For the complete DHIS2 documentation index, see llms.txt.

RMNCAH Digital Data Package Aggregate System Design¶

Introduction¶

This document describes the conceptual system design in DHIS2 for the Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) configuration package for aggregate reporting. The package is designed to facilitate the capture and analysis of a core set of indicators through routine health management information systems (HMIS) as described in the WHO Analysis and Use of Health Facility Data Guidance for RMNCAH Programme Managers (last updated October 2019).

The RMNCAH package includes two main components:

Aggregate data reporting component (data set, data elements, category combinations for required disaggregation, etc).
Dashboard component: focusing on how the data collection part of the configuration has been designed in DHIS2 (i.e. data sets and data elements).

This document is intended for use by DHIS2 implementers at country and regional level to be able to support implementation and localisation of the configuration package while adhering to the design principles set forth.

Overview¶

The RMNCAH configuration package for aggregate reporting contains the following datasets for entering input data:

Name	Periodicity	Purpose
RMNCAH	Monthly	Reporting of health facility data related to reproductive, maternal, newborn, child and adolescent health

Data set structure and design¶

This section will present the main sections (tables) of the immunisation dataset (reporting forms), explaining their configuration.

Antenatal Care 1^st Visit¶

This section has been configured with data elements using a disaggregation for age (10-14 yrs, 15-19 yrs, 20+ yrs); the total is summarised automatically during data entry
In analysis, this allows us to quickly add in the breakdown of ANC visits by age and pivot them as required.

Maternal Health¶

Delivery by Age¶

Data elements contain age disaggregation; the total is summarised automatically.

Delivery: Live & Still births¶

The inclusion of ‘population live births’ and ‘live births in facility’ provide denominators for core coverage indicators, such as PNC coverage.

Postpartum care¶

This section has been configured as individual data elements. No disaggregations are required here.

Family planning by age & sex¶

This section has been configured with data elements using a disaggregation for sex (M/F) and age (10-14 yrs, 15-19 yrs, 20+ yrs); the total is summarised automatically during data entry
In analysis, this allows us to quickly add in the breakdown of first-time family planning use by age & sex and pivot them as required.

Family planning by method¶

This section enables data entry for first-time FP planning users by method; and Postpartum FP use by method

Sexual & Reproductive Health¶

This section enables data entry for generating Couple Years of Protection indicator, which uses a denominator (population female 15-29 years) and units of contraception
This section has been configured as individual data elements. No disaggregations are required here.

Child Health¶

Data elements in this section use an age disaggregation (0-4, 5-9). The total is summed automatically in data entry and can also be used in the analytics.

Mortality: Maternal¶

This section has been configured with data elements using a disaggregation for age (10-14 yrs, 15-19 yrs, 20+ yrs); the total is summarized automatically during data entry
In analysis, this allows us to quickly add in the breakdown of maternal mortality by age and pivot them as required.

Mortality: Death Reviews Maternal & Perinatal¶

Mortality: Neonatal¶

This section has been configured as individual data elements. No disaggregations are required here.

Mortality: Child¶

Data elements in this section use an age disaggregation (0-4, 5-9). The total is summed automatically in data entry and can also be used in the analytics.

Mortality: Adolescent¶

This section consists of a single data element with disaggregation by sex (Male/Female) and Age (10-14, 15-19). The total is summed automatically in data entry and can also be used in the analytics.

Data elements from other health areas¶

The following data elements are included in RMNCAH dataset; however, these are generally captured through routine monthly facility datasets for other programmes/health areas such as Malaria and EPI (immunization). During implementation, it is recommended to map the following data elements to existing datasets in the HMIS for other programmes/health areas. If these data are already being captured in another source (e.g. DHIS2 data set), they should be removed from the RMNACH data set to reduce duplicate data capture and mitigate data quality errors.

