------------------------------------------------------------ revno: 686 committer: Jason P. Pickering <jason.p.picker...@gmail.com> branch nick: dhis2 timestamp: Sat 2009-09-12 16:30:17 +0200 message: DHIS2 user documentation Module 1 added in DocBook format with HTML files added: docs/dhis2_user_man_mod1.xml docs/dhis2_user_manual_mod1_en.htm docs/images/dhis2_information_cycle.png
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=== added file 'docs/dhis2_user_man_mod1.xml' --- docs/dhis2_user_man_mod1.xml 1970-01-01 00:00:00 +0000 +++ docs/dhis2_user_man_mod1.xml 2009-09-12 14:30:17 +0000 @@ -0,0 +1,512 @@ +<?xml version="1.0" encoding="UTF-8"?> +<!DOCTYPE article PUBLIC "-//OASIS//DTD DocBook XML V4.2//EN" +"http://www.oasis-open.org/docbook/xml/4.2/docbookx.dtd";> +<?altova_sps http://www.altova.com/sps/Template/Publishing/docbook.sps?> +<?xml-stylesheet type="text/xsl" href="C:\Program Files\Altova\XMLSpy2008\Stylesheets\docbook\html\docbook.xsl"?> +<article> + <articleinfo> + <date>12/09/09</date> + + <title>What is DHIS 2?</title> + + <author> + <surname>Unknown</surname> + + <affiliation> + <orgname></orgname> + </affiliation> + </author> + + <revhistory> + <revision> + <revnumber>1</revnumber> + + <date>12/09/09</date> + + <authorinitials>JPP</authorinitials> + + <revdescription> + <para>Initial conversion from MS Word format to DocBook</para> + </revdescription> + </revision> + </revhistory> + </articleinfo> + + <sect1> + <title>Background of The District Health Information Software â Version 2 + (DHIS 2)</title> + + <para></para> + + <highlights> + <para>After reading this chapter you will be able to understand:</para> + + <itemizedlist> + <listitem> + <para>What is DHIS2 and what purpose it serves with respect to + HMIS</para> + </listitem> + + <listitem> + <para>What is the difference between patient based and aggregate + data.</para> + </listitem> + + <listitem> + <para>What are the different modules in DHIS 2.</para> + </listitem> + + <listitem> + <para>What is Free and Open Source Software (FOSS), platform + (in)dependency, and itsimplications for HMIS.</para> + </listitem> + + <listitem> + <para>What is FOSS, platform (in)dependency, and their implications + for HMIS.</para> + </listitem> + </itemizedlist> + </highlights> + + <para>Computer based HMIS allows for a transition from a data (and paper) + based HMIS to and action led HMIS. Particular strengths of a computer + based HMIS enumerated below:</para> + + <itemizedlist> + <listitem> + <para>Promotes streamlining and standardization of data + records.</para> + </listitem> + + <listitem> + <para>Promotes streamlining and standardization of data + records.</para> + </listitem> + + <listitem> + <para>Promotes streamlining and standardization of data + records.</para> + </listitem> + + <listitem> + <para>Allows creation of an integrated warehouse, which supports + combining data from different sources and conducting cross + analysis.</para> + </listitem> + + <listitem> + <para>Facilitates Rationalization of reporting flows</para> + </listitem> + + <listitem> + <para>Supports customized reporting.</para> + </listitem> + + <listitem> + <para>Makes possible various kinds of indicator based analysis</para> + </listitem> + + <listitem> + <para>Allows integration of various software applications such as GIS + and Excel.</para> + </listitem> + + <listitem> + <para>Provides functionality to conduct data quality + validation.</para> + </listitem> + + <listitem> + <para>Allows immediate online transmission of data / reports as and + when required by the user</para> + </listitem> + </itemizedlist> + + <para>The District Health Information Software â Version 2 (DHIS 2) is + Free and Open Source Software (FOSS) HMIS designed and developed under a + global research and development initiative (called Health Information + Systems Project â HISP) originating from the Department of Informatics, + University of Oslo, Norway. The first version of DHIS application (DHIS + 1.3/1.4) was developed and subsequently upgraded on an ongoing base + continuously upgraded in South Africa by HISP South Africa since 1997. + This version was developed on Microsoft Office platform, and distributed + free. This application is currently the national standard in South Africa + and being used in all the health facilities in the country. Further, this + application is being used in many countries in Africa such as Ethiopia, + Nigeria, Botswana, Tanzania, Zambia, and, various other countries.</para> + + <para>In 2005, based on the various comments and feedback from the field + level use, the University of Oslo initiated the process of developing + Version 2 of DHIS, which used DHIS 1.4 as the basis for the functional + requirements. Using a modular structure DHIS 2 was developed based on data + warehousing principles. DHIS 2 is built on Java based frameworks. It is + platform independent, can run on both online and offline modes, is multi + language enabled and integrated with various other applications such as + Geographic Information Systems and Excel. </para> + + <para>The WHO and HMN (Health Metrics Network) are currently using DHIS 2 + for implementing an integrated solution in the first HMN country â Sierra + Leone. While DHIS 2 will be used for the aggregated statistics component + of the HMIS, it will be integrated with a free software application called + Open MRS for patient based management, and the WHO created Open Health for + GIS and Web pivot tables.