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Health Data Toolkit

The DHIS2 Health Data Toolkit is a collection of implementation tools and resources developed in collaboration with WHO, UNICEF, CDC and other global health partners to improve the quality and effective use of integrated health information systems at national scale.

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    About the DHIS2 Health Data Toolkit

    Developed in collaboration with WHO, UNICEF, CDC and other global health partners, the DHIS2 Health Data Toolkit is a set of curated resources for implementing DHIS2 for common public health use cases. These resources and tools are developed to support integrated health information system architectures, accelerate country implementation and improve the quality of national systems. A variety of resources include system design & configuration guides, software feature descriptions, tailored training materials, user guides, custom DHIS2 applications and reference metadata.

    The toolkit brings together WHO data standards with UiO’s evidence-based system design principles and implementation lessons to help countries leap-frog into an era of digital information at their fingertips.

    Try the Demo

    Explore our interactive demo: demos.dhis2.org/hmis

    The DHIS2 HMIS demo is tailored to promote principles for integrated health information system design and showcase data analysis products based on global guidelines and recommendations from subject matter experts. Here you can find dashboards, indicators, data entry forms, Tracker programs and custom apps in one harmonized space. Demo log-in details are available by language on the demo landing page at the link above.

    Integrated health management information systems (HMIS)

     The HISP Centre has promoted integrated, sustainable health information system (HIS) design since the inception of DHIS2 as a district-focused health information management software. As a WHO Collaborating Centre for Innovation and Implementation Research in HIS strengthening, we continue to work closely with countries and partners to learn from Ministries of Health and local innovations to develop best practices for integrated information system design. HISP Centre’s action research approach is deeply embedded in understanding data use practices and supporting data analysis and use at all levels of the health system.

    Common Metadata Library for HIS

    One key advantage of DHIS2 is that it can be used for multiple health programs, within a single, harmonized instance. There are several practical reasons to share metadata across health programs and case-based trackers or electronic registries: to reduce duplication of data entry and improve data flows, to share metadata and data between programs for improved analyses, and to to facilitate maintenance of metadata in the system.

    Common HIS metadata includes core concepts like indicator types, reusable data elements for population data, as well as a set of common Tracker metadata to re-use across case surveillance and person-centered monitoring tracker programs.

    The common HIS metadata library is the perfect jump-start to your DHIS2 implementation and can be downloaded from the Metadata Downloads page.

    Health Facility Profile

    The Health Facility Profile (HFP) is a foundational component of an integrated HMIS that reduces the duplication of expensive data collection activities, enables triangulation and use by many health system actors, and services as a complementary routine data source to comprehensive health facility services. The HFP empowers health facilities to self-report key information about service availability and readiness, fosters accessibility and utilization of facility data across health programs to optimize access to primary to healthcare services and to respond effectively and efficiently to emerging health threats.

    The HFP was developed in collaboration with the WHO’s Division of Data, Analytics and Delivery for Impact (DDI) to seamlessly integrate essential health facility attributes into the national Health Management Information System (HMIS), with support from The Global Fund. This initiative recognizes the pivotal role of health facility attributes in shaping healthcare accessibility, quality, and responsiveness, aiming to enhance the overall efficiency of the healthcare system.

    Key features include:

    • A dynamic digital questionnaire format that can be deployed at flexible intervals depending on need to collect information on:
      • Availability of services
      • Trained facility staff, by cadre
      • Availability of equipment and essential medicines
      • Facility infrastructure
      • Infection prevention & control measures
      • Preparedness for delivering healthcare services in routine or emergency circumstances
    • Standardized data elements mapped to a subset of the WHO’s Harmonized Health Facility Assessment (HHFA) questionnaire to improve monitoring of key metrics in between large-scale health facility assessment initiatives
    • Indicators and dashboards for visualizing health facility profile data, such as service availability maps and indicators for health emergency preparedness

    In addition to HFP analyses for routine planning and use in health emergencies, the data collected through the HFP are intended to populate disease programme specific indicators contained within HMIS modules such as availability of trained staff, equipment and medicines for delivering specific services.

    HMIS Modules by Health Programme: Core Indicators & Dashboards

    As part of the WHO Toolkit for Routine Health Information Systems, many WHO health programmes have developed routine data analysis guidelines and worked with the HISP Centre to develop DHIS2-based tools for integrating programme data into a national health information management system (HMIS). WHO-recommended dashboards, core indicators and corresponding DHIS2 metadata are available as a resource for countries.