Data Element Name	Data Element UID	Related Dataset Name	Related Data Set UID
EPI - TT 2 doses given	KKTW2h1CzRK	Immunization	jqSaKxtj8IA
HIV - ANC clients tested for HIV	DYpD9YKSmmb	HIV Monthly	XvcWsuHBsGA
HIV - ANC clients tested positive for HIV	krrsaGDzb17	HIV Monthly	XvcWsuHBsGA
HIV - ANC clients with known HIV positive status	xCZ83jjG3pU	HIV Monthly	XvcWsuHBsGA
MAL - ACTs courses received by patients	l7gcisIvTBN	Malaria burden reduction	O34y2Kyxx6P
MAL - SP course received for IPTp (1^st dose)	vCwegNjEuxN	Malaria burden reduction	O34y2Kyxx6P
MAL - SP course received for IPTp (3^rd dose)	SPhiBDEbG0o	Malaria burden reduction	O34y2Kyxx6P
MAL - Total malaria cases (confirmed + presumed)	kRasaq1REFp	Malaria burden reduction	O34y2Kyxx6P
TB - New and relapse TB cases by age and sex	tr0lVojK425	TB case notification	OyutuMOPgkt

Validation Rules¶

The following validations rules have been configured and enforced in the system.

All these validation rules have been created, they can be enforced in the system and run once all the data has been captured. A typical example is the validation rule for ANC 1^st visit (20+ years) against ANC 1^st visit before 12 weeks (20+ years).

Essentially, we cannot report ANC 1^st visit (20+ years) before 12 weeks more than ANC 1^st visit (20+ years). Here ANC 1^st visit (20+years) before 12 weeks=103 and ANC 1^st visit (20+years)=100 and therefore we see a violation flagged.

This can be easily corrected for erroneous entries and the validation is passed otherwise, this violation will be logged in the system for future validation rule analysis. Depending on the dataset configuration, form completion can be disallowed until all the validations failures are addressed. This same logic should apply to all these rules if they are enforced in the system.

RMNCAH Outputs¶

The RMNCAH outputs included in the aggregate package include:

Indicators
Aligned to core indicator list contained in WHO Health Facility Data Analysis Guide for RMNCAH Programme Managers
Analytical outputs
Charts
Pivot Tables
Maps
Dashboard
Aligned to Figures 4-18 in WHO Health Facility Data Analysis Guide for RMNCAH Programme Managers, which provides example data visualizations and interpretation guidance

Dashboard¶

Dashboard items (charts and pivot table) are aligned to the WHO Analysis and Use of Health Facility Data Guidance for RMNCAH Programme Managers.

Indicators¶

RMNCAH-specific indicators contain the prefix ‘RMNCAH’. Some indicators used by RMNCAH programme managers for analysis are captured by other health programmes, such as malaria, HIV or immunisation. In these cases, the indicators retain the prefix from the vertical health program that generally captured the indicator. For example, immunisation coverage is ‘borrowed’ from the EPI programme package and indicators that are part of the core RMNCAH indicator list retain their ‘EPI’ prefixes:

All Core Facility Indicators included in the WHO Analysis and Use of Health Facility Data Guidance for RMNCAH Programme Managers are included in an Indicator Group with the dashboard package, even those that are not necessarily represented in the dashboard. This allows data users of the dashboard package to carry out additional analysis in DHIS2, such as referencing other indicators when investigating issues or questions that arise out of reviewing the dashboard.

Indicator Groups¶

The following indicator groups have been configured as part of the package:

RMNCAH: includes all RMNCAH indicators configured for the package
RMNCAH - Childhood and Young Adolescence
RMNCAH - Maternal and Newborn Health: includes indicators related to ANC, delivery, stillbirth, etc.
RMNCAH - Mortality: includes indicators related to adolescent, child, neonatal, and maternal deaths
RMNCAH - Postnatal: includes indicators related to PNC visits for mother, child, and documented birthweight
RMNCAH - Sexual and reproductive health: includes indicators related to contraception use, postpartum care, couple year protection, and cervical cancer screening coverage

A detailed overview of these items, including their names and descriptions, can be found in the metadata reference guide.

References¶

WHO Analysis and Use of Health Facility Data Guidance for RMNCAH Programme Managers (October 2019)
WHO toolkit for analysis and use of health facility data, accessed at: https://www.who.int/healthinfo/tools_data_analysis_routine_facility/en/

Acknowledgements¶

The WHO RMNCAH digital data package for DHIS2 was designed in collaboration with the World Health Organisation, UNICEF, Norwegian Institute of Public Health and University of Oslo Health Information Systems Programme.

