This abstract has been accepted at the 2024 DHIS2 Annual Conference
From paper to pixels: Evaluating the scale-up of DHIS2 Tracker among HIV projects in 14 countries
Background: An effective HIV response requires detailed analysis of individual level data, yet in many countries longitudinal tracking of clients is still done on paper. DHIS2 tracker presents a unique opportunity for low cost, flexible deployment of a Health Management Information System (HMIS), yet little is published about DHIS2 Tracker deployment at scale. Under the PEPFAR funded Meeting Targets and Maintaining Epidemic Control (EpiC) project, we supported the rollout and scale up of DHIS2 Tracker amongst HIV programs in 14 countries. In this global program evaluation, we aimed to (1) determine the time to achieve scale up of HIV HMIS among PEFPAR supported partners and (2) evaluate user satisfaction. Description: The HIV programs we evaluated varied in size dramatically, with an average of 37,972 clients supported per project, annually (range: 1,649 to 290,371). Each project operates through several implementing partners, ranging from 4 46. Individual level HMIS were adapted using different approaches: some were developed from scratch, while others were developed using a metadata package customized to fit the project context. End users, managers, and other stakeholders were trained, and the project team provided ongoing supportive supervision. To evaluate scale up time, we analyzed the number of clients in each system compared to the total number of clients reached by the project, monthly. “At scale” was defined as >=95% of clients included in the HMIS. To solicit feedback, we asked health informatics professionals in each country to complete a short survey. Lessons learned: On average, it took countries 7.6 months (95% CI: 6.4 9.7, range 4 12 months) to reach scale. Projects that served large populations (>20,000 clients) and had more than 10 partners, took longer to reach scale (9.8 and 9.1 months, respectively). When users were asked how DHIS2 affected regular data review and analysis tasks, most felt that reviewing data (71%) and reporting (71%) were easier with DHIS2. All surveyed respondents felt DHIS2 improved the quality of client support. Users noted ongoing challenges with system downtime, lack of timely support, and unrealistic stakeholder expectations that systems be fully utilized quickly. Conclusions/next steps: All projects were able to reach scale, with time from rollout to full utilization ranging from 4 12 months. DHIS2 proved an efficient and easy to use option for transitioning to electronic HMIS for HIV projects. However, stakeholders need to recognize that significant investments and time are required for technology adoption. Lessons learned can inform other
Primary Author: Kayla Stankevitz
Keywords:
DHIS2 tracker, HIV, PEPFAR, Asia, Africa
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