Proposal to Strenghern Health Information System [HIS]

\ud The HMIS Program described in this document aims at improving and strengthening the current Health Management Information System (HMIS) in Tanzania, known as MTUHA. The consortium behind the HMIS Program is headed by the Ministry of Health & Social Welfare (MOHSW) and consists of the following additional partners; Ifakara Health Research and Development Centre, University of Dar es Salaam and the University of Oslo, representing national and international capacity in HMIS. The HMIS Program is linked to the Payment for performance (P4P) funding scheme which is initiated by the Norway Tanzania Partnership Initiative. The P4P has a focus on maternal and child health and relies upon quality indicators on performance in these areas from health facilities and districts. The provision of quality data and indicators on MDG 4 & 5 is therefore a key target for the HMIS Program. The chosen approach is, however, to derive these data from the HMIS and not to establish a separate data collection structure, hence the HMIS Program. Quality information by way of essential indicators, such as for monitoring the Millennium Development Goals 4 & 5, are crucial for health services delivery and program management as well as for M&E. Currently, however, the HMIS is not providing such needed data of sufficient completeness, timeliness and quality, leading health programs and funding agencies to establish their own structures for data collection, and thus creating fragmentation and adding to the problem. The HMIS Program aims at changing this negative trend and turning the HMIS into the key source of shared essential quality information in Tanzania by; focusing on action oriented use of information for management at each level of the health services and by providing timely quality information to all stakeholders, including all health programs and funding agencies in the HMIS strengthening process – making it an all-inclusive national process, focusing on capacity development; on-site support and facilitation, short courses and continuous education, building capacity in the MOHSW and establishing a national network of HMIS support, and by building on experience, methods and tools from Africa’s “best practices” HMIS, such as South Africa – and Zanzibar Within this proposal the aim is to carry out the HMIS strengthening process in 1/3 of the districts in the country, 7 regions, during the first 3 years. The objective, however, is to cover the entire country during the 5 years duration of the NTPI. By aiming at quick and tangible results, the expectation is that other funding agencies will join forces and thereby ensuring national coverage.\ud \u

Breaking Down Silos: How to Share Data to Improve the Health of People Experiencing Homelessness

Housing is a key social determinant of health. Stable housing can help maintain health and reduce unnecessary emergency room use and hospital admissions, while research indicates that addressing the health-related needs of people experiencing or at risk of homelessness is crucial to accessing and sustaining housing.Because homelessness in California exists on an unprecedented scale — with more than 150,000 people experiencing homelessness on any given day — purposeful collaborations between the health care and homeless systems of care are critical. Such efforts have taken a variety of forms, including Whole Person Care pilot programs and collaborations aimed at improving care for those who frequently touch both the health care and homeless systems of care — while reducing the costs of the two systems so they can serve more people.This report focuses on ways in which California's housing and health care sectors are sharing data to better coordinate and support mutual clients within their communities. Data sharing has been pivotal in breaking down silos and improving coordination between the two systems to better address clients' needs.Yet despite dedicated and committed partnerships in place for cross-sector collaboration, data sharing efforts have not occurred without challenges. Communities have raised a common set of barriers they have faced, including privacy issues, relationships and collaboration, interoperability, and data quality.While there are no uniform ways to address the common challenges, communities have creatively employed strategies and taken advantage of opportunities to continue pushing forward data sharing efforts. These opportunities have proven most effective when tailored to each community's own needs, structures, relationships, and motivations

Incident Analysis & Digital Forensics in SCADA and Industrial Control Systems

SCADA and industrial control systems have been traditionally isolated in physically protected environments. However, developments such as standardisation of data exchange protocols and increased use of IP, emerging wireless sensor networks and machine-to-machine communication mean that in the near future related threat vectors will require consideration too outside the scope of traditional SCADA security and incident response. In the light of the significance of SCADA for the resilience of critical infrastructures and the related targeted incidents against them (e.g. the development of stuxnet), cyber security and digital forensics emerge as priority areas. In this paper we focus on the latter, exploring the current capability of SCADA operators to analyse security incidents and develop situational awareness based on a robust digital evidence perspective. We look at the logging capabilities of a typical SCADA architecture and the analytical techniques and investigative tools that may help develop forensic readiness to the level of the current threat environment requirements. We also provide recommendations for data capture and retention

