This community innovation has been accepted at the 2025 DHIS2 Annual Conference
Randomized Controlled Trials using DHIS2 Tracker
Digital health registries can improve evidence based maternal and child health services. For instance, in Palestine, a large scale transformation replaced a paper based health information system in primary healthcare with a digital eRegistry, across West Bank and Gaza. Similarly, in Bangladesh, we implemented a district wide eRegistry across two tiers of the health system: health facilities and community based care. These implementations enabled cluster randomized controlled trials to evaluate effectiveness of digital health registries. We randomized entire districts, and 50 150 health facilities, to either receive the DHIS2 based digital registry (intervention group) or continue using paper based systems or simplified “paper on screen” systems (control group). The interventions evaluated include clinical decision support, quality improvement dashboards, SMS to clients, and clinical guidelines for number of health visits during pregnancy. Outcomes included quality of care in terms of screening and management of pregnant women for conditions during antenatal care, and health outcomes of mother and baby. All data for outcome assessment were obtained from DHIS2 Tracker for primary healthcare, and from hospital health information systems. Our trials show that the intervention led to better quality of care such as improved screening and management for anemia, and hypertension, and marginal improvements in health outcomes. These embedded evaluations provided robust evidence and demonstrate how to run clinical trials completely within a health information system without adding additional data collections. Our projects demonstrate the dual role of digital health registries as both direct health interventions and providers of research data. Our current project in Ethiopia uses similar principles of RCT of real world implementations for NCD risk prevention among pregnant women.
Primary Author: Mahima Venkateswaran
Keywords:
randomized controlled trials, digital registries, health information systems
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