</para> + + <para>In this training manual, we will take the DHIS 2 as the basis to + illustrate the various functionalities that a computer based HMIS should + provide.</para> + + <sect2> + <title>Purpose of DHIS2</title> + + <para>The purpose of DHIS can be summarized as follows: </para> + + <orderedlist> + <listitem> + <para>Provide a comprehensive HMIS solution based on data + warehousing principles and a modular structure which can easily be + customized to the needs of different health systems - nations, + states, districts, and facilities. </para> + </listitem> + + <listitem> + <para>Provide data entry facilities which can either be in the form + of standard (scroll down) lists (of data elements), or can be + customized to replicate paper forms â to make easy the process of + data entry. </para> + </listitem> + + <listitem> + <para>Provide different kinds of tools for data validation and + improvement of data quality.</para> + </listitem> + + <listitem> + <para>Provide different tools for reporting â both for automated + routine reports and analysis reports, and in addition provide the + user with functionality and flexibility to make their user defined + reports</para> + </listitem> + + <listitem> + <para>A dashboard for monitoring and evaluation of health programs + that can allow for the generation and analysis of different + indicators, and also carry out data quality analysis.</para> + </listitem> + + <listitem> + <para>Systems management functions to carry out various operations + to manage hierarchy of organization units, + addition/deletion/modification of data elements etc.</para> + </listitem> + + <listitem> + <para>Functionality to design and modify indicators.</para> + </listitem> + + <listitem> + <para> Functionalities of export-import, so that data entered on an + offline version can be exported to the district or higher level + systems. Export import can also be made in relation to other + applications such as Excel and Epi Info. </para> + </listitem> + + <listitem> + <para>Integration with other software systems â such as + <acronym>RIMS</acronym>.</para> + </listitem> + + <listitem> + <para>Integration with <glossterm>Geographic Information + Systems</glossterm> (<acronym>GIS</acronym>).</para> + </listitem> + + <listitem> + <para>User management module for passwords, security, and defining + authorization.</para> + </listitem> + + <listitem> + <para>Further modules can be developed (such as for human resources + management) and integrated as per user needs. </para> + </listitem> + </orderedlist> + + <para>In summary, DHIS 2 provides a comprehensive HMIS solution for the + reporting and analysis needs of health facilities at any level. It is a + tried and tested application in various countries, and also now being + adopted by WHO for their HMN implementation</para> + </sect2> + + <sect2> + <title>Difference between Aggregated and Patient data in a HMIS </title> + + <para><emphasis>Patient data</emphasis> is data relating to ONE patient, + such as his/her diagnosis, name, age, earlier medical history etc. + Patient based data is important when you want to track longitudinally + the progress of a patient over time. For example, if we want to track + how a patient is adhering to and responding to the process of TB + treatment (typically taking place over 6-9 months), we would need + patient based data. </para> + + <para><emphasis>Aggregated data</emphasis> is the consolidation of data + relating to multiple patients, and therefore cannot be traced back to a + specific patient. They are merely counts, such as incidences of Malaria, + TB, or other diseases. Typically, the routine data that a health + facility deals with is this kind of aggregated statistics, and is used + for the generation of routine reports and indicators. </para> + + <para>Patient data is highly confidential and therefore must be + protected so that no one other than doctors can get it. When in paper, + it must be properly stored in a secure place. For computers, patient + data needs secure systems with passwords and restrained access.</para> + + <para>Security concerns for aggregated data are not as crucial as for + patient data, as there are no ways of relating it to a person. However, + data can still be misused and misinterpreted by others, and should not + be distributed uncritically. A data policy needs to be established by + the managers about who gets access to what data.</para> + </sect2> + + <sect2> + <title>Use of DHIS 2 in HMIS: data collection, processing, + interpretation, and analysis. </title> + + <para>The wider context of HMIS can be comprehensively described through + the information cycle presented in Figure 1.1 below. The information + cycle pictorially depicts the different components, stages and processes + through which the data is collected, checked for quality, processed, + analyzed and used.