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