    These modules are designed to facilitate and improve access and use of routine data as part of an integrated national system for better planning, resource allocation and management.

    • Dashboards and recommended data visualizations for interpreting routine data
    • Core indicators aligned to global guidelines & standards
    • Aggregate data model to feed core indicators. This can be used to develop aggregate data sets for paper-based reporting into DHIS2; or to receive aggregated data from Tracker, EMRs, surveys and other external sources.

    HMIS dashboards can be referenced on our interactive demo site. All metadata by health program is available on the Metadata Downloads page.

    Community Health

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    HIV

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    Integrated Disease Surveillance

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    Immunization

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    Malaria

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    Nutrition

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    Rehabilitation

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    RMNCAH

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    Sensory Function (eye and ear care)

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    Tuberculosis

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    Data Analysis Apps

    HISP Centre has partnered with HISP Tanzania and other groups in the development of custom DHIS2 apps for data analysis that can be installed and used in national systems to enhance core DHIS2 analytics functionality:

    Scorecard App

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    Bottleneck Analysis App

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    Action Tracker

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    Immunization Analysis App

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    Animal Health

    An estimated 60% of emerging infectious diseases originate in animals, both domestic and wildlife (WHO, 2023). The high risk of zoonotic spillover into human populations demands close collaboration, communication and coordination between animal and public health sectors.

    The DHIS2 Animal Health toolkit is designed for implementation by Ministries of Agriculture & Livestock to improve routine, systematic surveillance in animal populations. Developed in partnership with CDC and the Food and Agriculture Organization (FAO), this toolkit improves early warning and detection of diseases in animals, including zoonoses that can infect humans and cause outbreaks. DHIS2 can operate as an independent surveillance platform for Ministries of Livestock and actors working in veterinary and animal health; or it can be integrated into a DHIS2 platform alongside public health surveillance data or as part of a One Health data platform.

    Read more about DHIS2 for animal health and One Health use cases here.

    • DHIS2 resources for animal health
    • Tracker program aligned with FAO recommended metadata for reporting diseases in animals, such as clinical symptoms, laboratory results and control measures
    • DHIS2 dashboard for visualizing the distribution of potential animal health threats, species affected, and other key metrics for controlling the spread of disease
    • Downloadable metadata available

    Community Health Information Systems (CHIS)

    The CHIS toolkit for DHIS2 was developed with UNICEF and WHO to accompany the WHO Analysis and Use of Community Data: Guidance for community health service monitoring. Tools and guidance are designed to enhance community-based health programs, to monitor their impact, and to make evidence-based policy adjustments according to the real needs of the targeted communities. As the types of services that community health workers provide in communities are highly heterogeneous across countries, we provide a modular approach for countries to select indicators as relevant to national monitoring frameworks and integrate community-based health service data into the national system. CHIS dashboards and indicators are harmonized with related health facility data indicators in programme-specific HMIS modules to increase visibility, access, analysis and use of these data for health program planning. In addition, a practical implementation guide is available for national and local-decision makers involved in the design, planning, deployment, governance and scale up of successful DHIS2-based CHIS.

    Data Quality

    The Data Quality Toolkit for DHIS2 combines guidance and DHIS2-based tools to improve the quality of routine data at all levels, from the point of data entry to routine and annual data quality reviews. Minimum standards and measures for data quality follow the WHO’s Data Quality Assurance framework and incorporate best practices in DHIS2 design and configuration leveraged from 40+ countries who have implemented data quality procedures and tools in national DHIS2 systems. The toolkit leverages core DHIS2 functionality for configuring validation rules, establishing min-max values, conducting outlier analysis, comparing internal consistency, and analyzing completeness and timeliness. A custom application for facilitating annual data quality reviews using the WHO DQR framework module 4 is also available for optional installation and use.

    Integrated disease surveillance and response for notifiable and epidemic-prone diseases

    A suite of DHIS2 tools, core software functionalities and resources was developed in close collaboration with WHO World Health Emergencies, WHO AFRO, and US CDC with support from Gavi to improve the wide-scale use of DHIS2 as a national scale integrated disease surveillance platform.