Using District Health Information System (DHIS2) for Health Data Integration in Special Region of Yogyakarta

A number of applications have been used for managing health data and information and tend to be fragmented between health programs in health offices. In consequence, the analysis and interpretation process becomes difficult since the data is scattered in separate sources. One of the solutions offered as an effort to synchronize and integrate health data in Indonesia is through implementing District Health Information Software (DHIS2). DHIS2 is an application that emphasizes data integration at the health office level. Faculty of Medicine, Public Health and Nursing UGM has been partnered with the Special Region of Yogyakarta Health Office to carry out community service activities in the context of utilizing DHIS2 for health data integration in the province. The implementation of DHIS2 was divided into 4 stages, namely workshop on data availability, socialization, and training of DHIS2; data mapping and customizing DHIS2; implementing health data integration; and dissemination, supervision, and evaluation. Six health offices were the target of community service activities in the province. DHIS2 has facilitated health office staff to analyse and visualize health information that is used for decision making and advocacy. This community service activity supports the government’s efforts to provide one-stop data and contributes to strengthening health information systems both nationally and regionally

The principles of an ideal homelessness administrative data system: lessons from global practice

Discussions of homelessness measurement methodologies have largely focused on the generation of primary data, for example point-in-time counts. Though there is long standing tradition in the use of administrative data for measuring homelessness, relatively little examination of administrative data as method exists, i.e. the set of socio-technical practices through which administrative data are generated. This paper undertakes an internationally informed review of 50 administrative data systems in order to deconstruct these systems and stage a methodological discussion. Uniquely, the review included systems from other policy fields outside of homelessness, including health and education, in order to learn from wider data practices. The discussion elaborates on six key design considerations driving administrative data systems, including; function; data architecture; data quality; ethico-legal considerations; privacy preservation; and data access and accessibility. To conclude, we outline what an ideal data system would look like in order to improve the potential use of administrative data to measure homelessness and our response to it, but, more importantly, in mobilising data more effectively in order to facilitate research and operational uses of data. The six design elements can inform future homelessness administrative data systems, whilst also sensitising researchers and users of current administrative data to its (socially) constructed nature

HIS Standardization in Developing Countries: Use of Boundary Objects to Enable Multiple Translations

Standardization and integration of Health Information Systems (HIS) in most developing countries has been reported as a complex undertaking due to poverty, multiplicity of diseases and diverse actors working in various initiatives within the healthcare context. The need for collaborative investments in HIS strengthening is highlighted by major actors such as WHO, as significant to achieve an integrated HIS. However, despite the fact that involvement of multiple partners is desirable as a vehicle to attain an integrated HIS, entailed challenges should be understood and well managed. By drawing on the concept of translation from actor network theory supplemented by the notion of boundary objects, we examine the HIS standardization challenges and the strategies to curb them in the context of multiple divergent actors engaging in HIS integration process in Tanzania. The article stresses the need to coordinate the standardization process through circulation of boundary objects across the involved multiple actors

Development of insect production automation: Automated processes for the production of Black Soldier Fly (Hermetia illucens)

