1.7. Roll out

The roll out process is traditionally associated with installation and basic training of the system. It is, however, useful to consider it as a more comprehensive process involving multiple phases.

The first phase corresponds to the traditional activities where the first objective is about data completeness: To ensure that close to 100% of the data is being collected. First this implies that the system should be implemented and used at all districts in the country. Second it implies that data for all data elements included in the forms are actually reported by the districts or facilities. Data being reported within a reasonable time frame - timeliness - is also relevant in this context.

The second objective is related to data quality: To ensure that data capture errors are reduced to a minimum. Several measures should be effected to achieve this: First data entry and data review should be done by skilled personnel. Second automatic data evaluation methods such as logical validation rules and outlier analysis should be applied to the data.

The second phase is about enabling district and hospital officers to use standard analysis tools such as reports, charts an pivot tables. Users should be able to find and execute those tools with relevant data. This must be followed by a basic understanding of the purpose, meaning and consequences of those tools and of the data being analyzed.

The third phase involves data usage: Regular use of data analysis to improve evaluation, planning and monitoring of health activities at all levels. Data from the information system should be used to evaluate the effects of implemented measures by looking at key indicators. That learning should later be used to make informed decisions on future planning. For instance when low immunization rates are discovered through an immunization report coming from the information system an outreach vaccination campaign could be effectuated. The effects of the campaign could then be monitored and evaluated based on up-to-date reports and informed decisions made on whether to intensify or wind down. The system could later provide information regarding what quantity of vaccine doses which must be ordered from the supplier.

To accommodate for large-scale roll out processes a detailed plan must be made for training and follow-up as covering all districts in a country represents a logistical challenge in terms of workshop venues, trainers, participants, equipment and hardware. To speed up the process several teams could give parallel trainings.