</para> + + <figure> + <title>The health information cycle </title> + + <mediaobject> + <imageobject> + <imagedata fileref="images/dhis2_information_cycle.png" /> + </imageobject> + </mediaobject> + </figure> + + <para>DHIS 2 supports the different facets of the information cycle + including:<itemizedlist> + <listitem> + <para>Collecting data.</para> + </listitem> + + <listitem> + <para>Running quality checks.</para> + </listitem> + + <listitem> + <para>Data access at multiple levels.</para> + </listitem> + + <listitem> + <para>Reporting.</para> + </listitem> + + <listitem> + <para>Making graphs and maps and other forms of analysis.</para> + </listitem> + + <listitem> + <para>Enabling comparison across time (for example, previous + months) and space (for example, across facilities and + districts).</para> + </listitem> + + <listitem> + <para>See trends (displaying data in time series to see their min + and max levels).</para> + </listitem> + </itemizedlist></para> + + <para>As a first step, DHIS 2 serves as a data collection, recording and + compilation tool, and all data (be it in numbers or text form) can be + entered into it. Data entry can be done in lists of data elements or in + customized user defined forms based on the paper forms. </para> + + <para>As a next step, DHIS 2 can be used to increase data quality. + Firstly, at the point of data entry, a check can be made to see if data + falls within acceptable range levels of minimum and maximum values for + any particular data element. Such checking, for example, can help to + identify typing errors at the time of data entry. Further, user can + define various validation rules, and DHIS 2 can run the data through the + validation rules to identify violations.</para> + + <para>When data has been entered and verified, DHIS 2 can help to make + different kinds of reports. The first kind are the routine reports that + can be predefined, so that all those reports that need to be routine + generated can be done on a click of a button. Further, DHIS 2 can help + in the generation of analytical reports through comparisons of for + example indicators across facilities or over time. Graphs, maps, reports + and health profiles are amongst the outputs that DHIS 2 can produce, and + these should routinely be produced, analyzed, and acted upon by health + managers.</para> + </sect2> + + <sect2> + <title>Overview of DHIS 2.0</title> + + <sect3> + <title>The different modules of DHIS 2</title> + + <para>DHIS is based on a modular approach of design. A module can be + seen as an independent component of application that is capable of + both processing inputs as well as outputs, that is used to communicate + with other modules. The modules are flexible enough to allow changes + in one module without having any effect on other modules. As long as + input and output stays the same, it doesnât matter what happens inside + a module. A module can then be changed without affecting other + modules, which will be working as long as the output from the first + module comes out as normal. This modular feature allows DHIS 2 to be + constantly upgraded in terms of functionality, integrated with other + applications such as Excel pivot tables and GIS. Thus modularity + allows DHIS 2 to be flexible, and changes can take place in the + different modules without affecting others.</para> + + <para>Currently, DHIS2 has several modules for functions such as data + entry, data quality checks, report generation etc. These modules have + been categorised and presented under two core categories namely + Maintenance and Services. The Services module supports data record, + analysis, report generation etc. And the Maintenance module allows you + to set the content and structure of the Services module.</para> + </sect3> + + <sect3> + <title>Web-based versus standalone HMIS and their suitability</title> + + <para>DHIS 2 can run both as a web based and offline application. As a + web based application, the DHIS 2 application can run on a central + server and make use of client-server architecture. For example, at the + state level, the DHIS 2 can run on a server, and the different + districts act as clients, drawing upon the server application through + the Internet for local use of the application. </para> + + <para>In a standalone application, the DHIS 2 can run as an + independent application on individual computers in different sites + such as PHCs, CHCs etc. So, if computerization is taking place at the + Block level, then the DHIS 2 will be installed separately on each of + the block level computers. The disadvantage of a standalone + application is that of platform dependency â where the application + needs to be configured to the platform on each of the respective + machines. A thick client requires a local runtime environment. For + example a Windows Form application will only run on a Windows platform + with the .Net framework installed. The major advantage of the offline + version is that it can run without any dependency on the Internet. + This allows the application to run in remote locations where there is + limited or no Internet connectivity. </para> + + <para>The main advantage of a web based solution is that it is + centralized, which enables easy, online updation