To assist in interpretation and visualization of AMR data, CAPTURA is working on developing the QAAPT application. QAAPT is intended for use by decision-makers, such as healthcare professionals and national AMR coordinators, engaged in AMR surveillance. It is possible for users to analyze AMR data and generate dashboards to display AMR patterns, trends and antibiograms.
Quickly analyze AMR secondary datasets that have been taken from WHONET, any other EHR, and manually entered datasets.
Install on any web server, including local computers, cloud servers, shared hosting servers, and organization-owned servers.
Assist different tiers of AMR data users and decision-makers in LMICs in making data-driven decisions rapidly.Detail: https://qaapt.com
Summary: The UK Government has established the Fleming Fund to respond to the global threat of antimicrobial resistance (AMR). The Fleming Fund Regional Grants Grants includes a “call for data”, which aims to expand the volume of historical and current data available on AMR and antimicrobial use (AMU) across regions in Africa and Asia.
The CAPTURA consortium has been awarded two out of four Regional grants to work with 12 countries in South and South East Asia to collect and analyse retrospective data on AMR and AMU in the human health sector in these countries.
CAPTURA aims to increase the volume of data available to improve spatiotemporal mapping of AMR and antimicrobial use (AMU).
This will be done by working with local governments to identify and subsequently assess the quality of available data on AMR and AMU. Relevant data will be collated and analysed to provide meta-data and give regional and inter-regional context. The project will also help identify gaps in data and areas for quality improvement that can be addressed in future initiatives to strengthen surveillance capacity. The information resource generated by the project will improve awareness, advocacy, policy, and interventions needed to combat AMR and antimicrobial misuse.
Summary: MTaPS Program supports the Global Health Security Agenda (GHSA) in 13 countries to help build countries' capacity to protect themselves from infectious disease threats and to raise global health security as a national and worldwide priority. The Program's GHSA work focuses on contributing to antimicrobial resistance (AMR) containment, specifically by supporting infection prevention and control (IPC), antimicrobial stewardship (AMS), and multisectoral coordination (MSC) on AMR.
Bangladesh developed a national action plan for AMR (NAP-AMR) 2017-2022 with an associated roadmap, which includes the development of a web-based system for document sharing as an output. Currently, sectors have their own web presence, but a common platform for AMR information is lacking. For example, IEDCR regularly uploads AMR surveillance findings to their website gathered from 9 sentinel sites (hospitals) that is publicly accessible. DLS, DOF, BLRI, and BARA are at different stages of their web-based information system development. The workshop participants underscored the need for a common web-based platform with data across the sectors that are accessible to the public. This was also a recommendation from the Global Antibiotic Resistance Partnership (GARP) Bangladesh National Working Group. A follow-up workshop on the NAP-AMR implementation status on March 4, 2020, one of recommendation was to create a publicly available web-based platform to share AMR- related information and data across sectors. CDC/DGHS convened a Follow up meeting on 2nd September 2020. One of recommendation was, there should be a system of information sharing under one umbrella to avoid missing information and duplication of efforts by developing/incorporating a web-based AMR information sharing platform for the members of One Health.
Summary: MTaPS/Bangladesh supported CDC, DGHS for developing national STGs for common infectious diseases. In Bangladesh, MTaPS first reviewed the common disease patterns in the country to identify the important infectious diseases based on their burden. CDC, DGHS established a small core working group, MTaPS assisted to formulate a methodology for developing the STGs with common infectious diseases and antibiotics list based on last three editions 2016, 2017, and 2018 of Health Bulletins and existing hospital antibiotic guidelines and incorporate in WHO AWaRe classification. Then template distributed to core working group comprising experts from different disciplines to designate their present practices of both preferred and alternative drug according to WHO AWaRe classification for the treatment of included infectious diseases and STG developed. Finally, all chapters reviewed by different senior professional associations. Then CDC, DGHS finalized the STG.
