Overview, not Overwhelm: Framing Operational BI Tools using Organizational Capabilities

In contexts where fragmentation of information systems is a problem, data warehouse (DW) has brought disparate sources of information together. While bringing data together from multiple health programs and patient record systems, how does one make sense of huge amounts of integrated information? Recent research and industry uses the term, “Operational BI” for decision making tools used in operational activities. In this paper, we highlight the use of DHIS 2, a large-scale, open-source, Health Management Information System (HMIS) that acts as a DW. Firstly, we present the results of a survey done in 13 countries to assess how Operational BI Tools are used. We then show 3 generations of BI Tools in DHIS 2 that have evolved from action-research done over 18 years in more than 30 countries. Secondly, we develop the Overview-Overwhelm (O-O) analytical framework for large-scale systems that need to work with Big Data. The O-O framework combines lessons from DHIS 2 BI Tools design and implementation survey results

Distributed Development to Enable User Participation: Multilevel design in the HISP network

Through the study of a long term, globally targeted effort to design health information systems in the Global South, we explore challenges to distributed participation within and across countries, and describe efforts at addressing these. Networked action research projects can enable pooling of resources, skills, best practices and tools, and cross-country collaboration does not have to preclude local ownership, as illustrated by the case material in this article. We highlight specifically the need for circulation of people, artefacts, and standards, to both support local practices and foster the capacity of all stakeholders to take active part in the design and implementation of information systems. The deep effects of global technological change call for a multilevel approach bridging local implementations with global research and participatory design efforts and co-evolution of standardised tools

Writing PD: accounting for socially-engaged research

As participants in participatory process, PD academics report on the practices and outcomes of their work and thereby shape what is known of individual projects and the wider field of participatory design. At present, there is a dominant form for this reporting, led by academic publishing models. Yet, the politics of describing others has received little discussion. Our field brings diverging sensibilities to co-design, conducting experiments and asking what participation means in different contexts. How do we match this ingenuity in designing with ingenuity of reporting? Should designers, researchers and other participants all be writing up participatory work, using more novel and tailored approaches? Should we write more open and playful collaborative texts? Within some academic discourse, considerable value is placed on reflexivity, positionality, inclusivity and auto-ethnography as part of reflecting. Yet, PD spends no time in discussing its written outputs. Drawing on the results of a PDC’16 workshop, I encourage us to challenge this silence and discuss “Writing PD”

Cloud Computing for Development – Improving the Health Information System in Ghana

The health sector in many developing countries is undergoing restructuring to meet set goals, especially the health related Millennium Development Goals. To be able to monitor the performance of the health sector, an efficient Health Information System (HIS) is essential. This paper describes the process of implementing an online data warehouse based on the open source District Health Information Software 2 (DHIS2) in Ghana, integrating existing vertical reporting systems run by various health programmes. We discuss how an online deployment has solved many of the challenges facing the previous HIS in Ghana, and how it is an example of how cloud computing can be leverage to great effect in developing countries. IST-Africa 2013 Conference Proceedings

Big Data Analytics for developing countries – Using the Cloud for Operational BI in Health

The multi-layered view of digital divide suggests there is inequality of access to ICT, inequality of capability to exploit ICT and inequality of outcomes after exploiting ICT. This is evidently clear in the health systems of developing countries. In this paper, we look at cloud computing being able to provide computing as a utility service that might bridge this digital divide for Health Information Systems in developing countries. We highlight the role of Operational Business Intelligence (BI) tools to be able to make better decisions in health service provisioning. Through the case of DHIS2 software and its Analytics-as-a-Service (AaaS) model, we look at how tools can exploit Cloud computing capabilities to perform analytics on Big Data that is resulting from integration of health data from multiple sources. Beyond looking at purely warehousing techniques, we suggest understanding Big Data from Organizational Capabilities and expanding organizational capabilities by offloading computing as a utility to vendors through cloud computing