and deployment of the + application. The only requirements on the clientsâ side are to have + web browser installed on the used computer and have an Internet + connection. The hardware on the server is often more powerful than the + single computer. Another advantage of the web application is that is + platform independent, allowing the same software to be accessed + through a web browser regardless of the clientâs operating system. + </para> + + <para>Where connectivity is available, and there is need for + centralized management, a web based application is useful, and a + standalone application is preferred when these conditions are not + available or required. However, in most cases, a mix of these two + approaches would be required, with a server based deployment working + for district-state-national level processing, and a standalone + deployment at lower levels where connectivity is limited. The + advantage of such an approach is that it is flexible, inclusive, and + scaleable because as facilities get internet connectivity they can be + hooked up to the network.</para> + </sect3> + + <sect3> + <title>Free and Open Source Software (FOSS): benefits and challenges + </title> + + <para>Software carries the instructions that tell a computer how to + operate. The human authored and human readable form of those + instructions is called source code. Before the computer can actually + execute the instructions, the source code must be translated into a + machine readable (binary) format, called the object code. All + distributed software includes the object code, but FOSS makes the + source code available as well. </para> + + <para>Proprietary software owners license their copyrighted object + code to a user, which allows the user to run the program. FOSS + programs, on the other hand, license both the object and the source + code, permitting the user to run, modify and possibly redistribute the + programs. With access to the source code, the users have the freedom + to run the program for any purpose, redistribute, probe, adapt, learn + from, customize the software to suit their needs, and release + improvements to the public for the good of the community. Hence, some + FOSS is also known as free software, where âfreeâ refers, first and + foremost, to the above freedoms rather than in the monetary sense of + the word.</para> + + <para>Within the public health sector, FOSS can potentially have a + range of benefits, including:</para> + + <itemizedlist> + <listitem> + <para>Lower costs as it does not involve paying for prohibitive + license costs.</para> + </listitem> + + <listitem> + <para>Given the information needs for the health sector are + constantly changing and evolving, there is a need for the user to + have the freedom to make the changes as per the user requirements. + This is often limited in proprietary systems.</para> + </listitem> + + <listitem> + <para>In the health sector, including in NRHM; a key agenda is + that of integration, which involves the technical linking of + different pieces of software (for example, DHIS 2 and RIMS). For + this, the source code needs to be made available to the developers + to create the integration. This availability is often not possible + in the case of proprietary software. And when it is, it comes at a + high cost and contractual obligations.</para> + </listitem> + + <listitem> + <para>FOSS applications like DHIS2 typically are supported by a + global network of developers, and thus have access to cutting edge + research and development knowledge. </para> + </listitem> + </itemizedlist> + </sect3> + + <sect3> + <title>Understanding platform independency</title> + + <para>All computers have an Operating System (OS) to manage it and the + programs running it. Such OS serve as the middle layer between the + software application, such as DHIS 2, and the hardware, such as the + CPU and RAM. The most popularly used OS is Microsoft Windows, which + comes in various versions (such as XP, Vista). However, this OS costs + money, and have also been reported to have security issues that makes + it vulnerable to virus attacks. Operating Systems like Linux are free, + and are more secure with respect to virus attacks. Usually, many of + the applications will work on one OS, and not on others. Platform + independency implies that the software application can run on ANY OS - + Windows, Linux, Macintosh etc. DHIS 2 is platform independent, and is + extremely useful in the context of public health when typically you + have systems in different places running different kinds of OS. + </para> + </sect3> + + <sect3> + <title>Auxiliary software that can be used with DHIS</title> + + <para>A variety of auxiliary software can be run with DHIS 2, such as + GIS (for mapping), BIRT (for reporting), Excel (for analysis through + pivot table operations), Open MRS (for patient based management), and + CRIS (for HIV/AIDS management). Being based on Open Standards and an + Open Architecture, DHIS 2 can build bridges to speak to the other + systems. Further, auxiliary modules can be developed and integrated + with the core DHIS 2 application. </para> + </sect3> + </sect2> + </sect1> +</article> === added file 'docs/dhis2_user_manual_mod1_en.htm' --- docs/dhis2_user_manual_mod1_en.htm 1970-01-01 00:00:00 +0000 +++ docs/dhis2_user_manual_mod1_en.htm 2009-09-12 14:30:17 +0000 @@ -0,0 +1,244 @@ +<html><head><meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1"><title>What is DHIS 2?