MTaPS will support CDC, DGHS to develop a publicly available web-based platform to facilitate dissemination of AMR information, and an app version of the STG in accordance with the developed STG for common infectious diseases, also transforming from mobile phone app to nationally recognized STG app and building capacity of practitioners to increase the use of WHO AWaRe classification.
Summary: Antimicrobial resistance (AMR) is an emerging public health threat causing significant morbidity, mortality, and healthcare costs especially in low- and medium-income countries, but to date few groups have explored advanced AMR data management within DHIS2. In this work, we describe a collaboration between the Bangladesh Ministry of Health and Family Welfares Directorate General of Health Services (DGHS), the CAPTURA Project (Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia) led by the International Vaccine Institute (Republic of Korea) supported by the UK Department of Health Fleming Fund, and the WHONET development team at the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance (United States). WHONET, www.whonet.org, is a free software promoted by the World Health Organization supporting local, national, regional, and international resistance surveillance activities in over 2,500 human, animal, and food microbiology laboratories in over 130 countries. WHONET supports advanced automated features for interpretation of antimicrobial susceptibility test measurements by CLSI and EUCAST standards; multidrug-resistance profiles; 190 public health, clinical, and quality control isolate alerts; and statistical detection of hospital and community outbreaks using SaTScan. WHONET supports international guidelines for the management of repeat isolates, e.g. first isolate per patient per species per data stratification and data subset, which is not supported by DHIS2 core functionality. WHONETs import tool BacLink permits the capture and standardization (ETL-extract, transform, and load) of microbiology data from diverse laboratory information systems, test instruments, and desktop applications.
To support WHONET and DHIS2 interoperability, we have developed pre-defined and user-defined data export options of two types: 1) aggregate statistics (and associated metadata) to DHIS2 Data Sets; and 2) isolate listings (and associated metadata) to DHIS2 Event Programs. These WHONET listing and analysis exports can be visualized within DHIS2 dashboards, pivot tables, charts, and maps. Metadata exports are consistent across all WHONET installations, permitting simple data exchange between DHIS2 instances. In Bangladesh, we have installed WHONET in 31 laboratories and trained more than 140 microbiologists, clinicians, IT staff, and national AMR policymakers. Three years of laboratory data from 41 governmental and private hospitals in eight divisions are being submitted to the DGHS AMR-dedicated DHIS2 server through the WHONET-DHIS2 interoperability features described, leveraging both WHONETs advanced data management and alert capabilities for AMR data with existing Bangladesh DHIS2 platforms for web-based visualization for all communicable diseases supporting the development, implementation, monitoring, and impact evaluation in near real-time of national resistance containment strategies.
Summary: Currently in DHIS2 application, the programs are created as per organism groups. When the data needs to be imported from WHONET, it will be difficult to identify the program since it will need to first look at organism isolated and then identify the respective program which does not look feasible.
An easier way out will be to create a single program for all the organisms containing all antibiotics. All the data to be imported can be imported in this single program and then the same aggregation logic can be used to aggregating data as is followed for organism group specific programs. Thus the columns heads in WHONET file will need to be mapped to the attributes and data elements in 'AMR data import' program.
Summary: The US Agency for International Development (USAID) funded the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program to provide support to the Ministry of Health and Family Welfare (MOHFW), its component directorates (Directorate General of Health Services [DGHS], Directorate General of Family Planning [DGFP], Directorate General of Drug Administration [DGDA]), and other key entities (National Tuberculosis Program [NTP]) to strengthen the capacity of policy makers, health care providers, and institutions to improve commodity management, with an emphasis on governance, procurement, institutional capacity-building, health information systems, and other health system strengthening initiatives aimed at ensuring continuous availability of commodities to support health care delivery and the timely availability of reliable data to support evidence-based decision making.
SIAPS developed and implemented comprehensive systems for MOHFW that track procurement and facilitate catalogue preparation, procurement planning, package development, tracking, and linking with drug registration.