Name	Operator	Instruction	Left Side description	Right Side description
RMNCAH ANC 1^st visit 10-14years >= ANC 1^st visit 10-14years before 12weeks	greater_than_or_equal_to	ANC 1^st visit (10-14years) should be greater than or equal to ANC 1^st visit (10-14years) before 12weeks	ANC 1^st Visit (10-14years)	ANC 1^st visit (10-14years) before 12weeks
RMNCAH ANC 1^st visit 15-19years >= ANC 1^st visit 15-19years before 12weeks	greater_than_or_equal_to	ANC 1^st visit (15-19years) should be greater than or equal to ANC 1^st visit (15-19years) before 12weeks.	ANC 1^st Visit (15-19years)	ANC 1^st visit (15-19years) before 12weeks
RMNCAH ANC 1^st visit 20+ years >= ANC 1^st visit 20+ years before 12weeks	greater_than_or_equal_to	ANC 1^st visit (20+ years) should be greater than or equal to ANC 1^st visit (20+ years) before 12weeks	ANC 1^st Visit (20+ years)	ANC 1^st visit (20+ years) before 12weeks
RMNCAH ANC 4^th visit <= Total ANC 1^st Visit	less_than_or_equal_to	ANC 4^th visit should be less than or equal to Total ANC 1^st visit	ANC 4^th visit	Total ANC 1^st visit
RMNCAH ANC 8^th visit <= ANC 4^th Visit	less_than_or_equal_to	ANC 8^th visit should be less than or equal to ANC 4^th visit	ANC 8^th visit	ANC 4^th visit
RMNCAH ANC blood pressure measured in 3^rd trimester <= ANC blood pressure measured	less_than_or_equal_to	ANC blood pressure in 3^rd trimester measured should be less than or equal to ANC blood pressure measured	ANC blood pressure measured in 3^rd trimester	ANC blood pressure measured
RMNCAH ANC blood pressure measured <= Total ANC 1^st Visit	less_than_or_equal_to	ANC blood pressure measured should be less than or equal to Total ANC 1^st visit	ANC blood pressure measured	Total ANC 1^st visit
RMNCAH ANC haemoglobin level measured <= Total ANC 1^st Visit	less_than_or_equal_to	ANC haemoglobin level measured should be less than or equal to Total ANC 1^st visit	ANC haemoglobin level measured	Total ANC 1^st visit
RMNCAH ANC screened for syphilis <= Total ANC 1^st Visit	less_than_or_equal_to	ANC screened for syphilis should be less than or equal to Total ANC 1^st visit	ANC screened for syphilis	Total ANC 1^st visit
RMNCAH ANC syphilis seropositive <= ANC screened for syphilis	less_than_or_equal_to	ANC syphilis seropositive should be less than or equal to ANC screened for syphilis	ANC syphilis seropositive	ANC screened for syphilis
RMNCAH ANC treated for syphilis <= ANC syphilis seropositive	less_than_or_equal_to	ANC treated for syphilis should be less than or equal to ANC syphilis seropositive	ANC treated for syphilis	ANC syphilis seropositive
RMNCAH Child 0-4 with acute respiratory illness (ARI)>= child 0-4 with pneumonia	greater_than_or_equal_to	Child Health: Child 0-4 with acute respiratory illness (ARI) should be greater than or equal to Child 0-4 diagnosed with pneumonia. All numbers can be zeros	Child 0-4 diagnosed with acute respiratory illness (ARI)	Child 0-4 diagnosed with pneumonia
RMNCAH Child 0-4 with diarrhoea >= sum of child 0-4 treatments for diarrhoea	greater_than_or_equal_to	Child Health: Child 0-4 with diarrhoea should be greater than or equal to sum of child 0-4 treatments for diarrhoea (Zinc, ORS, ORS +Zinc). All numbers can be zeros	Child 0-4 with diarrhoea	Sum of child 0-4 diarrhoea treatments: ORS, Zinz, ORS + Zinc
RMNCAH Child 0-4 with pneumonia >= sum of child 0-4 Amoxicilin treatments for pneumonia	greater_than_or_equal_to	Child Health: Child 0-4 with pneumonia should be greater than or equal to sum of child 0-4 Amoxicilin treatments for pneumonia (dispersed tablet, oral syrup). All numbers can be zeros	Child 0-4 diagnosed with pneumonia	Sum of child 0-4 pneumonia Amoxicilin treatments: dispersed tablet, oral syrup
RMNCAH Child 0-4 with pneumonia >= sum of child 0-4 treatments for pneumonia	greater_than_or_equal_to	Child Health: Child 0-4 with pneumonia should be greater than or equal to sum of child 0-4 treatments for pneumonia (Amoxicilin, other antibiotic, other medication). All numbers can be zeros	Child 0-4 diagnosed with pneumonia	Sum of child 0-4 pneumonia treatments: Amoxicilin, other antibiotic, other medication
