Multiple enrollments in a tracker capture program

[Orly_MUGWANEZA]

Hello,

Is it possible to have multiple enrollments for a single tracked entity instance in a tracker capture program?

[Gassim (AL-Gassim Sharaf Addin)]

Welcome back to the community @Orly_MUGWANEZA ! (:

Yes, that’s the default unless the option not to allow multiple enrollments is checked, see screenshot:

[SamuelJohnson]

Note that even if you choose to allow multiple enrolments, each TE can only have one open enrolment for that program at any point in time - so the user will need to complete the first enrolment before they can create a second.

[fernando (maposse)]

Hi @SamuelJohnson and @Gassim,

Please. can you describe a scenario where these two concepts: multiple enrolments and only enroll once are applicable in practice. Both terms are confusing for me. Some examples can help clarify my doubt and make feel confident.

Thanks

[Gassim (AL-Gassim Sharaf Addin)]

Thanks for the note @SamuelJohnson!

@fernando, sure! @SamuelJohnson and others feel free to add!

One example is from the screenshot above in the Child Program where one can be enrolled once because the TEI only gets that type of attention when the mother gives birth and once that program is completed and the enrollment is closed then the TEI can’t be enrolled again. However, another example where the opposite is possible (can enroll multiple times) would be when the TEI can receive the type of attention more than once in a lifetime. There are many cases where this is possible for example a person could need medical attention for an illness, recovers, and then some time in the future becomes ill again and needs to receive the medical attention again.

I hope this helps! I recommend going through the documentation of the metadata packages (available in the dhis2 docs site, click here). These documentation provide detailed explanation to how a program is configured which are quite helpful in understanding configurations.

[SamuelJohnson]

Hi Fernando,

The following topic discussed exactly that question, and contains another example similar to the the one that @Gassim shared:

Only enroll once (per tracked entity instance lifetime)

Good examples include: (a) a death registration program, which you would only want to ever complete once for a tracked entity (so you would tick this option); (b) an antenatal care (ANC) program, which a woman will be enrolled in once for every pregnancy she has (so you would leave this option un-ticked). Note that even if you leave this box un-ticked, you can’t create two enrollments at the same time for a single tracked entity - eg you would have to ‘complete’ the first ANC enrollment for t…

Cheers, Sam.

[fernando (maposse)]

Hi @SamuelJohnson and @Gassim ,

Thank you for you support. My last question: In the excerpts below, if a person falls ill again in the future and needs another medical attention, would we have to register them again?

1. There are many cases where this is possible for example a person could need medical attention for an illness, recovers, and then some time in the future becomes ill again and needs to receive the medical attention again.

2. Note that even if you leave this box un-ticked, you can’t create two enrollments at the same time for a single tracked entity - eg you would have to ‘complete’ the first ANC enrollment for this woman before you could re-enrol her again in the same ANC program.

Also, thanks for sharing the documentation.

[SamuelJohnson]

Hi Fernando,

There’s a lot of flexibility in how you choose to configure this in DHIS2, but no, you would not normally ever re-register the patient (=create a new tracked entity instance) but yes, you would create multiple enrolments for the same patient, treating each enrolment as a ‘case’ or ‘episode’ (case of malaria, case of diarrhoea, pregnancy,etc). So:

1. For a case of malaria, you would open the first enrolment when the patient falls ill and complete (close) the enrolment when the case/episode is finished; so you would then need open a new enrolment for the same patient if they fall ill with malaria again.

2. For a pregnacy/delivery, you would open the first enrolment when the client falls pregnant and complete (close) the enrolment when postnatal care is completed; you would then open a new enrolment for her if she falls pregnant again.

3. For one-off interventions like vaccination programs, you would open the enrolment when the child has their first dose, and complete the enrolment when the last dose has been administered; since the child won’t ever need these vaccinations again, there won’t be any need to re-enrol them again. (This program would usually have the setting “Only enrol once per tracked entity lifetime” ticked.)

4. For things like ART, which are continuous care rather than a time-limited ‘case’, you would usually just treat this as a single, ongoing enrolment (with an event for each visit) that is only completed if the patient exits the program.

I hope these examples help explain the options.