SIAPS also designed and implemented the Asset Management System (a module within the MOHFW Supply Chain Management Portal [SCMP; https://scmpbd.org/ams/]) which entails a systematic process for deploying, operating, maintaining, upgrading, and disposing of assets cost effectively. The DGFP electronic Logistics Management Information System (eLMIS), DGHS eLMIS, and TB Warehouse Inventory Management System (WIMS) are continuously updated with reproductive, maternal, neonatal, and child health and TB commodity information at the different levels. SIAPS also designed and implemented an automated drug registration system called Pharmadex for DGDA. e-TB Manager is another tool developed for NTP to track individual TB patients from detection to recovery. Funded by USAID, the Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program will provide pharmaceutical system strengthening assistance for sustained improvements in health system performance and advancing USAID's goals of preventing child and maternal deaths, controlling the HIV/AIDS epidemic, combatting infectious disease threats, and expanding essential health coverage. However, MTaPS will provide its support to DGDA, DGHS, DGFP, NTP, and, as a whole, to MOHFW to enable those tools to capture data and use it for decision making. MTaPS will also support them in reducing the lead time in the drug registration process and improving transparency in the registration system.
The goal of the global, five-year (2018-2023) MTaPS Program is to enable low- and middle-income countries to strengthen their pharmaceutical systems to ensure sustainable access to and appropriate use of safe, effective, quality-assured, and affordable essential medicines and medicine-related pharmaceutical services. An existing eLMIS was developed to support DGHS in collecting 24 priority medicines (total of 34, if different strengths of the same medicine are counted), which are commonly provided to government health facilities (HFs) from community clinics (CCs) to district hospitals. The eLMIS collects aggregated data about the 34 government-approved priority medicines that are consumed/distributed to government HFs. The eLMIS facilitates quick data entry, data validation, timely publication of the monthly LMIS report, instant availability of data, and increased efficiency of the supply chain. The primary purpose of the eLMIS was to increase visibility of medicine availability data at all levels of the system to inform supply chain management decisions, including forecasting, procurement, and distribution.
Summary: The WHO-DHIS2 health data toolkits are designed to accelerate high quality implementation of health information systems and digital solutions for public health programs. DHIS2 has released metadata packages to accelerate case detection, situation reporting, active surveillance and response for COVID-19.
Modules: COVID-19 Case-based surveillance [tracker], Contact registration & follow-up program [tracker], Ports of Entry screening & follow-up program [tracker], COVID-19 Surveillance Event Program [event], COVID-19 Aggregate Surveillance [aggregate], and Mobile app.
Summary: A potential solution to addressing this challenge lies with the most commonly used source of medicines in many developing countries-the private sector drug sellers. Accreditation of drug sellers was not present in Bangladesh until DGDA took the initiative during the implementation of HPNSDP. With the support from JDTAF, MSH worked with DGDA and other sector stakeholders to develop the first standards for retail medicine outlets and design and implement an accreditation program for two new levels of pharmaceutical outlets-Model Pharmacy and Model Medicine Shop. Accreditation standards for retail medicine outlets in Bangladesh have been approved by the competent authority. MSH also developed several strategies to support implementation of the standards. Realizing the importance of the continuation of the activity and the extensive relevant experience, MOHFW has included the piloting of the approved model for accreditation of retail medicine outlets. DFID Bangladesh is supporting the 4th HNPSP, through the, 'Better Health in Bangladesh' program for a period of five years.
Pharmacy Council of Bangladesh (PCB) is an autonomous organization, considered as the controlling authority of pharmacy education and practice in the country. The council provides registration for all grades of pharmacists. The main objective of the Pharmacy Council of Bangladesh is to regulate the practice of Pharmacy throughout Bangladesh. As a counterpart, The Directorate General of Drug Administration (DGDA) under the MOHFW is the Drug Regulatory Authority of Bangladesh. DGDA has an efficient web portal with live data availability. PCB hence requires a web site that will commensurate with DGDA to further strengthening their partnership in dealing with pharmacists and retail drug outlets efficiently.