    Integrated disease surveillance

    Routine indicator-based surveillance in many countries comprises both weekly aggregate reporting and case-based modalities for priority diseases, which can be altered in frequency and scope in DHIS2 during periods of outbreaks or enhanced surveillance during emergencies. DHIS2 reference metadata are aligned to WHO AFRO’s Technical Guidelines for Integrated Disease Surveillance & Response (IDSR), which has been adopted by 44 Member States. These can be adapted based on regional and country context. Dashboards bring together both aggregate and case-based reporting for triangulation and include configurable outbreak/alert thresholds. System design guides explain how to configure disease thresholds, integrate lab data into case-based surveillance and use DHIS2 functionalities for surveillance use cases.

    Mpox surveillance

    The Mpox Surveillance Toolkit is designed to integrate mpox surveillance into routine health information systems (rHMIS), allowing for comprehensive data reporting and monitoring. This toolkit supports both case-based and aggregate reporting, ensuring alignment with the latest WHO 2024 interim guidance and newest WHO CRF/CIF updates.

    Key components include:

    • Aggregate weekly dataset for Integrated Disease Surveillance (IDS)
    • Tracker for the Case Reporting Form (CRF)
    • Tracker for the Case Investigation Form (CIF)

    The metadata packages in this toolkit are designed as stand-alone modules, making it easier for stakeholders to adopt without requiring major system overhauls. The modular approach allows gradual implementation, ensuring essential surveillance components are adopted effectively, even in settings where broader systems may not yet be fully established.

    Acute Febrile Illness Surveillance

    Developed in partnership with US CDC’s Division of Global Health Protection, the DHIS2 toolkit for acute febrile illness (AFI) supports sentinel surveillance activities to complement routine surveillance and improve the detection of emerging, unknown and re-emerging disease threats.

    Entomology & Vector Control

    The DHIS2 modules for Entomology and Vector Control have been developed to support countries to improve the collection and use of entomological and vector control intervention data to inform programmatic decisions. Data and work flows vary greatly among the various entomological activities, methods and procedures. The modular approach to the toolkit allows countries to choose which modules to implement depending on programme needs. These modules have been designed with the WHO Global Malaria Programme and the WHO Neglected Tropical Diseases department to align with WHO global recommendations, standard procedures and guidance.

    Incorporating entomology and vector control data into national health information systems alongside surveillance, stock and service delivery data can improve the triangulation of programme information for better intervention planning. The Entomology & Vector Control Design Guide describes the overall conceptual design of the modules for integrating entomology and vector control data into DHIS2.

    Learn more about the use of DHIS2 for entomology and vector control activities from our joint HISP-WHO webinar.

    Insecticide Treated Nets (ITNs)

    Insecticide treated nets (ITNs) are the most widely used vector control intervention and have substantially reduced the burden of malaria in Africa in recent decades. The following DHIS2 tools are designed to support various aspects of planning, implementing and monitoring ITN distribution campaigns.

    • ITN Campaign: these tools support 1) household registration and microplanning for a mass campaign distribution; 2) real-time monitoring of campaign activities such as bednets distributed, households reached and progress toward distribution targets; and 3) integration of campaign outcome data into the national HMIS for program management. Resources
    • ITN Bioefficacy Monitoring: this tool uses the DHIS2 event data model to support data: collection for measuring bioefficacy of ITNs according to the WHO cone bioassay testing guideline. Resources

    Indoor Residual Spraying (IRS)

    Along with ITNs, Indoor Residual Spraying (IRS) is one of two malaria vector control interventions recommended by WHO for large scale deployment. The following tools are available to support IRS interventions:

    • IRS Campaign: this tool supports the integration of campaign data into the national HMIS for triangulation and programme management, such as coverage of structures and people. Resources
    • IRS Residual Efficacy Monitoring: this tool uses the DHIS2 event model to collect data for measuring IRS efficacy according to the WHO cone bioassay procedure. Resources

    Vector Breeding Site Monitoring

    Larviciding is recommended by WHO as a supplementary intervention to ITNs or IRS in areas with ongoing malaria transmission where aquatic habitats are few, fixed and findable.