</title><meta name="generator" content="DocBook XSL Stylesheets VSPY V.1 "></head><body bgcolor="white" text="black" link="#0000FF" vlink="#840084" alink="#0000FF"><div class="article"><div class="titlepage"> +<div><h1 class="title"><a name="idarticle145147192"></a>What is DHIS 2?</h1></div><div><div class="author"><h3 class="author">Unknown</h3><div class="affiliation"><span class="orgname"><br></br></span></div></div></div><div><div class="revhistory"><table border="1" width="100%" summary="Revision history"><tr><th align="left" valign="top" colspan="3"><b>Revision History</b></th></tr><tr><td align="left">Revision 1</td><td align="left">12/09/09</td><td align="left">JPP</td></tr><tr><td align="left" colspan="3"><p>Initial conversion from MS Word format to DocBook</p></td></tr></table></div></div> + +<hr></div><div class="toc"><p><b>Table of Contents</b></p><dl><dt><a href="#idsect1140843160">Background of The District Health Information Software – Version 2 + (DHIS 2)</a></dt><dd><dl><dt><a href="#idsect2108621456">Purpose of DHIS2</a></dt><dt><a href="#idsect2177629568">Difference between Aggregated and Patient data in a HMIS </a></dt><dt><a href="#idsect2143099248">Use of DHIS 2 in HMIS: data collection, processing, + interpretation, and analysis. </a></dt><dt><a href="#idsect2132995144">Overview of DHIS 2.0</a></dt></dl></dd></dl></div><div class="sect1"><div class="titlepage"> +<div><h2 class="title" style="clear: both"><a name="idsect1140843160"></a>Background of The District Health Information Software – Version 2 + (DHIS 2)</h2></div> + +</div><p /><div class="highlights"><p>After reading this chapter you will be able to understand:</p><div class="itemizedlist"><ul type="disc"><li><p>What is DHIS2 and what purpose it serves with respect to + HMIS</p></li><li><p>What is the difference between patient based and aggregate + data.</p></li><li><p>What are the different modules in DHIS 2.</p></li><li><p>What is Free and Open Source Software (FOSS), platform + (in)dependency, and itsimplications for HMIS.</p></li><li><p>What is FOSS, platform (in)dependency, and their implications + for HMIS.</p></li></ul></div></div><p>Computer based HMIS allows for a transition from a data (and paper) + based HMIS to and action led HMIS. Particular strengths of a computer + based HMIS enumerated below:</p><div class="itemizedlist"><ul type="disc"><li><p>Promotes streamlining and standardization of data + records.</p></li><li><p>Promotes streamlining and standardization of data + records.</p></li><li><p>Promotes streamlining and standardization of data + records.</p></li><li><p>Allows creation of an integrated warehouse, which supports + combining data from different sources and conducting cross + analysis.</p></li><li><p>Facilitates Rationalization of reporting flows</p></li><li><p>Supports customized reporting.</p></li><li><p>Makes possible various kinds of indicator based analysis</p></li><li><p>Allows integration of various software applications such as GIS + and Excel.</p></li><li><p>Provides functionality to conduct data quality + validation.</p></li><li><p>Allows immediate online transmission of data / reports as and + when required by the user</p></li></ul></div><p>The District Health Information Software – Version 2 (DHIS 2) is + Free and Open Source Software (FOSS) HMIS designed and developed under a + global research and development initiative (called Health Information + Systems Project – HISP) originating from the Department of Informatics, + University of Oslo, Norway. The first version of DHIS application (DHIS + 1.3/1.4) was developed and subsequently upgraded on an ongoing base + continuously upgraded in South Africa by HISP South Africa since 1997. + This version was developed on Microsoft Office platform, and distributed + free. This application is currently the national standard in South Africa + and being used in all the health facilities in the country. Further, this + application is being used in many countries in Africa such as Ethiopia, + Nigeria, Botswana, Tanzania, Zambia, and, various other countries.</p><p>In 2005, based on the various comments and feedback from the field + level use, the University of Oslo initiated the process of developing + Version 2 of DHIS, which used DHIS 1.4 as the basis for the functional + requirements. Using a modular structure DHIS 2 was developed based on data + warehousing principles. DHIS 2 is built on Java based frameworks. It is + platform independent, can run on both online and offline modes, is multi + language enabled and integrated with various other applications such as + Geographic Information Systems and Excel. </p><p>The WHO and HMN (Health Metrics Network) are currently using DHIS 2 + for implementing an integrated solution in the first HMN country – Sierra + Leone. While DHIS 2 will be used for the aggregated statistics component + of the HMIS, it will be integrated with a free software application called + Open MRS for patient based management, and the WHO created Open Health for + GIS and Web pivot tables.