Adapting a DHIS2 Standard Metadata Package: From Immunization (AEFI) to Circumcision (VMMC) Adverse Events

Title of my presentation: Adapting a DHIS2 Standard Metadata Package: From Immunization Adverse Events (AEFI) to Voluntary Medical Male Circumcision (VMMC) Adverse Events

Title date, and time of my session: “HIV: tracker innovations and adaptations for longitudinal analysis” on Wednesday, June 23 (14:00 - 15:00)

About Me: My name is David Nesbitt, a Technical Business Analyst with BAO Systems, headquartered in Washington DC. I work specifically on the DHIS2 Instance of the PEPFAR program’s HIV data collection system, DATIM.


Problem & Objectives
DATIM, the United States President’s Emergency Plan for AIDS Relief (PEPFAR)’s DHIS2 instance, is the monitoring and evaluation data collection system for global PEPFAR-funded HIV/AIDS. However, despite DATIM’s mature implementation status, Voluntary Medical Male Circumcision (VMMC) Notifiable Adverse Event Reporting has remained an Excel and email-based reporting process – separated from the rest of PEPFAR’s data ecosystem. Over time, as calls for data and reporting become more complex, the current PEPFAR VMMC NAE data collection process has become burdensome to manage and analyze. PEPFAR’s strategic information staff sought to explore whether setting up a system for VMMC notifiable adverse event reporting would be feasible within the same DATIM instance that currently supports other PEPFAR monitoring and evaluation data streams.

Almost simultaneously with PEPFAR’s decision to update AE reporting, DHIS2 and the WHO released their Adverse Event Following Immunization (AEFI) standard metadata package. Using AEFI as a template, the DATIM team tailored the adverse events reporting workflow using PEPFAR’s VMMC NAE forms as a guide for content, avoiding the need to develop a customized/”from-scratch” Tracker Program that would have required a costly and time consuming requirements discovery phase.

Our team was able to rapidly prototype a Tracker Capture VMMC NAE module for longitudinal updates as AE information is investigated, collected, and reported to PEPFAR. Workflow support, involving automatic, system generated email notifications to relevant users throughout the process, was greatly simplified by adapting the existing AEFI package. This rapid prototype is planned to be rolled out globally for PEPFAR implementing partners to report VMMC adverse events.

Conclusion & Future Direction
Leveraging a standard metadata package with a similar purpose (adverse events reporting) was an effective way to rapidly adapt DHIS2 metadata to enable practical implementation. Given the success in this area, PEPFAR is considering applying the same rapid prototyping model for other reportable adverse events, such as for cervical precancerous lesion treatment.

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Recording of the session can be found here:

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