DHIS2 functions as national digital public infrastructure (DPI) for routine health information management in many low and middle income countries. In Uganda, DHIS2 captures antenatal care (ANC) and birth related data largely as aggregate indicators, which limits reuse of individual level data for services such as birth registration and integration with civil registration and vital statistics (CRVS) systems. This paper presents an implementation and methods use case describing how DHIS2 was configured and piloted to support individual-level ANC and birth data workflows and to explore interoperability pathways with CRVS. The use case was piloted within Uganda’s national DHIS2 platform in Mukono District. In this context, DHIS2 is currently used to track individual-level ANC data at public HCII and HCIII facilities, and five facilities have fully transitioned to a digital ANC eRegistry. The pilot focused on differentiated service delivery contexts by examining public HCII and HCIII workflows for ANC and birth data. Mixed implementation methods were used to generate operational understanding of system configuration and readiness, including DHIS2 Tracker and metadata configuration reviews, workflow mapping, stakeholder consultations, and analysis of secondary data from public health facility digital systems and infrastructure assessments. Analysis was guided by CFIR and PRISM. The use case documents how ANC and birth data are captured at the point of care and transformed through routine reporting workflows within DHIS2, and examines DHIS2 functionalities relevant to interoperability with CRVS, including Tracker configuration, metadata structures, user roles, and reporting processes. Attention is given to how facility-level shapes feasible configuration choices and workflow design. This implementation and methods use case illustrates how DHIS2 can be positioned as a connector within national DPI ecosystems.
Great job @Evie_P_A . This is a great example of how DHIS2 can extend beyond routine reporting and contribute to broader digital public infrastructure. The exploration of interoperability between DHIS2 and CRVS systems for birth registration is particularly interesting. Thank you for sharing this important work from Uganda.This is a great example of how DHIS2 can extend beyond routine reporting and contribute to broader digital public infrastructure. The exploration of interoperability between DHIS2 and CRVS systems for birth registration is particularly interesting. Thank you for sharing this important work from Uganda.
Thank you very much. A major insight from this work was that the biggest interoperability gaps were not necessarily technical but often related to workflow design, governance, and coordination between health and civil registration systems. We are currently exploring how the remaining duplicate birth notification entry between DHIS2 and the CRVS platform can be eliminated through interoperable workflows. I would be interested to hear about similar experiences from other countries.
That’s a very interesting observation. It’s often easy to focus on the technical aspects of interoperability, but workflow alignment and governance can have an even greater impact on successful implementation. The challenge of eliminating duplicate data entry is one that many health information systems face, so I look forward to hearing how this evolves and learning from experiences shared by other countries.
Thank you very much! I appreciate your encouragement. This work has been an exciting opportunity to explore how DHIS2 can support not only routine health reporting but also broader Digital Public Infrastructure and CRVS integration. I’m grateful for the opportunity to share our experience from Uganda.
Thank you so much for the kind words! This was truly a collaborative effort, and I am grateful to the entire team for their expertise and commitment. The work brought together stakeholders from public health, health informatics, DHIS2 implementation, and civil registration systems, and we learned a great deal throughout the process. We hope the lessons from Uganda can contribute to ongoing discussions on interoperability, Digital Public Infrastructure, and strengthening birth registration systems through DHIS2. @Alice_Mugisha@Flavia@bntare@Prosper_BEHUMBIIZE@SandraNabatanzi and many others played a pivotal role in making sure this work is successful.
This was truly a collaborative effort, and I am grateful to the entire team for their expertise and commitment. The work brought together stakeholders from public health, health informatics, DHIS2 implementation, and civil registration systems, and we learned a great deal throughout the process. We hope the lessons from Uganda can contribute to ongoing discussions on interoperability, Digital Public Infrastructure, and strengthening birth registration systems through DHIS2.