背景:尽管埃塞俄比亚在采用地区卫生信息系统版本2(DHIS2)进行国家汇总数据报告方面取得了显着进展,尚未对该系统的成熟度进行全面评估。
目的:本研究旨在评估埃塞俄比亚DHIS2实施的成熟度水平,并提出一个路线图,以指导朝着更高的成熟度水平迈进。我们还旨在评估当前的成熟度状态,执行差距,以及在埃塞俄比亚实施DHIS2的未来方向。评估重点是数字卫生系统治理,熟练的人力资源,信息和通信技术(ICT)基础设施,互操作性,数据质量和使用。
方法:通过咨询研讨会,在关键利益相关者的参与下,使用持续改进阶段工具进行了协作评估,以衡量5个核心领域的成熟度水平。13个组件,和39个子组件。5点量表(1=新兴,2=可重复,3=已定义,4=管理,和5=优化)用于衡量DHIS2实施成熟度水平。
结果:国家DHIS2实施的成熟度水平目前处于定义阶段(分数=2.81),并计划到2025年移至可管理阶段(分数=4.09)。领域成熟度得分表明,除了ICT基础设施,处于可重复阶段(分数=2.14),其余4个结构域处于定义的阶段(分数=3).在国家一级制定标准化和基本的DHIS2进程,制定一项为期10年的战略计划,以指导包括DHIS2在内的数字卫生系统的实施,并在设施一级具备完成与DHIS2相关的特定任务所需的能力,这是迄今为止埃塞俄比亚卫生部的主要力量。缺乏支持DHIS2实施的劳动力能力准则;核心能力的不可用性(知识,技能,和能力)在卫生系统的所有级别完成DHIS2任务所需;以及ICT基础设施,例如该地区的通信网络和互联网连接,区域,和区域一级是该国有效实施DHIS2的主要障碍。
结论:在持续改进阶段成熟度模型工具包的基础上,埃塞俄比亚DHIS2的实施状况处于确定的阶段,与其他4个领域相比,ICT基础设施领域处于最低阶段。到2025年,计划通过改善已识别的差距,将成熟度状态从定义阶段转移到管理阶段。建议采取各种行动点,以解决已确定的差距并达到规定的成熟度。负责任的机构,必要的资源,并列出了达到规定的成熟度级别所需的验证方法。
BACKGROUND: Although Ethiopia has made remarkable progress in the uptake of the District Health Information System version 2 (DHIS2) for national aggregate data reporting, there has been no comprehensive assessment of the maturity level of the system.
OBJECTIVE: This study aims to assess the maturity level of DHIS2 implementation in Ethiopia and propose a road map that could guide the progress toward a higher level of maturity. We also aim to assess the current maturity status, implementation gaps, and future directions of DHIS2 implementation in Ethiopia. The assessment focused on digital health system governance, skilled human resources, information and communication technology (ICT) infrastructure, interoperability, and data quality and use.
METHODS: A collaborative assessment was conducted with the engagement of key stakeholders through consultative workshops using the Stages of Continuous Improvement tool to measure maturity levels in 5 core domains, 13 components, and 39 subcomponents. A 5-point scale (1=emerging, 2=repeatable, 3=defined, 4=managed, and 5=optimized) was used to measure the DHIS2 implementation maturity level.
RESULTS: The national DHIS2 implementation\'s maturity level is currently at the defined stage (score=2.81) and planned to move to the manageable stage (score=4.09) by 2025. The domain-wise maturity score indicated that except for ICT infrastructure, which is at the repeatable stage (score=2.14), the remaining 4 domains are at the defined stage (score=3). The development of a standardized and basic DHIS2 process at the national level, the development of a 10-year strategic plan to guide the implementation of digital health systems including DHIS2, and the presence of the required competencies at the facility level to accomplish specific DHIS2-related tasks are the major strength of the Ministry of Health of Ethiopia so far. The lack of workforce competency guidelines to support the implementation of DHIS2; the unavailability of core competencies (knowledge, skills, and abilities) required to accomplish DHIS2 tasks at all levels of the health system; and ICT infrastructures such as communication network and internet connectivity at the district, zonal, and regional levels are the major hindrances to effective DHIS2 implementation in the country.
CONCLUSIONS: On the basis of the Stages of Continuous Improvement maturity model toolkit, the implementation status of DHIS2 in Ethiopia is at the defined stage, with the ICT infrastructure domain being at the lowest stage as compared to the other 4 domains. By 2025, the maturity status is planned to move from the defined stage to the managed stage by improving the identified gaps. Various action points are suggested to address the identified gaps and reach the stated maturity level. The responsible body, necessary resources, and methods of verification required to reach the specified maturity level are also listed.