The Dawn of a New IT Era
The genesis of the modern national health information and surveillance system can be traced to the adoption of the DHIS-1.4 in 2010. This intervention assisted in strengthening the MoHCC national Health Information and Surveillance System (HISS). The system was piloted in Mashonaland Central Province from February-April 2010 and rolled out nationally in August 2010.
The introduction of DHIS-1.4 resulted in a remarkable improvement in the completeness of the reporting system but timeliness remained a major challenge, an issue being addressed with the implementation of DHIS-2 in 2013.
With funding from the Centre for Disease Control (CDC) and technical assistance provided by Research Triangle International (RTI), the health ministry in the first quarter of 2013 successfully piloted DHIS-2 in the Manicaland province. The lessons learnt from the pilot were used to inform the national rollout to all central, municipal, provincial, district, mission and rural hospitals in the country.
Working in collaboration with the MoHCC and other development partners, the Global Fund played a key role in supporting the introduction of the new system. Through UNDP, the Global Fund provided additional funding of US $2.7m. This was crucial in addressing the funding gap for the national rollout in 2013 and ensuring that implementation was not delayed.
This support facilitated the procurement of 309 laptops and training of health workers on the new system. Enhancing the skills and capacities of core staff, two female ministry staff were sponsored by Global Fund to undertake advanced training in India on Routine Health Information System (RHIS). Having RHIS skills is very important at all levels of the health services because improved health information is directly linked to good management and service delivery.
Subsequently, all key health workers at sites where DHIS-2 has been installed have since been trained accordingly.
Meanwhile, to ensure that all health facilities countrywide are fully covered, the MoHCC scheduled a planning and review meeting with all stakeholders in January 2014. Going forward, a 3-year (2014-2016) action plan is being developed to further guide the rollout of DHIS-2 to the health facility level.
In addition, funding from the Global Fund enabled the University of Oslo, Norway, to provide technical assistance to the MoHCC in the implementation of DHIS-2. And with the inclusion of in-patient dataset in the DHIS-2, health workers in admitting hospitals have also been trained in International Classification of Diseases (ICD-10) coding concepts to equip them in .relevant skills.
The DHIS-2 software is used in more than 30 countries in Africa, Asia, Latin America and the South Pacific. In Africa, other countries that have successfully adopted the new system are Kenya, Tanzania, Uganda, Rwanda, Ghana and Liberia.