Summary: Improving access to quality medicines and pharmaceutical services is an essential component of the health services strategy to improve clinical care. Most leading causes of death and disability in developing countries can be prevented, treated, or at least alleviated with cost-effective essential medicines. Despite this fact, hundreds of millions of people do not have regular access to essential medicines and many of those who do have access are given the wrong treatment, receive too little medicine for their illness, or do not use the medicine correctly. Ensuring the availability, affordability, accessibility, and appropriate use of quality medicines are thus crucially important in order to improve health status of the population. This is a challenge for many countries, including Bangladesh.
A potential solution to addressing this challenge lies with the most commonly used source of medicines in many developing countries-the private sector drug seller. Accreditation of drug sellers was not present in Bangladesh until DGDA took the initiative during the implementation of HPNSDP. With the support from JDTAF, MSH worked with DGDA and other sector stakeholders to develop the first standards for retail medicine outlets and design and implement an accreditation program for two new levels of pharmaceutical outlets-pharmacies and medicine shops. Accreditation standards for retail drug shops in Bangladesh have been approved by the competent authority. MSH also developed the several strategies to support implementation of the standards. Realizing the importance of the continuation of the activity and the extensive relevant experience, DFID included the piloting of the approved model for accreditation of drug store sellers DFID Bangladesh is supporting the 4th HNPSP, through the, 'Better Health in Bangladesh' program for a period of five years.
The DGDA under the MOHFW is the competent drug regulatory authority of Bangladesh. This DGDA supervises and implements all prevailing drug regulations in the country and regulates all activities of, but not limited to retail drug stores. To strengthen monitoring and supervision of DGDA and also to provide a sustainable incentive for the medicine outlet owners, BHB project has a provision to develop a pharmacy management software. This pharmacy management software is a pre-requisite for the Model Pharmacy, according to the newly developed standard. In model medicine shops, this management software is preferred but not a must.
Summary: Prevalence of malnutrition among children and mothers is alarmingly high and calls for action to achieve food security, mainly for the rural population of Bangladesh, is an utmost need. The National Nutrition Programme (NNP) is one of the success stories of GO-NGO partnership effort to assist people specifically children and women affected by malnutrition in Bangladesh. The success of the Bangladesh Integrated Nutrition Project (BINP), undertaken by the Government of Bangladesh in a large but limited area with the World Bank and other donors has demonstrated that community mobilization and community nutrition services delivered by NGOs can bring rapid and sustainable reductions in severe malnutrition among children. NGOs are able to deliver targeted food and micronutrient supplements to reproductive women who are suffering chronic energy and micronutrient deficiency.
Summary: The USAID-funded TB Platforms for Sustainable Detection, Care and Treatment project aims to support the National Tuberculosis Control Program (NTP) towards achieving the Department of Health's commitment to find and treat 2.5 million Filipinos with tuberculosis and reach 90% TB treatment coverage by 2022. DHIS2 Installation, Configuration and Implementations for NTP, Philippine's.
Summary: To design and develop custom application to track each facility quarterly budget and expenditure. This custom app has integrated with DHIS2. The DHIS2 org units and users are automatically synchronized with the custom app as well as all types of permission has been managed by utilizing DHIS2 permission resources.
Summary: The user activity capture dashboard widget can be embedded into any dashboard, and captures information on how long a user is using a dashboard, how much time is spent on a dashboard. Those data on user activity are then sent to the data store. When a user lands on the dashboard with this widget, the widget text shows a welcome message, reminding him when he last visited this dashboard.
A separate user activity widget then aggregates these data for all users, and is designed to help different level managers to analyse the dashboard activity of the user. It presents, the username, start time, and end time, organizational unit, dashboard detail for every time a user visited a dashboard. The data can be downloaded by a manager in the form of an Excel Sheet, or analysed individual user activity directly within the app. This app is generic so the community can easily download from app store and use this app with any DHIS instance v2.27 and above.