    • Larviciding: this tool uses the DHIS2 Tracker data model to allow users to collect data on breeding sites (larval habitats), treatment of breeding sites with larvicides, and monitoring the effectiveness of larvicidal treatments. Resources

    HIV

    Working closely with the WHO Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, DHIS2 has developed implementation products to improve analysis and use of routine HIV data and implement electronic individual-level systems for person-centered monitoring through the cascade of HIV prevention, case detection and diagnosis, ART uptake and maintenance, and viral suppression. The following DHIS2 resources are aligned with the WHO’s Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact.

    HIV dashboards & indicators for routine monitoring & programme management

    More than 40 countries integrate recommended HIV programme management indicators and dashboards into the national DHIS2 system to improve analysis and use of routine data. At this level, data are anonymized and aggregated from various paper-based and electronic individual level systems to provide actionable insights to health stakeholders at all levels (e.g. programme managers, district health managers, policy & planning units) while safeguarding against unauthorized access to sensitive, confidential patient-level information. DHIS2 metadata for core indicators are aligned with the WHO’s corresponding Digital Adaptation Kit (DAK) resources. Data visualizations and dashboards are based on the WHO’s Analysis & use of health facility data: guidance for HIV programme managers. This module also includes support for facility reporting of HIV-related health commodities for triangulation and analysis with service delivery data.

    HIV Tracker for Person-Centered Monitoring

    The DHIS2 Tracker data model can be used to support person-centered monitoring throughout the cascade of HIV prevention interventions and case surveillance. The design of the Tracker programs promoted through this toolkit allows for individual-level data collected through DHIS2 Tracker to be mapped and exchanged as aggregated values for programme monitoring & analysis with the HIV indicators and dashboards above. Note that the DHIS2 Tracker for person-centered monitoring does not serve as the data source for all HIV indicators included in HIV module above. Additional data sources such as Spectrum estimates of PLHIV and stock data are typically required for full programmatic analysis.

    The DHIS2 Tracker tools for HIV prevention and case surveillance are aligned to the data dictionaries and indicator references published in the WHO’s corresponding Digital Adaptation Kit (DAK). Note that these tools are not designed to support all aspects of clinical care guidelines and case management contained in the DAK or to replace robust facility EMRs; however, data from EMRs can be consumed into the DHIS2 tracker model for analysis and use as part of a national registry.

    Immunization

    The World Health Organization (WHO), UNICEF, and Gavi, the Vaccine Alliance have partnered with DHIS2 to improve national immunization coverage through better data collection, analysis and use. The DHIS2 Immunization Toolkit is a modular suite of tools that support routine immunization, supplemental immunization activities, zero-dose identification and triangulation of programme data to improve interventions.

    Check our our DHIS2 immunization channel on YouTube to browse webinars and recordings (available in English and French) on the use of DHIS2 tools for immunization programmes.

    Routine immunization module for HMIS

    The routine immunization module is developed with the WHO department for Immunization, Vaccines & Biologicals with subject matter expertise from WHO AFRO’s immunization programme. The module supports analysis of key indicators for the Expanded Programme on Immunization (EPI) such as vaccine coverage, cold-chain equipment, and facility stock management. We also provide guidance on integrating new antigens such as the malaria vaccine into routine immunization data systems.

    Enhanced Dashboards & Analytics Tools

    The following tools are available as optional add-on applications for enhancing analysis and use of immunization data in DHIS2. In addition, triangulation dashboards for EPI programmes bring disease surveillance data together with routine immunization data to improve programme performance and identify immunity gaps.

    Electronic Immunization Registry (EIR)

    These tools support the digitization of national-scale immunization registries with DHIS2 Tracker. Designed for clinicians and staff at health facilities, the tool enables registration and tracking of children through the routine immunization schedule. The design is based on the WHO recommended schedule for routine immunizations for children and can be adapted to national vaccination policies, as well as for other use cases such as vaccination of health care workers and adult populations for influenza or COVID-19. The registry supports the generation of key indicators that are included in the routine immunization module for HMIS, as well as additional analyses made possible with individual level data to detect immunity gaps and delayed immunization.

    Campaigns (Supplemental Immunization Activities)

    Immunization campaigns or supplemental immunization activities (SIA) are typically run in areas with immunity gaps or low coverage rates. Such campaigns can be conducted as a response to an outbreak of a vaccine-preventable disease like meningitis, or can be targeted in areas or populations that face barriers to accessing routine health services.