RMNCAH Child 5-9 with acute respiratory illness (ARI)>= child 5-9 with pneumonia	greater_than_or_equal_to	Child Health: Child 5-9 with acute respiratory illness (ARI) should be greater than or equal to Child 5-9 diagnosed with pneumonia. All numbers can be zeros	Child 5-9 diagnosed with acute respiratory illness (ARI)	Child 5-9 diagnosed with pneumonia
RMNCAH Child 5-9 with diarrhoea >= sum of child 5-9 treatments for diarrhoea	greater_than_or_equal_to	Child Health: Child 5-9 with diarrhoea should be greater than or equal to sum of child 5-9 treatments for diarrhoea (Zinc, ORS, ORS +Zinc). All numbers can be zeros	Child 5-9 with diarrhoea	Sum of child 5-9 diarrhoea treatments: ORS, Zinz, ORS + Zinc
RMNCAH Child 5-9 with pneumonia >= sum of child 5-9 Amoxicilin treatments for pneumonia	greater_than_or_equal_to	Child Health: Child 5-9 with pneumonia should be greater than or equal to sum of child 5-9 Amoxicilin treatments for pneumonia (dispersed tablet, oral syrup). All numbers can be zeros	Child 5-9 diagnosed with pneumonia	Sum of child 5-9 pneumonia Amoxicilin treatments: dispersed tablet, oral syrup
RMNCAH Child 5-9 with pneumonia >= sum of child 5-9 treatments for pneumonia	greater_than_or_equal_to	Child Health: Child 5-9 with pneumonia should be greater than or equal to sum of child 5-9 treatments for pneumonia (Amoxicilin, other antibiotic, other medication). All numbers can be zeros	Child 5-9 diagnosed with pneumonia	Sum of child 5-9 pneumonia treatments: Amoxicilin, other antibiotic, other medication
RMNCAH Child death all causes (0-4years) = sum of child death causes (0-4years)	equal_to	Child mortality: death all causes (0-4years) should be equal to the sum of child death causes (0-4years)	Child death all causes (0-4years)	Sum of child death causes (0-4years)
RMNCAH Child death all causes (5-9years) = sum of child death causes (5-9years)	equal_to	Child mortality: death all causes (5-9years) should be equal to the sum of child death causes (5-9years)	Child death all causes (5-9years)	Sum of child death causes (5-9years)
RMNCAH Delivery in facility = sum of delivery by type (normal, assisted, CS)	equal_to	Total Delivery in facility should be equal to sum of Delivery by type (normal, assisted, CS)	Total Delivery in facility	Sum of delivery by type
RMNCAH Live births with documented weight <= Live births	less_than_or_equal_to	Delivery: Live births with documented weight should be less than or equal to Live births	Live births with documented birth weight	Live births in facility
RMNCAH Maternal death all causes (10-14years) = sum of maternal death causes (10-14years)	equal_to	Maternal mortality: death all causes (10-14years) should be equal to the sum of maternal death causes (10-14years)	Maternal death all causes (10-14years)	Sum of maternal death causes (10-14years)
RMNCAH Maternal death all causes (15-19years) = sum of maternal death causes (15-19years)	equal_to	Maternal mortality: death all causes (15-19years) should be equal to the sum of maternal death causes (15-19years)	Maternal death all causes (15-19years)	Sum of maternal death causes (15-19years)
RMNCAH Maternal death all causes (20+ years) = sum of maternal death causes (20+ years)	equal_to	Maternal mortality: death all causes (20+ years) should be equal to the sum of maternal death causes (20+ years)	Maternal death all causes (20+ years)	Sum of maternal death causes (20+ years)
RMNCAH Maternal death all causes >= maternal death audited	greater_than_or_equal_to	Maternal death all causes should be greater than or equal to maternal death audited. All numbers can be zeros	Maternal death all causes	Maternal death audited
RMNCAH Neonatal death all causes = sum of individual neonatal death causes	equal_to	RMNCAH Neonatal death all causes should be or equal to sum of the separate neonatal death causes. All numbers can be zero	Neonatal death all causes	Sum of neonatal death causes
