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  • About
    • About DHIS2
      Learn about what DHIS2 is and how it fits into the global HISP movement for strengthening health information systems
      What is DHIS2?
      • Our Vision & Partners Menu icon
        Our history, purpose, vision, and partners
      • Impact Menu icon
        Where and how DHIS2 makes a difference
      • Research Menu icon
        DHIS2 and the Health Information Systems Programme
      • Global Network Menu icon
        Our HISP network of regional DHIS2 experts
      • News & Events Menu icon
        DHIS2 updates, media, and upcoming events
      • Community Forum Menu icon
        Ask questions and share insights in our online community
      • Careers Menu icon
        Come join the DHIS2 team
      • Contact Menu icon
        Connect with us
  • Features
    • Software Features
      Discover how DHIS2 supports collection, validation, analysis, visualization, and sharing of data
      What can DHIS2 do?
      • Data Management & Analytics Menu icon
        Manage and analyze data with charts, graphs, maps, and dashboards
      • Individual Data Menu icon
        Using Tracker for individual-level / case-based data
      • Mobile Data Entry Menu icon
        Online and offline data capture with the DHIS2 Android App
      • Customizable Platform Menu icon
        Promoting adaptation and innovation with open-source technology
      • Security Menu icon
        Protecting the security and privacy of your data
      • Integration & Interoperability Menu icon
        Integrating DHIS2 with other tools and systems
      • Software Roadmap Menu icon
        Explore features and fixes in upcoming DHIS2 software releases
  • Resources
    • DHIS2 Resources
      Explore resources for starting, scaling, managing and maintaining a DHIS2 project
      How can you get started with DHIS2?
      • Downloads Menu icon
        Resources for downloading and installing DHIS2
      • Documentation Menu icon
        Guidance to help plan, implement, maintain, and use DHIS2
      • Support Menu icon
        Options for getting support for your DHIS2 project
      • Hosting Menu icon
        Resources for hosting a DHIS2 database
      • Developer Resources Menu icon
        Information on DHIS2 core software and app development
      • Demo Menu icon
        Try out DHIS2 with our interactive demo databases
      • Training Menu icon
        Develop your skills with the DHIS2 Academy
      • Trust Center Menu icon
        Learn about our security processes and principles
  • Academy
    • DHIS2 Academy
      Develop your DHIS2 skills and build the capacity of your team with DHIS2 Academies
      How can you develop DHIS2 skills?
      • Schedule Menu icon
        Upcoming Academy trainings, webinars, and events
      • Fundamentals Menu icon
        Learn the basics of DHIS2 with our free online courses
      • Level 1 Menu icon
        Develop your core skills with regional Level 1 Academies
      • Level 2 Menu icon
        Build specialized skills with international DHIS2 experts
      • In-Country Academies Menu icon
        Support for national and sub-national trainings through local partners
      • Annual Conference Menu icon
        Meet and share knowledge at our annual gathering of DHIS2 experts
      • Training Material Menu icon
        Browse our free library of training materials
  • Health
    • DHIS2 for Health
      DHIS2 is widely used as an integrated health information platform, facilitating holistic data management across programs to provide decision makers at all levels with the right data
      How does DHIS2 support health system management?
      • Disease Surveillance Menu icon
        Supporting integrated disease surveillance, early warning & response
      • Individual Records
        Recording, tracking, analyzing and reporting patient-level data
      • COVID-19 Menu icon
        Deploying DHIS2 for COVID-19 surveillance & vaccine delivery
      • Logistics Menu icon
        Integrated health logistics and stock management with DHIS2
      • Health Data Toolkit Menu icon
        Standards-based implementation toolkits for common public health use cases
      • Demo Menu icon
        Explore DHIS2 for Health with our interactive demo database
      • Impact Stories Menu icon
        Real stories about how DHIS2 makes a difference in public health
  • Logistics
    • DHIS2 for Logistics
      DHIS2 offers a platform to manage stocks and equipment at the facility or community level that can be seamlessly integrated with full-scale, upstream national logistics management information systems
      How can DHIS2 be used as an eLMIS?
      • Why use DHIS2 for eLMIS? Menu icon
        Learn why DHIS2 an efficient and cost effective eLMIS solution
      • Use Cases & Features Menu icon
        See how DHIS2-LMIS supports stock management, equipment monitoring, and more
      • Integration with eLMIS or ERP Menu icon
        Connecting DHIS2-LMIS with upstream systems for end-to-end visibility and management
      • eLMIS Sandbox Menu icon
        Explore DHIS2-LMIS features with our interactive demo
      • Impact Stories Menu icon
        Read how countries use DHIS2 to improve logistics and support better health outcomes
      • Resources & Guidance Menu icon
        Useful resources to help configure and use DHIS2 for Logistics
      • Community Forum Menu icon
        Get support and share insights in our online DHIS2-LMIS community
  • COVID-19
    • COVID-19 Response
      DHIS2 offers standardized tools that support coronavirus surveillance & vaccine delivery
      How is DHIS2 used against COVID-19?
      • Surveillance Toolkit Menu icon
        Tools to deploy DHIS2 for COVID surveillance & response
      • Vaccine Delivery Toolkit Menu icon
        Leverage DHIS2 tools to support COVID vaccine distribution
      • Digital Certificates Menu icon
        Secure vaccine and test result certificates using DHIS2 data
      • Training Material Menu icon
        Quick guides, documentation, and training material
      • Success Stories Menu icon
        Examples of innovative uses of DHIS2 for COVID-19 surveillance & vaccination
      • Support & Discussion Menu icon
        Ask questions and get support on using DHIS2 for COVID-19
  • Education
    • DHIS2 for Education
      Learn how countries can extend the DHIS2 software platform from the health sector to the education sector for the collection, analysis, visualization, and use of data from institutions of learning
      How can DHIS2 be used for education management?
      • Overview Menu icon
        Explore the key features and use cases of DHIS2 for Education
      • Projects & Partnerships Menu icon
        Learn about our collaboration with international education partners
      • Pilot Countries Menu icon
        See how countries are using DHIS2 to manage education data
      • News & Updates Menu icon
        Read updates on DHIS2 for Education projects and events
      • Impact Stories
      • Community Forum Menu icon
        Ask questions and share insights in our online community