    • Design & configure DHIS2 for real-time monitoring of campaigns. Resources
    • Use DHIS2 applications and functionalities to support microplanning, real-time monitoring and triangulate campaign coverage with other data sources. Resources
    • Implement DHIS2 for campaign use cases: implementation considerations for variable deployment strategies, such as offline data collection and infrastructure requirements unique to campaign use cases. Resources

    Vaccine Preventable Disease Surveillance

    The HISP Centre in partnership with WHO Health Emergencies, WHO AFRO and CDC WHO AFRO’s Technical Guidelines for Integrated Disease Surveillance & Response (IDSR). These can be adapted based on regional and country context. Dashboards bring together both aggregate and case-based reporting for triangulation and include configurable outbreak/alert thresholds. System design guides explain how to configure disease thresholds, integrate lab data into case-based surveillance and use DHIS2 functionalities for surveillance use cases.

    Epidemic-prone Diseases: Mpox

    Designed in collaboration with Gavi and WHO, this Mpox toolkit leverages extensive feedback from the HISP network and partner countries. It offers a flexible, scalable solution for integrating Mpox vaccination into existing health systems or introducing it in epidemic contexts. The toolkit’s adaptable structure can support other vaccines like Ebola, ensuring its utility in broader public health responses while maintaining essential functionality for epidemic-prone diseases.

    Adverse Events Following Immunization

    DHIS2 Tracker can be used to support the notification, reporting, investigation and analysis of adverse events following immunization. This tool is ideal for countries that already manage their immunization programme data in DHIS2, and can streamline reporting from the lowest levels of the health system and triangulate with other programme data, including immunization registry data. The tool incorporates WHO recommended core variables for AEFI reporting and can be used to generate data for reporting into WHO’s global system for pharmacological surveillance, VigiBase.

    Malaria

    The malaria toolkit for DHIS2 is developed in partnership with the WHO Global Malaria Programme (GMP) to support a broad range of data management functions, from routine case surveillance and service delivery to monitoring availability of health facility commodities and preventative interventions. These tools support data collection from public and private facilities as well as community health workers to provide a comprehensive picture for malaria programme managers and sub-national health staff.

    Various modules and tools can be selected and adapted by countries according to the interventions they deploy based on malaria transmission and other factors. The tools support countries to deploy appropriate interventions and monitoring systems according to sub-national stratification in both burden reduction and elimination settings. The toolkit is a part of WHO GMP’s recommended digital solutions for malaria, designed to support the recommendations within GMP’s consolidated Guidelines for Malaria (2023).

    Malaria Module for HMIS

    The malaria module for HMIS supports routine reporting and analysis of service delivery, treatment, and other activities such as continuous bed-net distribution from public facilities, private facilities and community health workers. Datasets and indicators for burden reduction and elimination settings can be selectively deployed at sub-national level according to stratification. The module also includes a Data Quality dashboard for malaria programmes, district-level dashboards, and analyses for triangulating facility stock data with service delivery data. As part of an integrated HMIS, new interventions such as the malaria vaccine are also supported in DHIS2 as part of an integrated immunization module and can be triangulated with routine malaria surveillance data.

    Malaria Surveillance in Elimination Settings

    DHIS2-based tools help to transform surveillance into a core malaria intervention and accelerate country progress toward elimination. These tools support countries to implement key recommendations contained in the WHO’s Malaria Surveillance, Monitoring & evaluation: a reference manual (2018) in elimination-targeted geographies. The DHIS2 Tracker model allows for case notification, investigation & classification to identify local transmission and prevent re-introduction in areas where malaria is already eliminated. The foci investigation tracker enables surveillance staff to identify, investigate, map and classify foci based on malaria transmission as well as conduct and monitor foci response activities. The design allows for cases to be linked to foci and analyzed on a map; and optimizes decentralized workflows where data collection and reporting may be carried out by numerous actors at health facility, district surveillance officer or national program level.

    These tools were developed with support from the Global Fund and the Bill & Melinda Gates Foundation, with technical leadership provided by the WHO Global Malaria Programme and inputs from the Digital Solutions for Malaria Elimination Community of Practice.

    Vector Control for Malaria Programmes

    Tools for entomology and vector control activities such as ITN and IRS campaigns are included in the section Entomology & Vector Control. Many of these tools support the integration of key entomological and vector control data into a national HMIS for triangulation with service delivery and surveillance data for improving programme management.