Summary: Every week, e-Registries implementations in Palestine and Bangladesh run validation analysis on aggregated tracker data. Triggering validation rules will persist and send tailored notifications (validation rule instruction) to user's dashboards. For example, a validation result may inform a user their clinic did not provide proper screening of pregnant women for diabetes last month, and link to detailed instructions on how to do so. Users can then interact with each notification as thumbs up/down or comment. This app builds on earlier efforts by allowing custom sorting and filtering of the various validation notifications. It is possible to sort validation results with newest first, validation rule priorities, validation rules group and feedback type.
Summary: Four levels of facilities visualization in DHIS2 MFL app. To integrate the service, resource and administrative domains with DHIS2 based master facility visualization app.
Summary: New facility management that extracted by DHIS2 Middleware app, updated and deleted facilities management, DHIS2 blank filed facilities management, Notification center, GIS Map for facility location.
Interoperability between Multiple DHIS instances, Human Resource Information System (HRIS) and DHIS2, Automatic and Manual mode based data transaction, Multiple DHIS2 instances integration, Real time log monitor.
Summary: Routine Health Information System (RHIS) is the complete health automation system for Ministry of Health and Family Welfare (MOHFW) with the modules: Birth and Death Registration, Child Care e-Registration, EPI for Women and Children, IMCI Case Management, Mother and Newborn Register, Health Assistant and CSBA.
Summary: Patient record management, Follow-up management, Auto prescription generate, Patient Shifting, Death certificate, HRM, Billing, Inventory/store management, Bed management, Indoor Activities Management, Doctors Management.
Summary: Maternal, neonatal and child health (MNCH) holds one of the biggest focuses in Bangladesh national health care system. Since the Millennium Development Goals were set in 2000, Bangladesh made notable progresses in curbing maternal mortality and child mortality. Between 1990 and 2015, the maternal mortality ratio (MMR) and under-5 mortality ratio (U5MR) in Bangladesh fell by an impressive 69.1% and 73% respectively1. Priority MNCH medicines help to avert these unnecessary deaths thus and tracking its availability in various health centers is crucial. DHIS2 is a flexible, web-based open-source information system with visualization features including GIS, charts and pivot tables. DHIS2 is being used in Bangladesh for collecting logistics data for priority maternal, neonatal and child health (MNCH) from different levels like District Hospital (DH), Civil Surgeon Office (CSO) which covers District Reserve Store, Upazila Health Complex (UHC), Union Sub Center (USC), Community Clinic (CC) and other health related NGO's/Facilities. We have developed an interoperable mechanism through which data on these MNCH medicines is entered into DHIS2 and populated to the Ministry of Health and Family Welfare(MoHFW), Bangladesh owned Supply Chain Management Portal (SCMP) where interactive dashboards are visible.
So far, we have implemented DHIS2 based eLMIS in 19 districts in around 4000 facilities by successfully exporting DHIS2 data through server side language with MySQL and PostgreSQL database. As a result, we are now able to track various variants like reported, non-reported facilities, national level stock, monthly stock, stock out facilities, number of days stock out, data monitoring, timeliness, nearest expiry medicines, nearest expiry quantity and data upload statistics. Due to the system, from 2015 to 2018the data reporting rate has increased from 60% to 97%, the average reporting rate has increased from 70% to 97%, which is remarkable. The government can now take necessary steps for stock out facilities and ensure the availability of these lifesaving medicines. They are planning to procure MNCH medicines based on the data made available from the system. Timely procurement and ensuring the availability of the medicines using this platform can help to minimize maternal, newborn and child health mortality.
Other projects: Distributed Supply Chain Management System (D2LMIS), Internet Service Providers Automation System (ISPERP), Interoperability between RHIS and DHIS2, DHIS2 MiddleWare Application for Ministry of Health, Interoperability between Electronic Tuberculosis Manager (e-TB Manager) and DHIS2, Restaurant Management System with PoS (Online Based), Dashboard and Website for ICT Division, Inventory Management System, Custom BI for SAP