Total Cost of Ownership of DHIS2 as national HMIS

Implementation - Implémentation
1

Hi, does anyone have examples of a ‘total cost of ownership’ analysis in different LMICs that have deployed DHIS2 as their core national HMIS?

I am looking for a rough ballpark figure for the ongoing costs of hosting and maintenance (after the initial adoption/configuration). I KNOW it depends on infinite variables but I also know that it’s possible to get to a ballpark estimate based on population size and typical number of indicators etc. I have done this myself but do not want to share my own figure to avoid anchoring bias.

Thanks!

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Dear Jack,

It is as you say depending on a range of factors (type of use, no of users, local cost levels etc).

We have made this DHIS2 budget guide. Feel free to make a copy and play with it: DHIS2 budget guide example (2024).xlsx - Google Sheets
The tab called annual maintenance costs are particularly relevant for your yearly budget. You need to account for (every year):

  • capacity building, both for end users (new functionality, people quit etc) and for the team maintaining and developing DHIS2
  • Infrastructure (hosting, connectivity and replacement of devices + MDM). This depends greatly on how you use DHIS2 (point of care = many users, aggregate only at district level = less users, load that influence server costs etc)
  • Staff salaries for the team maintaining DHIS2
  • Regular supportive supervision (not DHIS2 specific)
  • Regular evaluation/quality improvement
  • External technical assistance to address issues not solved by the national team

I guess this was a “it depends”-answer, but hopefully the document can help to plan/budget. Happy to discuss further if you want!

Anne Thorseng,
Program team lead, implementation team, HISP Center

1 Like
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Haha, thank you Anne! I did find that document and used it to come up with my own estimate.

Inspired by that, I made a slightly different version, linked to a (very editable) workplan via the date inputs. You are also very welcome to view/copy/edit in case it is helpful here: DHIS2 Transition Plan Template with Budget.xlsx - Google Sheets

I found it easier to have each of the ‘phases’ referencing the same unit costs along the left. For the project I was costing out, we also landed on slightly different phases to the stencil you guys provided.

And then to my original question, do you (or anyone??) have any reference material/case study for this actually happening in-country? How much have implementations actually costed vs. how much they were budgeted to cost (eg, using this budgeting tool)?

Thanks!
Jack

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Nice to see you use it as inspiration and coming up with your own plan.
To your first question - no, I have not seen good case studies or been part of TCO exercises for DHIS2, but would also be interested to see it so do share here (and I will do the same if I see one). We have used the budgeting guide primarily to plan/adjust implementation strategies and to advocate for funding for specific projects, but have not conducted studies on it afterwards to map exact costs vs results. Would be very interesting to do!

I don’t know the project you are working on, but if it is a national system where we recommend that the country has in-house staff to manage their own systems it is important to factor in continous capacity building of that team.

Feel free to reach me if you want to discuss offline (anneat@uio.no). Good luck!