</p><p>In this training manual, we will take the DHIS 2 as the basis to + illustrate the various functionalities that a computer based HMIS should + provide.</p><div class="sect2"><div class="titlepage"> +<div><h3 class="title"><a name="idsect2108621456"></a>Purpose of DHIS2</h3></div> + +</div><p>The purpose of DHIS can be summarized as follows: </p><div class="orderedlist"><ol type="1"><li><p>Provide a comprehensive HMIS solution based on data + warehousing principles and a modular structure which can easily be + customized to the needs of different health systems - nations, + states, districts, and facilities. </p></li><li><p>Provide data entry facilities which can either be in the form + of standard (scroll down) lists (of data elements), or can be + customized to replicate paper forms – to make easy the process of + data entry. </p></li><li><p>Provide different kinds of tools for data validation and + improvement of data quality.</p></li><li><p>Provide different tools for reporting – both for automated + routine reports and analysis reports, and in addition provide the + user with functionality and flexibility to make their user defined + reports</p></li><li><p>A dashboard for monitoring and evaluation of health programs + that can allow for the generation and analysis of different + indicators, and also carry out data quality analysis.</p></li><li><p>Systems management functions to carry out various operations + to manage hierarchy of organization units, + addition/deletion/modification of data elements etc.</p></li><li><p>Functionality to design and modify indicators.</p></li><li><p> Functionalities of export-import, so that data entered on an + offline version can be exported to the district or higher level + systems. Export import can also be made in relation to other + applications such as Excel and Epi Info. </p></li><li><p>Integration with other software systems – such as + RIMS.</p></li><li><p>Integration with <i>Geographic Information + Systems</i> (GIS).</p></li><li><p>User management module for passwords, security, and defining + authorization.</p></li><li><p>Further modules can be developed (such as for human resources + management) and integrated as per user needs. </p></li></ol></div><p>In summary, DHIS 2 provides a comprehensive HMIS solution for the + reporting and analysis needs of health facilities at any level. It is a + tried and tested application in various countries, and also now being + adopted by WHO for their HMN implementation</p></div><div class="sect2"><div class="titlepage"> +<div><h3 class="title"><a name="idsect2177629568"></a>Difference between Aggregated and Patient data in a HMIS </h3></div> + +</div><p><span class="emphasis"><em>Patient data</em></span> is data relating to ONE patient, + such as his/her diagnosis, name, age, earlier medical history etc. + Patient based data is important when you want to track longitudinally + the progress of a patient over time. For example, if we want to track + how a patient is adhering to and responding to the process of TB + treatment (typically taking place over 6-9 months), we would need + patient based data. </p><p><span class="emphasis"><em>Aggregated data</em></span> is the consolidation of data + relating to multiple patients, and therefore cannot be traced back to a + specific patient. They are merely counts, such as incidences of Malaria, + TB, or other diseases. Typically, the routine data that a health + facility deals with is this kind of aggregated statistics, and is used + for the generation of routine reports and indicators. </p><p>Patient data is highly confidential and therefore must be + protected so that no one other than doctors can get it. When in paper, + it must be properly stored in a secure place. For computers, patient + data needs secure systems with passwords and restrained access.</p><p>Security concerns for aggregated data are not as crucial as for + patient data, as there are no ways of relating it to a person. However, + data can still be misused and misinterpreted by others, and should not + be distributed uncritically. A data policy needs to be established by + the managers about who gets access to what data.</p></div><div class="sect2"><div class="titlepage"> +<div><h3 class="title"><a name="idsect2143099248"></a>Use of DHIS 2 in HMIS: data collection, processing, + interpretation, and analysis. </h3></div> + +</div><p>The wider context of HMIS can be comprehensively described through + the information cycle presented in Figure 1.1 below. The information + cycle pictorially depicts the different components, stages and processes + through which the data is collected, checked for quality, processed, + analyzed and used.</p><div class="figure"><a name="idfigure143098152"></a><p class="title"><b>Figure&#160;1.&#160;The health information cycle </b></p><div class="mediaobject"><img src="images/dhis2_information_cycle.png"></div></div><p>DHIS 2 supports the different facets of the information cycle + including:<div class="itemizedlist"><ul type="disc"><li><p>Collecting data.</p></li><li><p>Running quality checks.