Rwanda HMIS využívající DHIS2¶

Recognized as a trailblazer in its category, the web-based R-HMIS has been operational countrywide since February 2012 and collects data from over 700 public health facilities. With improved data reporting timeliness, completeness, and accuracy, R-HMIS has made sweeping changes to how health data is being collected and used in Rwanda today.

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What did the situation look like before R-HMIS? With a system that was stretched to its limits, and lacking in capacity to gather data efficiently, it could at times take months to receive health reports from remote areas of the country. The data that eventually came through was likely to have passed through multiple sources and was usually not very reliable. The timing couldn’t have been better for a completely new system.

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A huge turnaround since February 2012. With the arrival of R-HMIS, web reports from every health facility in the country can be made available in a few clicks. Furthermore, data validation rules are keeping the data clean and of near to perfect quality.

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A country rollout achieved in 4 years – absolute record time! After spending almost two years of thorough preparation, it took just two years for Rwanda’s highly dedicated teams to roll out DHIS2 across Rwanda and make it the country’s official web-based Health Information System.

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Harmonizing an existing system. Resources such as people, registers, modems and computers were already available, so DHIS2 implementers took advantage of this infrastructure and focused on getting DHIS2 software up and running. Furthermore, in an effort to get everyone involved simultaneously, health personnel received intensive DHIS2 training at the same time as systems administrators working at the central level.

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A concisely prepared rollout. *"We harmonized all the reporting forms,"*recalls Andrew Muhire, the head of Rwanda's Health Management Information System at the Ministry of Health. "We ensured that we were only collecting highly relevant data or data that had direct links to our strategic plan. We selected program indicators that were linked to our targets: reducing the overall workload of our health personnel and improving the quality of data to drive decision making."

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A thoroughly revised system. The Rwandan DHIS2 experts went to great lengths to meet as many requirements as possible. For example, they revised data collection tools, including patient forms and registers, and health facility reporting tools. Standard operating procedures for data management at health centers and district hospital levels were introduced along with a routine data quality audit (DQA) system. Finally, referral hospitals, private dispensaries and clinics were integrated.

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Getting teams up to speed with web-based technology was a priority. Intensive training took place very early on in the process. The aim was clear, the motivation was high: to empower local teams with the expertise necessary to control their country's health data.

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Data quality assessments showing excellent results. Data completeness is hovering at around 98% today. People at all levels within the health sector use the collected data; at district and at central level.

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Migration of eIDSR, HIV and the TB system into DHIS2. We’re continually progressing with our HMIS; eIDSR - our disease surveillance system, HIV and TB systems are now migrated to DHIS2.

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eIDSR in a few words: Using web technology or a mobile phone app, eIDSR enables users to collect and report real-time epidemic surveillance data from health facilities. Data is stored in a central database, where it can be instantly retrieved for analysis, dashboards and decision-making. Automated alerts and reporting reminders can also be triggered to keep health officers informed about potential outbreaks and reporting delays.