

Graphs

Maps

Getting data in - Data warehousing Getting data out - Decision support

systems – ‘Business intelligence (BI)

Web Portal

Mobile

DHIS2 implementing the HMN architecture

Data

Warehouse

Paper based systems:

OPD, EPI, RCH,

other programs

Users of primary data

& data providers

Electronic

Medical

RecordsHR

Management

Logistics

& drugsMobile

reportingFinance

Users of

primary data

& data providers

Users of processed & integrated data

Integration of technologies,

systems, data & health programs

Integrated Health Information Architecture (“Horizontal integration”)

- integrating sub-systems, technologies, health services & programs

Performance

Based financing

reporting

ADX

Paper

reports

Aggregate &

indicator data

Integrated Dashboard

Integrated Data Source

Integrated Technology

TB MCH

Vaccine

IDSR

Malaria

AIDS

Others

TB

Vaccine

AIDS

Others

MCH

Malaria

IDSR

PUSKESMAS:

Programs use DHIS2,

both data use and

reporting

DISTRICT:

Integrated data

warehouse &

dashboard

Puskesmas – Health facility

PROVINCE:

Integrated data warehouse

& dashboard used by all

DHIS2

Data access

& use

DHIS2

Dashboard Integration

- District system

Integration Source of Data

DHIS : Data

warehouse

Statistical

data

Patients &

Medical records

Human Resource

records

Data transfer

To DHIS, e.g.:

#deliveries

@health centre per

month

& population data

Data transfer

DHIS, e.g.:

#midwifes

@health centre X

for periodDHIS is calculating

Indicators:

1. Deliveries per midwife

Per facility per month

2. Midwifes per population

3. Deliveries by type per

population

Integration

InteroperabilityInteroperability

Population

data

Integration of technology

Lightweight

Browser

SMS

Android app

or browser Tablet

PC/laptop

Integrate different technologies

Current DHIS2 in Indonesia

DHIS2

BPJS Kesehatan –

DHIS2 Data

Capture (Mobile)

BKKBN - Dashboard

Malaria/ Dengue

Tracker

MoH – Data Center

and Dashboard

District/Provincial Health

Office - Dashboard

University of Oslo

Universitas Gadjah

Mada

Inisiatif dan

Penelitian

Example: Yogyakarta Dashboard

Location of Hospital and Primary Health

Center

DHIS2 Implementation

1. Install and customize DHIS2 instance

2. Working on Organization Unit hierarchy (reporting/data flow)

3. Setting up data element, category and preparing indicators

4. Data sets, data entry and design data entry form

5. Data quality and validation rule

6. Pivot table and data visualizer

7. Using GIS modules

8. Dashboard, information sharing and interpretation

DHIS2 Usage Expectation

Manual/ Semi Manual

Multiple eHealth

Population Data

Individual Data

Other Data

DHIS2

Da

ta S

ou

rce

s

(Ag

gre

ga

te a

nd

In

div

idu

al)

Statistical Tools

Dashboards

Fix Format

Reporting

Secondary Data

Use

Info

rma

tio

n O

utp

uts

Datawarehouse