</p></li><li><p>Data access at multiple levels.</p></li><li><p>Reporting.</p></li><li><p>Making graphs and maps and other forms of analysis.</p></li><li><p>Enabling comparison across time (for example, previous + months) and space (for example, across facilities and + districts).</p></li><li><p>See trends (displaying data in time series to see their min + and max levels).</p></li></ul></div></p><p>As a first step, DHIS 2 serves as a data collection, recording and + compilation tool, and all data (be it in numbers or text form) can be + entered into it. Data entry can be done in lists of data elements or in + customized user defined forms based on the paper forms. </p><p>As a next step, DHIS 2 can be used to increase data quality. + Firstly, at the point of data entry, a check can be made to see if data + falls within acceptable range levels of minimum and maximum values for + any particular data element. Such checking, for example, can help to + identify typing errors at the time of data entry. Further, user can + define various validation rules, and DHIS 2 can run the data through the + validation rules to identify violations.</p><p>When data has been entered and verified, DHIS 2 can help to make + different kinds of reports. The first kind are the routine reports that + can be predefined, so that all those reports that need to be routine + generated can be done on a click of a button. Further, DHIS 2 can help + in the generation of analytical reports through comparisons of for + example indicators across facilities or over time. Graphs, maps, reports + and health profiles are amongst the outputs that DHIS 2 can produce, and + these should routinely be produced, analyzed, and acted upon by health + managers.</p></div><div class="sect2"><div class="titlepage"> +<div><h3 class="title"><a name="idsect2132995144"></a>Overview of DHIS 2.0</h3></div> + +</div><div class="sect3"><div class="titlepage"> +<div><h4 class="title"><a name="idsect3132994480"></a>The different modules of DHIS 2</h4></div> + +</div><p>DHIS is based on a modular approach of design. A module can be + seen as an independent component of application that is capable of + both processing inputs as well as outputs, that is used to communicate + with other modules. The modules are flexible enough to allow changes + in one module without having any effect on other modules. As long as + input and output stays the same, it doesn’t matter what happens inside + a module. A module can then be changed without affecting other + modules, which will be working as long as the output from the first + module comes out as normal. This modular feature allows DHIS 2 to be + constantly upgraded in terms of functionality, integrated with other + applications such as Excel pivot tables and GIS. Thus modularity + allows DHIS 2 to be flexible, and changes can take place in the + different modules without affecting others.</p><p>Currently, DHIS2 has several modules for functions such as data + entry, data quality checks, report generation etc. These modules have + been categorised and presented under two core categories namely + Maintenance and Services. The Services module supports data record, + analysis, report generation etc. And the Maintenance module allows you + to set the content and structure of the Services module.</p></div><div class="sect3"><div class="titlepage"> +<div><h4 class="title"><a name="idsect3168551400"></a>Web-based versus standalone HMIS and their suitability</h4></div> + +</div><p>DHIS 2 can run both as a web based and offline application. As a + web based application, the DHIS 2 application can run on a central + server and make use of client-server architecture. For example, at the + state level, the DHIS 2 can run on a server, and the different + districts act as clients, drawing upon the server application through + the Internet for local use of the application. </p><p>In a standalone application, the DHIS 2 can run as an + independent application on individual computers in different sites + such as PHCs, CHCs etc. So, if computerization is taking place at the + Block level, then the DHIS 2 will be installed separately on each of + the block level computers. The disadvantage of a standalone + application is that of platform dependency – where the application + needs to be configured to the platform on each of the respective + machines. A thick client requires a local runtime environment. For + example a Windows Form application will only run on a Windows platform + with the .Net framework installed. The major advantage of the offline + version is that it can run without any dependency on the Internet. + This allows the application to run in remote locations where there is + limited or no Internet connectivity. </p><p>The main advantage of a web based solution is that it is + centralized, which enables easy, online updation and deployment of the + application. The only requirements on the clients’ side are to have + web browser installed on the used computer and have an Internet + connection. The hardware on the server is often more powerful than the + single computer. Another advantage of the web application is that is + platform independent, allowing the same software to be accessed + through a web browser regardless of the client’s operating system. + </p><p>Where connectivity is available, and there is need for + centralized management, a web based application is useful, and a + standalone application is preferred when these conditions are not + available or required. However, in most cases, a mix of these two + approaches would be required, with a server based deployment working + for district-state-national level processing, and a standalone + deployment at lower levels where connectivity is limited. The + advantage of such an approach is that it is flexible, inclusive, and + scaleable because as facilities get internet connectivity they can be + hooked up to the network.