Using DHIS2 to digitize COVID-19 response in Guinea-Bissau

With the help of DHIS2 experts, Guinea-Bissau used DHIS2 core software and custom apps to streamline clinical, lab, travel certification and vaccination processes for COVID-19

Guinea-Bissau has used DHIS2 for health information management since 2011, and it was one of the first countries to adopt the DHIS2 COVID-19 Surveillance packages shortly after their release in March 2020. This included Point of Entry screening, case investigation, and tracking of quarantined travelers and health isolation and follow-up of confirmed cases. The implementation process involved localization — especially translating the package metadata and guidance into Portuguese — and adaptation to local requirements, and was carried out with the support of Saudigitus (HISP Mozambique), the National Institute of Health, UNDP and WHO.

The decision-making process that led to the selection of DHIS2 as the national platform for COVID-19 data was not straightforward, however. In the beginning, several other options were discussed. An Excel and Access-based tool was introduced for collecting lab data, which functioned in parallel to DHIS2, leading to information being stored in silos.

The government of Guinea-Bissau appointed a high commission for COVID-19 response, and one of their key challenges was coordinating all coronavirus-related activities and information systems. Saudigitus — an established HISP group with years of experience providing DHIS2 support to the Lusophone community — was invited to participate in the review process.

Integrating lab testing data with health data is the key

Laboratory testing is a key component of COVID-19 Surveillance, and an effective response requires having a system where data on suspected coronavirus cases, their contacts, and their testing results can all be seamlessly integrated. The situation in Guinea-Bissau at the start of this review was far from seamless. Lab data was entered in Excel and stored in Access databases that were not linked to the centralized health data system, and testing results were sent back to health facilities on paper forms, where they would need to be manually entered in order to be added to the national DHIS2 COVID-19 surveillance system.