RMNCAH Newborn with Timely 1^st PNC Visit <= newborn with at least 1 PNC visit	less_than_or_equal_to	Number of Newborns with timely 1^st PNC Visits should be less than or equal to number of newborns with at least 1 PNC visit	Newborns with timely 1^st PNC visit	Newborns with at least 1 PNC visit
RMNCAH Perinatal mortality death audited <= all perinatal death	less_than_or_equal_to	Perinatal mortality death audited should be less than or equal to Perinatal deaths in facility. Both numbers can be zero	Perinatal death audited	All perinatal deaths in facility
RMNCAH Population estimated Live births <= Population Expected pregnant women	less_than_or_equal_to	Delivery: Population estimated live births should be less than or equal to Expected number of pregnant women	Population estimated live births	Population expected pregnant women
RMNCAH Postpartum woman Timely 1^st PNC Visit <= client with at least 1 PNC visit	less_than_or_equal_to	Number of Postpartum women with timely 1^st PNC Visits should be less than or equal to number of Postpartum women with at least 1 PNC visit	Postpartum woman with timely 1^st PNC visit	Postpartum women with at least 1 PNC visit
RMNCAH Sum of women initiating contraception before discharge (by method) <= total facility deliveries (by age)	less_than_or_equal_to	FP by Method: Sum of Women initiating contraception before discharge (by method) should be less than or equal to Total facility deliveries (by age)	Sum of women initiating contraception by method	Total facility deliveries
RMNCAH Total Contraception first time user (by age and sex) = Total Contraception first time user (by method)	equal_to	Total Contraception first time user (by age and sex) should be equal to Total Contraception first time user (by method)	Total Contraception first time user (by age and sex)	Total Contraception first time user (by method)
RMNCAH Total deliveries <= Live births + still births	less_than_or_equal_to	Total facility deliveries should be less than or equal to Live births + still births (fresh + macerated)	Total facility deliveries	Sum of live births and still births
RMNCAH Total women initiating contraception before discharge (by age) <= total facility deliveries (by age)	less_than_or_equal_to	Total Women initiating contraception before discharge (by age) should be less than or equal to Total facility deliveries (by age)	Total women initiating contraception before discharge (by age)	Total facility deliveries (by age)
RMNCAH Total women initiating contraception before discharge (by age) = Total women initiating contraception before discharge (by method)	equal_to	Total Women initiating contraception before discharge (by age) should be equal to Total women initiating contraception before discharge (by method)	Total women initiating contraception before discharge (by age)	Total women initiating contraception before discharge (by method)
RMNCAH Total women initiating contraception before discharge (by method) <= total facility deliveries (by age)	less_than_or_equal_to	Total Women initiating contraception before discharge (by method) should be less than or equal to Total facility deliveries (by age)	Total women initiating contraception before discharge (by method)	Total facility deliveries (by age)
RMNCAH Women 15-49y screened for cervical cancer <= Estimated women 15-49y	less_than_or_equal_to	Women 15-49y screened for cervical cancer should be less than or equal to Estimated number of women 15-49y	Women 15-49y screened for cervical cancer	Estimated number of women 15-49years
RMNCAH Women received prophylatic uterotonic immediately after birth <= total facility deliveries (by age)	less_than_or_equal_to	Women received prophylatic uterotonic immediately after birth should be less than or equal to Total facility deliveries (by age)	Received uterotonic	Total facility deliveries(by age)