</p></div><div class="sect3"><div class="titlepage"> +<div><h4 class="title"><a name="idsect3131702240"></a>Free and Open Source Software (FOSS): benefits and challenges + </h4></div> + +</div><p>Software carries the instructions that tell a computer how to + operate. The human authored and human readable form of those + instructions is called source code. Before the computer can actually + execute the instructions, the source code must be translated into a + machine readable (binary) format, called the object code. All + distributed software includes the object code, but FOSS makes the + source code available as well. </p><p>Proprietary software owners license their copyrighted object + code to a user, which allows the user to run the program. FOSS + programs, on the other hand, license both the object and the source + code, permitting the user to run, modify and possibly redistribute the + programs. With access to the source code, the users have the freedom + to run the program for any purpose, redistribute, probe, adapt, learn + from, customize the software to suit their needs, and release + improvements to the public for the good of the community. Hence, some + FOSS is also known as free software, where “free” refers, first and + foremost, to the above freedoms rather than in the monetary sense of + the word.</p><p>Within the public health sector, FOSS can potentially have a + range of benefits, including:</p><div class="itemizedlist"><ul type="disc"><li><p>Lower costs as it does not involve paying for prohibitive + license costs.</p></li><li><p>Given the information needs for the health sector are + constantly changing and evolving, there is a need for the user to + have the freedom to make the changes as per the user requirements. + This is often limited in proprietary systems.</p></li><li><p>In the health sector, including in NRHM; a key agenda is + that of integration, which involves the technical linking of + different pieces of software (for example, DHIS 2 and RIMS). For + this, the source code needs to be made available to the developers + to create the integration. This availability is often not possible + in the case of proprietary software. And when it is, it comes at a + high cost and contractual obligations.</p></li><li><p>FOSS applications like DHIS2 typically are supported by a + global network of developers, and thus have access to cutting edge + research and development knowledge. </p></li></ul></div></div><div class="sect3"><div class="titlepage"> +<div><h4 class="title"><a name="idsect3150776480"></a>Understanding platform independency</h4></div> + +</div><p>All computers have an Operating System (OS) to manage it and the + programs running it. Such OS serve as the middle layer between the + software application, such as DHIS 2, and the hardware, such as the + CPU and RAM. The most popularly used OS is Microsoft Windows, which + comes in various versions (such as XP, Vista). However, this OS costs + money, and have also been reported to have security issues that makes + it vulnerable to virus attacks. Operating Systems like Linux are free, + and are more secure with respect to virus attacks. Usually, many of + the applications will work on one OS, and not on others. Platform + independency implies that the software application can run on ANY OS - + Windows, Linux, Macintosh etc. DHIS 2 is platform independent, and is + extremely useful in the context of public health when typically you + have systems in different places running different kinds of OS. + </p></div><div class="sect3"><div class="titlepage"> +<div><h4 class="title"><a name="idsect3150775400"></a>Auxiliary software that can be used with DHIS</h4></div> + +</div><p>A variety of auxiliary software can be run with DHIS 2, such as + GIS (for mapping), BIRT (for reporting), Excel (for analysis through + pivot table operations), Open MRS (for patient based management), and + CRIS (for HIV/AIDS management). Being based on Open Standards and an + Open Architecture, DHIS 2 can build bridges to speak to the other + systems. Further, auxiliary modules can be developed and integrated + with the core DHIS 2 application. </p></div></div></div></div></body></html> \ No newline at end of file === added file 'docs/images/dhis2_information_cycle.png' Binary files docs/images/dhis2_information_cycle.png 1970-01-01 00:00:00 +0000 and docs/images/dhis2_information_cycle.png 2009-09-12 14:30:17 +0000 differ
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