    Improve mortality data and strengthen national CRVS

    Mortality surveillance is a critical intervention for helping Ministries of Health understand the leading causes of death among their populations and make strategic decisions about planning and resource allocation. DHIS2 also supports the strengthening of national CRVS systems by facilitating birth and death notifications from health facilities.

    Cause of Death Reporting & Analysis

    The ICD-11 Cause of Death tool uses the DHIS2 Tracker data model and a custom DHIS2 web application to facilitate digitizing the WHO’s standard Medical Certificate of the Cause of Death (MCCOD) in a national DHIS2 system, facilitate ICD-11 coding for the underlying cause of death, and provide advanced analytics. The application supports interoperability with the WHO ICD-11 API and WHO’s DORIS coding tool to automate the selection of the underlying cause of death based on the data reported, assign and store the appropriate ICD-11 code in DHIS2.

    Countries that have not yet transitioned to ICD-11 can take advantage of the following resources for incorporating the MCCOD reporting form in DHIS2, exporting cause of death data to the WHO’s Anacod format for analysis, and where applicable use DHIS2 program rules engine to assign a cause of death based on ICD-10 Start-up Mortality List (SMoL). The core metadata captured in this DHIS2 tracker program is the same as the data collected through the ICD-11 custom application to ease the transition to ICD-11 when countries are ready.

    Rapid Mortality Surveillance

    The Rapid Mortality Surveillance (RMS) tool uses the DHIS2 event data model (tracker program without registration) to record anonymous, line-listed fact-of-death reporting from communities and health facilities. Combined with historical data on total deaths (captured in the HMIS, or modeled and imported from), RMS provides powerful analyses for calculating excess deaths and understanding the true impact of epidemics such as COVID-19 in near real-time – even in the absence of complete cause of death reporting.

    This tool is aligned with the WHO’s Technical Package for Rapid Mortality Surveillance and Epidemic Response (2020) and was developed with support from US CDC.

    Vital Events Notification

    Vital Events notification expands coverage of the reporting of vital events from health facilities such as birth, stillbirths, and death to the national CRVS. When implemented in DHIS2 using the Tracker data model, health facilities can send notifications to relevant CRVS stakeholders for registration or can exchange data with electronic CRVS systems. Notifications are not intended to replace the official national CRVS or the legal framework of implementing countries, but it is expected to improve and strengthen reporting of births and deaths. In turn, strong CRVS systems often provide key denominator data for many health performance indicators in the HMIS such as vaccination coverage.

    The DHIS2 Vital Events Notification tool was developed with UNICEF in support of Health Sector Contributions Towards Improving The Civil Registration of Births and Deaths in Low-Income Countries with support from Gavi.

    Non-communicable diseases

    Noncommunicable diseases (NCDs), including heart disease, stroke, cancer, diabetes and chronic lung disease, are responsible for 74% of all deaths worldwide. More than three-quarters of all NCD deaths occur in low- and middle-income countries (WHO). Due to the breadth of non-communicable disease conditions, leveraging DHIS2 as an integrated national health information system from primary care to tertiary care levels enables countries to monitor in near real-time the burden and distribution of NCDs while reducing the duplication of data collection and enabling analysis of co-morbidities with other health conditions.

    For additional non-communicable disease topics, see the Rehabilitation and Sensory, Vision & Hearing topics on this page.

    Hypertension

    An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries. Yet, only 1 in 5 adults (21%) with hypertension have their blood pressure under control (WHO, 2021). To help countries implement broad-scale hypertension screening and control programs, DHIS2 partnered with Resolve to Save Lives, WHO, Federal Ministry of Health Nigeria and HISP Nigeria to develop a point-of-care tool for rapidly registering hypertension patients and allowing for follow-up over time. The longitudinal data model generates key metrics for monitoring blood pressure control and is designed to populate DHIS2 dashboards as part of a national integrated HMIS. Based on the DHIS2 Tracker data model and using the DHIS2 Android app, this tool is available as a global resource for local adaptation and use.

