Kenya: Country Launches Africa’s First Comprehensive Web-based Healthcare System
By George Okore
NAIROBI---Kenya has launched a digital centre to improve provision of health services through efficient management of patients’ records, becoming the first country in Africa to adopt web based software of this magnitude.
The District Health Information Software (DHIS), launched by the Public Health and Sanitation ministry, will upgrade the country’s healthcare information system, thus enabling tracking and distribution of health commodities and quality of drugs.
Permanent Secretary in the Ministry Mark Bor said the data to be managed from the ministry headquarters, will revolutionise the county's healthcare management system. It also follows last week’s launch of the District Health and Human Resources Information System. He said the launch of the data centre was a significant step towards modernizing functions in the sector in a bid to ameliorate disease management and alleviate barriers that frustrate developmental efforts.
“This data centre is unprecedented in the history of the Health ministry and represents the biggest investment in IT to date. As technology improves, so does the quality of life therefore the ministry is willing to embrace technological advancements that will help improve the health sector,” says Mr Bor.
Dr Willis Akwale, Kenya's Director of Diseases Prevention and Control says DHIS will be the official reporting tool for the country’s healthcare system, especially Early Infant Diagnosis (EID) component that will dramatically improve testing and treatment for more than 120,000 infants exposed to HIV in Kenya each year.
The computer based system will track prevalence of diseases and monitor distribution of drugs and other supplies. It will also improve quality and efficiency of disease surveillance, enhancing protection and prevention by making processes such as HIV testing fast and easy. Swift communication once disease is detected will ensure quick administering of treatment. It has been launched by Hewlett Packard (HP), Ministry of Health and Clinton Health Access Initiative (CHAI).
Kenya adopted the use of the District Health Information Software (DHIS 2) in 2010, replacing File Transfer Protocol (FTP). DHIS was installed on a central server using the “cloud” based infrastructure. Other countries like South Africa have deployed DHIS in fewer districts.
DHIS is based on recommendations from previous evaluations of the Kenyan Health Information System. Several approaches were used in the deployment of the new system. In the preparatory stage, a national DHIS core team comprising Health records and information officers, ICT officers and epidemiologists was formed. The main task of the team was to coordinate the adoption, customisation and implementation of the system.
Other activities in the preparatory stage involved stakeholders’ briefing, establishment of a technical working group and hiring of technical assistants. A team from Oslo University was selected as the technical assistants through a competitive process. The strength of this team was that they were the main developers of the software.
The DHIS core team together with the technical assistants customized the system to reflect specific Kenyan reporting forms. Once this was complete, testing was done in Machakos, Nyamira and Kisumu East districts followed by a major pilot in Coast province.
After successful pilot in Coast province, a national rollout plan was prepared including training of Trainers (TOTs), Training of District Health Management Teams, supportive supervision and regular stakeholders meetings. A total of 170 laptops and 190 modems were procured to support the districts in data entry. Calling cards were supplied to districts on quarterly basis.
Consequently, the system was rolled out to all provinces between March-September 2011. As of now, users across Kenya are able to access the system online through modems and Local Area Networks. The old FTP system was officially closed. In general the software has been widely accepted as the main reporting system. In due course all other parallel systems will close.
DHIS provides simple analysis at the data entry point, encouraging data use for decision making at the lowest level. The system has inbuilt data quality checks which have led to the overall improved data quality. The system has a guest module which allows guests to view some data. This has improved the dissemination of public health information.
Due to the ease of data analysis, it is now easier to monitor the incidence of public health threats and initiate timely response. The software is based on a central server and any changes in the system are available to all users immediately. Due to poor network coverage in some areas, laptops and an offline data entry module will be introduced to solve the problem.
Dr Akwale describes the adoption of web based system for data management as a bold move to make healthcare easily available. “The deployment of DHIS was successful due to its good attributes and support from stakeholders. This success proves that a web based system, using a central server with universal access, can be appropriate for Kenya. It is however important that capacity building, relevant infrastructure and staffing levels be evaluated for the system to work well,” Says Dr Akwale.