In recent years, Black Soldier Fly (Hermetia illucens) has received attention as an attractive approach for recycling biowaste into value products. The production of Black Soldier Fly (BSF) uses biowaste as the input feedstock for the growing of BSF larvae in order to produce nutrient-rich larvae feedstock products and organic fertilizers. However, most of the operations in BSF production are still carried out manually, which limits production volume. This makes BSF products less competitive than other traditional feedstock products. Thus, this thesis aims to develop automated processes for the mass production of BSF larvae. In order to eliminate the dependence on manual work and to make feasible the industrialization of production, a six-step strategy was implemented. The sequence of steps was as follows: determining the requirements and specifications of the BSF production; calculating the desired capacity of processes; selecting machinery; designing automated processes; proposing a method of machinery integration; and designing state machines for automation software programming. The solution developed here consists of four components: a list of machinery with capacity analysis; a designed floor layout and 3D visualization of all production processes; a proposed automation control system for the integration of machinery; and composite function blocks of IEC 61499 standard for automation software programming. This thesis shows that the availability of current technologies makes feasible the automation of the BSF production process. In terms of further work, the selection of processing machines should be verified; and both the programming of automation software and the use of simulation could improve the design of the production automation

Liberian health system resilience: lessons from the 2014–2015 West African Ebola epidemic

I. BACKGROUND: Following a review of donor funding priorities and concepts of health system strengthening (HSS) and resilience, this dissertation documents health system resilience factors existing in the Liberian health system in late 2014/early 2015 as the Ebola epidemic flared. The effectiveness of the WHO health system building blocks framework in addressing resilience was assessed, and specific factors that can promote health system resilience for Liberia going forward were identified. II. METHODS: Methods applied as part of this intrinsic case study include document and literature review, analysis of health facility and population-level statistics, and key informant and group interviews at the county and national levels. The methodology allowed for an in-depth assessment of how HSS (using the WHO health system building blocks) and resilience factors (using the WHO-defined key aspects of emergency preparedness) exist (or could exist) within the Liberian institutional and cultural context, and for tentative conclusions to be drawn about the importance of system factors to building specific health system capacities and overall health system resilience. III. FINDINGS: While dealing with myriad other public health priorities, public health preparedness went largely unaddressed in pre-Ebola Liberia where effectively none of the 16 key components or their 51 essential attributes listed in the WHO table of emergency preparedness were in place. The lack of integration of public health preparedness into HSS interventions left the country vulnerable to public health emergencies. There are two limitations to the government’s Ebola recovery and investment plan: (1) lack of a holistic approach to addressing emergency preparedness; and (2) not integrating emergency preparedness needs and corresponding activities into the existing national HSS framework. IV. CONCLUSION: By integrating emergency preparedness and response initiatives into HSS activities, health systems in Liberia and elsewhere can be strengthened to be more resilient, and thus better able to anticipate and adapt to challenges, and ultimately improve the system to be able to anticipate new future challenges. However, strengthening health systems so that they are resilient takes resources, including sector-wide, HSS resources that can be used to build functioning, integrated systems and skilled, networked individuals and groups across sectors

Evaluation of the Conrad N. Hilton Foundation Chronic Homelessness Initiative: 2014

Under a September 2011 contract with the Conrad N. Hilton Foundation, Abt Associates has been conducting an evaluation of the Hilton Foundation's Chronic Homelessness Initiative with the goal of answering the overarching question: Is the Chronic Homelessness Initiative an effective strategy to end and prevent chronic homelessness in Los Angeles County? The evaluation is designed to provide both interim milestones related to improving the systems for serving people experiencing chronic homelessness and estimates of the effect of permanent supportive housing (PSH) on its residents and on the problem of chronic homelessness. Since the beginning of the Chronic Homelessness Initiative, the Foundation has distributed more than $42.3 million in multi-year grants to 21 nonprofit groups working in LA. The LA grantees include nonprofit groups working on regional systems change and capacity-building, as well as local groups providing direct services to chronically homeless individuals, PSH developers, and public policy advocates.In this report, the third of the annual updates, the evaluation team documents the significant progress that has been made on each of the six primary Hilton Foundation Chronic Homeless Initiative goals, summarized in the table below. Many of the five-year goals have been exceeded, and most others are on track to be reached within the next two years. These accomplishments are impressive; even more notable is the extensive systems change that has occurred, which promises to ensure continued success