DHIS overview
Background of DHIS
The Open Source Software developed by HISP is called the District Health Information Software (DHIS) because the key issue in South Africa after apartheid was to integrate the various types of data and reporting from different health programs within the District Health system. South Africa had a very fragmented and vertical health structure where all health programs had their own reporting structures and district and province management had problems in integrating the various flows of information and get the necessary overview. The solution was to establish a district database where data from all facilities (health centres, hospitals, clinics etc.) and health programs (e.g. mother and child health, immunisation) were managed. Managers could then get comprehensive reports correlating data from various sources. Demographic data (census) and data about infrastructure (e.g. number of beds, equipment) and personnel (number of doctors, nurses etc.) were also included. An indicator engine (module) makes it possible to combine and correlate different types of data into indicators; immunisation coverage (number of e.g. vaccines/target population), average length of stay (in-patient days/discharges), bed-occupancy (in-patient days/ beds), resources per population (e.g. doctors per population, beds per population) etc.
The possibility to combine all kinds of data from the health services, population, infrastructure etc. has shown very useful in South Africa and has enhanced management, planning and monitoring activities at the various levels of administration; from hospital management up to provincial management. While in South Africa the approach in the beginning was rather general (get the minimum essential data from all areas), now, as the organisations have learned more about how databases and information can be used, much more specialised approaches are also followed. For example; budget allocation to all hospitals in South Africa is now done based on a particular set of data reported through the DHIS where targets are compared with performance (e.g. in-patient days, bed-occupancy, average length of stay, resource utilisation, budget follow-up). Nutrition exemplifies another area where a specific set of data is reported organisation learns to manage database technology and appropriate approaches; they invent new ways of using the technology.
The rationale for developing DHIS 2.0
The rationale for developing DHIS 2.0 is to develop a platform independent and web-enabled version of the DHIS. The DHIS 1.3, an MS Access based application, was developed 8 years ago in Cape Town South Africa and has been continuously improved since then. Another version of the DHIS, the version 1.4 is also in development and it's important to understand that the decision to base version 1.4 to some extent on MS Access was triggered by the need to design and implement major innovations that have gradually emerged over the last 5-6 years, WITHOUT simultaneously have to deal with a major technology shift. So 1.4 will largely drive the conceptual development of the DHIS the next year while version 2.0 will focus more on implementing all those new designs and concepts in a new (Java-based) framework. DHIS 2.0 in turn will probably enable and trigger another round of mainly conceptual development towards version 3.0 and so on and so forth.
DHIS 2.0
The DHIS 2.0 can be regarded as a hybrid application suite that should cater for at least three main needs:
- The need to rapidly design data collection tools for a variety of purposes.
- The need to efficiently capture or import/collate this variety of data in an "integrated" manner, then to monitor the processing and flow of this data, and finally to communicate with various stakeholders in the process (re our recent discussions around SMS/WAP).
- The need to analyse relatively large and complicated data sets quickly and efficiently.
Another way of saying the same is that the term "hybrid" denotes that the
DHIS actually needs to combine the typical properties of a flexible TRANSACTION database with the typical properties of a DATA WAREHOUSE and some properties of a COMMUNICATION TOOL.
BASIC OVERVIEW OF THE DESIGN:
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