    Implementation in more than 100 high volume facilities in Nigeria reduced waiting time for follow-up visits to under 30 seconds; use of DHIS2 working lists re-linked 1,222 people (69%) of patients back to care; and helped to increased the number of diagnosed patients by more than 50% compared to the year prior to the digital intervention

    Nutrition

    Monitoring nutrition outcomes includes routine data collection from facilities and community-based interventions, as well as mass event activities (such as Vitamin A supplement campaigns). A metadata package was developed in collaboration with UNICEF and is intended as a practical tool to accompany UNICEF’s nutrition information systems guidelines to support the uptake of standard nutrition indicators and analyses in national DHIS2 systems. The package covers the following health interventions: vitamin A/IFA supplementation, infant and young child feeding, maternal counseling, growth monitoring & promotion, and wasting. Dashboards are designed to facilitate analysis of nutrition indicators from health facilities and community-based interventions, with further guidance provided on how to triangulate these data with components of the joint UNICEF/WHO CHIS package for monitoring community health workers interventions.

    Rehabilitation

    In response to a global call to action to increase access to rehabilitation as an essential health service through an integrated health system strengthening approach, HISP Centre has worked with the WHO Rehabilitation Division to develop DHIS2 resources for incorporating core strategic and operational metrics into national systems. WHO indicators based on routine facility data help programme planners and policy makers are incorporated into DHIS2 dashboards. DHIS2. An HMIS module has been developed in support of the Rehabilitation 2030 initiative.

    Reproductive, maternal, neonatal, child & adolescent health

    Based on WHO guidelines for the analysis and use of health facility data for RMNCAH programme managers, a collection of DHIS2 resources and metadata are available to facilitate the integration of routine facility data into a national HMIS for monitoring reproductive, maternal, neonatal, child and adolescent health.

    RMNCAH dashboards & indicators for analysis of facility data

    DHIS2 dashboards and core indicators support WHO-recommended data visualizations and interpretation guidance and can be used by national programmes as well as district and sub-national staff. Use of the module can be optimized by training staff to interpret indicator values and understand their implications for RMNCAH programme management as described in the WHO guidance document.

    Antenatal Care (ANC) Registry

    DHIS2 Tracker can be used as an electronic antenatal care (ANC) registry to facilitate person-centered monitoring and individualized follow-up of pregnant women through the cascade of primary health care services. HISP Centre in partnership with the Norwegian Institute of Public Health designed and published a DHIS2 Tracker-based ANC registry as a reference implementation to demonstrate how countries can incorporate data standards from the WHO Digital Adaptation Kit (DAK) for Antenatal Care into national DHIS2 systems. The DAK provides a comprehensive list of data elements for various services and stages in a typical ANC program, as well as nine indicators. We also recommend users to refer to the DAK documentation and Web Annexes for a broader conceptual understanding of this use case.

    The DHIS2 Tracker adaptation of the ANC DAK was developed in collaboration with the Makerere University School of Public Health, Norwegian Institute of Public Health, HISP Uganda, and the University of Bergen. The configuration uses a subset of the recommended ANC DAK data dictionary based on contextualization within a routine system through the joint research project, adheres to the core indicator definitions in the DAK and adds a suite of dashboard visualizations developed jointly with system users in Uganda.

    Sensory functions (ear & eye care)

    The global need for eye and ear care is projected to increase dramatically in the coming decades associated with demographic, behavioral and lifestyle trends. The World report on vision and World report on hearing recommend to strengthen national routine health information systems to monitor morbidity trends, track progress toward national programme objectives, and estimate service utilization, quality, and coverage for improved decision-making at all levels for health policy, management, and clinical care guidance.

    DHIS2 resources are available for national programmes to integrate routine ear and eye care indicators into DHIS2, aligned with the WHO’s Guidance on the Analysis & Use of routine health information systems: ear and eye care module. Reference dashboards are provided to demonstrate how routine data can be visualized in DHIS2 to provide timely insights for health programme staff.

    Tuberculosis (TB)

    The tuberculosis (TB) toolkit for DHIS2 is developed in partnership with the WHO Global Tuberculosis Programme (GTP). A modular set of resources is available for national TB programmes and HMIS teams to incorporate the WHO’s recommended reporting framework and dashboard analyses for case notification, laboratory results, treatment outcomes, indicators on comorbidity of TB in HIV patients, and prevention activities. Individual-level tools using DHIS2 Tracker are available for digitizing TB case surveillance and conducting sample-based anti-TB drug resistance surveys according to GTP protocols. This toolkit is made possible by support from The Global Fund.