Saudigitus was asked to bridge the process gaps, and facilitate the integration of data between these different systems. The first step was to expand the DHIS2 COVID-19 system from contact tracing into the lab testing context. This was done by creating an “Index Case” app, which linked patient data stored in DHIS2 Tracker with lab results, and allowed labs and health facilities to print COVID-19 test results directly from the DHIS2 system, and simplified the process of informing both patients and health workers responsible for contact tracing of positive test results.

Challenges coming and going: Validation of negative test results, and pre-filled traveler data at Ports of Entry

The need for new tools did not stop with positive test results. Under travel restrictions introduced by the government of Guinea-Bissau, travelers were required to demonstrate that they had tested negative for COVID-19 before they could be approved for air travel. A black market for negative COVID-19 test results promptly sprang up, and due to the absence of a centralized, searchable database where results were stored, it was very difficult and time consuming for authorities to determine which results were legitimate and which were falsified. The integration of test result data into DHIS2 made this validation possible via a QR code that was included on the lab results PDF produced by the DHIS2 system, and Saudigitus developed an Android app that enabled border authorities at Ports of Entry to perform this validation electronically by scanning the QR code on their mobile devices.

Using QR codes and an Android app to validate Covid-19 test results for travelers

The next challenge Saudigitus was asked to address was how to make the COVID-19 screening process at the Ports of Entry less cumbersome. The ability to enter cases directly into DHIS2 was helpful, but even with minimal data entry and temperature checks for incoming travelers, the waiting lines at the borders and airports were getting very long. To solve this problem, they developed an app that travelers can access via a public web portal where they submit their biographical data directly into the DHIS2 system. The traveler gets a system-generated code which the health worker performing their entry screening scans into their mobile device to access the traveler’s record in DHIS2. All the health worker needs to do at that point is verify the data, enter the traveler’s temperature, cutting down the time spent on data entry per person, and thus the amount of time that all of the other travelers have to spend waiting for their turn.

Another area where long waiting times led to innovation was the queue for scheduling COVID-19 exams, since the opening of borders for travel led to a large number of people wanting to request exams at once. To help address this, Saudigitus created an online form where members of the public can submit their request for a COVID-19 test, and which uses the biographical information they submit to create a Tracker record for them in DHIS2, so that this information is already entered into the lab testing system before they arrive to be tested. This system also makes it easier for testing centers to forecast test demand, for better allocation of resources and personnel.

Guinea-Bissau’s system allows travelers to enter their data directly into DHIS2

Make it public: One portal for public access to COVID-19 services and results

Data from Guinea-Bissau’s DHIS2 system is used to populate a public COVID-19 dashboard

One key element of Guinea-Bissau’s strategy in responding to COVID-19 — and the work of Saudigitus in helping to carry this strategy out — has been the implementation of public-facing tools and resources. In Guinea-Bissau, this includes a public-facing dashboard where anyone can go online to see the current status of the COVID-19 pandemic on a national level. And this approach is especially innovative when it comes to systems like the Point of Entry registration and Lab test scheduling applications, where the information submitted by the public jumpstarts the process of creating their personal record in Tracker, and thus greatly simplifies the data entry burden for health workers, making the entire system function more efficiently. Both of these apps, plus the web form where members of the public can check their own COVID-19 test results, are accessible through one public-facing web portal.

On the COVID-19 portal, people in Guinea-Bissau can register for travel, request a test, and check test results

Deploying DHIS2 for COVID-19 vaccine delivery in Guinea-Bissau and across Lusophone Africa

Throughout the COVID-19 pandemic, Saudigitus has provided implementation support, application development, and training not only to Guinea-Bissau but also to the four other countries in the greater African Lusophone community. The systems listed above are just a few examples of their work. Additional enhancements to these systems are under development in Guinea-Bissau, such as lab results notification by SMS. As vaccines for COVID-19 have become available, Saudigitus has leveraged their local partnerships and capacity for innovation to support the deployment of DHIS2 to manage COVID-19 vaccination campaigns in Guinea-Bissau, Mozambique, Cape Verde, and São Tomé and Príncipe.

Learn more about Saudigitus on their website: https://saudigitus.org/

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