INDUSTRY WATCH
E
Health Systems Africa (eHA)
is focused on improving
healthcare in northern
Nigeria by creating effective ways to
implement reliable health information
management systems; utilising
appropriate technology to design,
implement and manage health
projects, specialising in geographic
information systems (GIS), software
development and monitoring,
evaluation and research.
The latest development introduced by
eHA is the Electronic Integrated Disease
Surveillance and Response (eIDSR) app,
designed to strengthen the surveillance
for all priority reportable diseases and
to improve preparedness for potential
public health emergencies. The app
was designed in collaboration with
Sierra Leone’s Ministry of Health and
Sanitation (MoHS), the Centre for
Disease Control and Prevention (CDC)
and the World Health Organisation
(WHO), amongst others.
The app was built in-house by local
Sierra Leone and international eHealth
Africa software developers, building
on existing District Health Information
Software. The purpose of the eIDSR
app was to reduce the frequency of the
errors, which are prevalent in paper-
based reporting and during the process
of transferring data from one platform
to another. This solution enables the
entire health system to accurately
record and share health information.
The electronic systems can capture
IDSR data on any device, including
desktops, laptops, tablets and
smartphones. The application is based
on the code of the data capture for
DHIS2 (District Health Information
System 2), an interoperable, web-based
open-source information system. DHIS2
is housed in the MoHS server and is
managed by the MoHS Directorate of
Policy, Planning Information.
A key priority when developing the app
was leveraging the DHIS2 infrastructure
as much possible, but the modular
architecture of DHIS2 was utilised for
creating custom code where region-
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INTELLIGENTCIO
specific limitations existed.
Software Project Manager, Les
de Wit, explains: “For the project
to be successful there was a
focus on two key innovations:
the user interface (UI) and the
data transfer. The intuitive and
clear user interface allows even
low-literacy users with no prior
smartphone experience to quickly
learn the report submission
process. The app interface was
also adjusted to resemble the
paper form the health workers at
the facilities are used to. This leads
to faster data entry and therefore
timely submissions.
WEEKLY DISEASE
REPORTING HAS
IMPROVED FROM
OCCURRING IN 35%
OF SIERRA LEONEAN
HEALTH FACILITIES, TO 96%. THIS NEW DISEASE
REPORTING SYSTEM HAS ALSO CUT THE NUMBER
OF DATA ENTRY ERRORS IN HALF AND VERIFIES
DATA 60% FASTER THAN THE PREVIOUS PAPER-
BASED REPORTING SYSTEM.
“An additional step to ensure health
facilities submit correct data includes
a warning and confirmation when an
unusual report is entered – for example,
more deaths than cases for a disease
in the same week, or reported cases for
rare but highly relevant diseases.”
Other technical mechanisms also
help users to avoid data entry
mistakes, these include:
•
•
•
Mandatory completion: the
forms can’t be submitted until all
areas of the form are completed
Validation: a prompt is provided
to verify every entry for the
immediate reportable diseases
A practice app: each device was
designed with a practice eIDSR
app that HCWs can use to gain
skills without fear of submitting an
actual report
The current solution has been
specifically tailored for the Sierra
Leone context and the reality is that
many health facilities exist in a low
connectivity environment. In order
to overcome this, the data transfer
innovation allows the application to
submit the report via SMS if there
is no or poor Internet connectivity.
The user always submits the report
the same way using the form of the
mobile application. If the application
detects that there is insufficient
connectivity for data submission via the
Internet, the application automatically
switches to SMS submission in the
background. The user is not affected
by this; the only visible difference is
that the confirmation for successful
submission will indicate that it was
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