    TB Module for HMIS

    The TB module for HMIS supports routine reporting and analysis of case notification, diagnostic and laboratory data, treatment outcomes, indicators on comorbidity of TB in HIV patients, and prevention activities like screening of household contacts. The module also includes a Data Quality dashboard for TB programmes, district-level dashboards, and analyses for triangulating facility stock data and lab data with service delivery data to improve programme management.

    TB Case Surveillance

    For countries seeking to digitize individual-level case surveillance activities, the DHIS2 TB Case Surveillance tracker provides a high-quality design that is aligned to the WHO Global TB Programme’s guidelines and recommendations. The TB Case Surveillance tracker is intended for implementation alongside the TB HMIS modules, providing a tool for individual level data collection that can populate core TB programme monitoring indicators and dashboard analyses. The electronic tracker improves the ability of programme’s to link laboratory data to case notifications and monitor a given case through its outcome.

    Anti-tuberculosis drug resistance survey

    The TB DRS Module in DHIS2 is a data collection tool designed specifically for anti-tuberculosis (TB) drug resistance surveys (DRS), which are discrete studies measuring drug resistance among a selected sample of individuals who are representative of an entire population with TB. Surveys are implemented periodically until capacity for a continuous routine surveillance system is established. The TB DRS module allows countries to fully configure the survey data capture tool, by specifying the study design and the laboratory algorithm used for identification and speciation of TB, and phenotypic and/or genotypic resistance profiling to anti-TB drugs. This module can be implemented in addition to the TB case-based surveillance tracker with guidance provided by the WHO publication on electronic recording and reporting for tuberculosis care and control.

    Monitoring Impact of Health Emergencies on TB Programmes

    In early 2021, a new partnership between the Robert Koch Institute (RKI), the West and Central African network for TB Research (WARN/CARN TB), the Special Programme for Research and Training in Tropical Diseases (TDR) and the Global TB Programme at WHO was established to strengthen the capacity of national TB programmes (NTPs) in West and Central Africa to monitor and mitigate the impact of COVID-19 and future Public Health Emergencies (PHEs) on TB service provision.

    As a result, an impact assessment framework has been developed which outlines a common methodology to monitor and evaluate the impact of COVID-19 and future PHE on TB service provision across different epidemiological and process indicators. The framework is designed to strengthen routine TB surveillance by NTPs and to facilitate the identification and implementation of appropriate mitigation strategies to ensure the continued functionality of TB services during periods of significant disruption.

    The DHIS2 TB – COVID-19 Impact Assessment package has been designed to identify the core activities undertaken by TB programmes and to conduct a risk assessment with hypotheses about the potential points of disruption due to COVID-19 or other future PHEs and their consequences. For each possible disruption, one or more indicators have been developed to enable the measurement and monitoring of the potential impact of COVID-19.

    DHIS2 reference metadata

    To support the uptake of data standards, DHIS2 offers downloadable metadata packages for a variety of health programs and interventions. We partner with the WHO, UNICEF and other subject matter experts to incorporate global data standards into DHIS2 reference metadata. Metadata packages can be downloaded, referenced, edited, and customized according to country requirements. In general, metadata packages are not intended to be installed and used as-is into an existing country system. Rather, the metadata files and related resources can be used to quickly create demos in a country development environment, as a reference to edit missing metadata, indicators or data visualizations identified by country system stakeholders for inclusion in the national system, or as a baseline configuration for further development based on country-specific requirements.

    On the Metadata Downloads page, you can find downloadable .json files of DHIS2 metadata. These are typically grouped by health program area and interventions.

    • Dashboard packages: these include preconfigured dashboard visualizations based on indicators; the indicators are intentionally blank (not configured to data elements and category combinations) to facilitate mapping of indicators to existing DHIS2 metadata in a country system.
    • Aggregate domain metadata metadata packages: these typically correspond to dashboard packages and include dashboards as above, as well as fully pre-configured indicators complete with underlying data elements and category combinations required to populate them.
    • Tracker domain metadata: these packages contain Tracker programs and their metadata (data elements, option sets, example program indicators, etc).

    The downloadable package files also include an Excel-based metadata reference file and installation guide. Some metadata downloads contain multiple .json files to ease the selection and editing of the file (for example, to divide malaria HMIS indicators into groupings for burden reduction and elimination settings).