Assessing the acceptability and feasibility of biometric integration in DHIS2 at the community level: A small scale intervention in Nepal

This abstract has been accepted at the 2024 DHIS2 Annual Conference

Assessing the acceptability and feasibility of biometric integration in DHIS2 at the community level: A small scale intervention in Nepal

Background: The automated identification of individuals through biometric characteristics like fingerprint could be an important tool to address client duplication in DHIS2 tracker. Within HIV programs, identification of unique clients is important to enable treatment support. The EpiC project in Nepal —funded by the U.S. President’s Emergency Plan for AIDS Relief and the U.S. Agency for International Development — uses a DHIS2-based system called Mero Data to track services provided to individuals. EpiC Nepal conducted a small-scale intervention to integrate fingerprinting with Mero Data to assess the feasibility and acceptability of fingerprint integration in DHIS2 at the community level. Methodology: The intervention was implemented among six partners targeting high HIV-risk populations and utilized a Kotlin-based Android app with Androidx Security Crypto for secure fingerprint matching to tracked entity instances. In-person staff orientation was provided to capture client fingerprints at the community level and staff used standard questionnaires to gather feedback from service providers and clients. Data privacy was rigorously maintained, ensuring client confidentiality and individual consent. The intervention spanned March to June 2023 and included 12 key informant interviews (six clients; six staff) for qualitative feedback. Result: We reached 3,767 clients, of which 756 (20%) were offered fingerprinting. The remaining 80% could not be offered due to internet accessibility and technical problems in the application. Among the total offered, 753 (99.6%) agreed and fingerprints were collected. We carried out further analysis on the domains that were collected from the feedback sheet and the response rate was 87.6% (n=660). Results from a single sample Wilcoxon Signed rank test on all the domains showed significant statistical differences (p< 0.05), revealing acceptability and feasibility of the device to scale up the biometric integration at the community level. The qualitative analysis showed that agreement to fingerprints could have been affected by clients’ privacy concerns as there was difficulty securing a private place to provide their biometrics. The community staff found the integration helpful to avoid duplication of clients across the country. Difficulties implementing it at the community level included device theft risk, amount of time required, frequent biometric system outage, and internet connectivity. Conclusion: The integration of biometrics at the national level to link clients across the continuum of care seems feasible and acceptable, but aspects of privacy and secure internet facilities with improved biometric application need to be ensured.

Primary Author: Upendra Shrestha

Nepal, EpiC Nepal, Biometric integration, prevention services, feasibility, accessibility, key population