Assessing immunization data quality from routine reports in Mozambique

Background Worldwide immunization coverage shows an increase in the past years but the validity of the official reports for measuring change over time has been questioned. Facing this problem, donor supported initiatives like the Global Alliance for Vaccine and Immunizations, have been putting a lot of effort into assessing the quality of data used, since accurate immunization information is essential for the Expanded Program on Immunization managers to track and improve program performance. The present article, discusses the practices on record keeping, reporting and the support mechanism to ensure data quality in Mozambique. Methods A process evaluation study was carried out in Mozambique in one district (Cuamba) in Niassa Province, between January and March 2003. The study was based on semi-structured interviews, participant observation and review of the data collection materials. Results Differences were found for all vaccine types when comparing facility reports with the tally sheets. The same applies when comparing facility reports with district reports. The study also showed that a routine practice during supervision visits was data quality assessment for the outpatient services but none related to data consistency between the tally sheets and the facility report. For the Expanded Program on Immunization, supervisors concentrated more on the consistency checks between data in the facility reports and the number of vaccines received during the same period. Meetings were based on criticism, for example, why health workers did not reach the target. Nothing in terms of data quality was addressed nor validation rules. Conclusion In this paper we have argued that the quality of data, and consequently of the information system, must be seen in a broader perspective not focusing only on technicalities (data collection tools and the reporting system) but also on support mechanisms. Implications of a poor data quality system will be reflected in the efficiency of health services facing increased demands, with stagnant or decreasing resources

Improving quality and use of data through data-use workshops: Zanzibar, United Republic of Tanzania

PROBLEM\ud \ud In Zanzibar, United Republic of Tanzania, as in many developing countries, health managers lack faith in the national Health Management Information System (HMIS). The establishment of parallel data collection systems generates a vicious cycle: national health data are used little because they are of poor quality, and their relative lack of use, in turn, makes their quality remain poor.\ud \ud APPROACH\ud \ud An action research approach was applied to strengthen the use of information and improve data quality in Zanzibar. The underlying premise was that encouraging use in small incremental steps could help to break the vicious cycle and improve the HMIS.\ud \ud LOCAL SETTING\ud \ud To test the hypothesis at the national and district levels a project to strengthen the HMIS was established in Zanzibar. The project included quarterly data-use workshops during which district staff assessed their own routine data and critiqued their colleagues' data.\ud \ud RELEVANT CHANGES\ud \ud The data-use workshops generated inputs that were used by District Health Information Software developers to improve the tool. The HMIS, which initially covered only primary care outpatients and antenatal care, eventually grew to encompass all major health programmes and district and referral hospitals. The workshops directly contributed to improvements in data coverage, data set quality and rationalization, and local use of target indicators.\ud \ud LESSONS LEARNT\ud \ud Data-use workshops with active engagement of data users themselves can improve health information systems overall and enhance staff capacity for information use, presentation and analysis for decision-making

Networks of Action: Sustainable Health Information Systems Across Developing Countries

Our paper is motivated by one simple question: Why do so many action research efforts fail to persist over time? We approach this question, the problem of sustainability, building on a perspective on action research identifying the pivotal importance of networks. More precisely, local action research interventions need to be conceptualized and approached as but one element in a larger network of action in order to ensure sustainability. A vital aspect of our perspective is that local interventions depend heavily on the support of similar action research efforts in other locations. This is essential for the necessary processes of learning and experience sharing. We suggest that the scaling (i.e., spreading) of the intervention is a prerequisite, not a luxury, for sustainable action research. Empirically, we base our analysis on an ongoing, large-scale action research project within the health care sector (called HISP) in a number of developing countries. HISP provides a fruitful occasion to investigate key criteria for our approach to action research, namely sustainability, scalability, and capacity to be politically relevant to the participants. We contribute to three discourses: (1) models of action research, (2) lessons for health information systems in developing countries, and (3) more generally, IS implementations that are dispersed, large-scale, and have scarce resources